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Sample records for hoc within-woman analysis

  1. An Analysis Platform for Mobile Ad Hoc Network (MANET) Scenario Execution Log Data

    DTIC Science & Technology

    2016-01-01

    ARL-TR-7574 ● JAN 2016 US Army Research Laboratory An Analysis Platform for Mobile Ad Hoc Network (MANET) Scenario Execution Log...Analysis Platform for Mobile Ad Hoc Network (MANET) Scenario Execution Log Data by Jaime C Acosta and Yadira Jacquez Survivability/Lethality Analysis...August 2015 4. TITLE AND SUBTITLE An Analysis Platform for Mobile Ad Hoc Network (MANET) Scenario Execution Log Data 5a. CONTRACT NUMBER 5b. GRANT

  2. Moving beyond Univariate Post-Hoc Testing in Exercise Science: A Primer on Descriptive Discriminate Analysis

    ERIC Educational Resources Information Center

    Barton, Mitch; Yeatts, Paul E.; Henson, Robin K.; Martin, Scott B.

    2016-01-01

    There has been a recent call to improve data reporting in kinesiology journals, including the appropriate use of univariate and multivariate analysis techniques. For example, a multivariate analysis of variance (MANOVA) with univariate post hocs and a Bonferroni correction is frequently used to investigate group differences on multiple dependent…

  3. Moving beyond Univariate Post-Hoc Testing in Exercise Science: A Primer on Descriptive Discriminate Analysis

    ERIC Educational Resources Information Center

    Barton, Mitch; Yeatts, Paul E.; Henson, Robin K.; Martin, Scott B.

    2016-01-01

    There has been a recent call to improve data reporting in kinesiology journals, including the appropriate use of univariate and multivariate analysis techniques. For example, a multivariate analysis of variance (MANOVA) with univariate post hocs and a Bonferroni correction is frequently used to investigate group differences on multiple dependent…

  4. Within-woman change in regulatory T cells from pregnancy to the postpartum period.

    PubMed

    Wegienka, Ganesa; Havstad, Suzanne; Bobbitt, Kevin R; Woodcroft, Kimberley J; Zoratti, Edward M; Ownby, Dennis R; Cole Johnson, Christine

    2011-01-01

    Regulatory T cells (Treg cells) are an important area of investigation in human health and disease. In this study, the trajectory of percentage of Treg cells (defined as CD4+CD25+Foxp3+CD127--lymphocytes) was measured in the blood of 208 women during pregnancy and up to three additional times in the postpartum period (1, 6 and 12 months postpartum). Whether the trajectory was affected by gravidity, parity, neonatal sex, pet exposure, maternal atopic and asthma status, smoking, maternal race or other pregnancy factors was examined. Multilevel models were fit using full maximum likelihood methods and included both random and fixed effects. Overall, percentages of Treg cells increased from the prenatal to the postpartum period. Among women who were not atopic, nulliparous women had lower percentages of Treg cells over time compared with parous women. Atopic women with pets in the home during pregnancy had lower percentages of Treg cells than atopic women who did not have pets. The trajectory was not affected by the other factors investigated. We conclude that within-woman change in percentages of Treg cells may vary by time in relation to delivery, as well as by maternal atopic status and exposure to pets and number of prior births. The data did not indicate an overall decline in Treg cells in the postpartum period. Future work to better identify the role of Treg cells in successful pregnancy would ideally include a set of well characterized women sampled serially starting prior to pregnancy and throughout the postpartum period.

  5. Analysis of the Robustness Dynamics of Wireless Mobile Ad Hoc Networks via Time Varying Dual Basis Representation

    DTIC Science & Technology

    2015-01-08

    between nodes to analyze the robustness of a wireless mobile ad hoc network ( MANET ) with a time-varying wireless channel. This spectral analysis and...performance of a network. Using a simulation of wireless devices in a MANET with a time- varying channel, we show that robustness is a function of...a single eigenvalue is evaluated. 1. Introduction Mobile ad hoc networks ( MANETs ) are complex systems that can be foreseen supporting

  6. Performance Analysis of Ad Hoc Routing Protocols in City Scenario for VANET

    NASA Astrophysics Data System (ADS)

    Das, Sanjoy; Raw, Ram Shringar; Das, Indrani

    2011-12-01

    In this paper, performance analysis of Location Aided Routing (LAR), AODV and DSR protocol in city scenarios has been done. The mobility model considered is Manhattan model. This mobility model used to emulate the movement pattern of nodes i.e., vehicles on streets defined by maps. Our objective is to provide a comparative analysis among LAR, AODV and DSR protocol in city scenarios in Vehicular Ad hoc Networks. The simulation work has been conducted using the Glomosim 2.03 simulator. The results show that LAR1 protocol achieves maximum packet delivery ratio is 100% in the sparsely populated network. The delay is maximum in AODV 121.88 ms when the number of node is 10 in the network. The results show that LAR1 outperform DSR and AODV in term of packet delivery ratio and end to end delay.

  7. Analysis of a distributed algorithm to determine multiple routes with path diversity in ad hoc networks.

    SciTech Connect

    Ghosal, Dipak; Mueller, Stephen Ng

    2005-04-01

    With multipath routing in mobile ad hoc networks (MANETs), a source can establish multiple routes to a destination for routing data. In MANETs, mulitpath routing can be used to provide route resilience, smaller end-to-end delay, and better load balancing. However, when the multiple paths are close together, transmissions of different paths may interfere with each other, causing degradation in performance. Besides interference, the physical diversity of paths also improves fault tolerance. We present a purely distributed multipath protocol based on the AODV-Multipath (AODVM) protocol called AODVM with Path Diversity (AODVM/PD) that finds multiple paths with a desired degree of correlation between paths specified as an input parameter to the algorithm. We demonstrate through detailed simulation analysis that multiple paths with low degree of correlation determined by AODVM/PD provides both smaller end-to-end delay than AODVM in networks with low mobility and better route resilience in the presence of correlated node failures.

  8. Does Ad Hoc Coronary Intervention Reduce Radiation Exposure? – Analysis of 568 Patients

    PubMed Central

    Truffa, Márcio A. M.; Alves, Gustavo M.P.; Bernardi, Fernando; Esteves Filho, Antonio; Ribeiro, Expedito; Galon, Micheli Z.; Spadaro, André; Kajita, Luiz J.; Arrieta, Raul; Lemos, Pedro A.

    2015-01-01

    Background Advantages and disadvantages of ad hoc percutaneous coronary intervention have been described. However little is known about the radiation exposure of that procedure as compared with the staged intervention. Objective To compare the radiation dose of the ad hoc percutaneous coronary intervention with that of the staged procedure Methods The dose-area product and total Kerma were measured, and the doses of the diagnostic and therapeutic procedures were added. In addition, total fluoroscopic time and number of acquisitions were evaluated. Results A total of 568 consecutive patients were treated with ad hoc percutaneous coronary intervention (n = 320) or staged percutaneous coronary intervention (n = 248). On admission, the ad hoc group had less hypertension (74.1% vs 81.9%; p = 0.035), dyslipidemia (57.8% vs. 67.7%; p = 0.02) and three-vessel disease (38.8% vs. 50.4%; p = 0.015). The ad hoc group was exposed to significantly lower radiation doses, even after baseline characteristic adjustment between both groups. The ad hoc group was exposed to a total dose-area product of 119.7 ± 70.7 Gycm2, while the staged group, to 139.2 ± 75.3 Gycm2 (p < 0.001). Conclusion Ad hoc percutaneous coronary intervention reduced radiation exposure as compared with diagnostic and therapeutic procedures performed at two separate times. PMID:26351982

  9. The Impact of Using Item Parcels on ad hoc Goodness of Fit Indices in Confirmatory Factor Analysis: An Empirical Example.

    ERIC Educational Resources Information Center

    Takahashi, Tomone; Nasser, Fadia

    The Arabic version of I. G. Sarason's (1984) Reactions to Tests scale was used to examine the impact of using item parcels on ad hoc goodness of fit indices in confirmatory factor analysis. Item parcels with different numbers of items and different numbers of parcels per factor were used. Analyses were conducted on a sample of 420 tenth graders…

  10. Efficacy response in CF patients treated with ivacaftor: post-hoc analysis.

    PubMed

    Konstan, Michael W; Plant, Barry J; Elborn, J Stuart; Rodriguez, Sally; Munck, Anne; Ahrens, Richard; Johnson, Charles

    2015-05-01

    Clinical studies in patients with cystic fibrosis and G551D-CFTR showed that the group treated with ivacaftor had improved clinical outcomes. To better understand the effect of ivacaftor therapy across the distribution of individual FEV(1) responses, data from Phase 3 studies (STRIVE/ENVISION) were re-examined. In this post-hoc analysis of patients (n = 209) who received 48 weeks of ivacaftor or placebo, patients were assigned to tertiles according to FEV(1) response. These groups were then used to evaluate response (FEV(1), sweat chloride, weight, CFQ-R, and pulmonary exacerbation). The number needed to treat (NNT) was calculated for specific thresholds for each outcome. Across all tertiles, numerical improvements in FEV(1), sweat chloride, CFQ-R and the frequency of pulmonary exacerbations were observed in ivacaftor-treated patients: the treatment difference versus placebo was statistically significant for all outcomes in the upper tertile and for some outcomes in the lower and middle tertiles. The NNT for a ≥ 5% improvement in %predicted FEV(1) was 1.90, for a ≥ 5% body weight increase was 5.74, and to prevent a pulmonary exacerbation was 3.85. This analysis suggests that the majority of patients with clinical characteristics similar to STRIVE/ENVISION patients have the potential to benefit from ivacaftor therapy.

  11. Impact of endotracheal intubation on septic shock outcome: A post hoc analysis of the SEPSISPAM trial.

    PubMed

    Delbove, Agathe; Darreau, Cédric; Hamel, Jean François; Asfar, Pierre; Lerolle, Nicolas

    2015-12-01

    The objective of the study to is to determine the characteristics associated with endotracheal intubation in septic shock patients. This is a post hoc analysis of the database of the SEPSISPAM study, including patients with septic shock. Among the 776 patients, 633 (82%) were intubated within 12 hours of study inclusion (early intubation), 113 (15%) were never intubated, and 30 (4%) had delayed intubation. Intensive care units (ICUs) were classified according to frequency of early intubation: early intubation less than 80% of patients (lowest frequency: 7 ICUs, 254 patients), 80% to 90% (middle frequency: 5 ICUs, 170 patients), and greater than 90% (highest frequency: 6 ICUs, 297 patients). Type of ICU, pulmonary infection, lactate greater than 2 mmol/L, lower Pao2/fraction of inspired oxygen ratio, lower Glasgow score, and absence of immunosuppression were independently associated with early intubation. Patients never intubated had a lower initial severity and a low mortality rate. In comparison to patients intubated early, patients with delayed intubation had had fewer days alive without organ support by day 28. Intensive care units with the highest frequency of early intubation had a higher mortality rate in comparison to ICUs with middle frequency of early intubation. A nonsignificant increased mortality was observed in ICU with lowest frequency of early intubation. Practices regarding the place of endotracheal intubation in septic shock may impact outcome. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. A Post Hoc Analysis of D-Threo-Methylphenidate Hydrochloride (Focalin) Versus D,l-Threo-Methylphenidate Hydrochloride (Ritalin)

    ERIC Educational Resources Information Center

    Weiss, Margaret; Wasdell, Michael; Patin, John

    2004-01-01

    Objective: To evaluate clinical measures of the benefit/risk ratio in a post hoc analysis of a clinical trial of d-threo-methylphenidate hydrochloride (d-MPH) and d,l-threo-methylphenidate hydrochloride (d,l-MPH). Method: Data from a phase III clinical trial was used to compare equimolar doses of d-MPH and d,l-MPH treatment for…

  13. A Post Hoc Analysis of D-Threo-Methylphenidate Hydrochloride (Focalin) Versus D,l-Threo-Methylphenidate Hydrochloride (Ritalin)

    ERIC Educational Resources Information Center

    Weiss, Margaret; Wasdell, Michael; Patin, John

    2004-01-01

    Objective: To evaluate clinical measures of the benefit/risk ratio in a post hoc analysis of a clinical trial of d-threo-methylphenidate hydrochloride (d-MPH) and d,l-threo-methylphenidate hydrochloride (d,l-MPH). Method: Data from a phase III clinical trial was used to compare equimolar doses of d-MPH and d,l-MPH treatment for…

  14. On Post-Hoc Blocking.

    ERIC Educational Resources Information Center

    Bonett, Douglas G.

    1982-01-01

    Post-hoc blocking and analysis of covariance (ANCOVA) both employ a concomitant variable to increase statistical power relative to the completely randomized design. It is argued that the advantages attributed to the block design are not always valid and that there are circumstances when the ANCOVA would be preferred to post-hoc blocking.…

  15. Ad hoc supervision of general practice registrars as a 'community of practice': analysis, interpretation and re-presentation.

    PubMed

    Clement, T; Brown, J; Morrison, J; Nestel, D

    2016-05-01

    General practice registrars in Australia undertake most of their vocational training in accredited general practices. They typically see patients alone from the start of their community-based training and are expected to seek timely ad hoc support from their supervisor. Such ad hoc encounters are a mechanism for ensuring patient safety, but also provide an opportunity for learning and teaching. Wenger's (Communities of practice: learning, meaning, and identity. Cambridge University Press, New York, 1998) social theory of learning ('communities of practice') guided a secondary analysis of audio-recordings of ad hoc encounters. Data from one encounter is re-presented as an extended sequence to maintain congruence with the theoretical perspective and enhance vicariousness. An interpretive commentary communicates key features of Wenger's theory and highlights the researchers' interpretations. We argue that one encounter can reveal universal understandings of clinical supervision and that the process of naturalistic generalisation allows readers to transfer others' experiences to their own contexts. The paper raises significant analytic, interpretive, and representational issues. We highlight that report writing is an important, but infrequently discussed, part of research design. We discuss the challenges of supporting the learning and teaching that arises from adopting a socio-cultural lens and argue that such a perspective importantly captures the complex range of issues that work-based practitioners have to grapple with. This offers a challenge to how we research and seek to influence work-based learning and teaching in health care settings.

  16. Analysis and Proposal of Position-Based Routing Protocols for Vehicular Ad Hoc Networks

    NASA Astrophysics Data System (ADS)

    Okada, Hiraku; Takano, Akira; Mase, Kenichi

    One of the most promising applications of a mobile ad hoc network is a vehicular ad hoc network (VANET). Each vehicle is aware of its position information by GPS or other methods, so position-based routing is a useful approach in VANET. The position-based routing protocol can be classified roughly into a next-hop forwarding method and a directed flooding method. We evaluate performance of both methods by analytic approach and compare them in this paper. From the evaluation results, we conclude that it is effective for the position-based routing to choose either the next-hop forwarding method or the directed flooding method according to the environment. Then we propose the hybrid transmission method which can select one of them according to the environment, and clarify that the proposed method can keep the packet delivery ratio at a high level and reduce the delay time.

  17. Mediterranean Diet, Retinopathy, Nephropathy, and Microvascular Diabetes Complications: A Post Hoc Analysis of a Randomized Trial.

    PubMed

    Díaz-López, Andrés; Babio, Nancy; Martínez-González, Miguel A; Corella, Dolores; Amor, Antonio J; Fitó, Montse; Estruch, Ramon; Arós, Fernando; Gómez-Gracia, Enrique; Fiol, Miquel; Lapetra, José; Serra-Majem, Lluís; Basora, Josep; Basterra-Gortari, F Javier; Zanon-Moreno, Vicente; Muñoz, Miguel Ángel; Salas-Salvadó, Jordi

    2015-11-01

    To date no clinical trials have evaluated the role of dietary patterns on the incidence of microvascular diabetes complications. We hypothesized that a nutritional intervention based on the Mediterranean diet (MedDiet) would have greater protective effect on diabetic retinopathy and nephropathy than a low-fat control diet. This was a post hoc analysis of a cohort of patients with type 2 diabetes participating in the PREvención con DIeta MEDiterránea (PREDIMED) study, a multicenter randomized nutritional intervention trial conducted in a population at high cardiovascular risk. Individuals with type 2 diabetes who were free of microvascular complications at enrollment (n = 3,614, aged 55-80 years) were randomly assigned to one of three dietary interventions: MedDiet supplemented with extravirgin olive oil (MedDiet+EVOO), MedDiet supplemented with mixed nuts (MedDiet+Nuts), or a low-fat control diet. Two independent outcomes were considered: new onset of diabetic retinopathy and nephropathy. Hazard ratios (HRs) were calculated using multivariable-adjusted Cox regression. During a median follow-up of 6.0 years, we identified 74 new cases of retinopathy and 168 of nephropathy. Compared with the control diet, multivariable-adjusted HRs for diabetic retinopathy were 0.56 (95% CI 0.32-0.97) for the MedDiet+EVOO and 0.63 (0.35-1.11) for the MedDiet+Nuts. No between-group differences were found for nephropathy. When the yearly updated information on adherence to the MedDiet was considered, the HR for retinopathy in the highest versus the lowest quintile was 0.34 (0.13-0.89; P = 0.001 for trend). No significant associations were found for nephropathy. A MedDiet enriched with EVOO may protect against diabetic retinopathy but not diabetic nephropathy. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  18. A post hoc analysis of subgroup outcomes and creatinine in the phase III clinical trial (EMPOWER) of dexpramipexole in ALS.

    PubMed

    Bozik, Michael E; Mitsumoto, Hiroshi; Brooks, Benjamin R; Rudnicki, Stacy A; Moore, Dan H; Zhang, Bing; Ludolph, Albert; Cudkowicz, Merit E; van den Berg, Leonard H; Mather, James; Petzinger, Thomas; Archibald, Donald

    2014-09-01

    Our objective was to compare the phase II and phase III (EMPOWER) studies of dexpramipexole in ALS and evaluate potential EMPOWER responder subgroups and biomarkers based on significant inter-study population differences. In a post hoc analysis, we compared the baseline population characteristics of both dexpramipexole studies and analyzed EMPOWER efficacy outcomes and laboratory measures in subgroups defined by significant inter-study differences. Results showed that, compared with phase II, the proportion of El Escorial criteria (EEC) definite participants decreased (p = 0.005), riluzole use increased (p = 0.002), and mean symptom duration increased (p = 0.037) significantly in EMPOWER. Baseline creatinine (p < 0.001) and on-study creatinine change (p < 0.001) correlated significantly with ALSFRS-R in EMPOWER. In the EMPOWER subgroup defined by EEC-definite ALS, riluzole use, and < median symptom duration (15.3 months), dexpramipexole-treated participants had reduced ALSFRS-R slope decline (p = 0.015), decreased mortality (p = 0.011), and reduced creatinine loss (p = 0.003). In conclusion, significant differences existed between the phase II and EMPOWER study populations in ALS clinical trials of dexpramipexole. In a post hoc analysis of EMPOWER subgroups defined by these differences, potential clinical benefits of dexpramipexole were identified in the subgroup of riluzole-treated, short-symptom duration, EEC-definite ALS participants. Creatinine loss correlated with disease progression and was reduced in dexpramipexole-treated participants, suggesting it as a candidate biomarker.

  19. HOC Spectral Analysis of an Almost Periodic Random Sequence in Noise,

    DTIC Science & Technology

    1987-05-01

    Fp from expected HOC such as (ED n), (En D) and ( EDH ). I, 2. Some moment relations The second order moments of V nz , nzt can be expressed quite...0 J cos( )IH (I 2 dw M 1 jH0 (W)2d. When p = 2 we can prove in the same way that for large J, - EDH /(N-1) admits values between 1 and (2" a Theorem... EDH - a N-1 2 [ Proof. As before a is monotone and bounded and thus converges to a, where ii2 ( 2 2+12 2 +2 a 2 (1-2a cos w CO o + 2 (1-2a cos +a )cos

  20. A communication theoretical analysis of FRET-based mobile ad hoc molecular nanonetworks.

    PubMed

    Kuscu, Murat; Akan, Ozgur B

    2014-09-01

    Nanonetworks refer to a group of nanosized machines with very basic operational capabilities communicating to each other in order to accomplish more complex tasks such as in-body drug delivery, or chemical defense. Realizing reliable and high-rate communication between these nanomachines is a fundamental problem for the practicality of these nanonetworks. Recently, we have proposed a molecular communication method based on Förster Resonance Energy Transfer (FRET) which is a nonradiative excited state energy transfer phenomenon observed among fluorescent molecules, i.e., fluorophores. We have modeled the FRET-based communication channel considering the fluorophores as single-molecular immobile nanomachines, and shown its reliability at high rates, and practicality at the current stage of nanotechnology. In this study, for the first time in the literature, we investigate the network of mobile nanomachines communicating through FRET. We introduce two novel mobile molecular nanonetworks: FRET-based mobile molecular sensor/actor nanonetwork (FRET-MSAN) which is a distributed system of mobile fluorophores acting as sensor or actor node; and FRET-based mobile ad hoc molecular nanonetwork (FRET-MAMNET) which consists of fluorophore-based nanotransmitter, nanoreceivers and nanorelays. We model the single message propagation based on birth-death processes with continuous time Markov chains. We evaluate the performance of FRET-MSAN and FRET-MAMNET in terms of successful transmission probability and mean extinction time of the messages, system throughput, channel capacity and achievable communication rates.

  1. Preventive Ceftriaxone in Patients with Stroke Treated with Intravenous Thrombolysis: Post Hoc Analysis of the Preventive Antibiotics in Stroke Study

    PubMed Central

    Vermeij, Jan-Dirk; Westendorp, Willeke F.; Roos, Yvo B.; Brouwer, Matthijs C.; van de Beek, Diederik; Nederkoorn, Paul J.

    2016-01-01

    Background The Preventive Antibiotics in Stroke Study (PASS), a randomized open-label masked endpoint trial, showed that preventive ceftriaxone did not improve functional outcome at 3 months in patients with acute stroke (adjusted common OR 0.95; 95% CI 0.82-1.09). Post-hoc analyses showed that among patients who received intravenous thrombolysis (IVT), patients who received ceftriaxone had a significantly better outcome as compared with the control group. This study aimed to gain more insight into the characteristics of these patients. Methods In PASS, 2,550 patients were randomly assigned to preventive antibiotic treatment with ceftriaxone or standard care. In current post-hoc analysis, 836 patients who received IVT were included. Primary outcome included functional status on the modified Rankin Scale, analyzed with adjusted ordinal regression. Secondary outcomes included infection rate and symptomatic intracerebral hemorrhage (sICH) rate. Results For all patients in PASS, the p value for the interaction between IVT and preventive ceftriaxone regarding functional outcome was 0.03. Of the 836 IVT-treated patients, 437 were administered ceftriaxone and 399 were allocated to the control group. Baseline characteristics were similar. In the IVT subgroup, preventive ceftriaxone was associated with a significant reduction in unfavorable outcome (adjusted common OR 0.77; 95% CI 0.61-0.99; p = 0.04). Mortality at 3 months was similar (OR 0.75; 95% CI 0.48-1.18). Preventive ceftriaxone was associated with a reduction in infections (OR 0.43; 95% CI 0.28-0.66), and a trend towards an increased risk for sICH (OR 3.09; 95% CI 0.85-11.31). Timing of ceftriaxone administration did not influence the outcome (aOR 1.00; 95% CI 0.98-1.03; p = 0.85). Conclusions According to the post-hoc analysis of PASS, preventive ceftriaxone may improve the functional outcome in IVT-treated patients with acute stroke, despite a trend towards an increased rate of post-IVT-sICH. PMID:27336314

  2. Glutamine and antioxidants in the critically ill patient: a post hoc analysis of a large-scale randomized trial.

    PubMed

    Heyland, Daren K; Elke, Gunnar; Cook, Deborah; Berger, Mette M; Wischmeyer, Paul E; Albert, Martin; Muscedere, John; Jones, Gwynne; Day, Andrew G

    2015-05-01

    The recent large randomized controlled trial of glutamine and antioxidant supplementation suggested that high-dose glutamine is associated with increased mortality in critically ill patients with multiorgan failure. The objectives of the present analyses were to reevaluate the effect of supplementation after controlling for baseline covariates and to identify potentially important subgroup effects. This study was a post hoc analysis of a prospective factorial 2 × 2 randomized trial conducted in 40 intensive care units in North America and Europe. In total, 1223 mechanically ventilated adult patients with multiorgan failure were randomized to receive glutamine, antioxidants, both glutamine and antioxidants, or placebo administered separate from artificial nutrition. We compared each of the 3 active treatment arms (glutamine alone, antioxidants alone, and glutamine + antioxidants) with placebo on 28-day mortality. Post hoc, treatment effects were examined within subgroups defined by baseline patient characteristics. Logistic regression was used to estimate treatment effects within subgroups after adjustment for baseline covariates and to identify treatment-by-subgroup interactions (effect modification). The 28-day mortality rates in the placebo, glutamine, antioxidant, and combination arms were 25%, 32%, 29%, and 33%, respectively. After adjusting for prespecified baseline covariates, the adjusted odds ratio of 28-day mortality vs placebo was 1.5 (95% confidence interval, 1.0-2.1, P = .05), 1.2 (0.8-1.8, P = .40), and 1.4 (0.9-2.0, P = .09) for glutamine, antioxidant, and glutamine plus antioxidant arms, respectively. In the post hoc subgroup analysis, both glutamine and antioxidants appeared most harmful in patients with baseline renal dysfunction. No subgroups suggested reduced mortality with supplements. After adjustment for baseline covariates, early provision of high-dose glutamine administered separately from artificial nutrition was not beneficial and may be

  3. Weight Lifting and Physical Function Among Survivors of Breast Cancer: A Post Hoc Analysis of a Randomized Controlled Trial

    PubMed Central

    Brown, Justin C.; Schmitz, Kathryn H.

    2015-01-01

    Purpose Survivors of breast cancer may experience deterioration of physical function. This is important because poor physical function may be associated with premature mortality, injurious falls, bone fracture, and disability. We conducted a post hoc analysis to explore the potential efficacy of slowly progressive weight lifting to reduce the incidence of physical function deterioration among survivors of breast cancer. Methods Between October 2005 and August 2008, we conducted a single-blind, 12-month, randomized controlled trial of twice-per-week slowly progressive weight lifting or standard care among 295 survivors of nonmetastatic breast cancer. In this post hoc analysis of data from the Physical Activity and Lymphedema Trial, we examined incident deterioration of physical function after 12 months, defined as a ≥ 10-point decrease in the physical function subscale of the Medical Outcomes Short-Form 36-item questionnaire. Results The proportion of participants who experienced incident physical function deterioration after 12 months was 16.3% (24/147) in the control group and 8.1% (12/148) in the weight lifting group (relative risk, 0.49; 95% CI, 0.25 to 0.96; P = .04). No serious or unexpected adverse events occurred that were related to weight lifting. Conclusion Slowly progressive weight lifting compared with standard care reduced the incidence of physical function deterioration among survivors of breast cancer. These data are hypothesis generating. Future studies should directly compare the efficacy of weight lifting with other modalities of exercise, such as brisk walking, to appropriately inform the development of a confirmatory study designed to preserve physical function among survivors of breast cancer. PMID:25964257

  4. Ad Hoc Supervision of General Practice Registrars as a "Community of Practice": Analysis, Interpretation and Re-Presentation

    ERIC Educational Resources Information Center

    Clement, T.; Brown, J.; Morrison, J.; Nestel, D.

    2016-01-01

    General practice registrars in Australia undertake most of their vocational training in accredited general practices. They typically see patients alone from the start of their community-based training and are expected to seek timely ad hoc support from their supervisor. Such ad hoc encounters are a mechanism for ensuring patient safety, but also…

  5. Ad Hoc Supervision of General Practice Registrars as a "Community of Practice": Analysis, Interpretation and Re-Presentation

    ERIC Educational Resources Information Center

    Clement, T.; Brown, J.; Morrison, J.; Nestel, D.

    2016-01-01

    General practice registrars in Australia undertake most of their vocational training in accredited general practices. They typically see patients alone from the start of their community-based training and are expected to seek timely ad hoc support from their supervisor. Such ad hoc encounters are a mechanism for ensuring patient safety, but also…

  6. A post hoc analysis of d-threo-methylphenidate hydrochloride (focalin) versus d,l-threo-methylphenidate hydrochloride (ritalin).

    PubMed

    Weiss, Margaret; Wasdell, Michael; Patin, John

    2004-11-01

    To evaluate clinical measures of the benefit/risk ratio in a post hoc analysis of a clinical trial of d-threo-methylphenidate hydrochloride (d-MPH) and d,l-threo-methylphenidate hydrochloride (d,l-MPH). Data from a phase III clinical trial was used to compare equimolar doses of d-MPH and d,l-MPH treatment for attention-deficit/hyperactivity disorder (ADHD) on clinician ratings of improvement/deterioration, teacher ratings of remission, and duration of action. d-MPH was clinically and statistically significantly superior to d,l-MPH on clinician's dimensional ratings of global improvement, teacher ratings of remission of ADHD symptoms and parent 6:00 p.m. ADHD symptom ratings. No treatment differences were observed for symptom ratings at 3:00 p.m. and for 6:00 p.m. math test performance. The results suggest that the two drugs may have distinct profiles on the measures analyzed. Because d-MPH may have be more than twice the potency of d,l-MPH, the differences reported here are only applicable to the doses of the study drugs involved in the clinical trial. The results are limited by the exploratory nature of our analysis, small samples, and multiple analyses. The findings are suggestive that further study is warranted to look at these differences prospectively but cannot be used to draw clinical conclusions at this time.

  7. What Factors Determine Treatment Outcome in Aneurysmal Subarachnoid Hemorrhage in the Modern Era? A Post Hoc STASH Analysis.

    PubMed

    Teo, Mario; Guilfoyle, Mathew R; Turner, Carole; Kirkpatrick, Peter J

    2017-09-01

    The management of aneurysmal subarachnoid hemorrhage (aSAH) has changed dramatically in the last few decades with the publication of a few major studies, including ISAT (International Subarachnoid Aneurysm Trial, the International Cooperative Study on the Timing of Aneurysm Surgery Study). The aim of this study is to analyze the outcome of patients with aSAH based on a contemporary series, identify the risk factors for poor outcome, and focus on patients with good-grade aSAH (to match the ISAT cohort). Baseline demographic and outcome data (modified Rankin Scale) were available for the 803 patients recruited from the STASH (Simvastatin in Aneurysmal Subarachnoid Haemorrhage) trial for post hoc analysis, using a χ(2) test or 2-sample t test. Logistic regression analysis was performed to assess the risk factors for poor outcome at 6 months. Propensity matched analysis comparing coiling and clipping, and subgroup analysis of good-grade patients (World Federation of Neurosurgical Societies grade I-II) were also performed. Logistic regression analysis showed that the treatment modality (i.e., coiling or clipping) was not associated with poor outcome at 6 months (P = 0.839). The risk factors associated with poor outcome at 6 months were poor admission World Federation of Neurosurgical Societies grade (P < 0.0001), Fisher grade on initial computed tomography scan (P = 0.013), and the development of delayed cerebral ischemia (P < 0.0001). Subgroup analysis for good-grade patients only showed that 82% of patients after coiling and 78% of patients after clipping were classed as good outcome at 6 months (P = 0.181). In the current era of aSAH management, apart from patients' admission status, SAH blood load and the development of delayed cerebral ischemia, treatment modality with either coiling or clipping was not associated with poor outcome difference at 6 months. Copyright © 2017. Published by Elsevier Inc.

  8. Hematologic responses in patients with aplastic anemia treated with deferasirox: a post hoc analysis from the EPIC study.

    PubMed

    Lee, Jong Wook; Yoon, Sung-Soo; Shen, Zhi Xiang; Ganser, Arnold; Hsu, Hui-Chi; El-Ali, Ali; Habr, Dany; Martin, Nicolas; Porter, John B

    2013-07-01

    Reports are emerging of hematologic responses associated with iron chelation therapy; however, studies are limited in aplastic anemia patients. Deferasirox reduced iron overload in aplastic anemia patients enrolled in the EPIC (Evaluation of Patients' Iron Chelation with Exjade(®)) study (n=116). A post hoc analysis of hematologic responses was conducted on 72 patients with evaluable hematologic parameters (according to UK guideline criteria), 24 of whom received deferasirox without concomitant immunosuppressive treatment. Partial hematologic responses were observed in 11 of 24 (45.8%) patients; all became transfusion-independent. One patient had an additional platelet response and one patient had an additional platelet and hemoglobin response. Mean serum ferritin levels at end of study were significantly reduced in partial hematologic responders (n=11; -3948 ± 4998 ng/mL; baseline 6693 ± 7014 ng/mL; percentage change from baseline -45.7%; P=0.0029). In non-responders, the reduction in serum ferritin was less pronounced (n=13; -2021 ± 3242 ng/mL; baseline 4365 ± 3063 ng/mL; % change from baseline -27.6%; P=0.0171). Alongside reduction in iron overload, deferasirox may, therefore, improve hematologic parameters in a subset of aplastic anemia patients. Further investigation is required to elucidate the mechanisms involved.

  9. Headache relief after anterior cervical discectomy: post hoc analysis of a randomized investigational device exemption trial: clinical article.

    PubMed

    Schrot, Rudolph J; Mathew, Jesna S; Li, Yueju; Beckett, Laurel; Bae, Hyun W; Kim, Kee D

    2014-08-01

    The authors analyzed headache relief after anterior cervical discectomy. Headache may be relieved after anterior cervical discectomy, but the mechanism is unknown. If headaches were directly referred from upper cervical pathology, more headache relief would be expected from surgery performed at higher cervical levels. If spinal kinesthetics were the mechanism, then headache relief may differ between arthroplasty and fusion. Headache relief after anterior cervical discectomy was quantified by the operated disc level and by the method of operation (arthroplasty vs arthrodesis). The authors performed a post hoc analysis of an artificial disc trial. Data on headache pain were extracted from the Neck Disability Index (NDI) questionnaire. A total of 260 patients underwent single-level arthroplasty or arthodesis. Preoperatively, 52% reported NDI headache scores of 3 or greater, compared with only 13%-17% postoperatively. The model-based mean NDI headache score at baseline was 2.5 (95% CI 2.3-2.7) and was reduced by 1.3 points after surgery (95% CI 1.2-1.4, p < 0.001). Higher cervical levels were associated with a greater degree of preoperative headache, but there was no association with headache relief. There was no significant difference in headache relief between arthroplasty and arthrodesis. Most patients with symptomatic cervical spondylosis have headache as a preoperative symptom (88%). Anterior cervical discectomy with both arthroplasty and arthrodesis is associated with a durable decrease in headache. Headache relief is not related to the level of operation. The mechanism for headache reduction remains unclear.

  10. Effects of Safinamide on Pain in Fluctuating Parkinson’s Disease Patients: A Post-Hoc Analysis

    PubMed Central

    Cattaneo, Carlo; Barone, Paolo; Bonizzoni, Erminio; Sardina, Marco

    2016-01-01

    Background: Pain, a frequent non-motor symptom in Parkinson’s Disease (PD), significantly impacts on quality of life. Safinamide is a new drug with dopaminergic and non-dopaminergic properties, approved in Europe as adjunct therapy to levodopa for the treatment of fluctuating PD patients. Results from two 24-month, double-blind, placebo-controlled studies demonstrated that safinamide has positive effects on both motor functions and quality of life in PD patients. Objective: To investigate the effects of safinamide on pain management in PD patients with motor fluctuations using pooled data from studies 016 and SETTLE. Methods: This post-hoc analysis evaluated the reduction of concomitant pain treatments and the changes in the scores of the items related to pain of the Parkinson’s Disease Quality of Life Questionnaire (PDQ-39). A path analysis was performed in order to examine direct and indirect associations between safinamide and PDQ-39 pain-related items assessed after 6-months of treatment. Results: The percentage of patients with no pain treatments at the end of the trials was significantly lower in the safinamide group compared to the placebo group. Safinamide 100 mg/day significantly reduced on average the individual use of pain treatments by ≈24% and significantly improved two out of three PDQ-39 pain-related items of the “Bodily discomfort” domain. Path analysis showed that the direct effect of safinamide on pain accounted for about 80% of the total effect. Conclusions: These results suggest that safinamide may have a positive effect on pain, one of the most underestimated non-motor symptoms. Prospective studies are warranted to investigate this potential benefit. PMID:27802242

  11. Correlation of pain relief with physical function in hand osteoarthritis: randomized controlled trial post hoc analysis

    PubMed Central

    2010-01-01

    Introduction Nonsteroidal anti-inflammatory drugs are recommended for the relief of pain associated with hand osteoarthritis (OA) but do not alter the underlying structural changes that contribute to impaired physical function. The current analysis examined the relationship of pain relief with measures of function and global rating of disease in patients with hand OA. Methods This was a combined analysis of 2 prospective, randomized, double-blind, 8-week, multicenter, parallel-group studies comparing diclofenac sodium 1% gel with placebo gel (vehicle) in patients with radiographically confirmed mild to moderate hand OA. Patients (n = 783) aged ≥ 40 years applied diclofenac sodium 1% gel (2 g) or vehicle to each hand 4 times daily for 8 weeks. Outcome measures included pain intensity assessed on a 100-mm Visual Analog Scale (VAS); the Australian/Canadian Osteoarthritis Hand Index (AUSCAN) subscales for pain, stiffness, and physical function (100-mm VAS); and a global rating of disease (100-mm VAS). Change in VAS pain intensity from baseline to week 8 was categorized (<0%, 0%-<15%, 15%-<30%, 30%-<50%, 50%-<70%, and ≥ 70%) without regard to treatment and compared in each category with the mean change from baseline in each AUSCAN subindex and the global rating of disease. Pearson correlations between changes in outcome measures from baseline to week 8 were calculated. Results Changes in VAS pain intensity were accompanied by similar changes in AUSCAN scores and global rating of disease. Pearson correlations confirmed significant associations (P < 0.001) between change in VAS pain intensity and changes in AUSCAN pain (correlation coefficient [r] = 0.81), AUSCAN function (r = 0.75), AUSCAN stiffness (r = 0.66), and global rating of disease (r = 0.76). Conclusions Pain relief correlated with improvements in physical function, stiffness, and global rating of disease in patients with hand OA, irrespective of treatment. This suggests that pain or anticipation of pain

  12. Reducing consumption of confectionery foods: A post-hoc segmentation analysis using a social cognition approach.

    PubMed

    Naughton, Paul; McCarthy, Mary; McCarthy, Sinéad

    2017-10-01

    Considering confectionary consumption behaviour this cross-sectional study used social cognition variables to identify distinct segments in terms of their motivation and efforts to decrease their consumption of such foods with the aim of informing targeted social marketing campaigns. Using Latent Class analysis on a sample of 500 adults four segments were identified: unmotivated, triers, successful actors, and thrivers. The unmotivated and triers segments reported low levels of perceived need and perceived behavioural control (PBC) in addition to high levels of habit and hedonic hunger with regards their consumption of confectionery foods. Being a younger adult was associated with higher odds of being in the unmotivated and triers segments and being female was associated with higher odds of being in the triers and successful actors segments. The findings indicate that in the absence of strong commitment to eating low amounts of confectionery foods (i.e. perceived need) people will continue to overconsume free sugars regardless of motivation to change. It is therefore necessary to identify relevant messages or 'triggers' related to sugar consumption that resonate with young adults in particular. For those motivated to change, counteracting unhealthy eating habits and the effects of hedonic hunger may necessitate changes to food environments in order to make the healthy choice more appealing and accessible. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Pre and post hoc analysis of electronic health record implementation on emergency department metrics

    PubMed Central

    Ham, Nathan J.; Blankenship, Dennis E.; Payton, Mark E.; Murray, Kelly A.

    2017-01-01

    Longitudinal time-based emergency department (ED) performance measures were quantified 12 months before and 12 months after (March 2012–February 2014) implementation of a Meditech 6.0® electronic health record (EHR) at a single urban academic ED. Data assessed were length of stay from door to door, door to admission, door to bed, bed to provider, provider to disposition, and disposition to admission, as well as number of patients leaving against medical advice and number of patients leaving without being seen. Analysis of variance was used to compare levels before and after EHR implementation for each variable, with adjustments made for the number of admissions, transfers, and month. No difference was seen in monthly volume, admissions, or transfers. Implementation of an EHR resulted in a sustained increase in ED time metrics for mean length of stay and times from door to door, door to admission, door to bed, and provider to disposition. Decreased ED time metrics were seen in bed-to-provider and disposition-to-admit times. The number of patients who left against medical advice increased after implementation, but the number of patients who left without being seen was not significantly different. Thus, EHR implementation was associated with an increase in time with most performance metrics. Although general times trended back to near preimplementation baselines, most ED time metrics remained elevated beyond the study length of 12 months. Understanding the impact of EHR system implementation on the overall performance of an ED can help departments prepare for potential adverse effects of such systems on overall efficiency.

  14. Post hoc analysis of passive cavitation imaging for classification of histotripsy-induced liquefaction in vitro.

    PubMed

    Bader, Kenneth B; Haworth, Kevin J; Maxwell, Adam D; Holland, Christy K

    2017-08-02

    Histotripsy utilizes focused ultrasound to generate bubble clouds for transcutaneous tissue liquefaction. Image guidance of histotripsy pulses is required to provide spatially resolved monitoring of treatment progress. The aim of this study was to investigate the feasibility of plane wave B-mode and passive cavitation images to be used as binary classifiers of histotripsy-induced liquefaction. Prostate tissue phantoms were exposed to mechanically ablative histotripsy pulses over a range of pulse durations (5 - 20 μs) and peak negative pressures (12 - 23 MPa). Acoustic emissions were recorded during the insonation and beamformed to form passive cavitation images. Plane wave B-mode images were acquired following the insonation to detect the hyperechoic bubble cloud. Phantom samples were sectioned and stained to delineate the liquefaction zone. Correlation between passive cavitation and plane wave B-mode images and the liquefaction zone was assessed using receiver operating characteristic (ROC) curve analysis. Liquefaction of the phantom was observed for all insonation conditions. The area under the ROC (0.94 vs. 0.82), accuracy (0.90 vs. 0.83), and sensitivity (0.81 vs. 0.49) was greater for passive cavitation images relative to B-mode images (p < 0.05) along the azimuth of the liquefaction zone. The specificity was greater than 0.9 for both imaging modalities. These results demonstrate here denote a stronger correlation between histotripsy-induced liquefaction and passive cavitation imaging compared to plane wave B-mode imaging, albeit with limited passive cavitation image range resolution.

  15. The use of β2-agonist therapy before hospital attendance for severe asthma exacerbations: a post-hoc analysis.

    PubMed

    Patel, Mitesh; Pilcher, Janine; Hancox, Robert J; Sheahan, Davitt; Pritchard, Alison; Braithwaite, Irene; Shaw, Dominick; Black, Peter; Weatherall, Mark; Beasley, Richard

    2015-01-08

    Patterns of inhaled β2-agonist therapy use during severe asthma exacerbations before hospital attendance are poorly understood. To assess β2-agonist use prior to hospital attendance. We undertook an exploratory post hoc analysis of data from a 6-month clinical trial of 303 patients randomised to combination budesonide/formoterol inhaler according to a Single combination inhaler as Maintenance And Reliever Therapy regimen ('SMART') or fixed-dose budesonide/formoterol with salbutamol as reliever ('Standard'). Patterns of β2-agonist use for 14 days before hospital attendance with a severe asthma exacerbation were determined by electronic monitoring of inhaler use. There were 22 hospital attendances in 16 patients during the study. Seven and nine hospital attendances were eligible for analysis in the SMART and Standard groups, respectively. In both regimens, β2-agonist use increased before hospital attendance, with a median (range) maximum daily number of actuations of 14 (9 to 63) budesonide/formoterol in SMART and 46 (6 to 95) salbutamol in Standard with 4 (0 to 10) budesonide/formoterol actuations on the day of maximal salbutamol use. There was delay in obtaining medical review despite high β2-agonist use, in 9/16 patients. Different patterns of use were observed, including repeated days of no inhaled corticosteroid despite marked salbutamol use, which occurred in 3/9 patients in the Standard group. Delay in obtaining medical review in association with high β2-agonist use is common in patients before hospital presentation with severe exacerbations of asthma. The SMART regimen reduced nonadherence with inhaled corticosteroid therapy during severe exacerbations.

  16. Polypharmacy and effects of apixaban versus warfarin in patients with atrial fibrillation: post hoc analysis of the ARISTOTLE trial

    PubMed Central

    Brouwer, Marc A; Wojdyla, Daniel M; Thomas, Laine; Lopes, Renato D; Washam, Jeffrey B; Lanas, Fernando; Xavier, Denis; Husted, Steen; Wallentin, Lars; Alexander, John H; Granger, Christopher B; Verheugt, Freek W A

    2016-01-01

    Objective To determine whether the treatment effect of apixaban versus warfarin differs with increasing numbers of concomitant drugs used by patients with atrial fibrillation. Design Post hoc analysis performed in 2015 of results from ARISTOTLE (apixaban for reduction in stroke and other thromboembolic events in atrial fibrillation)—a multicentre, double blind, double dummy trial that started in 2006 and ended in 2011. Participants 18 201 ARISTOTLE trial participants. Interventions In the ARISTOTLE trial, patients were randomised to either 5 mg apixaban twice daily (n=9120) or warfarin (target international normalised ratio range 2.0-3.0; n=9081). In the post hoc analysis, patients were divided into groups according to the number of concomitant drug treatments used at baseline (0-5, 6-8, ≥9 drugs) with a median follow-up of 1.8 years. Main outcome measures Clinical outcomes and treatment effects of apixaban versus warfarin (adjusted for age, sex, and country). Results Each patient used a median of six drugs (interquartile range 5-9); polypharmacy (≥5 drugs) was seen in 13 932 (76.5%) patients. Greater numbers of concomitant drugs were used in older patients, women, and patients in the United States. The number of comorbidities increased across groups of increasing numbers of drugs (0-5, 6-8, ≥9 drugs), as did the proportions of patients treated with drugs that interact with warfarin or apixaban. Mortality also rose significantly with the number of drug treatments (P<0.001), as did rates of stroke or systemic embolism (1.29, 1.48, and 1.57 per 100 patient years, for 0-5, 6-8, and ≥9 drugs, respectively) and major bleeding (1.91, 2.46, and 3.88 per 100 patient years, respectively). Relative risk reductions in stroke or systemic embolism for apixaban versus warfarin were consistent, regardless of the number of concomitant drugs (Pinteraction=0.82). A smaller reduction in major bleeding was seen with apixaban versus warfarin with increasing numbers

  17. Polypharmacy and effects of apixaban versus warfarin in patients with atrial fibrillation: post hoc analysis of the ARISTOTLE trial.

    PubMed

    Jaspers Focks, Jeroen; Brouwer, Marc A; Wojdyla, Daniel M; Thomas, Laine; Lopes, Renato D; Washam, Jeffrey B; Lanas, Fernando; Xavier, Denis; Husted, Steen; Wallentin, Lars; Alexander, John H; Granger, Christopher B; Verheugt, Freek W A

    2016-06-15

     To determine whether the treatment effect of apixaban versus warfarin differs with increasing numbers of concomitant drugs used by patients with atrial fibrillation.  Post hoc analysis performed in 2015 of results from ARISTOTLE (apixaban for reduction in stroke and other thromboembolic events in atrial fibrillation)-a multicentre, double blind, double dummy trial that started in 2006 and ended in 2011.  18 201 ARISTOTLE trial participants.  In the ARISTOTLE trial, patients were randomised to either 5 mg apixaban twice daily (n=9120) or warfarin (target international normalised ratio range 2.0-3.0; n=9081). In the post hoc analysis, patients were divided into groups according to the number of concomitant drug treatments used at baseline (0-5, 6-8, ≥9 drugs) with a median follow-up of 1.8 years.  Clinical outcomes and treatment effects of apixaban versus warfarin (adjusted for age, sex, and country).  Each patient used a median of six drugs (interquartile range 5-9); polypharmacy (≥5 drugs) was seen in 13 932 (76.5%) patients. Greater numbers of concomitant drugs were used in older patients, women, and patients in the United States. The number of comorbidities increased across groups of increasing numbers of drugs (0-5, 6-8, ≥9 drugs), as did the proportions of patients treated with drugs that interact with warfarin or apixaban. Mortality also rose significantly with the number of drug treatments (P<0.001), as did rates of stroke or systemic embolism (1.29, 1.48, and 1.57 per 100 patient years, for 0-5, 6-8, and ≥9 drugs, respectively) and major bleeding (1.91, 2.46, and 3.88 per 100 patient years, respectively). Relative risk reductions in stroke or systemic embolism for apixaban versus warfarin were consistent, regardless of the number of concomitant drugs (Pinteraction=0.82). A smaller reduction in major bleeding was seen with apixaban versus warfarin with increasing numbers of concomitant drugs (Pinteraction=0.017). Patients with interacting

  18. Response to duloxetine in chronic low back pain: exploratory post hoc analysis of a Japanese Phase III randomized study.

    PubMed

    Tsuji, Toshinaga; Itoh, Naohiro; Ishida, Mitsuhiro; Ochiai, Toshimitsu; Konno, Shinichi

    2017-01-01

    Duloxetine is efficacious for chronic low back pain (CLBP). This post hoc analysis of a Japanese randomized, placebo-controlled trial (ClinicalTrials.gov, NCT01855919) assessed whether patients with CLBP with early pain reduction or treatment-related adverse events of special interest (TR-AESIs; nausea, somnolence, constipation) have enhanced responses to duloxetine. Patients (N = 456) with CLBP for ≥6 months and Brief Pain Inventory (BPI) average pain severity score of ≥4 were randomized (1:1) to duloxetine 60 mg/day or placebo for 14 weeks. Primary outcome was change from baseline in BPI average pain severity score (pain reduction). Subgroup analyses included early pain reduction (≥30%, 10%-30%, or <10% at Week 4) and early TR-AESIs (with or without TR-AESIs by Week 2). Measures included changes from baseline in BPI average pain severity score and BPI Interference scores (quality of life; QOL), and response rate (≥30% or ≥50% pain reduction at Week 14). Patients with ≥30% early pain reduction (n = 108) or early TR-AESIs (n = 50) had significantly greater improvements in pain and QOL than placebo-treated patients (n = 226), whereas patients with 10%-30% (n = 63) or <10% (n = 48) pain reduction did not; patients without early TR-AESIs (n = 180) had significant improvements in pain at Week 14. Response rates (≥30%/≥50% pain reduction) were 94.4%/82.4%, 66.7%/49.2%, and 25.0%/18.8% for patients with ≥30%, 10%-30%, and <10% early pain reduction, respectively, 74.0%/64.0% for patients with early TR-AESIs, 67.2%/54.4% for patients without early TR-AESIs, and 52.2%/39.4% for placebo. Early pain reduction or TR-AESIs may predict which CLBP patients are most likely to respond to duloxetine with improvements in pain and QOL.

  19. Bucindolol, systolic blood pressure, and outcomes in systolic heart failure: a prespecified post hoc analysis of BEST.

    PubMed

    White, Michel; Desai, Ravi V; Guichard, Jason L; Mujib, Marjan; Aban, Inmaculada B; Ahmed, Mustafa I; Feller, Margaret A; de Denus, Simon; Ahmed, Ali

    2012-05-01

    In the Beta-Blocker Evaluation of Survival Trial (BEST), systolic blood pressure (SBP) ≤ 120 mm Hg was an independent predictor of poor prognosis in ambulatory patients with chronic systolic heart failure (HF). Because SBP is an important predictor of response to β-blocker therapy, the BEST protocol prespecified a post hoc analysis to determine whether the effect of bucindolol varied by baseline SBP. In the BEST, 2706 patients with chronic systolic (left ventricular ejection fraction < 35%) HF and New York Heart Association class III (92%) or IV (8%) symptoms and receiving standard background therapy were randomized to receive either bucindolol (n = 1354) or placebo (n = 1354). Of these, 1751 had SBP ≤ 120 mm Hg, and 955 had SBP > 120 mm Hg at baseline. Among patients with SBP > 120 mm Hg, all-cause mortality occurred in 28% and 22% of patients receiving placebo and bucindolol, respectively (hazard ratio when bucindolol was compared with placebo, 0.77; 95% confidence interval [CI], 0.59-0.99; P = 0.039). In contrast, among those with SBP ≤ 120 mm Hg, 36% and 35% of patients in the placebo and bucindolol groups died, respectively (hazard ratio, 0.95; 95% CI, 0.81-1.12; P = 0.541). Hazard ratios (95% CIs; P values) for HF hospitalization associated with bucindolol use were 0.70 (0.56-0.89; P = 0.003) and 0.82 (0.71-0.95; P = 0.008) for patients with SBP > 120 and ≤ 120 mm Hg, respectively. Bucindolol, a nonselective β-blocker with weak α(2)-blocking properties, significantly reduced HF hospitalization in systolic HF patients regardless of baseline SBP. However, bucindolol reduced mortality only in those with SBP > 120 mm Hg. Copyright © 2012 Canadian Cardiovascular Society. All rights reserved.

  20. Perampanel with concomitant levetiracetam and topiramate: Post hoc analysis of adverse events related to hostility and aggression.

    PubMed

    Chung, Steve; Williams, Betsy; Dobrinsky, Cindy; Patten, Anna; Yang, Haichen; Laurenza, Antonio

    2017-10-01

    In 4 Phase III registration trials (3 in patients with partial seizures, N=1480; 1 in patients with PGTCS, N=163), perampanel administered to patients already receiving 1-3 concomitant antiepileptic drugs (AEDs) demonstrated statistically superior efficacy compared to placebo in reducing seizure frequency. However, use of perampanel in these studies was associated with a risk of psychiatric and behavioral adverse reactions, including aggression, hostility, irritability, anger, and homicidal ideation and threats. The present study is a post hoc analysis of pooled data from these 4 trials to determine if concomitant treatment with levetiracetam and/or topiramate increased the risk of hostility- and aggression-related AEs. Treatment-emergent AEs (TEAEs) were determined using a "Narrow & Broad" search based on the Medical Dictionary for Regulatory Activities (MedDRA) standard MedDRA query (SMQ) for hostility- and aggression-related events. The rate of hostility- and aggression-related TEAEs was observed to be similar among perampanel-treated patients: a) receiving levetiracetam (N=340) compared to those not receiving levetiracetam (N=779); b) receiving topiramate (N=223) compared to those not receiving topiramate (N=896); and c) receiving both levetiracetam and topiramate (N=47) compared to those not receiving levetiracetam and topiramate (N=1072). Severe and serious TEAEs related to hostility and aggression were rare and occurred at a similar rate regardless of concomitant levetiracetam and/or topiramate therapy. Taken together, these results suggest that concomitant treatment with levetiracetam and/or topiramate has no appreciable effect on the occurrence of hostility- or aggression-related TEAEs in patients receiving perampanel. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  1. Liver Safety of Statins in Prediabetes or T2DM and Nonalcoholic Steatohepatitis: Post Hoc Analysis of a Randomized Trial.

    PubMed

    Bril, Fernando; Portillo Sanchez, Paola; Lomonaco, Romina; Orsak, Beverly; Hecht, Joan; Tio, Fermin; Cusi, Kenneth

    2017-08-01

    Patients with nonalcoholic fatty liver disease have a high cardiovascular risk, but statins are rarely prescribed because of fear of hepatotoxicity. To prospectively assess the long-term safety of statins in patients with prediabetes/type 2 diabetes mellitus (T2DM) and nonalcoholic steatohepatitis (NASH). Post hoc analysis of statin use during a randomized, controlled trial assessing pioglitazone vs placebo for NASH. A total of 101 patients (86 receiving statins) with biopsy-proven NASH and prediabetes/T2DM were followed for up to 36 months. Oral glucose tolerance test and percutaneous liver biopsy (baseline, month 18, and month 36); liver magnetic resonance spectroscopy and euglycemic insulin clamp (baseline and month 18). Histologic and biochemical safety of statin use among patients with NASH. Only 37% of patients were receiving statins at enrollment despite their high cardiovascular risk. Statin nonusers had higher plasma alanine aminotransferase levels but similar histologic severity of liver disease at baseline. In both statin users and nonusers, the same number of patients (n = 4) had a twofold or greater increase in plasma aminotransferases during follow-up. One statin nonuser was discontinued from the study because of this elevation. Values returned to normal without any active measure in all other cases. No changes on liver histology or hepatic insulin resistance were observed in patients with NASH newly started on a statin and receiving placebo during the main study. Statin therapy is safe in patients with prediabetes/T2DM and NASH. Given their high cardiovascular risk, statin therapy should be encouraged in this population.

  2. Evolution of Blood Lactate and 90-Day Mortality in Septic Shock. A Post Hoc Analysis of the FINNAKI Study.

    PubMed

    Varis, Elina; Pettilä, Ville; Poukkanen, Meri; Jakob, Stephan M; Karlsson, Sari; Perner, Anders; Takala, Jukka; Wilkman, Erika

    2017-05-01

    Hyperlactatemia predicts mortality in patients with sepsis and septic shock, and its normalization is a potential treatment goal. We investigated the association of blood lactate and its changes over time with 90-day mortality in septic shock. We performed a post hoc analysis of 513 septic shock patients with admission blood lactate measurements in the prospective, observational, multicenter FINNAKI study. Repetitive lactate measurements were available in 496 patients for analyses of change in lactate values during intensive care unit stay.The 90-day mortality for all patients was 33.3%. Patients with admission lactate >2 mmol/L had higher 90-day mortality than those with admission lactate ≤2 mmol/L (43.4% vs. 22.6%, P < 0.001). Patients with persistent hyperlactatemia (>2 mmol/L) at ≥72 h had higher 90-day mortality compared with those with a lactate value of ≤2.0 mmol/L (52.0% vs. 24.3%, P < 0.001). Time-weighted mean lactate values were higher in non-survivors than in survivors, (median [IQR] 2.05 [1.38-4.22] mmol/L vs. 1.29 [0.98-1.77] mmol/L, P < 0.001). Time to normalization of lactate was comparable for 90-day non-survivors and survivors (median [IQR] 17.0 [3.5-43.5] vs. 15.0 [5.0-35.0] h, P = 0.67). In separate models, time-weighted mean lactate, lactate value at ≥72 h, and hyperlactatemia at ≥72 h were independently associated with 90-day mortality, but admission lactate and time to normalization of lactate were not. These findings may inform future clinical trials using combined surrogate endpoints for mortality in septic shock patients.

  3. The Efficacy Profile of Rotigotine During the Waking Hours in Patients With Advanced Parkinson's Disease: A Post Hoc Analysis

    PubMed Central

    LeWitt, Peter A.; Poewe, Werner; Elmer, Lawrence W.; Asgharnejad, Mahnaz; Boroojerdi, Babak; Grieger, Frank; Bauer, Lars

    2016-01-01

    Objectives Transdermal delivery of rotigotine maintains stable plasma concentrations for 24 hours. Three phase 3 studies of rotigotine as add-on to levodopa in advanced Parkinson's disease showed a significant reduction in “off” time from baseline to end of maintenance (EoM). However, detailed analyses over the range of a day have not yet been performed. The objective was to examine the time course of the efficacy profile of rotigotine throughout the day. Methods Post hoc analysis of diary data from 3 double-blind, placebo-controlled studies of rotigotine in patients with advanced Parkinson's disease inadequately controlled with levodopa, with average “off” time of ≥2.5 h/d (CLEOPATRA-PD [NCT00244387], 16-week maintenance; PREFER, 24-week maintenance; SP921 [NCT00522379], 12-week maintenance). Patients marked 30-minute intervals as “off,” “on without troublesome dyskinesia,” “on with troublesome dyskinesia,” or “sleep.” Diaries completed on the 3 days before EoM were analyzed. A 2-sample t test was performed for comparison of rotigotine + levodopa versus placebo + levodopa for mean percentage of time per status during four 6-hour periods: 12:00am (midnight) to 6:00am, 6:00am to 12:00pm (noon), noon to 6:00pm, and 6:00pm to midnight. Results Data were available for 967 patients (placebo + levodopa, 260; rotigotine + levodopa, 707). During the 24-hour period at EoM, an advantage in mean percentage time spent “off” and “on without troublesome dyskinesia” was observed with rotigotine + levodopa versus placebo + levodopa during the three 6-hour periods from 6:00am to midnight (P < 0.05; exploratory analysis). Conclusions These exploratory analyses of patients with motor fluctuations suggest that the efficacy of rotigotine transdermal patch, as captured by diary data, in reducing “off” time and increasing “on time without troublesome dyskinesia” may cover the full waking day. PMID:26882318

  4. Efficacy and safety of aripiprazole once-monthly in obese and nonobese patients with schizophrenia: a post hoc analysis

    PubMed Central

    De Hert, Marc; Eramo, Anna; Landsberg, Wally; Kostic, Dusan; Tsai, Lan-Feng; Baker, Ross A

    2015-01-01

    Purpose To assess the efficacy and safety of aripiprazole once-monthly 400 mg (AOM 400), an extended-release injectable suspension of aripiprazole, in obese and nonobese patients. Patients and methods This post hoc analysis of a 38-week randomized, double-blind, active-controlled, noninferiority study (NCT00706654) compared the clinical profile of AOM 400 in obese (body mass index [BMI] ≥30 kg/m2) and nonobese (BMI <30 kg/m2) patients with schizophrenia for ≥3 years. Patients were randomized 2:2:1 to AOM 400, oral aripiprazole 10–30 mg/d, or aripiprazole once-monthly 50 mg (AOM 50 mg) (subtherapeutic dose). Within obese and nonobese patient subgroups, treatment-group differences in Kaplan–Meier estimated relapse rates at week 26 (z-test) and in observed rates of impending relapse through week 38 (chi-square test) were analyzed. Treatment-emergent adverse events (TEAEs) (>10% in any treatment group) were summarized. Results At baseline of the randomized phase, obesity rates were similar among patients randomized to AOM 400 (n=95/265, 36%), oral aripiprazole (n=95/266, 36%), and AOM 50 mg (n=43/131, 33%). In both obese and nonobese patients, relapse rates through week 38 for patients randomized to AOM 400 (obese, 7.4%; nonobese, 8.8%) were similar to those in patients on oral aripiprazole (obese, 8.4%; nonobese, 7.6%), whereas relapse rates were significantly lower with AOM 400 versus AOM 50 mg (obese, 27.9% [P=0.0012]; nonobese, 19.3% [P=0.0153]). The most common TEAEs with AOM 400 in obese and nonobese patients were insomnia (12.6% and 11.2%), headache (12.6% and 8.2%), injection site pain (11.6% and 5.3%), akathisia (10.5% and 10.6%), upper respiratory tract infection (10.5% and 4.7%), weight increase (10.5% and 8.2%), and weight decrease (6.3% and 11.8%). Within the AOM 400 group, 7.6% of patients who were nonobese at baseline became obese, and 17.9% of obese patients became nonobese during randomized treatment. Conclusion The clinical profile of AOM 400

  5. A novel method to prioritize RNAseq data for post-hoc analysis based on absolute changes in transcript abundance.

    PubMed

    McNutt, Patrick; Gut, Ian; Hubbard, Kyle; Beske, Phil

    2015-06-01

    The use of fold-change (FC) to prioritize differentially expressed genes (DEGs) for post-hoc characterization is a common technique in the analysis of RNA sequencing datasets. However, the use of FC can overlook certain population of DEGs, such as high copy number transcripts which undergo metabolically expensive changes in expression yet fail to exceed the ratiometric FC cut-off, thereby missing potential important biological information. Here we evaluate an alternative approach to prioritizing RNAseq data based on absolute changes in normalized transcript counts (ΔT) between control and treatment conditions. In five pairwise comparisons with a wide range of effect sizes, rank-ordering of DEGs based on the magnitude of ΔT produced a power curve-like distribution, in which 4.7-5.0% of transcripts were responsible for 36-50% of the cumulative change. Thus, differential gene expression is characterized by the high production-cost expression of a small number of genes (large ΔT genes), while the differential expression of the majority of genes involves a much smaller metabolic investment by the cell. To determine whether the large ΔT datasets are representative of coordinated changes in the transcriptional program, we evaluated large ΔT genes for enrichment of gene ontologies (GOs) and predicted protein interactions. In comparison to randomly selected DEGs, the large ΔT transcripts were significantly enriched for both GOs and predicted protein interactions. Furthermore, enrichments were were consistent with the biological context of each comparison yet distinct from those produced using equal-sized populations of large FC genes, indicating that the large ΔT genes represent an orthagonal transcriptional response. Finally, the composition of the large ΔT gene sets were unique to each pairwise comparison, indicating that they represent coherent and context-specific responses to biological conditions rather than the non-specific upregulation of a family of genes

  6. Rotigotine transdermal system and evaluation of pain in patients with Parkinson’s disease: a post hoc analysis of the RECOVER study

    PubMed Central

    2014-01-01

    Background Pain is a troublesome non-motor symptom of Parkinson’s disease (PD). The RECOVER (Randomized Evaluation of the 24-hour Coverage: Efficacy of Rotigotine; Clintrials.gov: NCT00474058) study demonstrated significant improvements in early-morning motor function (UPDRS III) and sleep disturbances (PDSS-2) with rotigotine transdermal system. Improvements were also reported on a Likert pain scale (measuring any type of pain). This post hoc analysis of RECOVER further evaluates the effect of rotigotine on pain, and whether improvements in pain may be attributable to benefits in motor function or sleep disturbance. Methods PD patients with unsatisfactory early-morning motor impairment were randomized to optimal-dose (up to 16 mg/24 h) rotigotine or placebo, maintained for 4 weeks. Pain was assessed in the early-morning using an 11-point Likert pain scale (rated average severity of pain (of any type) over the preceding 12 hours from 0 [no pain] to 10 [worst pain ever experienced]). Post hoc analyses for patients reporting ‘any’ pain (pain score ≥1) at baseline, and subgroups reporting ‘mild’ (score 1–3), and ‘moderate-to-severe’ pain (score ≥4) were performed. Likert pain scale change from baseline in rotigotine-treated patients was further analyzed based on a UPDRS III/PDSS-2 responder analysis (a responder defined as showing a ≥30% reduction in early morning UPDRS III total score or PDSS-2 total score). As post hoc analyses, all p values presented are exploratory. Results Of 267 patients with Likert pain data (178 rotigotine, 89 placebo), 187 (70%) reported ‘any’ pain; of these 87 (33%) reported ‘mild’, and 100 (37%) ‘moderate-to-severe’ pain. Change from baseline pain scores decreased with rotigotine compared with placebo in patients with ‘any’ pain (-0.88 [95% CI: -1.56, -0.19], p = 0.013), and in the subgroup with ‘moderate-to-severe’ pain (-1.38 [-2.44, -0.31], p = 0.012). UPDRS III or PDSS-2 responders

  7. Rotigotine in Combination with the MAO-B Inhibitor Selegiline in Early Parkinson’s Disease: A Post Hoc Analysis

    PubMed Central

    Giladi, Nir; Asgharnejad, Mahnaz; Bauer, Lars; Grieger, Frank; Boroojerdi, Babak

    2016-01-01

    Background: Monoamine oxidase B (MAO-B) inhibitors and dopamine receptor agonists are common first-line treatment options in early Parkinson’s disease (PD). Objective: To evaluate the efficacy and safety of rotigotine transdermal patch as an add-on therapy to an MAO-B inhibitor in patients with early-PD. Methods: In two Phase III, randomized, double-blind, placebo-controlled studies in early-PD (SP512, SP513), patients were randomized to rotigotine (titrated to optimal dose ≤8 mg/24 h) or placebo, and maintained for 24 (SP512) or 33 (SP513) weeks. Post hoc analyses were performed on pooled data for patients receiving an MAO-B inhibitor (selegiline) at a stable dose at randomization and throughout the studies, with groups defined as “Selegiline+Rotigotine” and “Selegiline+Placebo”. Outcome measures included change from baseline in Unified Parkinson’s Disease Rating Scale (UPDRS) II (activities of daily living), III (motor), UPDRS II+III and responders (patients achieving ≥20%, ≥25% or ≥30% decrease in UPDRS II+III). As post hoc analyses, p-values are exploratory. Results: 130 patients were evaluable for efficacy analyses (“Selegiline+Rotigotine”: 84, “Selegiline+Placebo”: 46). Combined treatment with rotigotine and selegiline improved UPDRS III and UPDRS II+III scores versus selegiline alone (LS-mean [95% CI] treatment difference for UPDRS III: –4.89 [–7.87 to –1.91], p = 0.0015; for UPDRS II+III: –5.76 [–9.71 to –1.82], p = 0.0045). Higher proportion of patients in the “Selegiline+Rotigotine” group were classified as ≥20%, ≥25% or ≥30% responders (all p < 0.001). Combined treatment appeared more effective in patients aged ≤65 years versus > 65 years (although patient numbers in the subgroups were low). Adverse event profile was consistent with the known safety profile of rotigotine. Conclusions: In these post hoc analyses, adjunctive treatment with rotigotine in patients already receiving an

  8. The safety and tolerability of cariprazine in long-term treatment of schizophrenia: a post hoc pooled analysis.

    PubMed

    Nasrallah, Henry A; Earley, Willie; Cutler, Andrew J; Wang, Yao; Lu, Kaifeng; Laszlovszky, István; Németh, György; Durgam, Suresh

    2017-08-24

    Schizophrenia is a chronic and debilitating neuropsychiatric disorder that often requires long-term pharmacotherapy to manage symptoms and prevent relapse. Cariprazine is a potent dopamine D3 and D2 receptor partial agonist that is FDA-approved in the US for the treatment of schizophrenia and manic or mixed episodes associated with bipolar I disorder in adults; the recommended dose range is 1.5-6 mg/d. To further characterize the long-term safety of cariprazine, data from two 48-week open-label, flexible-dose extension studies were pooled for post hoc analyses. Outcomes were evaluated in the pooled safety population (patients who received ≥1 dose of cariprazine during an open-label extension period); findings were summarized using descriptive statistics for the overall cariprazine group and in modal daily dose groups (1.5-3, 4.5-6, and 9 mg/d). Of the 679 patients in the overall cariprazine safety population, 40.1% completed the study. The only adverse events (AEs) leading to discontinuation of ≥2% of patients in any dose group were akathisia, worsening of schizophrenia, and psychotic disorder. Treatment-emergent AEs (TEAEs) of akathisia, insomnia, weight increased, and headache were reported in ≥10% of the overall population. Mean prolactin levels decreased in all dose groups (overall, -15.4 ng/mL). Clinically insignificant changes in aminotransferase levels and alkaline phosphatase were observed; no dose-response relationship was observed across groups. Mean total (-5.3 mg/dL), low-density lipoprotein (-3.5 mg/dL), and high-density lipoprotein (-0.8 mg/dL) cholesterol levels decreased; no dose-response relationship was observed for metabolic parameters. Mean change in body weight was 1.58 kg; body weight increase and decrease ≥7% occurred in 27% and 11% of patients, respectively. Mean changes in cardiovascular parameters, including blood pressure and pulse, were generally not considered clinically significant. EPS-related TEAEs that occurred in

  9. Long-term healthcare costs and functional outcomes associated with lack of remission in schizophrenia: a post-hoc analysis of a prospective observational study

    PubMed Central

    2012-01-01

    Background Little is known about the long-term outcomes for patients with schizophrenia who fail to achieve symptomatic remission. This post-hoc analysis of a 3-year study compared the costs of mental health services and functional outcomes between individuals with schizophrenia who met or did not meet cross-sectional symptom remission at study enrollment. Methods This post-hoc analysis used data from a large, 3-year prospective, non-interventional observational study of individuals treated for schizophrenia in the United States conducted between July 1997 and September 2003. At study enrollment, individuals were classified as non-remitted or remitted using the Schizophrenia Working Group Definition of symptom remission (8 core symptoms rated as mild or less). Mental health service use was measured using medical records. Costs were based on the sites’ medical information systems. Functional outcomes were measured with multiple patient-reported measures and the clinician-rated Quality of Life Scale (QLS). Symptoms were measured using the Positive and Negative Syndrome Scale (PANSS). Outcomes for non-remitted and remitted patients were compared over time using mixed effects models for repeated measures or generalized estimating equations after adjusting for multiple baseline characteristics. Results At enrollment, most of the 2,284 study participants (76.1%) did not meet remission criteria. Non-remitted patients had significantly higher PANSS total scores at baseline, a lower likelihood of being Caucasian, a higher likelihood of hospitalization in the previous year, and a greater likelihood of a substance use diagnosis (all p < 0.05). Total mental health costs were significantly higher for non-remitted patients over the 3-year study (p = 0.008). Non-remitted patients were significantly more likely to be victims of crime, exhibit violent behavior, require emergency services, and lack paid employment during the 3-year study (all p < 0.05). Non-remitted patients also

  10. Design and Analysis of A Beacon-Less Routing Protocol for Large Volume Content Dissemination in Vehicular Ad Hoc Networks

    PubMed Central

    Hu, Miao; Zhong, Zhangdui; Ni, Minming; Baiocchi, Andrea

    2016-01-01

    Large volume content dissemination is pursued by the growing number of high quality applications for Vehicular Ad hoc NETworks(VANETs), e.g., the live road surveillance service and the video-based overtaking assistant service. For the highly dynamical vehicular network topology, beacon-less routing protocols have been proven to be efficient in achieving a balance between the system performance and the control overhead. However, to the authors’ best knowledge, the routing design for large volume content has not been well considered in the previous work, which will introduce new challenges, e.g., the enhanced connectivity requirement for a radio link. In this paper, a link Lifetime-aware Beacon-less Routing Protocol (LBRP) is designed for large volume content delivery in VANETs. Each vehicle makes the forwarding decision based on the message header information and its current state, including the speed and position information. A semi-Markov process analytical model is proposed to evaluate the expected delay in constructing one routing path for LBRP. Simulations show that the proposed LBRP scheme outperforms the traditional dissemination protocols in providing a low end-to-end delay. The analytical model is shown to exhibit a good match on the delay estimation with Monte Carlo simulations, as well. PMID:27809285

  11. Design and Analysis of A Beacon-Less Routing Protocol for Large Volume Content Dissemination in Vehicular Ad Hoc Networks.

    PubMed

    Hu, Miao; Zhong, Zhangdui; Ni, Minming; Baiocchi, Andrea

    2016-11-01

    Large volume content dissemination is pursued by the growing number of high quality applications for Vehicular Ad hoc NETworks(VANETs), e.g., the live road surveillance service and the video-based overtaking assistant service. For the highly dynamical vehicular network topology, beacon-less routing protocols have been proven to be efficient in achieving a balance between the system performance and the control overhead. However, to the authors' best knowledge, the routing design for large volume content has not been well considered in the previous work, which will introduce new challenges, e.g., the enhanced connectivity requirement for a radio link. In this paper, a link Lifetime-aware Beacon-less Routing Protocol (LBRP) is designed for large volume content delivery in VANETs. Each vehicle makes the forwarding decision based on the message header information and its current state, including the speed and position information. A semi-Markov process analytical model is proposed to evaluate the expected delay in constructing one routing path for LBRP. Simulations show that the proposed LBRP scheme outperforms the traditional dissemination protocols in providing a low end-to-end delay. The analytical model is shown to exhibit a good match on the delay estimation with Monte Carlo simulations, as well.

  12. Effect of vitamin D3 on bone turnover markers in critical illness: post hoc analysis from the VITdAL-ICU study.

    PubMed

    Schwetz, V; Schnedl, C; Urbanic-Purkart, T; Trummer, C; Dimai, H P; Fahrleitner-Pammer, A; Putz-Bankuti, C; Christopher, K B; Obermayer-Pietsch, B; Pieber, T R; Dobnig, H; Amrein, K

    2017-08-25

    In this post hoc analysis of the VITdAL-ICU study, an RCT in critically ill adults with 25-hydroxyvitamin D levels ≤20 ng/ml, vitamin D3 did not have a significant effect on β-Crosslaps and osteocalcin. Observational studies have shown accelerated bone loss in ICU survivors. A reversible contributor is vitamin D deficiency. In a post hoc analysis of the VITdAL-ICU study, we evaluated the effect of high-dose vitamin D3 on the bone turnover markers (BTM) β-Crosslaps (CTX) and osteocalcin (OC). The VITdAL-ICU study was a randomized, double-blind, placebo-controlled trial in critically ill adults with 25-hydroxyvitamin D levels ≤20 ng/ml who received placebo or high-dose vitamin D3 (a loading dose of 540,000 IU and starting 1 month after the loading dose five monthly maintenance doses of 90,000 IU). In this analysis on 289 survivors (209 telephone, 80 personal follow-up visits), BTM were analyzed on days 0, 3, 7, 28, and 180; self-reported falls and fractures were assessed. Bone mineral density (BMD) was measured after 6 months. At baseline, CTX was elevated; OC was low in both groups-after 6 months, both had returned to normal. There were no differences between groups concerning BTM, BMD, falls, or fractures. In linear mixed effects models, CTX and OC showed a significant change over time (p < 0.001, respectively), but there was no difference between the vitamin D and placebo group (p = 0.688 and p = 0.972, respectively). Vitamin D supplementation did not have a significant effect on BTM. Further studies should assess the effectiveness of vitamin D on musculoskeletal outcomes in ICU survivors.

  13. Neuromathematical Trichotomous Mixed Methods Analysis: Using the Neuroscientific Tri-Squared Test Statistical Metric as a Post Hoc Analytic to Determine North Carolina School of Science and Mathematics Leadership Efficacy

    ERIC Educational Resources Information Center

    Osler, James Edward, II; Mason, Letita R.

    2016-01-01

    This study examines the leadership efficacy amongst graduates of The North Carolina School of Science and Mathematics (NCSSM) for the classes of 2000 through 2007 from a neuroscientific and neuromathematic perspective. NCSSM alumni (as the primary unit of analysis) were examined using a novel neuromathematic post hoc method of analysis. This study…

  14. Safety and effectiveness of daily teriparatide for osteoporosis in patients with severe stages of chronic kidney disease: post hoc analysis of a postmarketing observational study

    PubMed Central

    Nishikawa, Atsushi; Yoshiki, Fumito; Taketsuna, Masanori; Kajimoto, Kenta; Enomoto, Hiroyuki

    2016-01-01

    Teriparatide (recombinant 1–34 N-terminal sequence of human parathyroid hormone) for the treatment of osteoporosis should be prescribed with caution in patients with severe stages of chronic kidney disease (CKD). However, in clinical settings, physicians and surgeons who treat such patients have few available options. We sought to further explore the safety and effectiveness of teriparatide for the treatment of osteoporosis in Japanese patients with severe stages of CKD. This was a post hoc analysis of a postmarketing surveillance study that included patients with osteoporosis at high risk of fracture and stage 4 or 5 CKD. Patients received subcutaneous teriparatide 20 μg daily for up to 24 months. Safety profiles were assessed by physician-reported adverse drug reactions (ADRs). Effectiveness was assessed by measuring bone formation (via procollagen type 1 N-terminal propeptide [P1NP]), bone mineral density (BMD), and the incidence of clinical vertebral or nonvertebral fragility fractures. A total of 33 patients with severe stages of CKD (stage 4, n=30; stage 5, n=3) were included. All patients were female, and 81.8% had a history of previous fracture. No serious ADRs were recorded; a total of 4 ADRs were recorded for 4 of 33 patients. Increases in BMD and P1NP levels were observed both overall and in most individual patients. New fractures occurred in 1 patient with stage 5 CKD, but not in patients with stage 4 CKD. In this post hoc analysis conducted in Japan, teriparatide appeared to be effective for the treatment of osteoporosis in elderly female patients with severe stages of CKD, and no new safety concerns were observed. PMID:27895472

  15. Erythropoietin in patients with traumatic brain injury and extracranial injury-A post hoc analysis of the erythropoietin traumatic brain injury trial.

    PubMed

    Skrifvars, Markus B; Bailey, Michael; French, Craig; Presneill, Jeffrey; Nichol, Alistair; Little, Lorraine; Duranteau, Jacques; Huet, Olivier; Haddad, Samir; Arabi, Yaseen; McArthur, Colin; Cooper, D James; Bellomo, Rinaldo

    2017-09-01

    Erythropoietin (EPO) may reduce mortality after traumatic brain injury (TBI). Secondary brain injury is exacerbated by multiple trauma, and possibly modifiable by EPO. We hypothesized that EPO decreases mortality more in TBI patients with multiple trauma, than in patients with TBI alone. A post hoc analysis of the EPO-TBI randomized controlled trial conducted in 2009 to 2014. To evaluate the impact of injuries outside the brain, we calculated an extracranial Injury Severity Score (ISS) that included the same components of the ISS, excluding head and face components. We defined multiple trauma as two injured body regions with an Abbreviated Injury Scale (AIS) score of 3 or higher. Cox regression analyses, allowing for potential differential responses per the presence or absence of extracranial injury defined by these injury scores, were used to assess the effect of EPO on time to mortality. Of 603 included patients, the median extracranial ISS was 6 (interquartile range, 1-13) and 258 (43%) had an AIS score of 3 or higher in at least two body regions. On Cox regression, EPO was associated with decreased mortality in patients with greater extracranial ISS (interaction p = 0.048) and weakly associated with differential mortality with multiple trauma (AIS score > 3 or in two regions, interaction p = 0.17). At 6 months in patients with extracranial ISS higher than 6, 10 (6.8%) of 147 EPO-treated patients compared with 26 (17%) of 154 placebo-treated patients died (risk reduction, 10%; 95% confidence interval, 2.9-17%; p = 0.007). In this post hoc analysis, EPO administration was associated with a potential differential improvement in 6-month mortality in TBI patients with more severe extracranial injury. These findings need confirmation in future clinical and experimental studies. Therapeutic study, level III.

  16. Nausea and Vomiting following Balanced Xenon Anesthesia Compared to Sevoflurane: A Post-Hoc Explorative Analysis of a Randomized Controlled Trial

    PubMed Central

    Fahlenkamp, Astrid V.; Stoppe, Christian; Cremer, Jan; Biener, Ingeborg A.; Peters, Dirk; Leuchter, Ricarda; Eisert, Albrecht; Apfel, Christian C.; Rossaint, Rolf; Coburn, Mark

    2016-01-01

    Objective Like other inhalational anesthetics xenon seems to be associated with post-operative nausea and vomiting (PONV). We assessed nausea incidence following balanced xenon anesthesia compared to sevoflurane, and dexamethasone for its prophylaxis in a randomized controlled trial with post-hoc explorative analysis. Methods 220 subjects with elevated PONV risk (Apfel score ≥2) undergoing elective abdominal surgery were randomized to receive xenon or sevoflurane anesthesia and dexamethasone or placebo after written informed consent. 93 subjects in the xenon group and 94 subjects in the sevoflurane group completed the trial. General anesthesia was maintained with 60% xenon or 2.0% sevoflurane. Dexamethasone 4mg or placebo was administered in the first hour. Subjects were analyzed for nausea and vomiting in predefined intervals during a 24h post-anesthesia follow-up. Results Logistic regression, controlled for dexamethasone and anesthesia/dexamethasone interaction, showed a significant risk to develop nausea following xenon anesthesia (OR 2.30, 95% CI 1.02–5.19, p = 0.044). Early-onset nausea incidence was 46% after xenon and 35% after sevoflurane anesthesia (p = 0.138). After xenon, nausea occurred significantly earlier (p = 0.014), was more frequent and rated worse in the beginning. Dexamethasone did not markedly reduce nausea occurrence in both groups. Late-onset nausea showed no considerable difference between the groups. Conclusion In our study setting, xenon anesthesia was associated with an elevated risk to develop nausea in sensitive subjects. Dexamethasone 4mg was not effective preventing nausea in our study. Group size or dosage might have been too small, and change of statistical analysis parameters in the post-hoc evaluation might have further contributed to a limitation of our results. Further trials will be needed to address prophylaxis of xenon-induced nausea. Trial Registration EU Clinical Trials EudraCT-2008-004132-20 ClinicalTrials.gov NCT

  17. Efficacy of Rotigotine at Different Stages of Parkinson’s Disease Symptom Severity and Disability: A Post Hoc Analysis According to Baseline Hoehn and Yahr Stage

    PubMed Central

    Giladi, Nir; Nicholas, Anthony P.; Asgharnejad, Mahnaz; Dohin, Elisabeth; Woltering, Franz; Bauer, Lars; Poewe, Werner

    2016-01-01

    Background: The efficacy of rotigotine has been demonstrated in studies of patients with early (i.e. not receiving levodopa) and advanced (i.e. not adequately controlled on levodopa; average 2.5 h/day in ‘off’ state) Parkinson’s disease (PD). Objective: To further investigate the efficacy of rotigotine transdermal patch across different stages of PD symptom severity and functional disability, according to baseline Hoehn and Yahr (HY) staging. Methods: Post hoc analysis of six placebo-controlled studies of rotigotine in patients with early PD (SP506, SP512, SP513; rotigotine ≤8 mg/24 h) or advanced-PD (CLEOPATRA-PD, PREFER, SP921; rotigotine ≤16 mg/24 h). Data were pooled and analyzed according to baseline HY stage (1, 2, 3 or 4) for change from baseline to end of maintenance in Unified Parkinson’s Disease Rating Scale (UPDRS) II (activities of daily living), UPDRS III (motor) and UPDRS II+III; statistical tests are exploratory. Results: Data were available for 2057 patients (HY 1 : 262; HY 2 : 1230; HY 3 : 524; HY 4 : 41). Patients at higher HY stages were older, had a longer time since PD diagnosis and higher baseline UPDRS II+III scores vs patients at lower HY stages. Rotigotine improved UPDRS II+III versus placebo for each individual HY stage (p < 0.05 for each HY stage), with treatment differences increasing with increasing HY stages. Similar results were observed for UPDRS II and UPDRS III. Conclusions: This post hoc analysis suggests that rotigotine may be efficacious across a broad range of progressive stages of PD symptom severity and functional disability (HY stages 1–4). PMID:27567886

  18. Quality of life in Japanese women with postmenopausal osteoporosis treated with raloxifene and vitamin D: post hoc analysis of a postmarketing study.

    PubMed

    Ohta, Hiroaki; Hamaya, Etsuro; Taketsuna, Masanori; Sowa, Hideaki

    2015-01-01

    To assess the effect of active vitamin D3 on quality of life (QOL) and pain in raloxifene-treated Japanese women with postmenopausal osteoporosis. This is a post hoc analysis of a previous prospective postmarketing observational study conducted without a comparator group. This study was conducted in 60 Japanese hospitals from September 2007 to February 2009. We compared changes from baseline in QOL and pain in patients receiving raloxifene plus active vitamin D3 with those in patients receiving raloxifene monotherapy at 8 and 24 weeks after treatment. Japan Pharmaceutical Information Center (JapicCTI-070465). QOL and pain were assessed using Short Form-8 (SF-8), European Quality of Life Instrument 5 Dimensions (EQ-5D), Japanese Osteoporosis Quality of Life Questionnaire (JOQOL), visual analogue pain scales (VAS pain), and pain frequency scores. A total of 506 patients were included in the post hoc analysis. Both raloxifene monotherapy (RLX, n = 354) and active vitamin D3 cotreatment (COMBI, n = 152) significantly improved QOL and reduced pain from the baseline at Week 8 and Week 24. The COMBI group had significantly greater improvements in JOQOL total score and activity of daily living (total) domain at Week 24 and last observation carried forward (LOCF) than the RLX group. The COMBI group also had significantly greater improvements in SF-8 domains of general health (at Week 8, Week 24, and LOCF), role physical (at Week 24 and LOCF), and mental health (at LOCF) than the RLX group. The COMBI group also had significantly greater reduction in VAS pain at LOCF than the RLX group (mean [SD]: RLX = -0.99 [2.72], COMBI = -1.54 [2.21], P = 0.042). Active vitamin D3 supplementation to raloxifene treatment for 24 weeks may have additional benefits in improving QOL and relieving pain in Japanese women with postmenopausal osteoporosis.

  19. The effect of macrobiotic Ma-Pi 2 diet on systemic inflammation in patients with type 2 diabetes: a post hoc analysis of the MADIAB trial

    PubMed Central

    Soare, Andreea; Del Toro, Rossella; Roncella, Elena; Khazrai, Yeganeh Manon; Angeletti, Silvia; Dugo, Laura; Fallucca, Sara; Fontana, Lucia; Altomare, Maria; Formisano, Valeria; Capata, Francesca; Gesuita, Rosaria; Manfrini, Silvia; Fallucca, Francesco; Pianesi, Mario; Pozzilli, Paolo

    2015-01-01

    Introduction Current guidelines for the management of type 2 diabetes (T2D) emphasize diet as essential therapy. However, the effect of diet on systemic inflammation remains unclear. We investigated the effects of consuming a macrobiotic Ma-Pi 2 diet versus a standard recommended diet (control diet) on markers of inflammation in patients with T2D. Methods This was a post hoc analysis of the MADIAB trial, a 21-day randomized controlled trial conducted in 51 patients (25 males and 26 females) with T2D. Patients were randomized 1:1 to the Ma-Pi 2 macrobiotic diet or a control diet based on dietary guidelines for T2D. Biological antioxidant potential of plasma and circulating levels of high-sensitivity C reactive protein, interleukin-6, tumor necrosis factor-α, and insulin-like growth factor-1 were assessed. Results After 21 days on the Ma-Pi 2 or control diet, markers of inflammation were reduced in both groups. The antioxidant potential of plasma improved significantly in the Ma-Pi group. A significant reduction in insulin growth factor-1 was observed in the Ma-Pi group versus control group (p<0.001). Conclusions Findings of this post hoc analysis demonstrated that the Ma-Pi 2 diet is a safe dietary strategy to reduce levels of the markers of insulin resistance and inflammation, compared with baseline values, in the short term. Furthermore, the Ma-Pi 2 diet was superior to the control diet in reducing insulin growth factor-1 and may be beneficial for patients with T2D. Trial registration number Current Controlled Trials ISRCTN10467793. PMID:25852946

  20. Has number of previous episodes any effect on response to group psychoeducation in bipolar patients? A 5-year follow-up post hoc analysis.

    PubMed

    Colom, Francesc; Reinares, María; Pacchiarotti, Isabella; Popovic, Dina; Mazzarini, Lorenzo; Martínez-Arán, Anabel; Torrent, Carla; Rosa, Adriane; Palomino-Otiniano, Rosario; Franco, Carolina; Bonnin, Caterina M; Vieta, Eduard

    2010-04-01

    Colom F, Reinares M, Pacchiarotti I, Popovic D, Mazzarini L, Martínez-Arán A, Torrent C, Rosa A, Palomino-Otiniano R, Franco C, Bonnin CM, Vieta E. Has number of previous episodes any effect on response to group psychoeducation in bipolar patients? A 5-year follow-up post hoc analysis. One of the main utilities of staging in bipolar disorder is enhancing the formulation of pharmacological and non-pharmacological treatment strategies. Hence, it is essential to ascertain whether the number of previous episodes influences treatment response. Hereby, we present a 5-year post hoc study on the efficacy of group psychoeducation for bipolar disorders according to the number of previous episodes. For this subanalysis, we have compared the 5-year outcome of 120 euthymic psychoeducated versus non-psychoeducated bipolar patients according to the number of previous episodes at study entry. Patients with more than seven episodes at study entry did not show any significant improvement with psychoeducation according to time to recurrence. Patients with more than 14 episodes did not benefit from psychoeducation in terms of a reduction of time spent ill. Patients with 7 or 8 episodes showed a benefit in terms of fewer days spent in hypomania, depression, mixed episodes or any episodes but not mania, while patients with 9-14 episodes showed a benefit in terms of fewer days spent in hypomania and depression but not in mixed states or mania. Only patients who presented up to 6 episodes showed reduction in time spent in any episode polarity. The number of previous episodes clearly worsens response to psychoeducation, perhaps in a more subtle way than that observed with other psychological therapies. Psychoeducation should be delivered as soon as possible in the illness course, supporting the idea of early intervention.

  1. The Value of Abdominal Drainage After Laparoscopic Cholecystectomy for Mild or Moderate Acute Calculous Cholecystitis: A Post Hoc Analysis of a Randomized Clinical Trial.

    PubMed

    Prevot, Flavien; Fuks, David; Cosse, Cyril; Pautrat, Karine; Msika, Simon; Mathonnet, Muriel; Khalil, Haitham; Mauvais, François; Regimbeau, Jean-Marc

    2016-11-01

    Although the preoperative management of mild and moderate (Grade I-II) acute calculous cholecystitis (ACC) has been standardized, there is no consensus on the value of abdominal drainage after early cholecystectomy. In a post hoc analysis of a randomized controlled trial (NCT01015417) focused on the value of postoperative antibiotic therapy in patients with ACC, we determined the value of abdominal drainage in patients having undergone laparoscopic cholecystectomy for Grades I-II ACC. All postoperative complications were analyzed after using a propensity score. A post hoc test was used to assess the statistical robustness of our results. Of the 414 enrolled patients, 178 did not have abdominal drainage (forming the no-drainage group) and 236 had drainage (the drainage group). After matching on PS, the deep incisional site infection was 1.1 versus 0.8 %, p = 0.78. This result is similar for the superficial incisional site infections; the distant infections; the overall morbidity, and the readmission rate. Only the hospital length of stay was significantly longer in the drainage group (3.3 vs. 5.1 days, p = 0.003). Neither abdominal drainage nor the absence of postoperative antibiotic therapy was found to be a risk factor for deep incisional site infections. The use of abdominal drainage depends on the surgeon's personal preferences but is often used in high-risk populations. However, abdominal drainage does not appear to be of any benefit (in terms of postoperative outcomes) and may even compromise recovery in patients having undergone early laparoscopic cholecystectomy for mild or moderate ACC.

  2. Vitamin D supplementation improves well-being in patients with frequent respiratory tract infections: a post hoc analysis of a randomized, placebo-controlled trial.

    PubMed

    Bergman, Peter; Norlin, Anna-Carin; Hansen, Susanne; Björkhem-Bergman, Linda

    2015-09-29

    The aim of this study was to test the hypothesis that vitamin D supplementation improves well-being in patients with frequent respiratory tract infections (RTIs). We performed a post hoc analysis of a randomized, placebo-controlled and double-blind study in which patients with frequent RTIs were randomized to placebo or vitamin D (4000 IE/day for 1 year, n = 124). At the last visit of the study, patients were asked to perform a general assessment of their well-being during the study. The majority of patients, both placebo- and vitamin D treated, stated that they had felt 'better' during the study; 52% in the placebo group and 70% in the vitamin D group, relative risk 1.3 (95% CI 1.0-1.8; p = 0.06, Fisher's exact test). Statement of better well-being was associated with an increase in 25-hydroxyvitamin D (25-OHD) levels (p < 0.001). In contrast, worse well-being was associated with unchanged 25-OHD levels. Notably, a 25-OHD level above 100 nmol/L at the study end was associated with a higher chance of having a better well-being (p < 0.01). Four patients on anti-depressive treatment could terminate their antidepressant medication during the study. These patients had a significant increase in 25-OHD levels from low levels at study-start. Vitamin D supplementation to patients with frequent RTIs might be beneficial, not only for infections, but also for their general well-being. However, given the post hoc design of this study, these findings need to be confirmed in additional clinical trials before firm conclusions can be drawn. http://www.clinicaltrials.gov (NCT01131858), registered March 22, 2010.

  3. Tolvaptan use in cancer patients with hyponatremia due to the syndrome of inappropriate antidiuretic hormone: a post hoc analysis of the SALT-1 and SALT-2 trials.

    PubMed

    Gralla, Richard J; Ahmad, Fatima; Blais, Jaime D; Chiodo, Joseph; Zhou, Wen; Glaser, Linda A; Czerwiec, Frank S

    2017-03-02

    Hyponatremia is a common electrolyte disorder in cancer patients and has been associated with poor prognosis. A frequent cause of cancer-related hyponatremia is the syndrome of inappropriate antidiuretic hormone (SIADH). This study was a post hoc subgroup analysis of the SALT-1 (Study of Ascending Levels of Tolvaptan in Hyponatremia) and SALT-2 clinical trials. Hyponatremic subjects with SIADH and cancer received the oral selective vasopressin V2-receptor antagonist tolvaptan (n = 12) or matching placebo (n = 16) once-daily for 30 days. The initial tolvaptan dose (15 mg) was titrated over 4 days to 30 or 60 mg per day, as needed, according to serum sodium level and tolerability. Baseline serum sodium levels in the SIADH/cancer cohort of the SALT trials was 130 and 128 mEq/L for tolvaptan and placebo, respectively. Mean change from baseline in average daily serum sodium AUC for tolvaptan relative to placebo was 5.0 versus -0.3 mEq/L (P < 0.0001) at day 4, and 6.9 versus 1.0 mEq/L (P < 0.0001) at day 30; the observed treatment effects were similar to those in the overall SIADH population (i.e., with and without cancer) at both time points. Serum sodium normalization was observed in 6/12 and 0/13 subjects at day 4 and 7/8 and 2/6 subjects at day 30 in the tolvaptan and placebo groups, respectively (P < 0.05 for both). Common treatment-emergent AEs for tolvaptan were consistent with previously reported results. In this post hoc study of the SALT trial population, oral tolvaptan was an effective and safe therapy for the treatment of hyponatremia in subjects with SIADH and cancer.

  4. Subsequent Chemotherapy and Treatment Patterns After Abiraterone Acetate in Patients with Metastatic Castration-resistant Prostate Cancer: Post Hoc Analysis of COU-AA-302.

    PubMed

    de Bono, Johann S; Smith, Matthew R; Saad, Fred; Rathkopf, Dana E; Mulders, Peter F A; Small, Eric J; Shore, Neal D; Fizazi, Karim; De Porre, Peter; Kheoh, Thian; Li, Jinhui; Todd, Mary B; Ryan, Charles J; Flaig, Thomas W

    2017-04-01

    Treatment patterns for metastatic castration-resistant prostate cancer (mCRPC) have changed substantially in the last few years. In trial COU-AA-302 (chemotherapy-naïve men with mCRPC), abiraterone acetate plus prednisone (AA) significantly improved radiographic progression-free survival and overall survival (OS) when compared to placebo plus prednisone (P). This post hoc analysis investigated clinical responses to docetaxel as first subsequent therapy (FST) among patients who progressed following protocol-specified treatment with AA, and characterized subsequent treatment patterns among older (≥75 yr) and younger (<75 yr) patient subgroups. Data were collected at the final OS analysis (96% of expected death events). Subsequent therapy data were prospectively collected, while response and discontinuation data were collected retrospectively following discontinuation of the study drug. At the discretion of the investigator, 67% (365/546) of patients from the AA arm received subsequent treatment with one or more agents approved for mCRPC. Efficacy analysis was performed for patients for whom baseline and at least one post-baseline prostate-specific antigen (PSA) values were available. Baseline and at least one post-baseline PSA values were available for 100 AA patients who received docetaxel as FST. While acknowledging the limitations of post hoc analyses, 40% (40/100) of these patients had an unconfirmed ≥50% PSA decline with first subsequent docetaxel therapy, and 27% (27/100) had a confirmed ≥50% PSA decline. The median docetaxel treatment duration among these 100 patients was 4.2 mo. Docetaxel was the most common FST among older and younger patients from each treatment arm. However, 43% (79/185) of older patients who progressed on AA received no subsequent therapy for mCRPC, compared with 17% (60/361) of younger patients. Patients with mCRPC who progress with AA treatment may still derive benefit from subsequent docetaxel therapy. These data support further

  5. Lurasidone for major depressive disorder with mixed features and anxiety: a post-hoc analysis of a randomized, placebo-controlled study.

    PubMed

    Tsai, Joyce; Thase, Michael E; Mao, Yongcai; Ng-Mak, Daisy; Pikalov, Andrei; Loebel, Antony

    2017-04-01

    The aim of this post-hoc analysis was to evaluate the efficacy of lurasidone in treating patients with major depressive disorder (MDD) with mixed features who present with mild and moderate-to-severe levels of anxiety. The data in this analysis were derived from a study of patients meeting the DSM-IV-TR criteria for unipolar MDD, with a Montgomery-Åsberg Depression Rating Scale (MADRS) total score ≥26, presenting with two or three protocol-defined manic symptoms, who were randomized to 6 weeks of double-blind treatment with either lurasidone 20-60 mg/day (n=109) or placebo (n=100). Anxiety severity was evaluated using the Hamilton Anxiety Rating Scale (HAM-A). To evaluate the effect of baseline anxiety on response to lurasidone, the following two anxiety groups were defined: mild anxiety (HAM-A≤14) and moderate-to-severe anxiety (HAM-A≥15). Change from baseline in MADRS total score was analyzed for each group using a mixed model for repeated measures. Treatment with lurasidone was associated with a significant week 6 change versus placebo in MADRS total score for patients with both mild anxiety (-18.4 vs. -12.8, p<0.01, effect size [ES]=0.59) and moderate-to-severe anxiety (-22.0 vs. -13.0, p<0.001, ES=0.95). Treatment with lurasidone was associated with a significant week 6 change versus placebo in HAM-A total score for patients with both mild anxiety (-7.6 vs. -4.0, p<0.01, ES=0.62), and moderate-to-severe anxiety (-11.4 vs. -6.1, p<0.0001, ES=0.91). In this post-hoc analysis of an MDD with mixed features and anxiety population, treatment with lurasidone was associated with significant improvement in both depressive and anxiety symptoms in subgroups with mild and moderate-to-severe levels of anxiety at baseline.

  6. Pregabalin versus SSRIs and SNRIs in benzodiazepine-refractory outpatients with generalized anxiety disorder: a post hoc cost-effectiveness analysis in usual medical practice in Spain

    PubMed Central

    De Salas-Cansado, Marina; Olivares, José M; Álvarez, Enrique; Carrasco, Jose L; Barrueta, Andoni; Rejas, Javier

    2012-01-01

    Background Generalized anxiety disorder (GAD) is a prevalent health condition which seriously affects both patient quality of life and the National Health System. The aim of this research was to carry out a post hoc cost-effectiveness analysis of the effect of pregabalin versus selective serotonin reuptake inhibitors (SSRIs)/serotonin norepinephrine reuptake inhibitors (SNRIs) in treated benzodiazepine-refractory outpatients with GAD. Methods This post hoc cost-effectiveness analysis used secondary data extracted from the 6-month cohort, prospective, noninterventional ADAN study, which was conducted to ascertain the cost of illness in GAD subjects diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria. Benzodiazepine-refractory subjects were those who claimed persistent symptoms of anxiety and showed a suboptimal response (Hamilton Anxiety Rating Scale ≥ 16) to benzodiazepines, alone or in combination, over 6 months. Patients could switch to pregabalin (as monotherapy or addon) or to an SSRI or SNRI, alone or in combination. Effectiveness was expressed as quality-adjusted life years gained, and the perspective was that of the National Health System in the year 2008. A sensitivity analysis was performed using bootstrapping techniques (10,000 resamples were obtained) in order to obtain a cost-effectiveness plane and a corresponding acceptability curve. Results A total of 282 subjects (mean Hamilton Anxiety Rating Scale score 25.8) were identified, comprising 157 in a pregabalin group and 125 in an SSRI/SNRI group. Compared with SSRI/SNRI, pregabalin (average dose 163 mg/day) was associated with higher quality-adjusted life years gained (0.1086 ± 0.0953 versus 0.0967 ± 0.1003, P = 0.334), but increased health care costs (€1014 ± 762 versus €846 ± 620, P = 0.166) and drug costs (€376 ± 252 versus 220 ± 140, P < 0.001), resulting in an incremental cost-effectiveness ratio of €25,304 (95% confidence interval

  7. Antiosteoporotic Activity of Genistein Aglycone in Postmenopausal Women: Evidence from a Post-Hoc Analysis of a Multicenter Randomized Controlled Trial

    PubMed Central

    Arcoraci, Vincenzo; Atteritano, Marco; Squadrito, Francesco; D’Anna, Rosario; Marini, Herbert; Santoro, Domenico; Minutoli, Letteria; Messina, Sonia; Altavilla, Domenica; Bitto, Alessandra

    2017-01-01

    Genistein has a preventive role against bone mass loss during menopause. However, experimental data in animal models of osteoporosis suggest an anti-osteoporotic potential for this isoflavone. We performed a post-hoc analysis of a previously published trial investigating the effects of genistein in postmenopausal women with low bone mineral density. The parent study was a randomized, double-blind, placebo-controlled trial involving postmenopausal women with a femoral neck (FN) density <0.795 g/cm2. A cohort of the enrolled women was, in fact, identified at the baseline as osteoporotic (n = 121) on the basis of their T-score and analyzed thereafter for the 24 months’ treatment with either 1000 mg of calcium and 800 IU vitamin D3 (placebo; n = 59); or calcium, vitamin D3, and Genistein aglycone (54 mg/day; genistein; n = 62). According to the femoral neck T-scores, 31.3% of the genistein and 30.9% of the placebo recipients were osteoporotic at baseline. In the placebo and genistein groups, the 10-year hip fracture probability risk assessed by Fracture Risk Assessment tool (FRAX) was 4.1 ± 1.9 (SD) and 4.2 ± 2.1 (SD), respectively. Mean bone mineral density (BMD) at the femoral neck increased from 0.62 g/cm2 at baseline to 0.68 g/cm2 at 1 year and 0.70 g/cm2 at 2 years in genistein recipients, and decreased from 0.61 g/cm2 at baseline to 0.60 g/cm2 at 1 year and 0.57 g/cm2 at 2 years in placebo recipients. At the end of the study only 18 postmenopausal women had osteoporosis in the genistein group with a prevalence of 12%, whereas in the placebo group the number of postmenopausal women with osteoporosis was unchanged, after 24 months. This post-hoc analysis is a proof-of concept study suggesting that genistein may be useful not only in postmenopausal osteopenia but also in osteoporosis. However, this proof-of concept study needs to be confirmed by a large, well designed, and appropriately focused randomized clinical trial in a population at high risk of fractures

  8. Antiosteoporotic Activity of Genistein Aglycone in Postmenopausal Women: Evidence from a Post-Hoc Analysis of a Multicenter Randomized Controlled Trial.

    PubMed

    Arcoraci, Vincenzo; Atteritano, Marco; Squadrito, Francesco; D'Anna, Rosario; Marini, Herbert; Santoro, Domenico; Minutoli, Letteria; Messina, Sonia; Altavilla, Domenica; Bitto, Alessandra

    2017-02-22

    Genistein has a preventive role against bone mass loss during menopause. However, experimental data in animal models of osteoporosis suggest an anti-osteoporotic potential for this isoflavone. We performed a post-hoc analysis of a previously published trial investigating the effects of genistein in postmenopausal women with low bone mineral density. The parent study was a randomized, double-blind, placebo-controlled trial involving postmenopausal women with a femoral neck (FN) density <0.795 g/cm². A cohort of the enrolled women was, in fact, identified at the baseline as osteoporotic (n = 121) on the basis of their T-score and analyzed thereafter for the 24 months' treatment with either 1000 mg of calcium and 800 IU vitamin D3 (placebo; n = 59); or calcium, vitamin D3, and Genistein aglycone (54 mg/day; genistein; n = 62). According to the femoral neck T-scores, 31.3% of the genistein and 30.9% of the placebo recipients were osteoporotic at baseline. In the placebo and genistein groups, the 10-year hip fracture probability risk assessed by Fracture Risk Assessment tool (FRAX) was 4.1 ± 1.9 (SD) and 4.2 ± 2.1 (SD), respectively. Mean bone mineral density (BMD) at the femoral neck increased from 0.62 g/cm² at baseline to 0.68 g/cm² at 1 year and 0.70 g/cm² at 2 years in genistein recipients, and decreased from 0.61 g/cm² at baseline to 0.60 g/cm² at 1 year and 0.57 g/cm² at 2 years in placebo recipients. At the end of the study only 18 postmenopausal women had osteoporosis in the genistein group with a prevalence of 12%, whereas in the placebo group the number of postmenopausal women with osteoporosis was unchanged, after 24 months. This post-hoc analysis is a proof-of concept study suggesting that genistein may be useful not only in postmenopausal osteopenia but also in osteoporosis. However, this proof-of concept study needs to be confirmed by a large, well designed, and appropriately focused randomized clinical trial in a population at high risk of

  9. Tolerability of cariprazine in the treatment of acute bipolar I mania: A pooled post hoc analysis of 3 phase II/III studies.

    PubMed

    Earley, Willie; Durgam, Suresh; Lu, Kaifeng; Debelle, Marc; Laszlovszky, István; Vieta, Eduard; Yatham, Lakshmi N

    2017-06-01

    Atypical antipsychotics have broad-spectrum efficacy against core symptoms of acute mania/mixed states in bipolar disorder; however, they are associated with clinically significant adverse effects (AEs). This post hoc analysis evaluated the safety and tolerability of the atypical antipsychotic cariprazine in the treatment of adult patients with acute manic/mixed episodes of bipolar I disorder. Data were taken from three 3-week randomized, double-blind, placebo-controlled, flexible-dose trials of cariprazine 3-12mg/d. Patient subgroups categorized by modal daily dose (3-6mg/d; 9-12mg/d) were used to assess dose response. The pooled safety population comprised 1065 patients (placebo=442; cariprazine 3-6mg/d=263; cariprazine 9-12mg/d=360). More cariprazine- than placebo-treated patients reported double-blind treatment-emergent AEs; the overall AE incidence was similar among cariprazine-dose groups. AEs reported in ≥5% of cariprazine patients overall with at least twice the incidence of placebo were akathisia, extrapyramidal symptoms, restlessness, and vomiting. The incidence of SAEs was low and similar between the placebo- and cariprazine-treatment groups. Metabolic parameter changes were small and generally similar between cariprazine and placebo groups; mean increases in fasting glucose levels were greater with cariprazine (3-6mg/d=6.6mg/dL; 9-12mg/d=7.2mg/dL) than placebo (1.7mg/dL). Mean weight change was 0.54kg and 0.17kg for cariprazine and placebo, respectively; weight increase ≥7% was <3% in all treatment groups. Cariprazine was not associated with clinically meaningful changes in electrocardiogram parameters. Post hoc analysis, flexible-dose design, short trial duration. Cariprazine was generally safe and well-tolerated in patients with manic/mixed episodes associated with bipolar I disorder. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  10. Telavancin for Acute Bacterial Skin and Skin Structure Infections, a Post Hoc Analysis of the Phase 3 ATLAS Trials in Light of the 2013 FDA Guidance

    PubMed Central

    Pushkin, Richard; Barriere, Steven L.; Corey, G. Ralph; Stryjewski, Martin E.

    2015-01-01

    Two phase 3 ATLAS trials demonstrated noninferiority of telavancin compared with vancomycin for complicated skin and skin structure infections. Data from these trials were retrospectively evaluated according to 2013 U.S. Food and Drug Administration (FDA) guidance on acute bacterial skin and skin structure infections. This post hoc analysis included patients with lesion sizes of ≥75 cm2 and excluded patients with ulcers or burns (updated all-treated population; n = 1,127). Updated day 3 (early) clinical response was defined as a ≥20% reduction in lesion size from baseline and no rescue antibiotic. Updated test-of-cure (TOC) clinical response was defined as a ≥90% reduction in lesion size, no increase in lesion size since day 3, and no requirement for additional antibiotics or significant surgical procedures. Day 3 (early) clinical responses were achieved in 62.6% and 61.0% of patients receiving telavancin and vancomycin, respectively (difference, 1.7%, with a 95% confidence interval [CI] of −4.0% to 7.4%). Updated TOC visit cure rates were similar for telavancin (68.0%) and vancomycin (63.3%), with a difference of 4.8% (95% CI, −0.7% to 10.3%). Adopting current FDA guidance, this analysis corroborates previous noninferiority findings of the ATLAS trials of telavancin compared with vancomycin. PMID:26248356

  11. Telavancin for Acute Bacterial Skin and Skin Structure Infections, a Post Hoc Analysis of the Phase 3 ATLAS Trials in Light of the 2013 FDA Guidance.

    PubMed

    Pushkin, Richard; Barriere, Steven L; Wang, Whedy; Corey, G Ralph; Stryjewski, Martin E

    2015-10-01

    Two phase 3 ATLAS trials demonstrated noninferiority of telavancin compared with vancomycin for complicated skin and skin structure infections. Data from these trials were retrospectively evaluated according to 2013 U.S. Food and Drug Administration (FDA) guidance on acute bacterial skin and skin structure infections. This post hoc analysis included patients with lesion sizes of ≥75 cm(2) and excluded patients with ulcers or burns (updated all-treated population; n = 1,127). Updated day 3 (early) clinical response was defined as a ≥20% reduction in lesion size from baseline and no rescue antibiotic. Updated test-of-cure (TOC) clinical response was defined as a ≥90% reduction in lesion size, no increase in lesion size since day 3, and no requirement for additional antibiotics or significant surgical procedures. Day 3 (early) clinical responses were achieved in 62.6% and 61.0% of patients receiving telavancin and vancomycin, respectively (difference, 1.7%, with a 95% confidence interval [CI] of -4.0% to 7.4%). Updated TOC visit cure rates were similar for telavancin (68.0%) and vancomycin (63.3%), with a difference of 4.8% (95% CI, -0.7% to 10.3%). Adopting current FDA guidance, this analysis corroborates previous noninferiority findings of the ATLAS trials of telavancin compared with vancomycin.

  12. Safety and Tolerability of Nafamostat Mesilate and Heparin as Anticoagulants in Leukocytapheresis for Ulcerative Colitis: Post Hoc Analysis of a Large-Scale, Prospective, Observational Study.

    PubMed

    Sawada, Koji; Ohdo, Maiko; Ino, Tomoko; Nakamura, Takashi; Numata, Toyoko; Shibata, Hiroshi; Sakou, Jun-ichi; Kusada, Masahiro; Hibi, Toshifumi

    2016-04-01

    Nafamostat mesilate is the first anticoagulant of choice for leukocytapheresis (LCAP) with a Cellsorba E column for treating ulcerative colitis (UC). However, because of complications, mainly due to allergy to nafamostat mesilate, heparin may be used as a substitute. To evaluate the safety and tolerability of nafamostat mesilate and heparin as anticoagulants in LCAP for UC, we conducted post hoc analysis of data from a large-scale, prospective, observational study of LCAP, which was conducted at 116 medical facilities in Japan between May 2010 and December 2012. Of 832 patients included in this analysis, nafamostat mesilate and heparin were used in 676 (81.3%) and 113 (13.6%), respectively. There were no significant differences in the incidence of adverse reactions (8.6% vs. 7.1%) and intrafilter pressure increases (12.7% vs. 16.8%) between the nafamostat mesilate and heparin groups. Adverse reactions of hemorrhage or blood pressure decreases associated with heparin use were not observed. There were no significant differences in rates of clinical remission (69.1% vs. 68.1%) and mucosal healing (62.9% vs. 63.6%) between the nafamostat mesilate and heparin groups. Thus, the safety and tolerability were comparable in the nafamostat mesilate and heparin groups, indicating that both nafamostat mesilate and heparin can be well tolerated as anticoagulants in LCAP for UC.

  13. Improvement of gastrointestinal health status in subjects consuming Lactobacillus reuteri NCIMB 30242 capsules: a post-hoc analysis of a randomized controlled trial.

    PubMed

    Jones, Mitchell L; Martoni, Christopher J; Ganopolsky, Jorge G; Sulemankhil, Imran; Ghali, Peter; Prakash, Satya

    2013-12-01

    Gastrointestinal (GI) symptoms are conditions that are frequently observed in clinical practice. A post-hoc analysis has been undertaken to evaluate the effect of bile salt hydrolase-active L. reuteri NCIMB 30242 on GI health status based on Rome III questionnaire response in otherwise healthy hypercholesterolemic subjects. A total of 127 subjects received either L. reuteri NCIMB 30242 or placebo capsules over a 9-week intervention in a randomized, double-blind, placebo-controlled, parallel-arm, multicenter study. Subjects were asked to complete the Rome III diagnostic GI questionnaire prior to the baseline and end point visits of the clinical study. GI health status was evaluated, per questionnaire, by assessing all questions with 5- or 7-point response scales for symptoms of the stomach and intestines. Subjects receiving L. reuteri NCIMB 30242 reported significant improvements in general GI health status (p = 0.029) and in symptoms related to diarrhea (p = 0.018) as compared to placebo over the intervention period. Further, a greater proportion of L. reuteri-treated subjects showed improved general GI health status (p = 0.042) and improved diarrhea symptoms (p = 0.03). L. reuteri NCIMB 30242 capsules appear to be well tolerated and potentially beneficial for GI health status. Further clinical investigation is warranted for the treatment of functional GI disorders.

  14. Impact of Preoperative Radiotherapy on Anastomotic Leakage and Stenosis After Rectal Cancer Resection: Post Hoc Analysis of a Randomized Controlled Trial.

    PubMed

    Qin, Qiyuan; Ma, Tenghui; Deng, Yanhong; Zheng, Jian; Zhou, Zhiyang; Wang, Hui; Wang, Lei; Wang, Jianping

    2016-10-01

    Evidence regarding the effect of preoperative radiotherapy on anastomotic integrity remains conflicting in rectal cancer surgery. Prospective comparisons with appropriate controls are needed. This study aimed to assess the impact of preoperative radiotherapy on anastomotic leakage and stenosis after rectal cancer resection. This was a post hoc analysis of a randomized controlled trial (NCT01211210). Data were retrieved from the leading center of the trial, which is a tertiary hospital. The full analysis population of 318 patients was included. Patients were randomly assigned to receive preoperative radiation (50 Gy per 25 fractions) and 5-fluorouracil infusion, alone (arm A) or combined with oxaliplatin (arm B), or preoperative chemotherapy with 5-fluorouracil and oxaliplatin without radiation (arm C). The rates of anastomotic leakage and stenosis were calculated for each treatment arm. Multivariate analysis was used to verify the effect of preoperative radiotherapy. The treatment arms were comparable in terms of most baseline characteristics, but more diversions were used in the chemoradiotherapy arms. Anastomotic leakage occurred in 20.2% of patients in arm A, 23.6% of patients in arm B, and 8.5% of patients in arm C (p = 0.007). The corresponding rates of stenosis were 17.0%, 18.9%, and 6.8% (p = 0.02). Multivariate analysis confirmed the correlation between preoperative radiotherapy and clinical leakage (p = 0.02), which was associated with delayed stenosis (p < 0.001). For patients undergoing chemoradiotherapy, radiation proctitis was identified as an independent risk factor for clinical leakage (p = 0.01) and stenosis (p < 0.001). The main limitations were discrepancies in stoma creation and chemotherapy regimen among the treatment arms. Preoperative radiotherapy increases the risk of anastomotic leakage and stenosis after rectal cancer resection. Clinical leakage independently contributes to the development of stenosis.

  15. Effect of dutasteride on clinical progression of benign prostatic hyperplasia in asymptomatic men with enlarged prostate: a post hoc analysis of the REDUCE study.

    PubMed

    Toren, Paul; Margel, David; Kulkarni, Girish; Finelli, Antonio; Zlotta, Alexandre; Fleshner, Neil

    2013-04-15

    To assess the role of dutasteride in preventing clinical progression of benign prostatic hyperplasia in asymptomatic men with larger prostates. Post hoc analysis of four year, double blind Reduction by Dutasteride of Prostate Cancer Events (REDUCE) study 1617 men randomised to dutasteride or placebo with a prostate size >40 mL and baseline International Prostate Symptom Score (IPSS) <8. Subjects who took medications for benign prostatic hyperplasia were excluded at study entry. Placebo or dutasteride 0.5 mg daily. Comparison of risk of clinical progression of benign prostatic hyperplasia at four years (defined as a ≥ 4 point worsening on IPSS, acute urinary retention, urinary tract infection, or surgery related to benign prostatic hyperplasia). 825 participants took placebo, 792 took dutasteride. A total of 464 (29%) experienced clinical progression benign prostatic hyperplasia, 297(36%) taking placebo, 167 (21%) taking dutasteride (P<0.001). The relative risk reduction was 41% and the absolute risk reduction 15%, with a number needed to treat (NNT) of 7. Among men who had acute urinary retention and surgery related to benign prostatic hyperplasia, the absolute risk reduction for dutasteride was 6.0% and 3.8%, respectively. On multivariable regression analysis adjusting for covariates, dutasteride significantly reduced clinical progression of benign prostatic hyperplasia with an odds ratio of 0.47 (95% CI 0.37 to 0.59, P<0.001). Analysis of time to first event yielded a hazard ratio of 0.673 (P<0.001) for those taking dutasteride. Sexual adverse events were most common and similar to prior reports. Further prospective studies may be warranted to demonstrate generalisability of these results. This study is the first to explore the benefit of treating asymptomatic or mildly symptomatic men with an enlarged prostate. Dutasteride significantly decreased the incidence of benign prostatic hyperplasia clinical progression.

  16. Effect of dutasteride on clinical progression of benign prostatic hyperplasia in asymptomatic men with enlarged prostate: a post hoc analysis of the REDUCE study

    PubMed Central

    Toren, Paul; Margel, David; Kulkarni, Girish; Finelli, Antonio; Zlotta, Alexandre

    2013-01-01

    Objective To assess the role of dutasteride in preventing clinical progression of benign prostatic hyperplasia in asymptomatic men with larger prostates. Design Post hoc analysis of four year, double blind Reduction by Dutasteride of Prostate Cancer Events (REDUCE) study Participants 1617 men randomised to dutasteride or placebo with a prostate size >40 mL and baseline International Prostate Symptom Score (IPSS) <8. Subjects who took medications for benign prostatic hyperplasia were excluded at study entry. Interventions Placebo or dutasteride 0.5 mg daily. Main outcome measures Comparison of risk of clinical progression of benign prostatic hyperplasia at four years (defined as a ≥4 point worsening on IPSS, acute urinary retention, urinary tract infection, or surgery related to benign prostatic hyperplasia). Results 825 participants took placebo, 792 took dutasteride. A total of 464 (29%) experienced clinical progression benign prostatic hyperplasia, 297(36%) taking placebo, 167 (21%) taking dutasteride (P<0.001). The relative risk reduction was 41% and the absolute risk reduction 15%, with a number needed to treat (NNT) of 7. Among men who had acute urinary retention and surgery related to benign prostatic hyperplasia, the absolute risk reduction for dutasteride was 6.0% and 3.8%, respectively. On multivariable regression analysis adjusting for covariates, dutasteride significantly reduced clinical progression of benign prostatic hyperplasia with an odds ratio of 0.47 (95% CI 0.37 to 0.59, P<0.001). Analysis of time to first event yielded a hazard ratio of 0.673 (P<0.001) for those taking dutasteride. Sexual adverse events were most common and similar to prior reports. Limitations Further prospective studies may be warranted to demonstrate generalisability of these results. Conclusions This study is the first to explore the benefit of treating asymptomatic or mildly symptomatic men with an enlarged prostate. Dutasteride significantly decreased the incidence of

  17. Effects of statins on the progression of cerebral white matter lesion: Post hoc analysis of the ROCAS (Regression of Cerebral Artery Stenosis) study.

    PubMed

    Mok, Vincent C T; Lam, Wynnie W M; Fan, Yu Hua; Wong, Adrian; Ng, Ping Wing; Tsoi, Tak Hon; Yeung, Vincent; Wong, Ka Sing

    2009-05-01

    Arteriosclerotic related cerebral white matter lesion (WML) is associated with increased risk of death, stroke, dementia, depression, gait disturbance, and urinary incontinence. We investigated the effects of statins on WML progression by performing a post hoc analysis on the ROCAS (Regression of Cerebral Artery Stenosis) study, which is a randomized, double-blind, placebo-controlled study evaluating the effects of statins upon asymptomatic middle cerebral artery stenosis progression among stroke-free individuals. Two hundreds and eight randomized subjects were assigned to either placebo (n = 102) or simvastatin 20 mg daily (n = 106) for 2 years. Baseline severity of WML was graded visually into none, mild, and severe. Volume (cm3) of WML was determined quantitatively at baseline and at end of study using a semi-automated method based on MRI. Primary outcome was the change in WML volume over 2 years. After 2 years of follow-up, there was no significant change in WML volume between the active and the placebo group as a whole. However, stratified analysis showed that for those with severe WML at baseline, the median volume increase in the active group (1.9 cm3) was less compared with that in the placebo group (3.0 cm3; P = 0.047). Linear multivariate regression analysis identified that baseline WML volume (beta = 0.63, P < 0.001) and simvastatin treatment (beta = -0.214, P = 0.043) independently predicted change in WML volume. Our findings suggest that statins may delay the progression of cerebral WML only among those who already have severe WML at baseline.

  18. Delay Analysis of Max-Weight Queue Algorithm for Time-Varying Wireless Ad hoc Networks—Control Theoretical Approach

    NASA Astrophysics Data System (ADS)

    Chen, Junting; Lau, Vincent K. N.

    2013-01-01

    Max weighted queue (MWQ) control policy is a widely used cross-layer control policy that achieves queue stability and a reasonable delay performance. In most of the existing literature, it is assumed that optimal MWQ policy can be obtained instantaneously at every time slot. However, this assumption may be unrealistic in time varying wireless systems, especially when there is no closed-form MWQ solution and iterative algorithms have to be applied to obtain the optimal solution. This paper investigates the convergence behavior and the queue delay performance of the conventional MWQ iterations in which the channel state information (CSI) and queue state information (QSI) are changing in a similar timescale as the algorithm iterations. Our results are established by studying the stochastic stability of an equivalent virtual stochastic dynamic system (VSDS), and an extended Foster-Lyapunov criteria is applied for the stability analysis. We derive a closed form delay bound of the wireless network in terms of the CSI fading rate and the sensitivity of MWQ policy over CSI and QSI. Based on the equivalent VSDS, we propose a novel MWQ iterative algorithm with compensation to improve the tracking performance. We demonstrate that under some mild conditions, the proposed modified MWQ algorithm converges to the optimal MWQ control despite the time-varying CSI and QSI.

  19. Maternal waterpipe smoke exposure and the risk of asthma and allergic diseases in childhood: A post hoc analysis.

    PubMed

    Waked, Mirna; Salameh, Pascale

    2015-01-01

    This analysis was conducted with the objective of evaluating association between waterpipe passive smoking exposure and asthma, and allergies among Lebanese children. Data were taken from a crosssectional study on children from public and private schools. A sample of 22 schools participated in the study, where standardized written core questionnaires were distributed. From 5 to 12-year-old students filled in the questionnaires at home, while 13-14-year-old students filled it in in the class. In total, 5522 children were evaluated for the prevalence of asthma, allergic rhinitis and atopic eczema, and their associated factors, including waterpipe exposure due to parents' smoking. The descriptive results of parental smoking were, as follows: among mothers: 1609 (29%) mothers smoked cigarettes, 385 (7%) smoked waterpipe and 98 (1.8%) smoked both; among fathers: 2449 (44.2%) smoked cigarettes, 573 (10.3%) smoked waterpipe and 197 (3.5%) smoked both. Maternal waterpipe smoking was significantly and moderately associated with allergic diseases (p < 0.001; ORa = 1.71), including probable asthma, rhinitis and dermatitis (p < 0.001 for all). Quite on the opposite, father's waterpipe smoking was not associated with any of the diseases. Parental cigarette smoking demonstrated some positive effects: father's cigarette smoking did not show association with dermatitis or asthma diagnosed by a physician, while mother's cigarette smoking showed a positive association only with probable asthma. Moreover, no interactions between cigarette and waterpipe smoking were observed. Maternal waterpipe smoking should be regarded as a high risk behavior; however, additional studies are necessary to confirm this finding. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  20. Neutrophil Gelatinase-Associated Lipocalin as a Diagnostic Marker for Acute Kidney Injury in Oliguric Critically Ill Patients: A Post-Hoc Analysis

    PubMed Central

    Egal, Mohamud; de Geus, Hilde R.H.; Groeneveld, A.B. Johan

    2016-01-01

    Background Oliguria occurs frequently in critically ill patients, challenging clinicians to distinguish functional adaptation from serum-creatinine-defined acute kidney injury (AKIsCr). We investigated neutrophil gelatinase-associated lipocalin (NGAL)'s ability to differentiate between these 2 conditions. Methods This is a post-hoc analysis of a prospective cohort of adult critically ill patients. Patients without oliguria within the first 6 h of admission were excluded. Plasma and urinary NGAL were measured at 4 h after admission. AKIsCr was defined using the AKI network criteria with pre-admission serum creatinine or lowest serum creatinine value during the admission as the baseline value. Hazard ratios for AKIsCr occurrence within 72 h were calculated using Cox regression and adjusted for risk factors such as sepsis, pre-admission serum creatinine, and urinary output. Positive predictive values (PPV) and negative predictive values (NPV) were calculated for the optimal cutoffs for NGAL. Results Oliguria occurred in 176 patients, and 61 (35%) patients developed AKIsCr. NGAL was a predictor for AKIsCr in univariate and multivariate analysis. When NGAL was added to a multivariate model including sepsis, pre-admission serum creatinine and lowest hourly urine output, it outperformed the latter model (plasma p = 0.001; urinary p = 0.048). Cutoff values for AKIsCr were 280 ng/ml for plasma (PPV 80%; NPV 79%), and 250 ng/ml for urinary NGAL (PPV 58%; NPV 78%). Conclusions NGAL can be used to distinguish oliguria due to the functional adaptation from AKIsCr, directing resources to patients more likely to develop AKIsCr. PMID:27505067

  1. Combination of transcatheter arterial chemoembolization and interrupted dosing sorafenib improves patient survival in early-intermediate stage hepatocellular carcinoma: A post hoc analysis of the START trial.

    PubMed

    Lee, Teng-Yu; Lin, Chen-Chun; Chen, Chiung-Yu; Wang, Tsang-En; Lo, Gin-Ho; Chang, Chi-Sen; Chao, Yee

    2017-09-01

    The survival benefit of treatment for unresectable hepatocellular carcinoma (HCC) with transcatheter arterial chemoembolization (TACE) combined with sorafenib remains uncertain. We compared the survival of patients treated with TACE and sorafenib with that of patients treated with TACE alone. This was a post hoc analysis of the Study in Asia of the Combination of TACE with Sorafenib in Patients with HCC (START) trial. All patients who received TACE and interrupted dosing of sorafenib for early or intermediate-stage HCC in Taiwan from 2009 to 2010 were recruited into the TACE and sorafenib group. They were randomly matched 1:1 by age, sex, Child-Pugh score, tumor size, tumor number, and tumor stage with patients from Taichung Veterans General Hospital in Taiwan who received TACE alone and who fulfilled the selection criteria of the START trial during the same time period (control group). Patient survival [cumulative incidence and hazard ratio (HR)] of the 2 groups were analyzed and compared. The baseline characteristics of the 36 patients in each group were similar. Tumor response rates were significantly better in the TACE and sorafenib group (P < .04). Overall survival of the TACE and sorafenib group was also significantly better than that of the control (TACE alone) group over the 2 years [78%, 95% confidence interval (95% CI) 64-91 vs 49, 95% CI 32-66; P = .012]. In the multivariate regression analysis, TACE and sorafenib was found to be independently associated with a decreased risk of mortality (HR 0.33, 95% CI 0.12-0.89; P = .015). Multivariate stratified analyses verified this association in each patient subgroup (all HR < 1.0). With a high patient tolerance to an interrupted sorafenib dosing schedule, the combination of TACE with sorafenib was associated with improved overall survival in early-intermediate stage HCC when compared with treatment with TACE alone.

  2. Risk-based evaluation of efficacy of rolofylline in patients hospitalized with acute heart failure - Post-hoc analysis of the PROTECT trial.

    PubMed

    Demissei, Biniyam G; Postmus, Douwe; Liu, Licette C Y; Cleland, John G; O'Connor, Christopher M; Metra, Marco; Ponikowski, Piotr; Teerlink, John R; Cotter, Gad; Davison, Beth A; Edwards, Christopher; Givertz, Michael M; Bloomfield, Daniel M; Dittrich, Howard C; Voors, Adriaan A; Hillege, Hans L

    2016-11-15

    The selective adenosine A1 receptor antagonist rolofylline showed a neutral overall result on clinical outcomes in the PROTECT trial. However, we hypothesized that response to rolofylline treatment could be influenced by underlying clinical risk. We performed a post-hoc analysis of the PROTECT trial - a large, double-blind, randomized, placebo-controlled trial that enrolled 2033 patients. Baseline risk of 180-day all-cause mortality was estimated using a previously published 8-item model. Evaluation of efficacy of rolofylline across subpopulations defined based on estimated risk of mortality was performed using subpopulation treatment effect pattern plot (STEPP) analysis. Findings were validated in an independent cohort of acute heart failure patients. Median estimated risk of mortality was 13.0%, IQR [8.0%-23.0%] and was comparable between the rolofylline and placebo arms. In low to intermediate risk subgroups of patients, rolofylline was associated with a higher rate of 180-day all-cause mortality (11.9% in the rolofylline versus 8.4% in the placebo arms, p=0.050). In the high risk subgroup of patients, particularly those with estimated risk of mortality between 20% and 30%, 180-day all-cause mortality rate was markedly lower in the rolofylline arm (18.4% in the rolofylline versus 34.0% in the placebo arms, p=0.003). The trend towards potential harm with rolofylline treatment in the low to intermediate risk subpopulations and significant benefit in high risk patients was also observed in the validation cohort. Our findings suggest that selective adenosine A1 receptor antagonism could be harmful in low risk acute heart failure patients, while it might significantly benefit higher risk patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. Safety and efficacy of tiotropium Respimat versus HandiHaler in patients naive to treatment with inhaled anticholinergics: a post hoc analysis of the TIOSPIR trial

    PubMed Central

    Wise, Robert; Calverley, Peter MA; Dahl, Ronald; Dusser, Daniel; Metzdorf, Norbert; Müller, Achim; Fowler, Andy; Anzueto, Antonio

    2015-01-01

    Background: Patients with chronic obstructive pulmonary disease (COPD) who were naive to anticholinergics before the TIOtropium Safety and Performance In Respimat (TIOSPIR) trial may reflect patients seen in practice, in particular in primary care. In addition, investigating safety in these patients avoids the potential bias in patients who previously received anticholinergics and may be tolerant of their effects. Aims: The aim of this study was to evaluate whether patients naive to anticholinergic therapy who were treated with tiotropium Respimat 2.5 or 5 μg had different safety and efficacy outcomes than patients treated with tiotropium HandiHaler 18 μg. Methods: A post hoc analysis of patients who were not receiving anticholinergics before TIOSPIR (N=6,966/17,135) was conducted. Primary end points were risk of death from any cause and risk of COPD exacerbation. Secondary outcomes included severe exacerbation and major adverse cardiovascular events (MACE). Additional analysis of exacerbations was carried out in anticholinergic-naive patients with moderate (GOLD II) disease. Results: Anticholinergic-naive patients had less severe disease than the total TIOSPIR population. Discontinuations because of anticholinergic side effects were infrequent (0.9% overall). Similar to the primary study, patients in the tiotropium Respimat groups had no difference in the risk of death or risk of any or severe exacerbation than patients treated with tiotropium HandiHaler. Risk of MACE was similar across the Respimat and HandiHaler groups. Rates of exacerbations in the subgroup of patients with moderate disease were similar across the Respimat and HandiHaler groups. Conclusions: Tiotropium Respimat and HandiHaler have similar safety and efficacy profiles in patients who are naive to anticholinergic therapy. PMID:26540491

  4. An optimized approach for right atrial flutter ablation: a post hoc analysis of the AURUM 8 study.

    PubMed

    Lewalter, Thorsten; Weiss, Christian; Mewis, Christian; Jung, Werner; Haverkamp, Wilhelm; Proff, Jochen; Bauer, Wolfgang

    2017-03-01

    Radiofrequency catheter ablation of typical atrial flutter can vary largely in duration from patient to patient. The purpose of this work was to determine optimal combination of ablation settings leading to the highest procedural efficacy. Our retrospective multivariate analysis comprised 448 patients undergoing atrial flutter ablation with nonirrigated 8-mm catheters at 19 clinical centers. Four procedural variables were included in the prognostic model: preset maximum temperature, preset maximum power, catheter-tip material (gold vs. platinum-iridium), and ablation technique (maximum voltage-guided vs. conventional anatomical approach). Univariate and multivariate analyses were performed using the logistic regression (for acute ablation success) and Cox constant proportional hazard models (for cumulative ablation time). Significant multivariate predictors of acute ablation success were a higher preset maximum temperature (odds 1.083 per 1 °C, P < 0.05) and gold-tip catheter (odds 2.096, P < 0.05). Predictors of cumulative ablation time were the maximum voltage-guided ablation technique (hazard ratio 1.856, P < 0.001), higher preset maximum temperature (hazard ratio 1.039 per 1 °C, P < 0.001), and gold-tip catheter (hazard ratio 1.225, P < 0.05). The combination of optimal settings (70 °C, 70 W, gold-tip catheter, maximum voltage-guided technique) increased the acute success rate from 91.7 % (for the entire study cohort) to 100 %, and reduced median cumulative ablation time from 8.3 to 4.3 min, median total procedure duration from 76 to 55 min, and median fluoroscopy time from 14 to 7 min. The combination of maximum voltage-guided gold-tip ablation at 70 °C and 70 W was associated with 100 % ablation success and minimal ablation times for nonirrigated ablation of atrial flutter.

  5. Preoperative opioid strength may not affect outcomes of anterior cervical procedures: a post hoc analysis of 2 prospective, randomized trials

    PubMed Central

    Kelly, Michael P.; Anderson, Paul A.; Sasso, Rick C.; Riew, K. Daniel

    2015-01-01

    Object The aim of this study is to evaluate the relationship between preoperative opioid strength and outcomes of anterior cervical decompressive surgery. Methods A retrospective cohort of 1004 patients enrolled in 1 of 2 investigational device exemption studies comparing cervical total disc arthroplasty (TDA) and anterior cervical discectomy and fusion (ACDF) for single-level cervical disease causing radiculopathy or myelopathy was selected. At a preoperative visit, opioid use data, Neck Disability Index (NDI) scores, 36-ltem Short-Form Health Survey (SF-36) scores, and numeric rating scale scores for neck and arm pain were collected. Patients were divided into strong (oxycodone/morphine/meperidine), weak (codeine/propoxyphene/ hydrocodone), and opioid-naïve groups. Preoperative and postoperative (24 months) outcomes scores were compared within and between groups using the paired t-test and ANCOVA, respectively. Results Patients were categorized as follows: 226 strong, 762 weak, and 16 opioid naïve. The strong and weak groups were similar with respect to age, sex, race, marital status, education level, Worker's Compensation status, litigation status, and alcohol use. At 24-month follow-up, no differences in change in arm or neck pain scores (arm: strong –52.3, weak –50.6, naïve –54.0, p = 0.244; neck: strong –52.7, weak –50.8, naïve –44.6, p = 0.355); NDI scores (strong –36.0, weak –33.3, naïve –32.3, p = 0.181); or SF-36 Physical Component Summary scores (strong: 14.1, weak 13.3, naïve 21.7, p = 0.317) were present. Using a 15-point improvement in NDI to determine success, the authors found no between-groups difference in success rates (strong 80.6%, weak 82.7%, naïve 73.3%, p = 0.134). No difference existed between treatment arms (TDA vs ACDF) for any outcome at any time point. Conclusions Preoperative opioid strength did not adversely affect outcomes in this analysis. Careful patient selection can yield good results in this patient

  6. Metabolic syndrome cluster does not provide incremental prognostic information in patients with stable cardiovascular disease: A post hoc analysis of the AIM-HIGH trial.

    PubMed

    Lyubarova, Radmila; Robinson, Jennifer G; Miller, Michael; Simmons, Debra L; Xu, Ping; Abramson, Beth L; Elam, Marshall B; Brown, Todd M; McBride, Ruth; Fleg, Jerome L; Desvigne-Nickens, Patrice; Ayenew, Woubeshet; Boden, William E

    Metabolic syndrome (MS) is a well-known risk factor for the development of cardiovascular (CV) disease; yet, controversy persists whether it adds incremental prognostic value in patients with established CV disease. This study was performed to determine if MS is associated with worse CV outcomes in patients with established CV disease treated intensively with statins. We performed a post hoc analysis of the Atherothrombosis Intervention in Metabolic Syndrome with Low HDL/High Triglycerides and Impact on Global Health Outcomes trial, in which patients with established CV disease and atherogenic dyslipidemia (n = 3414) were randomly assigned to receive extended release niacin or placebo during a mean 36-month follow-up, to assess whether the presence of MS or the number of MS components contributed to CV outcomes. The composite primary end point of CV events occurred in 15.1% of patients without MS vs 13.8%, 16.9%, and 16.8% of patients with MS in the subsets with 3, 4, and 5 MS components, respectively (corresponding adjusted hazard ratios 0.9, 1.1, and 1.1 relative to patients without MS), P = .55. Comparing subgroups with 3 vs 4 or 5 MS components, there was no significant difference in either the composite primary end point or secondary end points. Patients with diabetes mellitus had higher event rates, with or without the presence of MS. The presence of MS was not associated with worse CV outcomes in the AIM-HIGH population. The rate of CV events in statin-treated Atherothrombosis Intervention in Metabolic Syndrome with Low HDL/High Triglycerides and Impact on Global Health Outcomes patients with MS was not significantly influenced by the number of MS components. Copyright © 2017 National Lipid Association. All rights reserved.

  7. Improvement in Functional Outcomes With Adjunctive Aripiprazole Versus Placebo in Major Depressive Disorder: A Pooled Post Hoc Analysis of 3 Short-Term Studies

    PubMed Central

    Cain, Zachary J.; Ammerman, Diane; Eudicone, James M.; Tang, Yan; Rollin, Linda M.; Forbes, Robert A.; Berman, Robert M.; Baker, Ross A.

    2012-01-01

    Objective: To evaluate the effect of adjunctive aripiprazole to antidepressant therapy (ADT) on functional outcomes, as assessed by the Sheehan Disability Scale (SDS). Method: A post hoc analysis of pooled data from 3 similarly designed randomized, placebo-controlled trials was conducted (CN138-139 [September 2004–December 2006], CN138-163 [June 2004–April 2006], and CN138-165 [March 2005–April 2008]). Patients with DSM-IV major depressive disorder who had a prior inadequate response to ADT received adjunctive aripiprazole or placebo to standard ADT. The change from baseline to endpoint on total SDS score and on individual SDS domains and the distributional categorical shifts of patient-reported severity of functional impairment on the SDS were assessed. Results: Aripiprazole compared to placebo augmentation produced significant improvements in self-reported functioning levels in the SDS mean total score (–1.2 vs –0.7, P ≤ .001) and social life (–1.4 vs –0.7, P ≤ .001) and family life (–1.4 vs –0.7, P ≤ .001) domains. Additionally, a significant number of patients exhibited a shift from a severe/moderate level of impairment at baseline to a mild level of functional impairment after 6 weeks of adjunctive aripiprazole treatment compared with placebo in the SDS mean total score (P = .001) and social life (P ≤ .001) and family life (P = .001) scores. Conclusions: Aripiprazole augmentation of standard antidepressant therapy resulted in significant improvements in both total and individual domains of functioning, as assessed by the SDS, with significant categorical shifts from severe/moderate to mild levels of functioning compared with placebo augmentation. Trial Registration: ClinicalTrials.gov identifiers: NCT00095823, NCT00095758, and NCT00105196 PMID:23585999

  8. Post-Hoc analysis of a head-to-head hyaluronic acid comparison in knee osteoarthritis using the 2004 OMERACT-OARSI responder criteria.

    PubMed

    Onel, Erol; Kolsun, Kathleen; Kauffman, Jeffrey I

    2008-01-01

    Several intra-articular hyaluronic acid products are available for treating osteoarthritis (OA) of the knee, including hylan G-F 20 and the bioengineered straight-chain hyaluronic acid (Bio-HA). A recently published study in patients with knee OA demonstrated non-inferiority with regard to efficacy, using the pain subscore of the Western Ontario and McMaster Universities Osteoarthritis Index (safety data favoured Bio-HA with regard to knee effusions). However, the Osteoarthritis Research Society International (OARSI) Standing Committee for Clinical Trials Response Criteria Initiative together with the Outcome Measures in Rheumatology (OMERACT) committee have published new response criteria for OA clinical trials. These criteria focus on change in pain and physical function. The aim of this study was to reanalyse the data from the original comparative study of hylan G-F 20 and Bio-HA in knee OA utilising the new OMERACT-OARSI response criteria. The original study was a prospective, multicentre, randomized, double-blind trial of 321 patients with knee OA who received hylan G-F 20 or Bio-HA via three intra-articular injections 1 week apart. This post-hoc analysis of the data using the modified OMERACT-OARSI responder criteria focused only on efficacy. Using the OMERACT-OARSI criteria, 112 of the 157 patients (71%) receiving Bio-HA were considered to have a response compared with 99 of the 158 patients (63%) receiving hylan G-F 20 (p = 0.10). Application of the new, standardized definition of a responder in OA clinical trials to the existing data reinforces that Bio-HA is non-inferior to hylan G-F 20 for knee OA. Both agents were similarly well tolerated, but Bio-HA was associated with a lower incidence of effusions, suggesting that Bio-HA has an improved risk-benefit profile compared with hylan G-F 20.

  9. Factors influencing patients' recovery and the efficacy of a psychosocial post-discharge intervention: post hoc analysis of a randomized controlled trial.

    PubMed

    Hengartner, Michael P; Passalacqua, Silvia; Heim, Gisela; Andreae, Andreas; Rössler, Wulf; von Wyl, Agnes

    2016-12-01

    The aim of this post hoc analysis was to examine self-reported recovery following a post-discharge intervention and to focus on the moderators of this intervention programme. RCT using parallel group block randomisation, including 151 patients with ≤3 hospitalisations within the last 3 years, a GAF score ≤60, and aged 18-64 years, assessed at two psychiatric hospitals from Zurich, Switzerland, between September 2011 and February 2014. In the present study, the main outcome was the OQ-45 as assessed prior to discharge from the index hospitalisation and at 12-month follow-up. Participants received either the post-discharge intervention provided by a social worker or treatment as usual (TAU). Patients in the intervention group showed substantially less recovery over the 12-month observation period than controls (d = 0.44). In the TAU group, 15.6 % remained clinically impaired at 12-month follow-up as opposed to 48.1 % in the intervention group (p = 0.001). Among participants in the intervention group, an interdisciplinary meeting of significant network members was associated with less recovery (d = 0.46). Involuntary index admission (d = 0.42) and high educational degree (d = 0.52) were significant moderators of the intervention. Both factors related to less recovery over time in the intervention group relative to TAU. According to the OQ-45, this psychosocial post-discharge intervention revealed an unintended negative effect on self-reported recovery over time. Specifically, the meeting of significant network members related to a moderate deteriorating effect, suggesting that the involvement of some carers, relatives, or friends may cause harm to the patient. Considering with reservation pending replication, these findings could have important implications for brief interventions targeted at patients' social networks. This study was supported by a private foundation. ISRCTN58280620.

  10. Effect of pegloticase on renal function in patients with chronic kidney disease: a post hoc subgroup analysis of 2 randomized, placebo-controlled, phase 3 clinical trials.

    PubMed

    Yood, Robert A; Ottery, Faith D; Irish, William; Wolfson, Marsha

    2014-01-21

    Pegloticase is approved in the US for treatment of refractory chronic gout. Since chronic kidney disease (CKD) is common in these patients, we conducted a post-hoc analysis of 2 replicate phase 3 trials and the subsequent open-label extension study to determine the effects of pegloticase on renal function in patients with CKD stages 3 and 4, as well as the effects of renal dysfunction on pegloticase efficacy and safety. Patients with renal insufficiency were randomized to pegloticase 8 mg every 2 weeks (n = 42), pegloticase 8 mg every 4 weeks (n = 41), or placebo (n = 20) for 6 months as defined by the study protocols. Renal function was assessed by estimated glomerular filtration rate (eGFR). All patients completing the randomized trials could participate in an open-label extension study for a further 2.5 years. Uric acid response, the primary end point in the trials, was plasma uric acid <6.0 mg/dl for 80% of months 3 and 6.Mean eGFR in both pegloticase dosing cohorts remained constant over the randomized treatment phase and long-term open-label extension study. The number of patients achieving uric acid response was similar across CKD stages (32% stage 1, 23% stage 2, 35% stage 3, and 39% stage 4, respectively, P = 0.3). There was no difference in the pegloticase safety profile based on CKD stage. Pegloticase treatment does not impact eGFR in CKD patients and response to pegloticase is independent of CKD stage. Clinical trial identifier: NCT00325195.

  11. Effect of pegloticase on renal function in patients with chronic kidney disease: a post hoc subgroup analysis of 2 randomized, placebo-controlled, phase 3 clinical trials

    PubMed Central

    2014-01-01

    Background Pegloticase is approved in the US for treatment of refractory chronic gout. Since chronic kidney disease (CKD) is common in these patients, we conducted a post-hoc analysis of 2 replicate phase 3 trials and the subsequent open-label extension study to determine the effects of pegloticase on renal function in patients with CKD stages 3 and 4, as well as the effects of renal dysfunction on pegloticase efficacy and safety. Findings Patients with renal insufficiency were randomized to pegloticase 8 mg every 2 weeks (n = 42), pegloticase 8 mg every 4 weeks (n = 41), or placebo (n = 20) for 6 months as defined by the study protocols. Renal function was assessed by estimated glomerular filtration rate (eGFR). All patients completing the randomized trials could participate in an open-label extension study for a further 2.5 years. Uric acid response, the primary end point in the trials, was plasma uric acid <6.0 mg/dl for 80% of months 3 and 6. Mean eGFR in both pegloticase dosing cohorts remained constant over the randomized treatment phase and long-term open-label extension study. The number of patients achieving uric acid response was similar across CKD stages (32% stage 1, 23% stage 2, 35% stage 3, and 39% stage 4, respectively, P = 0.3). There was no difference in the pegloticase safety profile based on CKD stage. Conclusions Pegloticase treatment does not impact eGFR in CKD patients and response to pegloticase is independent of CKD stage. Trial registration Clinical trial identifier: NCT00325195 PMID:24447425

  12. The impact of treatment with indacaterol in patients with COPD: A post-hoc analysis according to GOLD 2011 categories A to D.

    PubMed

    Kerstjens, Huib A M; Deslée, Gaëtan; Dahl, Ronald; Donohue, James F; Young, David; Lawrence, David; Kornmann, Oliver

    2015-06-01

    Indacaterol is an inhaled, once-daily, ultra-long-acting β2-agonist for the treatment of chronic obstructive pulmonary disease (COPD). We report on the effectiveness of indacaterol and other bronchodilators compared with placebo in patients across the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2011 categories A to D. A post-hoc, subgroup pooled analysis of 6-month efficacy data from three randomized, placebo-controlled, parallel-group studies involving 3862 patients was performed across GOLD 2011 categories A to D, according to baseline forced expiratory volume in 1 s (FEV1) % predicted, modified Medical Research Council (mMRC) dyspnea scale, and exacerbation history in the 12 months prior to entry. Efficacy of once-daily indacaterol 150 and 300 μg, open-label tiotropium 18 μg, twice-daily salmeterol 50 μg, and formoterol 12 μg was compared with placebo. End points analysed were trough FEV1, transition dyspnea index (TDI), and St George's Respiratory Questionnaire (SGRQ) total score, all at Week 26, and mean rescue medication use over 26 weeks. Indacaterol 150 and 300 μg significantly improved FEV1, compared with placebo across all GOLD groups. Indacaterol 150 and 300 μg also significantly improved TDI, SGRQ total score, and mean rescue medication use compared with placebo across most GOLD subgroups. Treatment selection according to patient's symptoms as well as lung function is an important consideration in maintenance treatment of COPD. Indacaterol 150 and 300 μg effectively improved lung function and symptoms in patients across all GOLD 2011 categories. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Brexpiprazole as adjunctive treatment of major depressive disorder with anxious distress: Results from a post-hoc analysis of two randomised controlled trials.

    PubMed

    McIntyre, Roger S; Weiller, Emmanuelle; Zhang, Peter; Weiss, Catherine

    2016-09-01

    Anxiety symptoms are prevalent in major depressive disorder (MDD) and are associated with greater illness severity, suicidality, impaired functioning and poor response to antidepressant treatment (ADT). The efficacy and safety of brexpiprazole - a serotonin-dopamine activity modulator - as adjunctive treatment in patients with MDD was recently evaluated in two phase 3 studies. We here present a post-hoc analysis of the efficacy of adjunctive brexpiprazole in patients with MDD and symptoms of anxious distress, defined using proxies for DSM-5 criteria. Eligible patients were randomized to 2mg brexpiprazole+ADT or placebo+ADT (NCT01360645); or 1mg brexpiprazole+ADT, 3mg brexpiprazole+ADT, or placebo+ADT (NCT01360632), respectively. Patients were defined as having anxious distress if they had ≥2 of the symptoms tension (MADRS item 3 score ≥3), restlessness (IDS item 24 score ≥2), concentration (MADRS item 6 score ≥3), or apprehension (HAM-D item 10 score ≥3). Primary efficacy endpoint was change in MADRS total score from baseline to Week 6. 55% of the patients had anxious distress at baseline. Adjunctive brexpiprazole showed greater improvement than adjunctive placebo on the primary efficacy endpoint in both patients with (least square mean difference to placebo+ADT: 2mg+ADT: -2.95, p=0.0023; 3mg+ADT: -2.81, p=0.0027); and without anxious distress (1mg+ADT: -2.37, p=0.0093; 3mg+ADT: -2.23, p=0.0131). Brexpiprazole in patients with anxious distress was not associated with an increased incidence of activating adverse events (e.g., akathisia). Adjunctive brexpiprazole 2-3mg may be efficacious in reducing depressive symptoms and is well tolerated, in patients with MDD and anxious distress. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Factors associated with dose escalation of fesoterodine for treatment of overactive bladder in people >65 years of age: A post hoc analysis of data from the SOFIA study.

    PubMed

    Wagg, Adrian; Darekar, Amanda; Arumi, Daniel; Khullar, Vik; Oelke, Matthias

    2015-06-01

    To investigate factors which may influence dose escalation of antimuscarinics for overactive bladder (OAB) in older patients and how dose escalation affects treatment efficacy. A post hoc analysis of data from the 12-week randomized, placebo controlled phase of the SOFIA study investigating treatment with fesoterodine in older people with OAB. Predictors and outcomes in patients aged ≥65 years with OAB who did or did not choose to escalate from fesoterodine 4 to 8 mg before the first dose-escalation choice point (week 4) and at the end of the study (week 12) were assessed. Variables which significantly increased likelihood of dose escalation were, at baseline, body mass index (OR: 1.06, 95% CI 1.01, 1.12; P = 0.0222), and male gender (OR: 2.06, 95% CI 1.28, 3.32; P = 0.0028) and at week 4, change from baseline in urgency episodes (OR: 1.12, 95% CI 1.05, 1.20; P = 0.0008), patient perception of bladder control (PPBC) (OR: 1.44, 95% CI 1.12, 1.84; P = 0.004). At week 12, dose escalation was associated with slightly reduced treatment outcomes compared to week 4 non-escalators. No baseline disease related factor associated with dose escalation was identified. Magnitude of change in urgency episodes and reduction in PPBC at 4 weeks were associated with dose escalation. These data may be of use to healthcare providers as they allow judgement to be made in individual patients, allowing treatment decisions to be made. At end of treatment, improvements in efficacy and quality of life were achieved in both escalators and non-escalators. © 2014 Wiley Periodicals, Inc.

  15. Efficacy and tolerability of fesoterodine versus tolterodine in older and younger subjects with overactive bladder: a post hoc, pooled analysis from two placebo-controlled trials.

    PubMed

    DuBeau, Catherine E; Morrow, Jon D; Kraus, Stephen R; Creanga, Dana; Bavendam, Tamara

    2012-11-01

    To assess the efficacy and tolerability of fesoterodine 8 mg versus tolterodine extended release (ER) 4 mg in subjects with overactive bladder (OAB) stratified by age (<65, 65-74, and ≥75 years). This was a post hoc analysis of data from two double-blind trials. Subjects reporting ≥1 urgency urinary incontinence (UUI) episode and ≥8 micturitions/24 hr at baseline were randomized to fesoterodine (4 mg for 1 week, 8 mg for 11 weeks), tolterodine ER 4 mg, or placebo. Subjects completed 3-day bladder diaries, Urgency Perception Scale (UPS), Patient Perception of Bladder Condition (PPBC), and OAB questionnaire (OAB-q) at baseline and week 12. The primary endpoint in both studies was change from baseline to week 12 in UUI episodes. Among subjects <65 years (n = 2,670), improvements in UUI episodes, micturitions, urgency episodes, severe urgency episodes, frequency-urgency sum, UPS, PPBC, and all OAB-q scales and domains were significantly greater with fesoterodine versus tolterodine ER, and diary-dry rates were significantly higher. Among subjects 65-74 years (n = 990), improvements in mean voided volume per void, PPBC, and OAB-q Symptom Bother and Coping were significantly greater with fesoterodine versus tolterodine ER. Among subjects aged ≥75 years (n = 448), improvements in urgency episodes, severe urgency episodes, frequency-urgency sum, UPS, and OAB-q Symptom Bother were significantly greater with fesoterodine versus tolterodine ER. Both active treatments produced significant improvements in most outcomes versus placebo across age groups. Adverse event rates were similar among age groups. Fesoterodine 8 mg consistently improved several OAB-related variables versus tolterodine ER 4 mg in subjects aged <65, 65-74, and ≥75 years, with some differences reaching statistical significance, and was generally well tolerated. Copyright © 2012 Wiley Periodicals, Inc.

  16. Chronic exposure to ivabradine reduces readmissions in the vulnerable phase after hospitalization for worsening systolic heart failure: a post-hoc analysis of SHIFT.

    PubMed

    Komajda, Michel; Tavazzi, Luigi; Swedberg, Karl; Böhm, Michael; Borer, Jeffrey S; Moyne, Aurélie; Ford, Ian

    2016-09-01

    During the post-discharge phase following a heart failure hospitalization (HFH), patients are at high risk of early readmission despite standard of care therapy. We examined the impact of chronic exposure to ivabradine on early readmissions in patients hospitalized for heart failure during the course of the SHIFT study (Systolic Heart Failure treatment with the If inhibitor ivabradine Trial). A total of 1186 of the 6505 randomized patients experienced at least one HFH during the study, and had a more severe profile than those without HFH. Of these 1186 patients, 334 patients (28%) were rehospitalized within 3 months for any reason, mostly for cardiovascular causes (86%), including HFH (61%). Ivabradine was associated with fewer all-cause hospitalizations at 1 month [incidence rate ratio (IRR) 0.70, 95% confidence interval (CI) 0.50-1.00, P < 0.05], 2 months (IRR 0.75, 95% CI 0.58-0.98, P = 0.03), and 3 months (IRR 0.79, 95% CI 0.63-0.99, P = 0.04). A trend for a reduction in cardiovascular and HF hospitalizations was also observed in ivabradine-treated patients. We demonstrate in this post-hoc analysis that chronic exposure to ivabradine reduces the incidence of all-cause hospitalizations during the vulnerable phase after a HFH. Further studies are needed to investigate if in-hospital or early post-discharge initiation of ivabradine could be useful to improve early outcomes in patients hospitalized for HF. © 2016 The Authors. European Journal of Heart Failure © 2016 European Society of Cardiology.

  17. The Impact of Conscious Sedation versus General Anesthesia for Stroke Thrombectomy on the Predictive Value of Collateral Status: A Post Hoc Analysis of the SIESTA Trial.

    PubMed

    Schönenberger, S; Pfaff, J; Uhlmann, L; Klose, C; Nagel, S; Ringleb, P A; Hacke, W; Kieser, M; Bendszus, M; Möhlenbruch, M A; Bösel, J

    2017-08-01

    Radiologic selection criteria to identify patients likely to benefit from endovascular stroke treatment are still controversial. In this post hoc analysis of the recent randomized Sedation versus Intubation for Endovascular Stroke TreAtment (SIESTA) trial, we aimed to investigate the impact of sedation mode (conscious sedation versus general anesthesia) on the predictive value of collateral status. Using imaging data from SIESTA, we assessed collateral status with the collateral score of Tan et al and graded it from absent to good collaterals (0-3). We examined the association of collateral status with 24-hour improvement of the NIHSS score, infarct volume, and mRS at 3 months according to the sedation regimen. In a cohort of 104 patients, the NIHSS score improved significantly in patients with moderate or good collaterals (2-3) compared with patients with no or poor collaterals (0-1) (P = .011; mean, -5.8 ± 7.6 versus -1.1 ± 10.7). Tan 2-3 was also associated with significantly higher ASPECTS before endovascular stroke treatment (median, 9 versus 7; P < .001) and smaller mean infarct size after endovascular stroke treatment (median, 35.0 versus 107.4; P < .001). When we differentiated the population according to collateral status (0.1 versus 2.3), the sedation modes conscious sedation and general anesthesia were not associated with significant differences in the predictive value of collateral status regarding infarction size or functional outcome. The sedation mode, conscious sedation or general anesthesia, did not influence the predictive value of collaterals in patients with large-vessel occlusion anterior circulation stroke undergoing thrombectomy in the SIESTA trial. © 2017 by American Journal of Neuroradiology.

  18. Discontinuation of treatment of schizophrenic patients is driven by poor symptom response: a pooled post-hoc analysis of four atypical antipsychotic drugs.

    PubMed

    Liu-Seifert, Hong; Adams, David H; Kinon, Bruce J

    2005-12-23

    Stopping antipsychotic treatment can interrupt improvement and exacerbate the illness. The reasons for discontinuing treatment during controlled clinical trials were analyzed to explore this phenomenon. A post-hoc, pooled analysis was made of 4 randomized, double-blind clinical trials, 24-28 weeks in duration, involving 1627 patients with schizophrenia or a related disorder. Analyses combined all the atypical antipsychotic treatment groups in the studies. The majority of patients (53%) stopped their treatment at an early stage. Poor psychiatric response along with worsening symptoms was the most frequently given reason for discontinuing the course (36%), which was substantially more common than discontinuation due to poor tolerability of the medication (12%). This phenomenon was corroborated by less improvement in patients who discontinued treatment compared with those who completed, based on the PANSS total scores. Discontinuation due to poor response was, apparently, more predominantly linked to patient perception than to physicians' conclusions alone (80% vs. 20%). Discontinuation due to patient perception of poor response appeared to occur particularly early in the course of treatment. Patients who discontinued due to poor toleration of the medication responded in a more comparable manner with completers. Discontinuing treatment may lead to exacerbation of symptoms, undermining therapeutic progress. In these studies, poor response to treatment and worsening of underlying psychiatric symptoms, and to a lesser extent, intolerability to medication were the primary contributors to treatment being discontinued. Our findings suggest that adherence may be enhanced by effective symptom control, as objectively measured and as subjectively perceived. Such strategies may improve patients' willingness to undertake long-term therapy and increase the likelihood of a better prognosis.

  19. Growth patterns during the first 12 months of life: post-hoc analysis for South Australian Aboriginal and Caucasian infants in a randomised controlled trial of formula feeding.

    PubMed

    Hawke, Karen; Louise, Jennie; Collins, Carmel; Zhou, Shao J; Brown, Alex; Gibson, Robert; Makrides, Maria

    2017-05-01

    To compare growth characteristics of Aboriginal and Caucasian formula-fed in-fants in the first 12 months of life. We conducted post-hoc data analysis of infants who were part of a previous randomised controlled trial comparing infants randomly assigned to cow or goat milk-based infant formulae. Weight, height, and body composition were assessed at serial time points between study entry (~1-2 weeks of age) and 12 months. There was no growth difference between the randomised groups so the two groups were combined and the data were used to conduct a non-randomised comparison of the growth between Aboriginal (n=11) and Caucasian formula-fed (n=169) infants. Aboriginal formula-fed infants had significantly higher mean z-scores for weight (0.65 difference, [95% CI 0.11, 1.18], p=0.018) and weight-for-length (0.82 difference [95% CI 0.20, 1.44], p=0.010) at 2 months, and all time points onward compared with Caucasian formula-fed infants. Mean length z-scores and the overall growth trajectory across time did not differ between Aboriginal and Caucasian formula-fed infants. Concordant with the weight and weight-for-length z-scores, Aboriginal infants had increased fat mass at 2 months (292 g difference [95% CI 56, 528], p=0.015), and all time points onward compared to Caucasian infants. There was no difference in fat free mass. Though there was only a small number of Aboriginal infants for comparison, our data indicate Aboriginal formu-la-fed infants were heavier and had a larger increase in fat mass over time compared with Caucasian formula-fed infants. Further studies using a larger cohort are needed to substantiate these findings.

  20. Relationship between response to aripiprazole once-monthly and paliperidone palmitate on work readiness and functioning in schizophrenia: A post-hoc analysis of the QUALIFY study.

    PubMed

    Potkin, Steven G; Loze, Jean-Yves; Forray, Carlos; Baker, Ross A; Sapin, Christophe; Peters-Strickland, Timothy; Beillat, Maud; Nylander, Anna-Greta; Hertel, Peter; Nitschky Schmidt, Simon; Ettrup, Anders; Eramo, Anna; Hansen, Karina; Naber, Dieter

    2017-01-01

    Schizophrenia is a chronic disease with negative impact on patients' employment status and quality of life. This post-hoc analysis uses data from the QUALIFY study to elucidate the relationship between work readiness and health-related quality of life and functioning. QUALIFY was a 28-week, randomized study (NCT01795547) comparing the treatment effectiveness of aripiprazole once-monthly 400 mg and paliperidone palmitate once-monthly using the Heinrichs-Carpenter Quality-of-Life Scale as the primary endpoint. Also, patients' capacity to work and work readiness (Yes/No) was assessed with the Work Readiness Questionnaire. We categorized patients, irrespective of treatment, by work readiness at baseline and week 28: No to Yes (n = 41), Yes to Yes (n = 49), or No at week 28 (n = 118). Quality-of-Life Scale total, domains, and item scores were assessed with a mixed model of repeated measures. Patients who shifted from No to Yes in work readiness showed robust improvements on Quality-of-Life Scale total scores, significantly greater than patients not ready to work at week 28 (least squares mean difference: 11.6±2.6, p<0.0001). Scores on Quality-of-Life Scale instrumental role domain and items therein-occupational role, work functioning, work levels, work satisfaction-significantly improved in patients shifting from No to Yes in work readiness (vs patients No at Week 28). Quality-of-Life Scale total scores also significantly predicted work readiness at week 28. Overall, these results highlight a strong association between improvements in health-related quality of life and work readiness, and suggest that increasing patients' capacity to work is an achievable and meaningful goal in the treatment of impaired functioning in schizophrenia.

  1. Effects of calcium channel blocker-based combinations on intra-individual blood pressure variability: post hoc analysis of the COPE trial

    PubMed Central

    Umemoto, Seiji; Ogihara, Toshio; Matsuzaki, Masunori; Rakugi, Hiromi; Ohashi, Yasuo; Saruta, Takao; Ogihara, T; Saruta, T; Matsuzaki, M; Eto, T; Fujita, T; Higaki, J; Ito, S; Kamiya, A; Kikuchi, K; Matsuoka, H; Suzuki, H; Tei, C; Matsuoka, H; Kumagai, H; Ohashi, Y; Rakugi, H; Shimamoto, K; Takishita, S; Umemoto, S; Shimada, K; Hayashi, K; Kario, K; Kawana, M; Kitagawa, K; Makino, H; Matsumoto, M; Yoshikawa, J; Abe, K; Matsuura, H; Ohashi, Y; Otsuka, K; Tanabe, K; Suzuki, N; Nogawa, S; Utsunomiya, K; Yoshikawa, T; Yumura, W; Ohashi, Y; Umemoto, S; Kikuchi, K; Hasebe, N; Bunya, M; Fujii, W; Funayama, N; Gima, M; Hashizume, K; Hirayama, Y; Matsuhashi, H; Morimoto, H; Myojo, T; Ohori, K; Omiya, H; Ota, T; Sato, A; Shiokoshi, T; Tanaka, H; Yamazaki, K; Yoshie, H; Shimamoto, K; Abiru, M; Adachi, M; Fujise, Y; Hanawa, K; Ishii, K; Kadono, Y; Kaku, T; Kaneta, S; Kato, M; Kato, N; Kobayashi, H; Komakine, T; Matsumoto, T; Mita, T; Miura, N; Mukai, H; Nagao, K; Nakagawa, H; Nakagawa, M; Nakajima, N; Nishimiya, T; Nishino, Y; Nunokawa, A; Ohata, J; Ooiwa, H; Sato, R; Satoh, S; Shibata, S; Takada, M; Takagawa, Y; Takagi, Y; Takeichi, S; Tanaka, S; Togashi, N; Ura, N; Wakabayashi, C; Yoshida, D; Yoshida, H; Yoshida, K; Kitabatake, A; Tsutsui, H; Akutsu, M; Fujii, S; Furumoto, T; Kakinoki, S; Kawasaki, H; Kimura, T; Makiguchi, M; Matsuo, H; Okamoto, H; Oyama, Y; Shimokawa, J; Tsuzuki, N; Ito, S; Imai, Y; Domon, R; Ebina, H; Egawa, S; Haruyama, T; Hashimoto, H; Hayakawa, T; Inomata, H; Katahira, Y; Katakura, T; Kikuchi, R; Kimura, H; Kyogoku, S; Kyogoku, Y; Matsuo, K; Nakazawa, H; Odakura, H; Okuguchi, F; Ohtomo, E; Ouchi, H; Seino, M; Tadokoro, M; Tanno, Y; Uchida, N; Yamanaka, T; Yunomura, K; Okumura, K; Hatayama, T; Kanehira, Y; Kaneko, H; Kimura, M; Maeda, N; Mikuniya, A; Narita, H; Ono, M; Osanai, T; Sato, M; Yoshino, H; Momomura, S; Ono, M; Inoue, M; Iwase, T; Miyazaki, K; Taki, M; Aizawa, T; Hasunuma, Y; Makino, H; Okabayashi, H; Hosoda, S; Sumiyoshi, T; Abe, M; Kira, Y; Nagayama, M; Sakai, K; Yoshikawa, O; Ide, M; Kimura, N; Matsuzaka, S; Miyajima, Y; Sawai, K; Sumi, T; Takada, R; Toma, M; Yamada, Y; Yoda, K; Yokokawa, T; Yokoyama, S; Kanmatsuse, K; Kushiro, T; Anazawa, T; Ebuchi, T; Fujita, H; Katsumata, N; Masubuchi, K; Migita, T; Osada, T; Otsuka, Y; Saito, F; Shimoda, S; Sugino, K; Takahashi, A; Tani, S; Yumi, K; Daida, H; Arino, T; Iesaki, T; Inomata, Y; Nakahara, H; Shiraishi, H; Sudo, H; Degawa, T; Araki, T; Itaya, H; Komatsu, H; Kuwana, H; Mikawa, T; Nomoto, H; Ogawa, N; Sato, H; Takase, H; Toyoda, H; Yamamoto, M; Obayashi, K; Akabane, I; Hamamoto, H; Kanbara, R; Kato, H; Kimura, H; Mori, N; Yamada, K; Yamamuro, M; Isobe, M; Emoto, H; Inaba, O; Inazawa, T; Inomata, H; Isobe, K; Ito, Y; Komura, M; Kosuge, H; Maejima, Y; Miwa, N; Nishimori, T; Otomo, K; Sakurai, K; Sawada, M; Seya, M; Shimizu, M; Takagi, T; Tamura, M; Tanaka, K; Tezuka, D; Tokunaga, T; Yagishita, A; Yamashina, A; Hara, T; Hayashi, S; Hirayama, Y; Hirooka, Y; Iitaka, M; Ishiyama, T; Kijima, F; Kobayashi, H; Kobayashi, Y; Kondo, K; Kuwabara, T; Mugishima, M; Nakayama, Y; Nishizato, Y; Osamura, Y; Sakomura, Y; Saneshige, S; Shindo, N; Takao, N; Takata, Y; Tomiyama, H; Ishimaru, S; Obitsu, Y; Shigematsu, H; Baba, T; Fukushima, H; Hirayama, T; Magari, K; Makimura, S; Nagae, T; Osada, K; Osada, T; Shimizu, T; Suesada, H; Tamura, K; Yamazaki, T; Hirai, A; Fukasawa, T; Ono, H; Yamakado, M; Shiba, T; Otomi, S; Uehata, A; Takazawa, K; Aizawa, A; Iketani, T; Kino, M; Kobayashi, H; Morishima, T; Sakamoto, N; Sakamoto, T; Yamakawa, H; Kasanuki, H; Nagai, R; Kadowaki, T; Tanaka, J; Yamazaki, T; Takagi, M; Ui, S; Baba, S; Fujita, K; Hasegawa, T; Tajima, K; Tanaka, M; Yamato, N; Kuwajima, I; Harada, K; Miyata, H; Mizuno, S; Ueda, S; Sugi, K; Ando, H; Mishima, K; Moroi, M; Nishizawa, S; Suzuki, S; Yamazaki, J; Nakanishi, R; Nakano, H; Tokuyasu, K; Aoyagi, T; Fujioka, M; Kobayakawa, N; Nakajima, K; Hirayama, A; Tsukamoto, K; Araki, Y; Hara, H; Hara, K; Saruya, T; Umemura, S; Arima, M; Endo, T; Furumi, K; Hatori, Y; Ikeda, Y; Ikeya, Y; Kaneda, T; Kawada, T; Kawano, T; Kawashima, T; Kihara, M; Kikuta, M; Kitamura, A; Kobayashi, H; Kobayashi, S; Kuji, T; Masuda, S; Minamimoto, Y; Minamisawa, K; Mitsuhashi, T; Miyazaki, N; Nagashima, Z; Nakatogawa, T; Nakayama, R; Nyui, N; Ogawa, M; Onishi, T; Saka, K; Sano, T; Sato, A; Shiba, K; Shionoiri, F; Sugiyama, H; Suzuki, H; Takasaki, I; Tamura, K; Tokita, Y; Umemura, M; Yamaguchi, S; Yasuda, G; Nakamura, S; Takayanagi, K; Hayashi, T; Ichihara, M; Kobayashi, S; Sakai, Y; Uchida, T; Yaguchi, I; Komuro, I; Aoki, S; Hashimoto, Y; Ibuki, C; Isobe, Y; Kumasaka, R; Matsuda, M; Mizuno, K; Murakami, D; Nakamura, S; Nakatani, M; Ohba, T; Ohara, T; Okumura, T; Saito, A; Sakurai, T; Sato, S; Sato, W; Seimiya, K; Seino, Y; Shimizu, K; Takano, M; Tokuyama, K; Uchida, D; Yodogawa, K; Oshima, S; Kurabayashi, M; Baba, N; Furushima, Y; Goto, T; Hosoi, T; Iijima, T; Ito, K; Iwata, Y; Kubo, H; Matsumoto, M; Miyazaki, M; Naganuma, F; Nakada, K; Tokushima, M; Tsunoda, K; Wakamatsu, S; Yagihara, Y; Aizawa, Y; Aizawa, M; Aizawa, M; Hayashi, N; Hori, T; Kobayashi, H; Kodama, M; Maeda, K; Miura, K; Okada, K; Okura, Y; Sasagawa, Y; Takizawa, S; Tamura, M; Yamamoto, T; Murohara, T; Awaji, Y; Funahashi, H; Hayashi, D; Iida, M; Ishihara, D; Ishikawa, S; Kamide, S; Kanashiro, M; Kurebayashi, N; Kyo, S; Matsui, H; Matsuo, K; Morishima, M; Noda, H; Noda, T; Okumura, N; Ota, T; Shimizu, S; Somura, F; Takada, Y; Takeichi, Y; Takezawa, H; Uchikawa, T; Yoshikawa, D; Kimura, G; Ando, Y; Hoshiai, M; Okuda, N; Suzuki, S; Takada, K; Takada, N; Yamada, K; Hishida, H; Furuta, T; Hayashi, H; Ito, K; Kato, K; Nomura, M; Ota, T; Ohtsuki, M; Tabata, T; Taga, S; Tateishi, R; Ito, T; Fukuda, M; Iwa, T; Wakida, Y; Yonemoto, T; Watarai, M; Ito, M; Kawai, H; Murata, Y; Nomoto, S; Takemoto, K; Tsuboi, N; Yoshida, Y; Inoue, N; Ishikawa, M; Matsumoto, M; Muramatsu, T; Yoshida, R; Ono, M; Hanaki, Y; Sano, H; Shibata, Y; Sakai, K; Ajioka, M; Asano, H; Okamoto, R; Osanai, H; Uemura, Y; Yokoi, K; Tanaka, T; Kamiya, H; Miki, K; Niwa, M; Fujiwara, H; Minatoguchi, S; Arai, T; Kato, S; Kobayashi, H; Minagawa, T; Mori, N; Nakahara, K; Shimizu, Y; Tadokoro, M; Takahashi, N; Shigemasa, T; Kobayashi, I; Nakano, T; Ito, M; Fukui, A; Higashi, Y; Ito, T; Kano, U; Makino, K; Nakai, K; Nakajima, M; Nakajima, T; Sekoguchi, K; Tanaka, T; Tanigawa, T; Takekoshi, N; Enyama, H; Hirakawa, T; Ito, J; Ito, T; Kakuda, H; Kigoshi, T; Kondo, K; Masuya, K; Matoba, M; Nakagawa, A; Nakahashi, T; Nakato, H; Okada, H; Okuro, M; Takeuchi, Y; Tsugawa, H; Urata, T; Yasuhara, M; Shimizu, M; Ino, H; Araki, T; Fujino, N; Haraki, T; Hayashi, K; Hifumi, S; Konno, T; Minamoto, M; Miyamoto, S; Mori, M; Nakanishi, C; Sakamoto, Y; Sakata, K; Takeda, S; Ueda, K; Uchiyama, K; Takata, S; Kaneko, S; Aburadani, I; Inoki, I; Kitano, K; Kobayashi, D; Kontani, K; Maekawa, M; Maruyama, M; Matsunuma, K; Nagai, Y; Nagata, Y; Okajima, M; Otowa, K; Sekiguchi, Y; Shinmura, K; Usui, S; Yokoyama, H; Yonejima, M; Nakao, K; Hiraiwa, N; Ko, T; Masuda, I; Nagae, T; Nishino, K; Sakamoto, M; Kita, T; Nakagawa, Y; Kimura, T; Doi, T; Horiuchi, H; Kinoshita, M; Mizuno, M; Ohnishi, M; Shigemoto, K; Wada, A; Yamada, T; Yoshida, H; Nakagawa, M; Matsubara, H; Furukawa, K; Hatta, T; Inoue, A; Katsume, H; Masui, A; Matsumoto, S; Seki, T; Takeda, K; Taniguchi, Y; Tsuji, H; Saito, Y; Fukuoka, Y; Iwano, M; Katsuyama, T; Nakatani, A; Sakaguchi, Y; Konishi, T; Izumi, T; Toda, I; Kamimoto, A; Nagai, Y; Matsuwaka, E; Matsuwaka, R; Takei, K; Ueda, R; Wakaki, N; Iwasaka, T; Hamada, H; Hamada, S; Koga, H; Koito, H; Kono, K; Kurihara, H; Maeda, J; Morimoto, S; Takayama, Y; Aoyama, T; Imai, M; Ii, T; Kashii, S; Maenaka, M; Ohashi, H; Suyama, T; Matsuda, M; Aoyagi, Y; Kunisada, K; Mori, T; Mori, T; Uemura, J; Yokoi, Y; Morioka, N; Ozaki, T; Kanamasa, K; Ishikawa, K; Miyazaki, S; Arima, S; Kai, T; Kurooka, A; Shimada, I; Takewa, M; Taniguchi, M; Hattori, R; Haba, K; Yokota, R; Matsui, H; Tone, E; Yamahira, H; Kawarabayashi, T; Inaba, H; Sakaguchi, Y; Yamamoto, Y; Ito, H; Date, M; Dodo, M; Fujii, K; Imai, M; Inoue, K; Kanoh, Y; Komura, N; Senpuku, S; Takeda, M; Tateyama, H; Yasui, K; Yoneda, R; Morita, H; Kawanami, M; Tahara, A; Sado, T; Takamura, T; Taniwa, M; Kitaura, Y; Fukuda, M; Hanada, H; Nakamura, K; Sawada, K; Yamaguchi, M; Kodama, K; Higo, T; Hirata, A; Kanzaki, M; Komatsu, S; Matsuo, K; Murakawa, T; Nakanishi, H; Nemoto, T; Nishio, M; Ogasawara, N; Okuyama, Y; Ueda, Y; Imanishi, M; Kitamura, Y; Sakakibara, T; Yoshida, H; Yoshimi, H; Ogihara, T; Rakugi, H; Akiyama, M; Ikuno, Y; Imai, N; Imamura, Y; Inoyama, T; Kamide, K; Katahira, K; Katsuya, S; Katsuya, T; Kurokawa, Y; Matsuki, O; Matsuo, M; Nakamura, T; Ogura, E; Ohishi, M; Sasaki, R; Sugimoto, K; Tachi, J; Tanaka, H; Tanaka, H; Tsunetoshi, T; Yoshino, M; Hori, M; Awata, N; Fukukawa, T; Iimori, Y; Iwamoto, S; Sawami, K; Okamura, M; Kanayama, Y; Nagano, F; Nakayama, H; Suzuki, H; Amano, T; Tachibana, K; Arita, Y; Kirino, M; Sakuyama, K; Shukawa, M; Nishida, Y; Sakamoto, T; Yanagi, S; Hirota, K; Majima, T; Ota, T; Tanaka, T; Nohara, R; Funauchi, T; Isogai, O; Takashima, S; Koike, H; Nishimoto, M; Kawase, Y; Tojo, O; Chimori, Y; Harada, H; Takeoka, H; Kishi, S; Yokoyama, M; Hirata, K; Ejiri, J; Emoto, R; Furuta, Y; Hattori, K; Kuroda, R; Maehashi, N; Monnaka, H; Ohashi, Y; Okada, T; Suzuki, H; Takeuchi, M; Ohyanagi, M; Masai, M; Masuyama, T; Kawabata, M; Kajiya, T; Daito, N; Fujisawa, T; Fujita, S; Hasegawa, M; Hirakoba, M; Hirano, T; Ikeda, Y; Imai, N; Marumoto, K; Masuda, S; Miki, T; Mitsunaga, M; Mitsuoka, H; Miyachi, Y; Mukohara, N; Nagao, T; Nakada, K; Nishian, K; Nishioka, S; Ogura, T; Onishi, Y; Sakaguchi, K; Sano, I; Sano, W; Shigenobu, M; Tabuchi, A; Takashima, J; Taniguchi, Y; Uchida, H; Ueda, T; Urabe, N; Makino, H; Harada, S; Hirakawa, S; Hirata, H; Ishii, J; Koten, K; Nagake, Y; Nakajima, T; Nakamura, Y; Terami, T; Mitsudo, K; Fujii, M; Fujita, K; Iwano, E; Kadota, K; Nishihara, Y; Takaya, Y; Yamamoto, H; Yamamoto, T; Shigemasa, C; Hisatome, I; Kato, T; Miyakoda, H; Sakamoto, M; Shimoyama, M; Shimada, T; Tanabe, K; Goto, Y; Hanada, Y; Kawakami, K; Kitamura, J; Kitamura, K; Nakata, H; Oyake, N; Sugiura, H; Tsukihashi, H; Matsuzaki, M; Umemoto, S; Aoyagi, S; Aoyama, H; Fujino, T; Fukuta, S; Hiroyama, N; Ikeda, Y; Inamoto, Y; Kametani, R; Kamiya, A; Kanamaru, Y; Kotoku, S; Matsushima, A; Morita, J; Murano, Y; Nakatsuka, M; Nishimura, S; Nisnimura, Y; Okamura, T; Okuda, F; Onaka, U; Ozaki, M; Shimizu, A; Takata, C; Tamitani, M; Watada, T; Watada, T; Yamamoto, K; Yamauchi, M; Yorozu, T; Yoshikane, H; Yoshino, F; Higaki, J; Doiuchi, J; Fukuoka, T; Hashimoto, H; Igase, M; Kadota, H; Kaneko, H; Komatsu, S; Matsubara, Y; Miyoshi, K; Murakami, K; Murao, S; Niiya, T; Ochi, T; Satoh, A; Seki, T; Takahashi, H; Yamashita, T; Yoshino, T; Kohno, M; Fujita, N; Fukui, T; Hamamoto, T; Hasegawa, K; Hitomi, H; Ihara, K; Kiyomoto, H; Masugata, H; Matsumoto, I; Takahashi, N; Yoshikawa, K; Doi, Y; Arisawa, M; Egawa, T; Fukuda, M; Kawada, Y; Kusunose, H; Maeda, T; Minami, N; Nishinaga, M; Noguchi, T; Okabayashi, K; Sato, K; Satomi, T; Takada, J; Tamura, S; Usui, T; Yamada, M; Irahara, M; Azuma, H; Fujimura, M; Fujino, H; Fujino, M; Harada, E; Harada, S; Hiasa, Y; Hosokawa, S; Kawahara, K; Koshiba, K; Murakami, M; Nakaya, Y; Nii, H; Nozaki, S; Ota, A; Ozaki, T; Sone, K; Tsutsui, Y; Ueta, S; Nobuyoshi, M; Fujishima, Y; Hisano, K; Ikezono, H; Imawatari, R; Izumi, Y; Kanai, H; Nakamura, T; Nakamura, T; Noda, T; Ono, E; Tanaka, S; Tsuiki, T; Yanai, T; Sasaguri, T; Akimitsu, S; Dohmen, K; Fujisawa, K; Fukuyo, K; Harashima, S; Hayashi, T; Hirata, M; Hirata, Y; Ikeda, N; Ikematsu, H; Ikematsu, W; Kajiyama, W; Kawakami, Y; Kawasaki, I; Kondo, H; Kusuhara, H; Maeda, N; Miyahara, H; Motomura, A; Nakamura, K; Noguchi, T; Okinaga, T; Sato, M; Shimada, I; Shin, H; Soejima, K; Sugi, K; Taniguchi, T; Uwatoku, T; Yamaga, S; Yamaji, K; Yanagi, J; Yano, H; Saku, K; Enomoto, M; Hiratsuka, T; Imoto, K; Kamei, R; Kanaya, H; Kohara, M; Kusuda, M; Nishikawa, H; Sako, H; Imaizumi, T; Yano, K; Maemura, K; Ashizawa, N; Hazama, M; Ishida, Y; Ito, T; Kanda, M; Kimura, M; Noguchi, T; Oku, Y; Seto, S; Suzuki, S; Ogawa, H; Goto, K; Honjio, K; Horio, Y; Jinnouchi, H; Kaku, Y; Kawano, S; Kimura, T; Kiyohara, Y; Maki, A; Matsumoto, N; Misumi, K; Sakamoto, T; Sasaki, K; Sugiyama, S; Tanaka, E; Uemura, S; Tei, C; Arima, K; Daitoku, Y; Eto, H; Hashino, T; Ichinari, K; Ikeda, Y; Iriki, A; Kiyonaga, K; Kubota, K; Makise, Y; Masuzaki, S; Miyata, M; Mizoguchi, H; Niiyama, T; Samejima, Y; Yonezawa, S

    2016-01-01

    Visit-to-visit blood pressure (BP) variability is an important predictor of stroke. However, which antihypertensive drug combination is better at reducing visit-to-visit BP variability and therefore at reducing stroke incidence remains uncertain. We have previously reported that the dihydropyridine calcium channel blocker benidipine combined with a β-blocker appeared to be less beneficial in reducing the risk of stroke than a combination of benidipine and thiazide. Here, we further compare the visit-to-visit BP variability among three benidipine-based regimens, namely angiotensin receptor blocker (ARB), β-blocker and thiazide combinations. The present post hoc analysis included 2983 patients without cardiovascular events or death during the first 18 months after randomization. We compared the BP variability (defined as the s.d. and the coefficient of variation (CV)), maximum systolic BP (SBP) and diastolic BP (DBP) of the clinic mean on-treatment BPs obtained at 6-month intervals, starting 6 months after the treatment initiation, among the 3 treatments (ARB, n=1026; β-blocker, n=966; thiazide, n=991). During the first 6–36 months after randomization, both the s.d. and CV-BPs were lower in the benidipine–thiazide group than in the benidipine–β-blocker group (s.d.-SBP, P=0.019; s.d.-DBP, P=0.030; CV-SBP, P=0.012; CV-DBP, P=0.022). The s.d. and CV in the ARB group did not reach statistical significance compared with the other two groups. The maximum BPs did not differ among the three treatments. These findings suggest that the benidipine–thiazide combination may reduce visit-to-visit BP variability more than the benidipine–β-blocker combination. PMID:26490089

  2. Vitamin D supplementation to patients with frequent respiratory tract infections: a post hoc analysis of a randomized and placebo-controlled trial.

    PubMed

    Bergman, Peter; Norlin, Anna-Carin; Hansen, Susanne; Björkhem-Bergman, Linda

    2015-08-30

    Vitamin D is considered to be important for a healthy immune system. The aim of this study was to test the hypothesis that vitamin D supplementation reduces number of respiratory tract infections (RTIs) and prolong the time to the first RTI in adult patients with frequent RTIs. We performed a post hoc analysis of a randomized, placebo-controlled and double-blinded study, where adult patients with a high burden of RTIs were randomized to placebo or vitamin D (4000 IE/day for 1 year, n = 124 in the per protocol cohort presented here). Vitamin D supplementation increased the probability to stay free of RTI during the study year (RR 0.64, 95% CI 0.43-0.94). Further, the total number of RTIs was also reduced in the vitamin D-group (86 RTIs) versus placebo (120 RTIs; p = 0.05). Finally, the time to the first RTI was significantly extended in the vitamin D-group (HR 1.68, 95% CI 1.03-2.68, p = 0.0376). Vitamin D supplementation was found to significantly increase the probability of staying infection free during the study period. This finding further supports the notion that vitamin D-status should be monitored in adult patients with frequent RTIs and suggests that selected patients with vitamin D deficiency are supplemented. This could be a safe and cheap way to reduce RTIs and improve health in this vulnerable patient population. The original trial was registered at http://www.clinicaltrials.gov (NCT01131858).

  3. Chronotherapeutic oral drug absorption system verapamil is effective in reducing morning blood pressure in African Americans: a post hoc analysis of the chrono trial.

    PubMed

    Prisant, L Michael; Weber, Michael; Black, Henry R

    2005-03-01

    Results of several clinical trials have shown that verapamil is effective in reducing blood pressure (BP) in African Americans, a population at high risk for hypertension and target-organ damage. Nonetheless, adequate control of BP is perceived as difficult to achieve in this population. A post hoc analysis of data from the community-based CHRONO trial (Controlling Hypertension in the moRning with a ChrONO medication) was undertaken to assess racial/ethnic differences in the safety and efficacy of the Chronotherapeutic Oral Drug Absorption System (CODAS) formulation of verapamil in a real-world setting. Once-daily administration of the CODAS formulation of verapamil significantly reduced morning BP (P<0.0001) regardless of race or ethnicity. In the African-American population (N=466), the response rate for systolic BP (<140 mmHg or > or =10% reduction from baseline) and diastolic BP (<90 mmHg or reduction > or =10 mmHg from baseline) combined was 70.8%, and 60% of those individuals responded at the lowest (200 mg) dose. Of the 59.7% of African Americans who reached the target BP of <140/90 mmHg, 64% did so at the 200-mg dose. Response rates were not affected by gender, age or treatment history, and CODAS-verapamil was well tolerated in all ethnic/racial treatment groups. In a trial conducted in actual clinical practices, the CODAS formulation of verapamil was shown to be safe and effective in African Americans, Caucasians, Hispanics and Asians.

  4. Crenobalneotherapy (spa therapy) in patients with knee and generalized osteoarthritis: a post-hoc subgroup analysis of a large multicentre randomized trial.

    PubMed

    Forestier, R; Genty, C; Waller, B; Françon, A; Desfour, H; Rolland, C; Roques, C-F; Bosson, J-L

    2014-06-01

    To determine whether the addition of spa therapy to home exercises provides any benefit over exercises and the usual treatment alone in the management of generalised osteoarthritis associated with knee osteoarthritis. This study was a post-hoc subgroup analysis of our randomised multicentre trial (www.clinicaltrial.gov: NCT00348777). Participants who met the inclusion criteria of generalized osteoarthritis (Kellgren, American College of Rheumatology, or Dougados criteria) were extracted from the original randomised controlled trial. They had been randomised using Zelen randomisation. The treatment group received 18days of spa treatment in addition to a home exercise programme. Main outcome was number of patients achieving minimal clinically important improvement at six months (MCII) (≥-19.9mm on the VAS pain scale and/or ≥-9.1 points in a WOMAC function subscale), and no knee surgery. Secondary outcomes included the "patient acceptable symptom state" (PASS) defined as VAS pain ≤32.3mm and/or WOMAC function subscale ≤31 points. From the original 462 participants, 214 patients could be categorized as having generalised osteoarthritis. At sixth month, 182 (88 in control and 94 in SA group) patients, were analysed for the main criteria. MCII was observed more often in the spa group (n=52/94 vs. 38/88, P=0.010). There was no difference for the PASS (n=19/88 vs. 26/94, P=0.343). This study indicates that spa therapy with home exercises may be superior to home exercise alone in the management of patients with GOA associated with knee OA. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  5. Effectiveness of treat-to-target strategy for LDL-cholesterol control in type 2 diabetes: post-hoc analysis of data from the MIND.IT study.

    PubMed

    Ardigò, Diego; Vaccaro, Olga; Cavalot, Franco; Rivellese, Albarosa Angela; Franzini, Laura; Miccoli, Roberto; Patti, Lidia; Boemi, Massimo; Trovati, Mariella; Zavaroni, Ivana

    2014-04-01

    The paper presents a post-hoc analysis of the intensity of dyslipidaemia care operated in the first 2 years of Multiple-Intervention-in-type-2-Diabetes.ITaly (MIND.IT) study. MIND.IT is a multicentric, randomized, two-parallel arm trial involving 1461 type 2 diabetic patients at high cardiovascular (CV) risk. The study compares the usual care (UC) of CV prevention with a multifactorial intensive care (IC) approach aiming at achieving target values for the main CV risk factors according to a step-wise treat-to-target approach. Proportion of patients on target for low-density lipoprotein cholesterol (LDL-C) was about 10% at baseline and increased significantly more with IC than UC (43 vs. 27%; p < 0.001). However, the majority (57%) of patients, in this intended intensively treated cohort, failed to achieve the proposed target. Average LDL-C decreased from 144 ± 35 to 108 ± 31 mg/dl with IC and from 142 ± 28 to 118 ± 32 with UC (p-for-interaction <0.0001). IC was associated with a significantly greater increase in statin prescription and lower withdrawal from treatment than UC (43 vs. 11% and 28 vs. 61%, respectively; both p < 0.001). However, the new treatments were characterized in both groups by the use of low starting doses (≤ 10 mg of atorvastatin, equivalent dose in more than 90% of patients) without increase in case of missed target. The application of a multifactorial treat-to-target intervention is associated with a significant improvement in LDL-C beyond usual practice. However, the change in LDL-C appears to be more related to an increased number of treated patients and a decreased treatment withdrawal than to a true treat-to-target approach.

  6. Robust message routing for mobile (wireless) ad hoc networks.

    SciTech Connect

    Goldsby, Michael E.; Johnson, Michael M.; Kilman, Dominique Marie; Bierbaum, Neal Robert; Chen, Helen Y.; Ammerlahn, Heidi R.; Tsang, Rose P.; Nicol, David M.

    2004-01-01

    This report describes the results of research targeting improvements in the robustness of message transport in wireless ad hoc networks. The first section of the report provides an analysis of throughput and latency in the wireless medium access control (MAC) layer and relates the analysis to the commonly used 802.11 protocol. The second section describes enhancements made to several existing models of wireless MAC and ad hoc routing protocols; the models were used in support of the work described in the following section. The third section of the report presents a lightweight transport layer protocol that is superior to TCP for use in wireless networks. In addition, it introduces techniques that improve the performance of any ad hoc source routing protocol. The fourth section presents a novel, highly scalable ad hoc routing protocol that is based on geographic principles but requires no localization hardware.

  7. History of Depressive and Anxiety Disorders and Paroxetine Response in Patients With Irritable Bowel Syndrome: Post Hoc Analysis From a Placebo-Controlled Study

    PubMed Central

    Marks, David M.; Han, Changsu; Krulewicz, Stan; Pae, Chi-Un; Peindl, Kathleen; Patkar, Ashwin A.; Masand, Prakash S.

    2008-01-01

    Objective: Although irritable bowel syndrome (IBS) is highly comorbid with depressive and anxiety disorders, information on the clinical implications of this comorbidity is limited. We investigated whether a history of depressive and/or anxiety disorders was associated with response to treatment in a double-blind, randomized, placebo-controlled trial of paroxetine controlled release (CR) in IBS. Method: Seventy-two IBS subjects (diagnosed using Rome II criteria) were recruited from August 2003 to November 2005 and randomly assigned to receive flexibly dosed paroxetine CR (dose, 12.5–50 mg/day) or placebo for 12 weeks. The Mini-International Neuropsychiatric Interview (MINI-Plus version) was used to ascertain current (exclusionary) or past diagnoses of depressive and anxiety disorders. Subjective depression, anxiety, and stress were assessed at entry and throughout the trial using the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Perceived Stress Scale (PSS). Severity of IBS symptoms was determined by the Composite Pain Score (CPS), administered via Interactive Voice Response System, and the Clinical Global Impressions scale (CGI). The primary outcome was treatment response defined as ≥ 25% reduction in CPS from randomization to end of treatment. A post hoc analysis (multivariate logistic regression) was done to evaluate whether a history of depressive and/or anxiety disorder was associated with response to medication. Results: Baseline demographic and clinical characteristics (CPS, BDI, BAI, PSS, CGI scores) were similar between groups (history of depressive/anxiety disorder vs. no history). In multivariate logistic regression analysis, treatment response was not predicted by history of depressive and/or anxiety disorder (OR = 0.58, CI = 0.29 to 1.68, p = .32) or drug status (paroxetine CR vs. placebo) (OR = 1.26, CI = 0.68 to 3.21, p = .19). Drug status was significantly associated with the secondary outcome variable of treatment response

  8. A Post Hoc Analysis of the Effect of Weight on Efficacy in Depressed Patients Treated With Desvenlafaxine 50 mg/d and 100 mg/d

    PubMed Central

    Fayyad, Rana S.; Guico-Pabia, Christine J.; Boucher, Matthieu

    2015-01-01

    Objective: To assess the effect of baseline body mass index (BMI) on efficacy and weight change in adults with major depressive disorder (MDD) treated with desvenlafaxine or placebo in a pooled, post hoc analysis. Method: Adults with MDD were randomly assigned to placebo or desvenlafaxine (50 mg or 100 mg) in 8 short-term, double-blind studies and 1 longer-term randomized withdrawal study (the studies were published between 2007 and 2013). Change from baseline in 17-item Hamilton Depression Rating Scale (HDRS-17) total score at week 8 was analyzed in normal (BMI ≤ 25 kg/m2), overweight (25 kg/m2 < BMI ≤ 30 kg/m2), and obese (BMI > 30 kg/m2) subgroups using analysis of covariance (ANCOVA). Weight change was analyzed in BMI subgroups using ANCOVA and a mixed-effects model for repeated measures. Results: Desvenlafaxine 50 mg/d or 100 mg/d improved HDRS-17 scores significantly from baseline to week 8 (last observation carried forward) versus placebo in all BMI subgroups (normal: n = 1,122; overweight: n = 960; obese: n = 1,302; all P ≤ .0027); improvement was greatest in normal BMI patients. There was a statistically significant decrease in weight (< 1 kg) with short-term desvenlafaxine 50 mg/d and 100 mg/d versus placebo in all BMI subgroups (all P < .0001). In the randomized withdrawal study (n = 548), no statistically significant difference in weight was observed for desvenlafaxine versus placebo in any BMI subgroup. Baseline BMI predicted weight change in short-term and longer-term desvenlafaxine treatment. Conclusions: Desvenlafaxine significantly improved symptoms of depression versus placebo regardless of baseline BMI. In all BMI subgroups, desvenlafaxine was associated with statistically significant weight loss (< 1 kg) versus placebo over 8 weeks, but no significant differences longer term. Trial Registration: ClinicalTrials.gov identifiers: NCT00072774, NCT00277823, NCT00300378, NCT00384033, NCT00798707, NCT00863798, NCT01121484, NCT00824291, NCT

  9. Treatment with macrolides and glucocorticosteroids in severe community-acquired pneumonia: A post-hoc exploratory analysis of a randomized controlled trial.

    PubMed

    Ceccato, Adrian; Cilloniz, Catia; Ranzani, Otavio T; Menendez, Rosario; Agusti, Carles; Gabarrus, Albert; Ferrer, Miquel; Sibila, Oriol; Niederman, Michael S; Torres, Antoni

    2017-01-01

    Systemic corticosteroids have anti-inflammatory effects, whereas macrolides also have immunomodulatory activity in addition to their primary antimicrobial actions. We aimed to evaluate the potential interaction effect between corticosteroids and macrolides on the systemic inflammatory response in patients with severe community-acquired pneumonia to determine if combining these two immunomodulating agents was harmful, or possibly beneficial. We performed a post-hoc exploratory analysis of a randomized clinical trial conducted in three tertiary hospitals in Spain. This trial included patients with severe community-acquired pneumonia with high inflammatory response (C-reactive protein [CRP] >15 mg/dL) who were randomized to receive methylprednisolone 0.5 mg/kg/tpd or placebo. The choice of antibiotic treatment was at the physician's discretion. One hundred and six patients were classified into four groups according to antimicrobial therapy combination (β-lactam plus macrolide or β-lactam plus fluoroquinolone) and corticosteroid arm (placebo or corticosteroids). The primary outcome was treatment failure (composite outcome of early treatment failure, or of late treatment failure, or of both early and late treatment failure). The methylprednisolone with β-lactam plus macrolide group had more elderly patients, with comorbidities, and higher pneumonia severity index (PSI) risk class V, but a lower proportion of intensive care unit admission, compared to the other groups. We found non differences in treatment failure between groups (overall p = 0.374); however, a significant difference in late treatment failure was observed (4 patients in the placebo with β-lactam plus macrolide group (31%) vs. 9 patients in the placebo with β-lactam plus fluoroquinolone group (24%) vs. 0 patients in the methylprednisolone with β-lactam plus macrolide group (0%) vs. 2 patients [5%] in the methylprednisolone with β-lactam plus fluoroquinolone group overall p = 0.009). We found a

  10. Blood pressure‐lowering effects of sulodexide depend on albuminuria severity: post hoc analysis of the sulodexide microalbuminuria and macroalbuminuria studies

    PubMed Central

    Heerspink, Hiddo J. L.; de Zeeuw, Dick; Vogt, Liffert

    2016-01-01

    Aims It has been suggested that sulodexide is able to lower blood pressure (BP). This may be attributed to its ability to restore the endothelial surface layer (ESL). As ESL perturbation is known to be related to the degree of kidney damage, we investigated whether albuminuria, reflecting ESL status, modified the BP‐lowering potential of sulodexide. Methods A post hoc analysis of the double‐blind, randomized, placebo‐controlled sulodexide microalbuminuria (Sun‐MICRO) and macroalbuminuria (Sun‐MACRO) studies, including 1056 microalbuminuric and 843 macroalbuminuric subjects with type 2 diabetes receiving maximal tolerated renin–angiotensin‐aldosterone system inhibitor therapy, was carried out. We compared the effect of placebo and sulodexide on systolic BP (SBP) among albuminuria groups. Results Analysis of covariance, including data from both trials, showed that baseline urine albumin‐to‐creatinine ratio (UACR) was the only modifier of the SBP response (interaction with treatment P = 0.001). In subjects with an UACR >1000 mg g–1, sulodexide lowered SBP by 4.6 mmHg [95% confidence interval (CI) 3.6, 5.6; P < 0.001] compared with placebo, whereas a 2.3 mmHg (95% CI 0.9,3.7; P = 0.001) reduction was seen in subjects with a UACR of 300–1000 mg g–1. Sulodexide did not lower SBP in subjects with a UACR <300 mg g–1 (−0.2 mmHg, 95% CI −0.8, 0.5; P = 0.60). SBP‐lowering effects were not accompanied by changes in body weight. Conclusion The BP‐reducing potency of sulodexide is modified by the degree of albuminuria in subjects with type 2 diabetes. As ESL status deteriorates with increasing albuminuria and nephropathy severity, this suggests that ESL restoration may represent a new target for BP treatment in subjects with diabetic nephropathy. PMID:27412828

  11. Evaluation of blood pressure and heart rate in patients with hypertension who received tapentadol extended release for chronic pain: a post hoc, pooled data analysis.

    PubMed

    Biondi, David M; Xiang, Jim; Etropolski, Mila; Moskovitz, Bruce

    2014-08-01

    Hypertension is one of the most common co-existing conditions in patients with chronic pain, and the potential effects of an analgesic on heart rate and blood pressure are of particular concern for patients with hypertension. The purpose of this analysis was to evaluate changes in blood pressure and heart rate with tapentadol extended release (ER) treatment in patients with hypertension. We performed a post hoc analysis of data pooled from three randomized, placebo- and active-controlled, phase III studies of tapentadol ER for managing chronic osteoarthritis knee (NCT00421928, NCT00486811) or low back (NCT00449176) pain (15-week, double-blind treatment period). Data were independently analyzed for patients with a listed medical history of hypertension at baseline and patients with at least one listed concomitant antihypertensive medication at baseline. Heart rate, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured at each visit. In patients with a listed medical history of hypertension (n = 1,464), least-squares mean (LSM [standard error (SE)]) changes from baseline to endpoint with placebo, tapentadol ER, and oxycodone HCl controlled release (CR), respectively, were -0.7 (0.44), 0.2 (0.43), and -0.9 (0.45) beats per minute (bpm) for heart rate; -2.4 (0.64), -2.7 (0.64), and -3.7 (0.67) mmHg for SBP; and -1.0 (0.39), -1.3 (0.39), and -2.3 (0.41) mmHg for DBP; in patients with at least one listed concomitant antihypertensive medication (n = 1,376), the LSM (SE) changes from baseline to endpoint were -0.6 (0.45), 0.1 (0.44), and -0.7 (0.47) bpm for heart rate; -1.8 (0.66), -3.3 (0.65), and -3.7 (0.69) mmHg for SBP; and -0.7 (0.40), -1.4 (0.40), and -2.3 (0.42) mmHg for DBP. No clinically meaningful mean changes in heart rate or blood pressure were observed for the evaluated cohorts of patients with hypertension who were treated with tapentadol ER (100-250 mg twice daily).

  12. Pooled Post Hoc Analysis of Population Pharmacokinetics of Oxycodone and Acetaminophen Following Multiple Oral Doses of Biphasic Immediate-Release/Extended-Release Oxycodone/Acetaminophen Tablets.

    PubMed

    Morton, Terri; Franke, Ryan; Devarakonda, Krishna

    2016-07-01

    To examine whether biphasic immediate-release (IR)/extended-release (ER) oxycodone (OC)/acetaminophen (APAP) 7.5/325-mg tablets have clinically relevant variability in population pharmacokinetics (PK). Post hoc analysis of 2 phase 1 randomized, open-label, multiple-dose crossover studies. Single contract research organization clinic. Men and women aged 18 to 55 years with a body mass index of 19 to 30 kg/m(2) and body weight ≥ 59 kg. Fasted participants (N = 96) received 2 tablets of IR/ER OC/APAP 7.5/325 mg (total dose, 15/650 mg) every 12 hours for 4.5 days. Population PK analysis was performed using nonlinear mixed effects modeling and evaluated 6 population variables. The average PK estimates for OC were 75 L/hour for clearance (CL/F), 756 L for volume of distribution (V/F), and 0.581 per hour for absorption rate constant (Ka ). Body weight was a statistically significant source of variability in V/F for OC at steady state. Average estimates for APAP were 25 L/hour for CL/F and 119 L for V/F. Sex was identified as a statistically significant source of variability in CL/F with predicted values for APAP of 25 L/hour in men and 21 L/hour in women. Body weight affected variability in V/F, with a predicted value of 193 L in men and 174 L in women for a 72-kg participant at steady state. Dose adjustments of < 50% are not clinically relevant for IR/ER OC/APAP 7.5/325-mg tablets considering the approved dose of 1 to 2 tablets every 8 to 12 hours; thus, adjustment may be necessary for large deviations from normal body weight but not for sex. © 2015 World Institute of Pain.

  13. Effect of sacubitril/valsartan versus enalapril on glycaemic control in patients with heart failure and diabetes: a post-hoc analysis from the PARADIGM-HF trial

    PubMed Central

    Seferovic, Jelena P; Claggett, Brian; Seidelmann, Sara B; Seely, Ellen W; Packer, Milton; Zile, Michael R; Rouleau, Jean L; Swedberg, Karl; Lefkowitz, Martin; Shi, Victor C; Desai, Akshay S; McMurray, John J V; Solomon, Scott D

    2017-01-01

    Summary Background Diabetes is an independent risk factor for heart failure progression. Sacubitril/valsartan, a combination angiotensin receptor-neprilysin inhibitor, improves morbidity and mortality in patients with heart failure with reduced ejection fraction (HFrEF), compared with the angiotensin-converting enzyme inhibitor enalapril, and improves peripheral insulin sensitivity in obese hypertensive patients. We aimed to investigate the effect of sacubitril/valsartan versus enalapril on HbA1c and time to first-time initiation of insulin or oral antihyperglycaemic drugs in patients with diabetes and HFrEF. Methods In a post-hoc analysis of the PARADIGM-HF trial, we included 3778 patients with known diabetes or an HbA1c≥6·5% at screening out of 8399 patients with HFrEF who were randomly assigned to treatment with sacubitril/valsartan or enalapril. Of these patients, most (98%) had type 2 diabetes. We assessed changes in HbA1c, triglycerides, HDL cholesterol and BMI in a mixed effects longitudinal analysis model. Times to initiation of oral antihyperglycaemic drugs or insulin in subjects previously not treated with these agents were compared between treatment groups. Findings There were no significant differences in HbA1c concentrations between randomised groups at screening. During the first year of follow-up, HbA1c concentrations decreased by 0·16% (SD 1·40) in the enalapril group and 0·26% (SD 1·25) in the sacubitril/valsartan group (between-group reduction 0·13%, 95% CI 0·05–0·22, p=0·0023). HbA1c concentrations were persistently lower in the sacubitril/valsartan group than in the enalapril group over the 3-year follow-up (between-group reduction 0·14%, 95% CI 0·06–0·23, p=0·0055). New use of insulin was 29% lower in patients receiving sacubitril/valsartan (114 [7%] patients) compared with patients receiving enalapril (153 [10%]; hazard ratio 0·71, 95% CI 0·56–0·90, p=0·0052). Similarly, fewer patients were started on oral

  14. Effect of sacubitril/valsartan versus enalapril on glycaemic control in patients with heart failure and diabetes: a post-hoc analysis from the PARADIGM-HF trial.

    PubMed

    Seferovic, Jelena P; Claggett, Brian; Seidelmann, Sara B; Seely, Ellen W; Packer, Milton; Zile, Michael R; Rouleau, Jean L; Swedberg, Karl; Lefkowitz, Martin; Shi, Victor C; Desai, Akshay S; McMurray, John J V; Solomon, Scott D

    2017-05-01

    Diabetes is an independent risk factor for heart failure progression. Sacubitril/valsartan, a combination angiotensin receptor-neprilysin inhibitor, improves morbidity and mortality in patients with heart failure with reduced ejection fraction (HFrEF), compared with the angiotensin-converting enzyme inhibitor enalapril, and improves peripheral insulin sensitivity in obese hypertensive patients. We aimed to investigate the effect of sacubitril/valsartan versus enalapril on HbA1c and time to first-time initiation of insulin or oral antihyperglycaemic drugs in patients with diabetes and HFrEF. In a post-hoc analysis of the PARADIGM-HF trial, we included 3778 patients with known diabetes or an HbA1c ≥6·5% at screening out of 8399 patients with HFrEF who were randomly assigned to treatment with sacubitril/valsartan or enalapril. Of these patients, most (98%) had type 2 diabetes. We assessed changes in HbA1c, triglycerides, HDL cholesterol and BMI in a mixed effects longitudinal analysis model. Time to initiation of oral antihyperglycaemic drugs or insulin in subjects previously not treated with these agents were compared between treatment groups. There were no significant differences in HbA1c concentrations between randomised groups at screening. During the first year of follow-up, HbA1c concentrations decreased by 0·16% (SD 1·40) in the enalapril group and 0·26% (SD 1·25) in the sacubitril/valsartan group (between-group reduction 0·13%, 95% CI 0·05-0·22, p=0·0023). HbA1c concentrations were persistently lower in the sacubitril/valsartan group than in the enalapril group over the 3-year follow-up (between-group reduction 0·14%, 95% CI 0·06-0·23, p=0·0055). New use of insulin was 29% lower in patients receiving sacubitril/valsartan (114 [7%] patients) compared with patients receiving enalapril (153 [10%]; hazard ratio 0·71, 95% CI 0·56-0·90, p=0·0052). Similarly, fewer patients were started on oral antihyperglycaemic therapy (0·77, 0·58-1·02, p=0

  15. Safety and Tolerability of Adjunctive Aripiprazole in Major Depressive Disorder: A Pooled Post Hoc Analysis (studies CN138-139 and CN138-163)

    PubMed Central

    Thase, Michael E.; Trivedi, Madhukar H.; Fava, Maurizio; Han, Jian; Van Tran, Quynh; Pikalov, Andrei; Qi, Ying; Carlson, Berit X.; Marcus, Ronald N.; Berman, Robert M.

    2009-01-01

    Objective: To evaluate the safety and tolerability of aripiprazole adjunctive to standard antidepressant therapy (ADT) for patients with major depressive disorder (DSM-IV-TR criteria). Method: Data from 2 identical studies of aripiprazole augmentation (8 weeks of prospective ADT treatment followed by 6 weeks of randomized double-blind adjunctive treatment) were pooled. The incidence of treatment-emergent adverse events (TEAEs) and weight, electrocardiogram (ECG), and laboratory measurements were assessed during the 6-week phase, including time course, severity, resolution, and predictors. The studies were conducted from June 2004 to April 2006 and September 2004 to December 2006. Results: The safety analysis included 737 outpatients (aripiprazole, n = 371; placebo, n = 366). The majority of patients completed the trials (aripiprazole, 86%; placebo, 88%). Common TEAEs (≥ 5% and twice the placebo rate) with aripiprazole were akathisia (25%), restlessness (12%), insomnia (8%), fatigue (8%), blurred vision (6%), and constipation (5%). Most TEAEs were of mild to moderate severity (aripiprazole, 89%; placebo, 95%). TEAE rates in the aripiprazole and placebo groups were not affected by ADT, age, or gender. Discontinuation due to TEAEs was low (aripiprazole, 3%; placebo, 1%). Mean weight change was higher with aripiprazole versus placebo (1.73 kg vs 0.38 kg, P < .001). At endpoint, clinical laboratory parameters, vital signs, and ECG indices (including QTc interval) were similar between groups. Akathisia with aripiprazole generally occurred in the first 3 weeks (76%), was of mild to moderate severity (92%), and led to discontinuation in 3 patients (0.8%). Within the aripiprazole group, age (18–40 years) was the only positive predictor for akathisia. Conclusions: In this short-term post hoc analysis, aripiprazole as augmentation to ADT demonstrated a safety and tolerability profile similar to that in monotherapy studies in other psychiatric populations. Controlled long

  16. Costs and health resources utilization following switching to pregabalin in individuals with gabapentin-refractory neuropathic pain: a post hoc analysis.

    PubMed

    Navarro, Ana; Saldaña, María T; Pérez, Concepción; Masramón, Xavier; Rejas, Javier

    2012-06-01

    To analyze the changes in pain severity and associated costs resulting from resource utilization and reduced productivity in patients with gabapentin-refractory peripheral neuropathic pain who switched to pregabalin therapy in primary care settings in Spain. This is a post hoc analysis of a 12-week, multicentre, noninterventional cost-of-illness study. Patients were included in the study if they were over 18 years of age and had a diagnosis of chronic, treatment-refractory peripheral neuropathic pain. The analysis included all pregabalin-naïve patients who had previously shown an inadequate response to gabapentin and switched to pregabalin. Severity of pain before and after treatment with pregabalin, alone or as an add-on therapy, was assessed using the Short-Form McGill Pain Questionnaire (SF-MPQ) and its related visual analogue scale (VA). Healthcare resource utilization, productivity (including lost-workday equivalents [LWDE]), and related costs were assessed at baseline and after pregabalin treatment. A total of 174 patients switched to pregabalin had significant and clinically relevant reductions in pain severity (mean [SD] change on SF-MPQ VA scale, -31.9 [22.1]; P < 0.05 vs. baseline; effect size, 1.87). Reduction in pain was similar with both pregabalin monotherapy and add-on therapy. Significant reductions in healthcare resource utilization (concomitant drug use [in pregabalin add-on group], ancillary tests, and unscheduled medical visits) were observed at the end of trial. Additionally, there were substantial improvements in productivity, including a reduction in the number of LWDE following pregabalin treatment (-18.9 [26.0]; P < 0.0001). These changes correlated with substantial reductions in both direct (-652.9 ± 1622.4 €; P < 0.0001) and indirect healthcare costs (-851.6 [1259.6] €; P < 0.0001). The cost of care in patients with gabapentin-refractory peripheral neuropathic pain appeared to be significantly reduced after switching to

  17. Categorical improvements in disease severity in patients with major depressive disorder treated with vilazodone: post hoc analysis of four randomized, placebo-controlled trials

    PubMed Central

    Durgam, Suresh; Chen, Changzheng; Gommoll, Carl P; Edwards, John; Citrome, Leslie

    2016-01-01

    Background In three 8-week studies of vilazodone 40 mg/d (NCT00285376, NCT00683592, and NCT01473394) and a 10-week study of vilazodone 20 or 40 mg/d (NCT01473381), adults with major depressive disorder (MDD) showed significantly greater improvement with vilazodone versus placebo in global disease severity as measured by mean change from baseline in Clinical Global Impression of Severity (CGI-S) score. To assess the proportion of patients achieving clinically meaningful improvement, a post hoc pooled analysis was conducted using categorical shifts in disease severity based on CGI-S scores at baseline and end of treatment (EOT). Methods Analyses were conducted in the pooled intent-to-treat population (N=2,218). Definitions of categorical shifts included CGI-S ≥4 (moderately ill or worse) at baseline to CGI-S ≤2 (normal or borderline ill) at EOT; CGI-S ≥5 (markedly ill or worse) at baseline to CGI-S ≤2 at EOT; and CGI-S ≥6 (severely ill or worse) at baseline to CGI-S ≤3 (mildly ill or better) at EOT. Results At baseline, 2,217 patients were moderately ill or worse. The percentage who improved to normal or borderline ill was significantly higher with vilazodone than with placebo (40.0% versus 27.8%; odds ratio [OR] =1.7, P<0.001; number needed to treat [NNT] =9). In the 979 patients who were markedly ill or worse at baseline, the percentage who improved to normal or borderline ill was significantly higher with vilazodone than with placebo (36.8% versus 25.5%; OR =1.7, P<0.001; NNT =9). The small number of severely ill patients at baseline (n =43) provided inadequate power to detect statistically significant between-group differences, but an NNT =5 was found for improvement to mildly ill or better. Conclusion Categorical shift analyses, defined using baseline and EOT CGI-S scores, showed that significantly higher proportions of patients had clinically meaningful improvements in global disease severity with vilazodone 20–40 mg/d versus placebo. This type of

  18. Efficacy and tolerability of solifenacin in patients aged ≥ 65 years with overactive bladder: post-hoc analysis of 2 open-label studies.

    PubMed

    Capo', James P; Lucente, Vincent; Forero-Schwanhaeuser, Sergio; He, Weizhong

    2011-01-01

    Antimuscarinics have proven efficacy as first-line therapy in overactive bladder (OAB); however, data on their use in older adults are needed. To assess the efficacy and tolerability of solifenacin in patients aged ≥ 65 years, we conducted post-hoc analyses of data from VESIcare® Open-Label Trial (VOLT) and VESIcare® Efficacy and Research Study US (VERSUS). In both of these 12-week, open-label, flexible-dosing studies involving 2645 patients with OAB for ≥ 3 months, patients received 5 mg solifenacin daily for 4 weeks, with an option to increase to 10 mg at week 4 (both studies) and week 8 (VOLT). VERSUS patients had received tolterodine extended release 4 mg for ≥ 4 weeks without sufficient subjective improvement in urgency (mean ≥ 3 urgency episodes/24 h). Baseline values 14 days after tolterodine washout were used for comparison with VOLT. Common study endpoints were the Patient Perception of Bladder Condition (PPBC) scale and the Overactive Bladder Questionnaire (OAB-q). VOLT used a horizontal visual analog scale (VAS), and diary-recorded symptom data were captured in VERSUS. In the full analysis sets (FAS), 40% of VOLT and 44% of VERSUS patients were aged ≥ 65 years. After 12 weeks of solifenacin, older patients experienced decreases in OAB symptoms, and improvements from baseline on the PPBC, OAB-q, and VAS. In total, 59% of older VOLT and 62% of older VERSUS patients reported ≥ 1 treatment-emergent adverse event (AE); the AEs were mostly anticholinergic and of mild-to-moderate severity. Results were consistent with younger patients and the FAS. In this large group of older patients, flexibly dosed solifenacin was associated with reductions in diary-documented OAB symptoms (VERSUS). In both studies, solifenacin was associated with improvements in measures assessing patients' perception of their bladder problems, symptom bother, and aspects of health-related quality of life. Adverse event rates in older patients were comparable to those in

  19. Predictors of psychiatric hospitalization during 6 months of maintenance treatment with olanzapine long-acting injection: post hoc analysis of a randomized, double-blind study

    PubMed Central

    2013-01-01

    Background Hospitalization is a costly and distressing event associated with relapse during schizophrenia treatment. No information is available on the predictors of psychiatric hospitalization during maintenance treatment with olanzapine long-acting injection (olanzapine-LAI) or how the risk of hospitalization differs between olanzapine-LAI and oral olanzapine. This study aimed to identify the predictors of psychiatric hospitalization during maintenance treatment with olanzapine-LAI and assessed four parameters: hospitalization prevalence, incidence rate, duration, and the time to first hospitalization. Olanzapine-LAI was also compared with a sub-therapeutic dose of olanzapine-LAI and with oral olanzapine. Methods This was a post hoc exploratory analysis of data from a randomized, double-blind study comparing the safety and efficacy of olanzapine-LAI (pooled active depot groups: 405 mg/4 weeks, 300 mg/2 weeks, and 150 mg/2 weeks) with oral olanzapine and sub-therapeutic olanzapine-LAI (45 mg/4 weeks) during 6 months’ maintenance treatment of clinically stable schizophrenia outpatients (n=1064). The four psychiatric hospitalization parameters were analyzed for each treatment group. Within the olanzapine-LAI group, patients with and without hospitalization were compared on baseline characteristics. Logistic regression and Cox’s proportional hazards models were used to identify the best predictors of hospitalization. Comparisons between the treatment groups employed descriptive statistics, the Kaplan–Meier estimator and Cox’s proportional hazards models. Results Psychiatric hospitalization was best predicted by suicide threats in the 12 months before baseline and by prior hospitalization. Compared with sub-therapeutic olanzapine-LAI, olanzapine-LAI was associated with a significantly lower hospitalization rate (5.2% versus 11.1%, p < 0.01), a lower mean number of hospitalizations (0.1 versus 0.2, p = 0.01), a shorter mean duration of hospitalization (1.5 days

  20. Permissive Underfeeding or Standard Enteral Feeding in High- and Low-Nutritional-Risk Critically Ill Adults. Post Hoc Analysis of the PermiT Trial.

    PubMed

    Arabi, Yaseen M; Aldawood, Abdulaziz S; Al-Dorzi, Hasan M; Tamim, Hani M; Haddad, Samir H; Jones, Gwynne; McIntyre, Lauralyn; Solaiman, Othman; Sakkijha, Maram H; Sadat, Musharaf; Mundekkadan, Shihab; Kumar, Anand; Bagshaw, Sean M; Mehta, Sangeeta

    2017-03-01

    The optimal nutritional strategy for critically ill adults at high nutritional risk is unclear. To examine the effect of permissive underfeeding with full protein intake compared with standard feeding on 90-day mortality in patients with different baseline nutritional risk. This is a post hoc analysis of the PermiT (Permissive Underfeeding versus Target Enteral Feeding in Adult Critically Ill Patients) trial. Nutritional risk was categorized by the modified Nutrition Risk in Critically Ill score, with high nutritional risk defined as a score of 5-9 and low nutritional risk as a score of 0-4. Additional analyses were performed by categorizing patients by body mass index, prealbumin, transferrin, phosphate, urinary urea nitrogen, and nitrogen balance. Based on the Nutrition Risk in Critically Ill score, 378 of 894 (42.3%) patients were categorized as high nutritional risk and 516 of 894 (57.7%) as low nutritional risk. There was no association between feeding strategy and mortality in the two categories; adjusted odds ratio (aOR) of 0.84 (95% confidence interval [CI], 0.56-1.27) for high nutritional risk and 1.01 (95% CI, 0.64-1.61) for low nutritional risk (interaction P = 0.53). Findings were similar in analyses using other definitions, with the exception of prealbumin. The association of permissive underfeeding versus standard feeding and 90-day mortality differed when patients were categorized by baseline prealbumin level (≤0.10 g/L: aOR, 0.57 [95% CI, 0.31-1.05]; >0.10 and ≤0.15 g/L: aOR, 0.79 [95% CI, 0.42-1.48]; >0.15 g/L: aOR, 1.55 [95% CI, 0.80, 3.01]; interaction P = 0.009). Among patients with high and low nutritional risk, permissive underfeeding with full protein intake was associated with similar outcomes as standard feeding.

  1. Differences in glycemic control across world regions: a post-hoc analysis in patients with type 2 diabetes mellitus on dual antidiabetes drug therapy

    PubMed Central

    Brath, H; Paldánius, P M; Bader, G; Kolaczynski, W M; Nilsson, P M

    2016-01-01

    Objective: This post-hoc analysis of the EDGE (Effectiveness of Diabetes control with vildaGliptin and vildagliptin/mEtformin) study assessed inter-regional differences in baseline characteristics and response to treatment intensification with dual oral antidiabetes drugs (OADs) in patients with type 2 diabetes mellitus (T2DM). Methods: Patients with T2DM inadequately controlled with first-line monotherapy were assigned to receive a dipeptidyl peptidase-4 (DPP-4) inhibitor, vildagliptin, or comparator OADs as add-on dual therapy. The primary effectiveness end point (PEP) was achieving glycated hemoglobin (HbA1c) reduction >0.3% without hypoglycemia, peripheral edema, discontinuation owing to gastrointestinal events or weight gain ⩾5% at 12 months. The secondary effectiveness end point (SEP) was achieving HbA1c of <7% without hypoglycemia or weight gain ⩾3% at 12 months. Results: Baseline characteristics of patients (N=43 791), including mean HbA1c (8.2%), varied across regions. Baseline age (62.3 years) and T2DM duration (6.3 years) were greater in patients from Europe than those from India and the Middle East (age: 51.8 and 52.1 years; T2DM duration: 4.3 and 4.2 years, respectively). The probability of achieving PEP with dual therapy was higher in India (odds ratio (OR): 1.5), Latin America (OR: 1.2) and Middle East (OR: 2.0) than in Europe (OR: 0.8) and East Asia (OR: 0.3). Achievement of SEP in patients receiving dual therapy was greater in Latin America (OR: 1.7) and Middle East (OR: 1.7). Vildagliptin add-on therapy allowed more patients to achieve SEP across regions. Women aged ⩾45 years less often attained glycemic target (HbA1c<7%) without significant weight gain ⩾5% compared with women aged <45 years (OR: 0.876, 95% confidence interval: 0.774, 0.992; P=0.037). Conclusions: Baseline HbA1c and T2DM duration differed considerably across all regions. Treatment intensification with second OAD, particularly with a DPP-4 inhibitor vildagliptin, resulted

  2. Influence of Renal Impairment on Outcome for Thrombolysis-Treated Acute Ischemic Stroke: ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study) Post Hoc Analysis.

    PubMed

    Carr, Susan J; Wang, Xia; Olavarria, Veronica V; Lavados, Pablo M; Rodriguez, Jorge A; Kim, Jong S; Lee, Tsong-Hai; Lindley, Richard I; Pontes-Neto, Octavio M; Ricci, Stefano; Sato, Shoichiro; Sharma, Vijay K; Woodward, Mark; Chalmers, John; Anderson, Craig S; Robinson, Thompson G

    2017-09-01

    Renal dysfunction (RD) is associated with poor prognosis after stroke. We assessed the effects of RD on outcomes and interaction with low- versus standard-dose alteplase in a post hoc subgroup analysis of the ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study). A total of 3220 thrombolysis-eligible patients with acute ischemic stroke (mean age, 66.5 years; 37.8% women) were randomly assigned to low-dose (0.6 mg/kg) or standard-dose (0.9 mg/kg) intravenous alteplase within 4.5 hours of symptom onset. Six hundred and fifty-nine (19.8%) patients had moderate-to-severe RD (estimated glomerular filtration rate, <60 mL/min per 1.73 m(2)) at baseline. The impact of RD on death or disability (modified Rankin Scale scores, 2-6) at 90 days, and symptomatic intracerebral hemorrhage, was assessed in logistic regression models. Compared with patients with normal renal function (>90 mL/min per 1.73 m(2)), those with severe RD (<30 mL/min per 1.73 m(2)) had increased mortality (adjusted odds ratio, 2.07; 95% confidence interval, 0.89-4.82; P=0.04 for trend); every 10 mL/min per 1.73 m(2) lower estimated glomerular filtration rate was associated with an adjusted 9% increased odds of death from thrombolysis-treated acute ischemic stroke. There was no significant association with modified Rankin Scale scores 2 to 6 (adjusted odds ratio, 1.03; 95% confidence interval, 0.62-1.70; P=0.81 for trend), modified Rankin Scale 3 to 6 (adjusted odds ratio, 1.20; 95% confidence interval, 0.72-2.01; P=0.44 for trend), or symptomatic intracerebral hemorrhage, or any heterogeneity in comparative treatment effects between low-dose and standard-dose alteplase by RD grades. RD is associated with increased mortality but not disability or symptomatic intracerebral hemorrhage in thrombolysis-eligible and treated acute ischemic stroke patients. Uncertainty persists as to whether low-dose alteplase confers benefits over standard-dose alteplase in acute ischemic stroke patients with

  3. Oestrogen plus progestin and lung cancer in postmenopausal women (Women's Health Initiative trial): a post-hoc analysis of a randomised controlled trial.

    PubMed

    Chlebowski, Rowan T; Schwartz, Ann G; Wakelee, Heather; Anderson, Garnet L; Stefanick, Marcia L; Manson, JoAnn E; Rodabough, Rebecca J; Chien, Jason W; Wactawski-Wende, Jean; Gass, Margery; Kotchen, Jane Morley; Johnson, Karen C; O'Sullivan, Mary Jo; Ockene, Judith K; Chen, Chu; Hubbell, F Allan

    2009-10-10

    In the post-intervention period of the Women's Health Initiative (WHI) trial, women assigned to treatment with oestrogen plus progestin had a higher risk of cancer than did those assigned to placebo. Results also suggested that the combined hormone therapy might increase mortality from lung cancer. To assess whether such an association exists, we undertook a post-hoc analysis of lung cancers diagnosed in the trial over the entire follow-up period. The WHI study was a randomised, double-blind, placebo-controlled trial undertaken in 40 centres in the USA. 16 608 postmenopausal women aged 50-79 years with an intact uterus were randomly assigned by a computerised, stratified, permuted block algorithm to receive a once-daily tablet of 0.625 mg conjugated equine oestrogen plus 2.5 mg medroxyprogesterone acetate (n=8506) or matching placebo (n=8102). We assessed incidence and mortality rates for all lung cancer, small-cell lung cancer, and non-small-cell lung cancer by use of data from treatment and post-intervention follow-up periods. Analysis was by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00000611. After a mean of 5.6 years (SD 1.3) of treatment and 2.4 years (0.4) of additional follow-up, 109 women in the combined hormone therapy group had been diagnosed with lung cancer compared with 85 in the placebo group (incidence per year 0.16%vs 0.13%; hazard ratio [HR] 1.23, 95% CI 0.92-1.63, p=0.16). 96 women assigned to combined therapy had non-small-cell lung cancer compared with 72 assigned to placebo (0.14%vs 0.11%; HR 1.28, 0.94-1.73, p=0.12). More women died from lung cancer in the combined hormone therapy group than in the placebo group (73 vs 40 deaths; 0.11%vs 0.06%; HR 1.71, 1.16-2.52, p=0.01), mainly as a result of a higher number of deaths from non-small-cell lung cancer in the combined therapy group (62 vs 31 deaths; 0.09%vs 0.05%; HR 1.87, 1.22-2.88, p=0.004). Incidence and mortality rates of small-cell lung cancer were

  4. The effects of baseline characteristics, glycaemia treatment approach, and glycated haemoglobin concentration on the risk of severe hypoglycaemia: post hoc epidemiological analysis of the ACCORD study

    PubMed Central

    Bonds, Denise E; Gerstein, Hertzel C; Seaquist, Elizabeth R; Bergenstal, Richard M; Calles-Escandon, Jorge; Childress, R Dale; Craven, Timothy E; Cuddihy, Robert M; Dailey, George; Feinglos, Mark N; Ismail-Beigi, Farmarz; Largay, Joe F; O’Connor, Patrick J; Paul, Terri; Savage, Peter J; Schubart, Ulrich K; Sood, Ajay; Genuth, Saul

    2010-01-01

    Objectives To investigate potential determinants of severe hypoglycaemia, including baseline characteristics, in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial and the association of severe hypoglycaemia with levels of glycated haemoglobin (haemoglobin A1C) achieved during therapy. Design Post hoc epidemiological analysis of a double 2×2 factorial, randomised, controlled trial. Setting Diabetes clinics, research clinics, and primary care clinics. Participants 10 209 of the 10 251 participants enrolled in the ACCORD study with type 2 diabetes, a haemoglobin A1C concentration of 7.5% or more during screening, and aged 40-79 years with established cardiovascular disease or 55-79 years with evidence of significant atherosclerosis, albuminuria, left ventricular hypertrophy, or two or more additional risk factors for cardiovascular disease (dyslipidaemia, hypertension, current smoker, or obese). Interventions Intensive (haemoglobin A1C <6.0%) or standard (haemoglobin A1C 7.0-7.9%) glucose control. Main outcome measures Severe hypoglycaemia was defined as episodes of “low blood glucose” requiring the assistance of another person and documentation of either a plasma glucose less than 2.8 mmol/l (<50 mg/dl) or symptoms that promptly resolved with oral carbohydrate, intravenous glucose, or glucagon. Results The annual incidence of hypoglycaemia was 3.14% in the intensive treatment group and 1.03% in the standard glycaemia group. We found significantly increased risks for hypoglycaemia among women (P=0.0300), African-Americans (P<0.0001 compared with non-Hispanic whites), those with less than a high school education (P<0.0500 compared with college graduates), aged participants (P<0.0001 per 1 year increase), and those who used insulin at trial entry (P<0.0001). For every 1% unit decline in the haemoglobin A1C concentration from baseline to 4 month visit, there was a 28% (95% CI 19% to 37%) and 14% (4% to 23%) reduced risk of hypoglycaemia

  5. Global Coverage from Ad-Hoc Constellations in Rideshare Orbits

    NASA Technical Reports Server (NTRS)

    Ellis, Armin; Mercury, Michael; Brown, Shannon

    2012-01-01

    A promising area of small satellite development is in providing higher temporal resolution than larger satellites. Traditional constellations have required specific orbits and dedicated launch vehicles. In this paper we discuss an alternative architecture in which the individual elements of the constellation are launched as rideshare opportunities. We compare the coverage of such an ad-hoc constellation with more traditional constellations. Coverage analysis is based on actual historical data from rideshare opportunities. Our analysis includes ground coverage and temporal revisits for Polar, Tropics, Temperate, and Global regions, comparing ad-hoc and Walker constellation.

  6. Global Coverage from Ad-Hoc Constellations in Rideshare Orbits

    NASA Technical Reports Server (NTRS)

    Ellis, Armin; Mercury, Michael; Brown, Shannon

    2012-01-01

    A promising area of small satellite development is in providing higher temporal resolution than larger satellites. Traditional constellations have required specific orbits and dedicated launch vehicles. In this paper we discuss an alternative architecture in which the individual elements of the constellation are launched as rideshare opportunities. We compare the coverage of such an ad-hoc constellation with more traditional constellations. Coverage analysis is based on actual historical data from rideshare opportunities. Our analysis includes ground coverage and temporal revisits for Polar, Tropics, Temperate, and Global regions, comparing ad-hoc and Walker constellation.

  7. Effects of asenapine on depressive symptoms in patients with bipolar I disorder experiencing acute manic or mixed episodes: a post hoc analysis of two 3-week clinical trials

    PubMed Central

    2011-01-01

    Background Asenapine demonstrated superiority over placebo for mania in bipolar I disorder patients experiencing acute current manic or mixed episodes in 2 randomized, placebo-and olanzapine-controlled trials. We report the results of exploratory pooled post hoc analyses from these trials evaluating asenapine's effects on depressive symptoms in patients from these trials with significant baseline depressive symptoms. Methods In the original trials (A7501004 [NCT00159744], A7501005 [NCT00159796]), 977 patients were randomized to flexible-dose sublingual asenapine (10 mg twice daily on day 1; 5 or 10 mg twice daily thereafter), placebo, or oral olanzapine 5-20 mg once daily for 3 weeks. Three populations were defined using baseline depressive symptoms: (1) Montgomery-Asberg Depression Rating Scale (MADRS) total score ≥20 (n = 132); (2) Clinical Global Impression for Bipolar Disorder-Depression (CGI-BP-D) scale severity score ≥4 (n = 170); (3) diagnosis of mixed episodes (n = 302) by investigative site screening. For each population, asenapine and olanzapine were independently compared with placebo using least squares mean change from baseline on depressive symptom measures. Results Decreases in MADRS total score were statistically greater with asenapine versus placebo at days 7 and 21 in all populations; differences between olanzapine and placebo were not significant. Decreases in CGI-BP-D score were significantly greater with asenapine versus placebo at day 7 in all categories and day 21 in population 1; CGI-BP-D score reductions were significantly greater with olanzapine versus placebo at day 21 in population 1 and day 7 in populations 2 and 3. Conclusions These post hoc analyses show that asenapine reduced depressive symptoms in bipolar I disorder patients experiencing acute manic or mixed episodes with clinically relevant depressive symptoms at baseline; olanzapine results appeared to be less consistent. Controlled studies of asenapine in patients with acute

  8. Effects of asenapine on depressive symptoms in patients with bipolar I disorder experiencing acute manic or mixed episodes: a post hoc analysis of two 3-week clinical trials.

    PubMed

    Szegedi, Armin; Zhao, Jun; van Willigenburg, Arjen; Nations, Kari R; Mackle, Mary; Panagides, John

    2011-06-20

    Asenapine demonstrated superiority over placebo for mania in bipolar I disorder patients experiencing acute current manic or mixed episodes in 2 randomized, placebo-and olanzapine-controlled trials. We report the results of exploratory pooled post hoc analyses from these trials evaluating asenapine's effects on depressive symptoms in patients from these trials with significant baseline depressive symptoms. In the original trials (A7501004 [NCT00159744], A7501005 [NCT00159796]), 977 patients were randomized to flexible-dose sublingual asenapine (10 mg twice daily on day 1; 5 or 10 mg twice daily thereafter), placebo, or oral olanzapine 5-20 mg once daily for 3 weeks. Three populations were defined using baseline depressive symptoms: (1) Montgomery-Asberg Depression Rating Scale (MADRS) total score ≥20 (n = 132); (2) Clinical Global Impression for Bipolar Disorder-Depression (CGI-BP-D) scale severity score ≥4 (n = 170); (3) diagnosis of mixed episodes (n = 302) by investigative site screening. For each population, asenapine and olanzapine were independently compared with placebo using least squares mean change from baseline on depressive symptom measures. Decreases in MADRS total score were statistically greater with asenapine versus placebo at days 7 and 21 in all populations; differences between olanzapine and placebo were not significant. Decreases in CGI-BP-D score were significantly greater with asenapine versus placebo at day 7 in all categories and day 21 in population 1; CGI-BP-D score reductions were significantly greater with olanzapine versus placebo at day 21 in population 1 and day 7 in populations 2 and 3. These post hoc analyses show that asenapine reduced depressive symptoms in bipolar I disorder patients experiencing acute manic or mixed episodes with clinically relevant depressive symptoms at baseline; olanzapine results appeared to be less consistent. Controlled studies of asenapine in patients with acute bipolar depression are necessary to

  9. Impact of source data verification on data quality in clinical trials: an empirical post hoc analysis of three phase 3 randomized clinical trials

    PubMed Central

    Andersen, Jeppe Ragnar; Byrjalsen, Inger; Bihlet, Asger; Kalakou, Faidra; Hoeck, Hans Christian; Hansen, Gitte; Hansen, Henrik Bo; Karsdal, Morten Asser; Riis, Bente Juel

    2015-01-01

    AIM The aim of this project was to perform an empirical evaluation of the impact of on site source data verification (SDV) on the data quality in a clinical trial database to guide an informed decision on selection of the monitoring approach. METHODS We used data from three randomized phase III trials monitored with a combination of complete SDV or partial SDV. After database lock, individual subject data were extracted from the clinical database and subjected to post hoc complete SDV. Error rates were calculated with focus on the degree of on study monitoring and relevance and analyzed for potential impact on end points. RESULTS Data from a total of 2566 subjects including more than 3 million data fields were 100% source data verified post hoc. An overall error rate of 0.45% was found. No sites had 0% errors. 100% SDV yielded an error rate of 0.27% as compared with partial SDV having an error rate of 0.53% (P < 0.0001). Comparing partly and fully monitored subjects, minor differences were identified between variables of major importance to efficacy or safety. CONCLUSIONS The findings challenge the notion that a 0% error rate is obtainable with on site monitoring. Data indicate consistently low error rates across the three trials analyzed. The use of complete vs. partial SDV offers a marginal absolute error rate reduction of 0.26%, i.e. a need to perform complete SDV of about 370 data points to avoid one unspecified error and does not support complete SDV as a means of providing meaningful improvements in data accuracy. PMID:25327707

  10. Clinical Outcomes from Androgen Signaling-directed Therapy after Treatment with Abiraterone Acetate and Prednisone in Patients with Metastatic Castration-resistant Prostate Cancer: Post Hoc Analysis of COU-AA-302.

    PubMed

    Smith, Matthew R; Saad, Fred; Rathkopf, Dana E; Mulders, Peter F A; de Bono, Johann S; Small, Eric J; Shore, Neal D; Fizazi, Karim; Kheoh, Thian; Li, Jinhui; De Porre, Peter; Todd, Mary B; Yu, Margaret K; Ryan, Charles J

    2017-03-14

    In the COU-AA-302 trial, abiraterone acetate plus prednisone significantly increased overall survival for patients with chemotherapy-naïve metastatic castration-resistant prostate cancer (mCRPC). Limited information exists regarding response to subsequent androgen signaling-directed therapies following abiraterone acetate plus prednisone in patients with mCRPC. We investigated clinical outcomes associated with subsequent abiraterone acetate plus prednisone (55 patients) and enzalutamide (33 patients) in a post hoc analysis of COU-AA-302. Prostate-specific antigen (PSA) response was assessed. Median time to PSA progression was estimated using the Kaplan-Meier method. The PSA response rate (≥50% PSA decline, unconfirmed) was 44% and 67%, respectively. The median time to PSA progression was 3.9 mo (range 2.6-not estimable) for subsequent abiraterone acetate plus prednisone and 2.8 mo (range 1.8-not estimable) for subsequent enzalutamide. The majority of patients (68%) received intervening chemotherapy before subsequent abiraterone acetate plus prednisone or enzalutamide. While acknowledging the limitations of post hoc analyses and high censoring (>75%) in both treatment groups, these results suggest that subsequent therapy with abiraterone acetate plus prednisone or enzalutamide for patients who progressed on abiraterone acetate is associated with limited clinical benefit.

  11. Impact of bone-targeted therapies in chemotherapy-naïve metastatic castration-resistant prostate cancer patients treated with abiraterone acetate: post hoc analysis of study COU-AA-302.

    PubMed

    Saad, Fred; Shore, Neal; Van Poppel, Hendrik; Rathkopf, Dana E; Smith, Matthew R; de Bono, Johann S; Logothetis, Christopher J; de Souza, Paul; Fizazi, Karim; Mulders, Peter F A; Mainwaring, Paul; Hainsworth, John D; Beer, Tomasz M; North, Scott; Fradet, Yves; Griffin, Thomas A; De Porre, Peter; Londhe, Anil; Kheoh, Thian; Small, Eric J; Scher, Howard I; Molina, Arturo; Ryan, Charles J

    2015-10-01

    Metastatic castration-resistant prostate cancer (mCRPC) often involves bone, and bone-targeted therapy (BTT) has become part of the overall treatment strategy. Investigation of outcomes for concomitant BTT in a post hoc analysis of the COU-AA-302 trial, which demonstrated an overall clinical benefit of abiraterone acetate (AA) plus prednisone over placebo plus prednisone in asymptomatic or mildly symptomatic chemotherapy-naïve mCRPC patients. This report describes the third interim analysis (prespecified at 55% overall survival [OS] events) for the COU-AA-302 trial. Patients were grouped by concomitant BTT use or no BTT use. Radiographic progression-free survival and OS were coprimary end points. This report describes the third interim analysis (prespecified at 55% OS events) and involves patients treated with or without concomitant BTT during the COU-AA-302 study. Median follow-up for OS was 27.1 mo. Median time-to-event variables with 95% confidence intervals (CIs) were estimated using the Kaplan-Meier method. Adjusted hazard ratios (HRs), 95% CIs, and p values for concomitant BTT versus no BTT were obtained via Cox models. While the post hoc nature of the analysis is a limitation, superiority of AA and prednisone versus prednisone alone was demonstrated for clinical outcomes with or without BTT use. Compared with no BTT use, concomitant BTT significantly improved OS (HR 0.75; p=0.01) and increased the time to ECOG deterioration (HR 0.75; p<0.001) and time to opiate use for cancer-related pain (HR 0.80; p=0.036). The safety profile of concomitant BTT with AA was similar to that reported for AA in the overall intent-to-treat population. Osteonecrosis of the jaw (all grade 1/2) with concomitant BTT use was reported in <3% of patients. AA with concomitant BTT was safe and well tolerated in men with chemotherapy-naïve mCRPC. The benefits of AA on clinical outcomes were increased with concomitant BTT. Treatment of advanced prostate cancer often includes bone

  12. Sputnik: ad hoc distributed computation.

    PubMed

    Völkel, Gunnar; Lausser, Ludwig; Schmid, Florian; Kraus, Johann M; Kestler, Hans A

    2015-04-15

    In bioinformatic applications, computationally demanding algorithms are often parallelized to speed up computation. Nevertheless, setting up computational environments for distributed computation is often tedious. Aim of this project were the lightweight ad hoc set up and fault-tolerant computation requiring only a Java runtime, no administrator rights, while utilizing all CPU cores most effectively. The Sputnik framework provides ad hoc distributed computation on the Java Virtual Machine which uses all supplied CPU cores fully. It provides a graphical user interface for deployment setup and a web user interface displaying the current status of current computation jobs. Neither a permanent setup nor administrator privileges are required. We demonstrate the utility of our approach on feature selection of microarray data. The Sputnik framework is available on Github http://github.com/sysbio-bioinf/sputnik under the Eclipse Public License. hkestler@fli-leibniz.de or hans.kestler@uni-ulm.de Supplementary data are available at Bioinformatics online. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  13. Effect of smoking reduction and cessation on the plasma levels of the oxidative stress biomarker glutathione – Post-hoc analysis of data from a smoking cessation trial

    PubMed Central

    Mons, Ute; Muscat, Joshua E; Modesto, Jennifer; Richie, John P; Brenner, Hermann

    2016-01-01

    Cigarette smoke contains high concentrations of free radical components that induce oxidative stress. Smoking-induced oxidative stress is thought to contribute to chronic obstructive pulmonary disease, cardiovascular disease and lung cancer through degenerative processes in the lung and other tissues. It is uncertain however whether smoking cessation lowers the burden of oxidative stress. We used data from a randomized controlled cessation trial of 434 current smokers for a post-hoc examination of the effects of smoking cessation on blood plasma levels of total glutathione (tGSH), the most abundant endogenous antioxidant in cells, and total cysteine (tCys), an amino acid and constituent of glutathione. Smoking status was validated based on serum cotinine levels. Multivariate linear mixed models were fitted to examine the association of smoking cessation and change in cigarette consumption with tGSH and tCys. After 12 months follow-up, quitters (n=55) had significantly increased levels of tGSH compared to subjects who continued to smoke (P<0.01). No significant change in tGSH was found for subjects who continued to smoke but reduced their intensity of smoking. No significant effect of smoking cessation or reduction was observed on levels of tCys. These results suggest that smoking cessation but not smoking reduction reduces levels of oxidative stress. PMID:26708755

  14. Effect of smoking reduction and cessation on the plasma levels of the oxidative stress biomarker glutathione--Post-hoc analysis of data from a smoking cessation trial.

    PubMed

    Mons, Ute; Muscat, Joshua E; Modesto, Jennifer; Richie, John P; Brenner, Hermann

    2016-02-01

    Cigarette smoke contains high concentrations of free radical components that induce oxidative stress. Smoking-induced oxidative stress is thought to contribute to chronic obstructive pulmonary disease, cardiovascular disease and lung cancer through degenerative processes in the lung and other tissues. It is uncertain however whether smoking cessation lowers the burden of oxidative stress. We used data from a randomized controlled cessation trial of 434 current smokers for a post-hoc examination of the effects of smoking cessation on blood plasma levels of total glutathione (tGSH), the most abundant endogenous antioxidant in cells, and total cysteine (tCys), an amino acid and constituent of glutathione. Smoking status was validated based on serum cotinine levels. Multivariate linear mixed models were fitted to examine the association of smoking cessation and change in cigarette consumption with tGSH and tCys. After 12 months follow-up, quitters (n=55) had significantly increased levels of tGSH compared to subjects who continued to smoke (P<0.01). No significant change in tGSH was found for subjects who continued to smoke but reduced their intensity of smoking. No significant effect of smoking cessation or reduction was observed on levels of tCys. These results suggest that smoking cessation but not smoking reduction reduces levels of oxidative stress.

  15. Effects of levomilnacipran extended-release on major depressive disorder patients with cognitive impairments: post-hoc analysis of a phase III study.

    PubMed

    Wesnes, Keith A; Gommoll, Carl; Chen, Changzheng; Sambunaris, Angelo; McIntyre, Roger S; Harvey, Philip D

    2017-03-01

    Performance-based cognitive data were collected using the Cognitive Drug Research System in a study of levomilnacipran extended-release (ER) 40-120 mg/day (NCT01034462) in adults with major depressive disorder. These data were analyzed post-hoc to explore the relationship between cognitive measures, depression symptoms (Montgomery-Åsberg Depression Rating Scale, MADRS), and self-reported psychosocial functioning (Sheehan Disability Scale; SDS). Changes from baseline were analyzed in the intent-to-treat population and subgroups with impaired attention, as indicated by baseline Cognitive Drug Research System scores for Power of Attention and Continuity of Attention. Path analyses evaluated the direct and indirect effects of levomilnacipran ER on SDS total score change. Significantly greater improvements were observed for levomilnacipran ER versus placebo for Power of Attention, Continuity of Attention, MADRS, and SDS score changes; the mean differences were larger in the impaired subgroups than in the overall intent-to-treat population. Path analyses showed that the majority of SDS total score improvement (≥50%) was attributable to an indirect treatment effect through MADRS total score change; some direct effect of levomilnacipran ER on SDS total score improvement was also observed. In adults with major depressive disorder, levomilnacipran ER effectively improved measures of depression and cognition, which contributed toward reductions in self-reported functional impairment.

  16. Estimating HIV Incidence during Pregnancy and Knowledge of Prevention of Mother-to-Child Transmission with an Ad Hoc Analysis of Potential Cofactors.

    PubMed

    Egbe, Thomas Obinchemti; Tazinya, Rose-Mary Asong; Halle-Ekane, Gregory Edie; Egbe, Eta-Nkongho; Achidi, Eric Akum

    2016-01-01

    We determined the incidence of HIV seroconversion during the second and third trimesters of pregnancy and ad hoc potential cofactors associated with HIV seroconversion after having an HIV-negative result antenatally. We also studied knowledge of PMTCT among pregnant women in seven health facilities in Fako Division, South West Region, Cameroon. During the period between September 12 and December 4, 2011, we recruited a cohort of 477 HIV-negative pregnant women by cluster sampling. Data collection was with a pretested interviewer-administered questionnaire. Sociodemographic information, knowledge of PMTCT, and methods of HIV prevention were obtained from the study population and we did Voluntary Counselling and Testing (VCT) for HIV. The incidence rate of HIV seroconversion during pregnancy was 6.8/100 woman-years. Ninety percent of the participants did not use condoms throughout pregnancy but had a good knowledge of PMTCT of HIV. Only 31.9% of participants knew their HIV status before the booking visit and 33% did not know the HIV status of their partners. The incidence rate of HIV seroconversion in the Fako Division, Cameroon, was 6.8/100 woman-years. No risk factors associated with HIV seroconversion were identified among the study participants because of lack of power to do so.

  17. Effects of levomilnacipran extended-release on major depressive disorder patients with cognitive impairments: post-hoc analysis of a phase III study

    PubMed Central

    Gommoll, Carl; Chen, Changzheng; Sambunaris, Angelo; McIntyre, Roger S.; Harvey, Philip D.

    2017-01-01

    Performance-based cognitive data were collected using the Cognitive Drug Research System in a study of levomilnacipran extended-release (ER) 40–120 mg/day (NCT01034462) in adults with major depressive disorder. These data were analyzed post-hoc to explore the relationship between cognitive measures, depression symptoms (Montgomery–Åsberg Depression Rating Scale, MADRS), and self-reported psychosocial functioning (Sheehan Disability Scale; SDS). Changes from baseline were analyzed in the intent-to-treat population and subgroups with impaired attention, as indicated by baseline Cognitive Drug Research System scores for Power of Attention and Continuity of Attention. Path analyses evaluated the direct and indirect effects of levomilnacipran ER on SDS total score change. Significantly greater improvements were observed for levomilnacipran ER versus placebo for Power of Attention, Continuity of Attention, MADRS, and SDS score changes; the mean differences were larger in the impaired subgroups than in the overall intent-to-treat population. Path analyses showed that the majority of SDS total score improvement (≥50%) was attributable to an indirect treatment effect through MADRS total score change; some direct effect of levomilnacipran ER on SDS total score improvement was also observed. In adults with major depressive disorder, levomilnacipran ER effectively improved measures of depression and cognition, which contributed toward reductions in self-reported functional impairment. PMID:27861191

  18. Estimating HIV Incidence during Pregnancy and Knowledge of Prevention of Mother-to-Child Transmission with an Ad Hoc Analysis of Potential Cofactors

    PubMed Central

    Egbe, Thomas Obinchemti; Tazinya, Rose-Mary Asong; Halle-Ekane, Gregory Edie; Egbe, Eta-Nkongho; Achidi, Eric Akum

    2016-01-01

    Background. We determined the incidence of HIV seroconversion during the second and third trimesters of pregnancy and ad hoc potential cofactors associated with HIV seroconversion after having an HIV-negative result antenatally. We also studied knowledge of PMTCT among pregnant women in seven health facilities in Fako Division, South West Region, Cameroon. Method. During the period between September 12 and December 4, 2011, we recruited a cohort of 477 HIV-negative pregnant women by cluster sampling. Data collection was with a pretested interviewer-administered questionnaire. Sociodemographic information, knowledge of PMTCT, and methods of HIV prevention were obtained from the study population and we did Voluntary Counselling and Testing (VCT) for HIV. Results. The incidence rate of HIV seroconversion during pregnancy was 6.8/100 woman-years. Ninety percent of the participants did not use condoms throughout pregnancy but had a good knowledge of PMTCT of HIV. Only 31.9% of participants knew their HIV status before the booking visit and 33% did not know the HIV status of their partners. Conclusion. The incidence rate of HIV seroconversion in the Fako Division, Cameroon, was 6.8/100 woman-years. No risk factors associated with HIV seroconversion were identified among the study participants because of lack of power to do so. PMID:27127653

  19. Early-Stage Hyperoxia Is Associated with Favorable Neurological Outcomes and Survival after Severe Traumatic Brain Injury: A Post-Hoc Analysis of the Brain Hypothermia Study.

    PubMed

    Fujita, Motoki; Oda, Yasutaka; Yamashita, Susumu; Kaneda, Kotaro; Kaneko, Tadashi; Suehiro, Eiichi; Dohi, Kenji; Kuroda, Yasuhiro; Kobata, Hitoshi; Tsuruta, Ryosuke; Maekawa, Tsuyoshi

    2017-01-19

    The effects of hyperoxia on the neurological outcomes of patients with severe traumatic brain injury (TBI) are still controversial. We examined whether the partial pressure of arterial oxygen (PaO2) and hyperoxia were associated with neurological outcomes and survival by conducting post-hoc analyses of the Brain Hypothermia (B-HYPO) study, a multi-center randomized controlled trial of mild therapeutic hypothermia for severe TBI. The differences in PaO2 and PaO2/fraction of inspiratory oxygen (P/F) ratio on the 1st day of admission were compared between patients with favorable (n = 64) and unfavorable (n = 65) neurological outcomes and between survivors (n = 90) and deceased patients (n = 39). PaO2 and the P/F ratio were significantly greater in patients with favorable outcomes than in patients with unfavorable neurological outcomes (PaO2: 252 ± 122 vs. 202 ± 87 mm Hg, respectively, p = 0.008; P/F ratio: 455 ± 171 vs. 389 ± 155, respectively, p = 0.022) and in survivors than in deceased patients (PaO2: 242 ± 117 vs. 193 ± 75 mm Hg, respectively, p = 0.005; P/F ratio: 445 ± 171 vs. 370 ± 141, respectively, p = 0.018). Similar tendencies were observed in subgroup analyses in patients with fever control and therapeutic hypothermia, and in patients with an evacuated mass or other lesions (unevacuated lesions). PaO2 was independently associated with survival (odds ratio 1.008, p = 0.037). These results suggested that early-stage hyperoxia might be associated with favorable neurological outcomes and survival following severe TBI.

  20. Delphi consensus on the diagnosis and management of dyslipidaemia in chronic kidney disease patients: A post hoc analysis of the DIANA study.

    PubMed

    Cases Amenós, Aleix; Pedro-Botet Montoya, Juan; Pascual Fuster, Vicente; Barrios Alonso, Vivencio; Pintó Sala, Xavier; Ascaso Gimilio, Juan F; Millán Nuñez-Cortés, Jesús; Serrano Cumplido, Adalberto

    This post hoc study analysed the perception of the relevance of chronic kidney disease (CKD) in dyslipidaemia screening and the choice of statin among primary care physicians (PCPs) and other specialists through a Delphi questionnaire. The questionnaire included 4blocks of questions concerning dyslipidaemic patients with impaired carbohydrate metabolism. This study presents the results of the impact of CKD on screening and the choice of statin. Of the 497 experts included, 58% were PCPs and 42% were specialists (35, 7% were nephrologists). There was consensus by both PCPs and specialists, with no difference between PCPs and specialists, that CKD patients should undergo a dyslipidaemia screening and that the screening should be part of routine clinical practice. However, there was no consensus in considering the estimated glomerular filtration rate (eGFR) (although there was consensus among PCPs and nephrologists), or considering albuminuria when selecting a statin, or in determining albuminuria during follow-up after having initiated treatment with statins (although there was consensus among the nephrologists). The consensus to analyse the lipid profile in CKD patients suggests acknowledgment of the high cardiovascular risk of this condition. However, the lack of consensus in considering renal function or albuminuria, both when selecting a statin and during follow-up, suggests a limited knowledge of the differences between statins in relation to CKD. Thus, it would be advisable to develop a guideline/consensus document on the use of statins in CKD. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  1. Efficacy and Safety of Risedronate in Osteoporosis Subjects with Comorbid Diabetes, Hypertension, and/or Dyslipidemia: A Post Hoc Analysis of Phase III Trials Conducted in Japan.

    PubMed

    Inoue, Daisuke; Muraoka, Ryoichi; Okazaki, Ryo; Nishizawa, Yoshiki; Sugimoto, Toshitsugu

    2016-02-01

    Many osteoporotics have comorbid diabetes mellitus (DM), hypertension (HT), and dyslipidemia (DL). However, whether such comorbidities alter response to anti-osteoporotic treatment is unknown. We did post hoc analyses of combined data from three risedronate Japanese phase III trials to determine whether the presence of DM, HT, or DL affects its efficacy and safety. Data from 885 subjects who received 48-week treatment with risedronate were collected and combined from the three phase III trials. They were divided into two groups by the presence or absence of comorbidities: DM (n = 53) versus non-DM (n = 832); HT (n = 278) versus non-HT (n = 607); and DL (n = 292) versus non-DL (n = 593). Bone mineral density (BMD), urinary type 1 collagen N-telopeptide (uNTX), and serum bone-specific alkaline phosphatase (BAP) were measured at baseline and sequentially until 48 weeks. BMD or bone markers were not different between any of the two groups. Overall, BMD was increased by 5.52%, and uNTX and BAP were decreased by 35.4 and 33.8%, respectively. Some bone markers were slightly lower in DM and DL subjects, but the responses to risedronate were not significantly different. Statin users had lower uNTX and BAP, but showed no difference in the treatment response. All the other medications had no apparent effect. Adverse event incidence was marginally higher in DL compared with non-DL (Relative risk 1.06; 95% confidence interval 1.01-1.11), but was not related to increase in any specific events. Risedronate shows consistent safety and efficacy in suppressing bone turnover and increasing BMD in osteoporosis patients with comorbid DM, HT, and/or DL.

  2. Analysis of location-aware QoS-routing protocols based on partial temporal and spatial topology for real-time multimedia in mobile ad hoc networks

    NASA Astrophysics Data System (ADS)

    Hortos, William S.

    2004-08-01

    In the distributed operations of route discovery and maintenance, strong interaction occurs across mobile ad hoc network (MANET) protocol layers in the transport of service packets between source and destination nodes. Quality of service (QoS) requirements are specified for multimedia service classes by the application layer. Due to node mobility, knowledge of their locations is inherently incomplete. Network topology is thus only partially known in time and in space. Cross-layer interactions in the protocol are modeled in terms of a set of concatenated design parameters, updates on node positions and associated energy costs. Functional dependencies of the QoS metrics on the concatenated parameters are described. An analytical framework is established for development of new cross-layer designs that optimize layer interdependencies to achieve the "best" QoS available in the MANET given a partially known, time-varying topology. The designs, based on a reactive MANET protocol, adapt provisioned QoS to dynamic network conditions and residual energy capacities. Cross-layer optimization, given partially known topology, is based on stochastic dynamic programming and predictive estimation conditions derived from time-dependent models of MANET behavior. Models of real-time behavior are based on the control of conditional rates of multivariate point processes (MVPPs). These rates depend on the concatenated protocol and resource parameters. The analytical framework supports predictive models to estimate node mobility in addition to measurement-based estimates of probability distributions for voice, video, data, and other Internet traffic. Estimates of QoS metrics are given in terms of recursive stochastic filters of the network state, based on complete or partial observations of topology and events.

  3. Prior human papillomavirus-16/18 AS04-adjuvanted vaccination prevents recurrent high grade cervical intraepithelial neoplasia after definitive surgical therapy: Post-hoc analysis from a randomized controlled trial.

    PubMed

    Garland, Suzanne M; Paavonen, Jorma; Jaisamrarn, Unnop; Naud, Paulo; Salmerón, Jorge; Chow, Song-Nan; Apter, Dan; Castellsagué, Xavier; Teixeira, Júlio C; Skinner, S Rachel; Hedrick, James; Limson, Genara; Schwarz, Tino F; Poppe, Willy A J; Bosch, F Xavier; de Carvalho, Newton S; Germar, Maria Julieta V; Peters, Klaus; Del Rosario-Raymundo, M Rowena; Catteau, Grégory; Descamps, Dominique; Struyf, Frank; Lehtinen, Matti; Dubin, Gary

    2016-12-15

    We evaluated the efficacy of the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine in preventing HPV-related disease after surgery for cervical lesions in a post-hoc analysis of the PApilloma TRIal against Cancer In young Adults (PATRICIA; NCT00122681). Healthy women aged 15-25 years were randomized (1:1) to receive vaccine or control at months 0, 1 and 6 and followed for 4 years. Women were enrolled regardless of their baseline HPV DNA status, HPV-16/18 serostatus, or cytology, but excluded if they had previous or planned colposcopy. The primary and secondary endpoints of PATRICIA have been reported previously; the present post-hoc analysis evaluated efficacy in a subset of women who underwent an excisional procedure for cervical lesions after vaccination. The main outcome was the incidence of subsequent HPV-related cervical intraepithelial neoplasia grade 2 or greater (CIN2+) 60 days or more post-surgery. Other outcomes included the incidence of HPV-related CIN1+, and vulvar or vaginal intraepithelial neoplasia (VIN/VaIN) 60 days or more post-surgery. Of the total vaccinated cohort of 18,644 women (vaccine = 9,319; control = 9,325), 454 (vaccine = 190, control = 264) underwent an excisional procedure during the trial. Efficacy 60 days or more post-surgery for a first lesion, irrespective of HPV DNA results, was 88.2% (95% CI: 14.8, 99.7) against CIN2+ and 42.6% (-21.1, 74.1) against CIN1+. No VIN was reported and one woman in each group had VaIN2+ 60 days or more post-surgery. Women who undergo surgical therapy for cervical lesions after vaccination with the HPV-16/18 vaccine may continue to benefit from vaccination, with a reduced risk of developing subsequent CIN2+. © 2016 UICC.

  4. Remission and recovery associated with lurasidone in the treatment of major depressive disorder with subthreshold hypomanic symptoms (mixed features): post-hoc analysis of a randomized, placebo-controlled study with longer-term extension.

    PubMed

    Goldberg, Joseph F; Ng-Mak, Daisy; Siu, Cynthia; Chuang, Chien-Chia; Rajagopalan, Krithika; Loebel, Antony

    2017-04-01

    This post-hoc analysis assessed rates of symptomatic and functional remission, as well as recovery (combination of symptomatic and functional remission), in patients treated with lurasidone for major depressive disorder (MDD) associated with subthreshold hypomanic symptoms (mixed features). Patients with MDD plus two or three manic symptoms (defined as per the DSM-5 mixed-features specifier) were randomly assigned to flexible-dose lurasidone 20-60 mg/day (n=109) or placebo (n=100) for 6 weeks, followed by a 3-month open-label, flexible-dose extension study for U.S. sites only (n=48). Cross-sectional recovery was defined as the presence of both symptomatic remission (Montgomery-Åsberg Depression Rating Scale score ≤ 12) and functional remission (all Sheehan Disability Scale [SDS] domain scores ≤3) at week 6, and at both months 1 and 3 of the extension study ("sustained recovery"). A significantly higher proportion of lurasidone-treated patients (31.3%) achieved recovery (assessed cross-sectionally) compared to placebo (12.2%, p=0.002) at week 6. The number of manic symptoms at baseline moderated the effect size for attaining cross-sectional recovery for lurasidone treatment (vs. placebo) (p=0.028). Sustained recovery rates were higher in patients initially treated with lurasidone (20.8%) versus placebo (12.5%). In this post-hoc analysis of a placebo-controlled study with open-label extension that involved patients with MDD and mixed features, lurasidone was found to significantly improve the rate of recovery at 6 weeks (vs. placebo) that was sustained at month 3 of the extension study. The presence of two (as opposed to three) manic symptoms moderated recovery at the acute study endpoint.

  5. Post Hoc Analysis of Data from Two Clinical Trials Evaluating the Minimal Clinically Important Change in International Restless Legs Syndrome Sum Score in Patients with Restless Legs Syndrome (Willis-Ekbom Disease)

    PubMed Central

    Ondo, William G.; Grieger, Frank; Moran, Kimberly; Kohnen, Ralf; Roth, Thomas

    2016-01-01

    Study Objectives: Determine the minimal clinically important change (MCIC), a measure determining the minimum change in scale score perceived as clinically beneficial, for the international restless legs syndrome (IRLS) and restless legs syndrome 6-item questionnaire (RLS-6) in patients with moderate to severe restless legs syndrome (RLS/Willis-Ekbom disease) treated with the rotigotine transdermal system. Methods: This post hoc analysis analyzed data from two 6-mo randomized, double-blind, placebo-controlled studies (SP790 [NCT00136045]; SP792 [NCT00135993]) individually and as a pooled analysis in rotigotine-treated patients, with baseline and end of maintenance IRLS and Clinical Global Impressions of change (CGI Item 2) scores available for analysis. An anchor-based approach and receiver operating characteristic (ROC) curves were used to determine the MCIC for the IRLS and RLS-6. We specifically compared “much improved vs minimally improved,” “much improved/very much improved vs minimally improved or worse,” and “minimally improved or better vs no change or worse” on the CGI-2 using the full analysis set (data as observed). Results: The MCIC IRLS cut-off scores for SP790 and SP792 were similar. Using the pooled SP790+SP792 analysis, the MCIC total IRLS cut-off score (sensitivity, specificity) for “much improved vs minimally improved” was −9 (0.69, 0.66), for “much improved/very much improved vs minimally improved or worse” was −11 (0.81, 0.84), and for “minimally improved or better vs no change or worse” was −9 (0.79, 0.88). MCIC ROC cut-offs were also calculated for each RLS-6 item. Conclusions: In patients with RLS, the MCIC values derived in the current analysis provide a basis for defining meaningful clinical improvement based on changes in the IRLS and RLS-6 following treatment with rotigotine. Citation: Ondo WG, Grieger F, Moran K, Kohnen R, Roth T. Post hoc analysis of data from two clinical trials evaluating the minimal

  6. Lentiviral haemopoietic stem-cell gene therapy in early-onset metachromatic leukodystrophy: an ad-hoc analysis of a non-randomised, open-label, phase 1/2 trial.

    PubMed

    Sessa, Maria; Lorioli, Laura; Fumagalli, Francesca; Acquati, Serena; Redaelli, Daniela; Baldoli, Cristina; Canale, Sabrina; Lopez, Ignazio D; Morena, Francesco; Calabria, Andrea; Fiori, Rossana; Silvani, Paolo; Rancoita, Paola M V; Gabaldo, Michela; Benedicenti, Fabrizio; Antonioli, Gigliola; Assanelli, Andrea; Cicalese, Maria Pia; Del Carro, Ubaldo; Sora, Maria Grazia Natali; Martino, Sabata; Quattrini, Angelo; Montini, Eugenio; Di Serio, Clelia; Ciceri, Fabio; Roncarolo, Maria Grazia; Aiuti, Alessandro; Naldini, Luigi; Biffi, Alessandra

    2016-07-30

    Metachromatic leukodystrophy (a deficiency of arylsulfatase A [ARSA]) is a fatal demyelinating lysosomal disease with no approved treatment. We aimed to assess the long-term outcomes in a cohort of patients with early-onset metachromatic leukodystrophy who underwent haemopoietic stem-cell gene therapy (HSC-GT). This is an ad-hoc analysis of data from an ongoing, non-randomised, open-label, single-arm phase 1/2 trial, in which we enrolled patients with a molecular and biochemical diagnosis of metachromatic leukodystrophy (presymptomatic late-infantile or early-juvenile disease or early-symptomatic early-juvenile disease) at the Paediatric Clinical Research Unit, Ospedale San Raffaele, in Milan. Trial participants received HSC-GT, which consisted of the infusion of autologous HSCs transduced with a lentiviral vector encoding ARSA cDNA, after exposure-targeted busulfan conditioning. The primary endpoints of the trial are safety (toxicity, absence of engraftment failure or delayed haematological reconstitution, and safety of lentiviral vector-tranduced cell infusion) and efficacy (improvement in Gross Motor Function Measure [GMFM] score relative to untreated historical controls, and ARSA activity, 24 months post-treatment) of HSC-GT. For this ad-hoc analysis, we assessed safety and efficacy outcomes in all patients who had received treatment and been followed up for at least 18 months post-treatment on June 1, 2015. This trial is registered with ClinicalTrials.gov, number NCT01560182. Between April, 2010, and February, 2013, we had enrolled nine children with a diagnosis of early-onset disease (six had late-infantile disease, two had early-juvenile disease, and one had early-onset disease that could not be definitively classified). At the time of analysis all children had survived, with a median follow-up of 36 months (range 18-54). The most commonly reported adverse events were cytopenia (reported in all patients) and mucositis of different grades of severity (in five

  7. Trust Based Routing in Ad Hoc Network

    NASA Astrophysics Data System (ADS)

    Talati, Mikita V.; Valiveti, Sharada; Kotecha, K.

    Ad Hoc network often termed as an infrastructure-less, self- organized or spontaneous network.The execution and survival of an ad-hoc network is solely dependent upon the cooperative and trusting nature of its nodes. However, this naive dependency on intermediate nodes makes the ad-hoc network vulnerable to passive and active attacks by malicious nodes and cause inflict severe damage. A number of protocols have been developed to secure ad-hoc networks using cryptographic schemes, but all rely on the presence of trust authority. Due to mobility of nodes and limitation of resources in wireless network one interesting research area in MANET is routing. This paper offers various trust models and trust based routing protocols to improve the trustworthiness of the neighborhood.Thus it helps in selecting the most secure and trustworthy route from the available ones for the data transfer.

  8. Immunogenicity of AS03-adjuvanted and non-adjuvanted trivalent inactivated influenza vaccines in elderly adults: A Phase 3, randomized trial and post-hoc correlate of protection analysis

    PubMed Central

    Ruiz-Palacios, Guillermo M.; Leroux-Roels, Geert; Beran, Jiri; Devaster, Jeanne-Marie; Esen, Meral; Launay, Odile; McElhaney, Janet E.; van Essen, Gerrit A.; Benoit, Anne; Claeys, Carine; Dewé, Walthère; Durand, Christelle; Duval, Xavier; Falsey, Ann R.; Feldman, Gregory; Galtier, Florence; Gervais, Pierre; Hwang, Shinn-Jang; McNeil, Shelly; Richardus, Jan Hendrik; Trofa, Andrew; Oostvogels, Lidia

    2016-01-01

    ABSTRACT In this study we describe the immunogenicity results from a subset of older people (N = 5187) who participated in a Phase 3 randomized, observer-blinded trial of AS03-TIV versus TIV (Fluarix™) (ClinicalTrials.gov, NCT00753272). Participants received one dose of AS03-TIV or TIV in each study year and antibody titers against the vaccine strains were assessed using hemagglutination-inhibition (HI) assay at 21 d and 180 d post-vaccination in each vaccine group in the 2008/09 (Year 1) and 2009/10 (Year 2) influenza seasons. Manufacturing consistency of 3 lots of AS03-TIV for HI antibody responses in Year 1 was a co-primary objective. In a post-hoc analysis, a statistical regression model included 4830 subjects in whom immunogenicity and laboratory-confirmed attack rate data were available; the analysis was performed to assess HI antibody titers against A/H3N2 as a correlate of protection for laboratory-confirmed A/H3N2 influenza. AS03-TIV and TIV elicited strong HI antibody responses against each vaccine strain 21 d post-vaccination in both years. The manufacturing consistency of 3 lots of AS03-TIV was demonstrated. In both years and each vaccine group, HI antibody responses were lower for A/H1N1 than the other vaccine strains. Day 180 seroconversion rates (proportion with ≥4-fold increase in titer compared with pre-vaccination titer) in Year 1 in the AS03-TIV and TIV groups, respectively, were 87.7% and 74.1% for A/H3N2, 69.7% and 59.6% for influenza B, and 58.3% and 47.4% for A/H1N1. The post-hoc statistical model based on A/H3N2 attack rates and HI antibody titers estimated that a 4-fold increase in post-vaccination titers against A/H3N2 was associated with a 2-fold decrease in the odds of A/H3N2 infection. PMID:27690762

  9. Effect of aripiprazole 2 to 15 mg/d on health-related quality of life in the treatment of irritability associated with autistic disorder in children: a post hoc analysis of two controlled trials.

    PubMed

    Varni, James W; Handen, Benjamin L; Corey-Lisle, Patricia K; Guo, Zhenchao; Manos, George; Ammerman, Diane K; Marcus, Ronald N; Owen, Randall; McQuade, Robert D; Carson, William H; Mathew, Suja; Mankoski, Raymond

    2012-04-01

    There are limited published data on the impact of treatment on the health-related quality of life (HRQOL) in individuals with autistic disorder. The aim of this study was to evaluate the impact of aripiprazole on HRQOL in the treatment of irritability in pediatric patients (aged 6-17 years) with autistic disorder. This post hoc analysis assessed data from two 8-week, double-blind, randomized, placebo-controlled studies that compared the efficacy of aripiprazole (fixed-dose study, 5, 10, and 15 mg/d; flexible-dose study, 2-15 mg/d) with placebo in the treatment of irritability associated with autistic disorder. HRQOL was assessed at baseline and week 8 using 3 Pediatric Quality of Life Inventory (PedsQL™) scales. Clinically relevant improvement in HRQOL was determined using an accepted distribution-based criterion-1 standard error of measurement. In total, 316 patients were randomly assigned to receive treatment with aripiprazole (fixed-dose study, 166; flexible-dose study, 47) or placebo (fixed-dose study, 52; flexible-dose study, 51). Aripiprazole was associated with significantly greater improvement than placebo in PedsQL combined-scales total score (difference, 7.8; 95% CI, 3.8-11.8; P < 0.001) and in 3 PedsQL scale scores (differences [95% CI]: Emotional Functioning, 7.8 [3.4-12.2]; Social Functioning, 6.2 [0.7-11.8]; Cognitive Functioning, 9.3 [3.8-14.9]; all, P < 0.05). Patients who received aripiprazole were significantly more likely than those who received placebo to have a clinically meaningful improvement on the combined-scales total score (odds ratio [OR] = 1.9; 95% CI, 1.0-3.3; P < 0.05), Emotional Functioning scale (OR = 2.2; 95% CI, 1.2-4.0; P < 0.05) and Social Functioning scale (OR = 2.2; 95% CI, 1.2-4.1; P < 0.05), and were significantly less likely to experience deterioration (OR: 0.3, 95% CI: 0.1-0.8; P < 0.05) when "Stable" was used as the reference group. The findings from the present post hoc analysis suggest that aripiprazole was associated

  10. Immunogenicity of AS03-adjuvanted and non-adjuvanted trivalent inactivated influenza vaccines in elderly adults: A Phase 3, randomized trial and post-hoc correlate of protection analysis.

    PubMed

    Ruiz-Palacios, Guillermo M; Leroux-Roels, Geert; Beran, Jiri; Devaster, Jeanne-Marie; Esen, Meral; Launay, Odile; McElhaney, Janet E; van Essen, Gerrit A; Benoit, Anne; Claeys, Carine; Dewé, Walthère; Durand, Christelle; Duval, Xavier; Falsey, Ann R; Feldman, Gregory; Galtier, Florence; Gervais, Pierre; Hwang, Shinn-Jang; McNeil, Shelly; Richardus, Jan Hendrik; Trofa, Andrew; Oostvogels, Lidia

    2016-12-01

    In this study we describe the immunogenicity results from a subset of older people (N = 5187) who participated in a Phase 3 randomized, observer-blinded trial of AS03-TIV versus TIV (Fluarix™) (ClinicalTrials.gov, NCT00753272). Participants received one dose of AS03-TIV or TIV in each study year and antibody titers against the vaccine strains were assessed using hemagglutination-inhibition (HI) assay at 21 d and 180 d post-vaccination in each vaccine group in the 2008/09 (Year 1) and 2009/10 (Year 2) influenza seasons. Manufacturing consistency of 3 lots of AS03-TIV for HI antibody responses in Year 1 was a co-primary objective. In a post-hoc analysis, a statistical regression model included 4830 subjects in whom immunogenicity and laboratory-confirmed attack rate data were available; the analysis was performed to assess HI antibody titers against A/H3N2 as a correlate of protection for laboratory-confirmed A/H3N2 influenza. AS03-TIV and TIV elicited strong HI antibody responses against each vaccine strain 21 d post-vaccination in both years. The manufacturing consistency of 3 lots of AS03-TIV was demonstrated. In both years and each vaccine group, HI antibody responses were lower for A/H1N1 than the other vaccine strains. Day 180 seroconversion rates (proportion with ≥4-fold increase in titer compared with pre-vaccination titer) in Year 1 in the AS03-TIV and TIV groups, respectively, were 87.7% and 74.1% for A/H3N2, 69.7% and 59.6% for influenza B, and 58.3% and 47.4% for A/H1N1. The post-hoc statistical model based on A/H3N2 attack rates and HI antibody titers estimated that a 4-fold increase in post-vaccination titers against A/H3N2 was associated with a 2-fold decrease in the odds of A/H3N2 infection.

  11. Comparison of the effectiveness and tolerability of lidocaine patch 5% versus celecoxib for osteoarthritis-related knee pain: post hoc analysis of a 12 week, prospective, randomized, active-controlled, open-label, parallel-group trial in adults.

    PubMed

    Kivitz, Alan; Fairfax, Michael; Sheldon, Eric A; Xiang, Qinfang; Jones, Beverly A; Gammaitoni, Arnold R; Gould, Errol M

    2008-12-01

    Cyclooxygenase-2 (COX-2) selective inhibitors and nonselective NSAIDs are commonly used to treat osteoarthritis (OA) of the knee. The aim of this study was to compare the effectiveness of the lidocaine patch 5% with that of celecoxib 200 mg/d in the treatment of OA-related knee pain; however, the study was terminated prematurely by the sponsor because of tolerability concerns regarding the class of COX-2 selective inhibitors. A post hoc analysis of the available data is presented here. This multicenter, randomized, open-label, active-controlled, parallel-group study included patients >or=18 years of age with unilateral or bilateral moderate to severe OA of the knee. Patients were randomized to receive treatment with either the lidocaine patch 5% or celecoxib 200 mg/d. The primary efficacy end point was change from baseline to 12 weeks in the Western Ontario and McMaster Universities (WOMAC) OA Index pain subscale. Secondary end points included additional WOMAC subscales and Brief Pain Inventory (BPI) measures. Because this trial was prematurely terminated, a post hoc analysis was performed using a random pattern-mixture model of all observed cases of the intent-to-treat population. A total of 143 patients were randomized to treatment (lidocaine patch 5%, 69 patients; mean [SD] age, 60.2 [11.4] years; 65.2% female; 66.7% white; weight, 94.1 [23.3] kg) or celecoxib 200 mg/d (74 patients; age, 58.2 [12.1] years; 63.5% female; 68.9% white; weight, 94.3 [22.5] kg). Baseline pain WOMAC OA subscale scores (lidocaine patch 5%, 12.087; celecoxib 200 mg/d, 12.514) and mean rates of change over time (baseline to week 2, -1.5916 vs -1.6513 per week; weeks 2-6, -0.0168 vs -0.119 per week; weeks 6-12, -0.1818 vs -0.1579 per week) were not significantly different between the 2 groups. Improvement in additional WOMAC subscales and in several BPI measures were not significantly different between the 2 groups. Treatment-related adverse events were reported in 8 patients in each

  12. Low levels of high-density lipoprotein cholesterol and increased risk of cardiovascular events in stable ischemic heart disease patients: A post-hoc analysis from the COURAGE Trial (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation).

    PubMed

    Acharjee, Subroto; Boden, William E; Hartigan, Pamela M; Teo, Koon K; Maron, David J; Sedlis, Steven P; Kostuk, William; Spertus, John A; Dada, Marcin; Chaitman, Bernard R; Mancini, G B John; Weintraub, William S

    2013-11-12

    This study sought to assess the independent effect of high-density lipoprotein-cholesterol (HDL-C) level on cardiovascular risk in patients with stable ischemic heart disease (SIHD) who were receiving optimal medical therapy (OMT). Although low HDL-C level is a powerful and independent predictor of cardiovascular risk, recent data suggest that this may not apply when low-density lipoprotein-cholesterol (LDL-C) is reduced to optimal levels using intensive statin therapy. We performed a post-hoc analysis in 2,193 men and women with SIHD from the COURAGE trial. The primary outcome measure was the composite of death from any cause or nonfatal myocardial infarction (MI). The independent association between HDL-C levels measured after 6 months on OMT and the rate of cardiovascular events after 4 years was assessed. Similar analyses were performed separately in subjects with LDL-C levels below 70 mg/dl (1.8 mmol/l). In the overall population, the rate of death/MI was 33% lower in the highest HDL-C quartile as compared with the lowest quartile, with quartile of HDL-C being a significant, independent predictor of death/MI (p = 0.05), but with no interaction for LDL-C category (p = 0.40). Among subjects with LDL-C levels <70 mg/dl, those in the highest quintile of HDL-C had a 65% relative risk reduction in death or MI as compared with the lowest quintile, with HDL-C quintile demonstrating a significant, inverse predictive effect (p = 0.02). In this post-hoc analysis, patients with SIHD continued to experience incremental cardiovascular risk associated with low HDL-C levels despite OMT during long-term follow-up. This relationship persisted and appeared more prominent even when LDL-C was reduced to optimal levels with intensive dyslipidemic therapy. (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation; NCT00007657). Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  13. Does the effect of one-day simulation team training in obstetric emergencies decline within one year? A post-hoc analysis of a multicentre cluster randomised controlled trial.

    PubMed

    van de Ven, J; Fransen, A F; Schuit, E; van Runnard Heimel, P J; Mol, B W; Oei, S G

    2017-09-01

    Does the effect of one-day simulation team training in obstetric emergencies decline within one year? A post-hoc analysis of a multicentre cluster randomised controlled trial. J van de Ven, AF Fransen, E Schuit, PJ van Runnard Heimel, BW Mol, SG Oei OBJECTIVE: To investigate whether the effect of a one-day simulation-based obstetric team training on patient outcome changes over time. Post-hoc analysis of a multicentre, open, randomised controlled trial that evaluated team training in obstetrics (TOSTI study).We studied women with a singleton pregnancy beyond 24 weeks of gestation in 24 obstetric units. Included obstetric units were randomised to either a one-day, multi-professional simulation-based team training focusing on crew resource management in a medical simulation centre (12 units) or to no team training (12 units). We assessed whether outcomes differed between both groups in each of the first four quarters following the team training and compared the effect of team training over quarters. Primary outcome was a composite outcome of low Apgar score, severe postpartum haemorrhage, trauma due to shoulder dystocia, eclampsia and hypoxic-ischemic encephalopathy. During a one year period after the team training the rate of obstetric complications, both on the composite level and the individual component level, did not differ between any of the quarters. For trauma due to shoulder dystocia team training led to a significant decrease in the first quarter (0.06% versus 0.26%, OR 0.19, 95% CI 0.03 to 0.98) but in the subsequent quarters no significant reductions were observed. Similar results were found for invasive treatment for severe postpartum haemorrhage where a significant increase was only seen in the first quarter (0.4% versus 0.03%, OR 19, 95% CI 2.5-147), and not thereafter. The beneficial effect of a one-day, simulation-based, multiprofessional, obstetric team training seems to decline after three months. If team training is further evaluated or

  14. Post Hoc Analysis of Data from Two Clinical Trials Evaluating the Minimal Clinically Important Change in International Restless Legs Syndrome Sum Score in Patients with Restless Legs Syndrome (Willis-Ekbom Disease).

    PubMed

    Ondo, William G; Grieger, Frank; Moran, Kimberly; Kohnen, Ralf; Roth, Thomas

    2016-01-01

    Determine the minimal clinically important change (MCIC), a measure determining the minimum change in scale score perceived as clinically beneficial, for the international restless legs syndrome (IRLS) and restless legs syndrome 6-item questionnaire (RLS-6) in patients with moderate to severe restless legs syndrome (RLS/Willis-Ekbom disease) treated with the rotigotine transdermal system. This post hoc analysis analyzed data from two 6-mo randomized, double-blind, placebo-controlled studies (SP790 [NCT00136045]; SP792 [NCT00135993]) individually and as a pooled analysis in rotigotine-treated patients, with baseline and end of maintenance IRLS and Clinical Global Impressions of change (CGI Item 2) scores available for analysis. An anchor-based approach and receiver operating characteristic (ROC) curves were used to determine the MCIC for the IRLS and RLS-6. We specifically compared "much improved vs minimally improved," "much improved/very much improved vs minimally improved or worse," and "minimally improved or better vs no change or worse" on the CGI-2 using the full analysis set (data as observed). The MCIC IRLS cut-off scores for SP790 and SP792 were similar. Using the pooled SP790+SP792 analysis, the MCIC total IRLS cut-off score (sensitivity, specificity) for "much improved vs minimally improved" was -9 (0.69, 0.66), for "much improved/very much improved vs minimally improved or worse" was -11 (0.81, 0.84), and for "minimally improved or better vs no change or worse" was -9 (0.79, 0.88). MCIC ROC cut-offs were also calculated for each RLS-6 item. In patients with RLS, the MCIC values derived in the current analysis provide a basis for defining meaningful clinical improvement based on changes in the IRLS and RLS-6 following treatment with rotigotine. © 2016 American Academy of Sleep Medicine.

  15. Functional impairment related to painful physical symptoms in patients with generalized anxiety disorder with or without comorbid major depressive disorder: post hoc analysis of a cross-sectional study

    PubMed Central

    2011-01-01

    Background Generalized anxiety disorder (GAD) is the most frequent anxiety disorder in primary care patients. It is known that painful physical symptoms (PPS) are associated with GAD, regardless the presence of comorbid major depressive disorder (MDD). However the specific role of such symptoms in patients' functional impairment is not well understood. The objective of the present study is to assess functional impairment related to the presence of PPS in patients with GAD. Methods This is a post hoc analysis of a cross-sectional study. Functioning, in the presence (overall pain score >30; Visual Analog Scale) or absence of PPS, was assessed using the Sheehan Disability Scale (SDS) in three groups of patients; 1) GAD and comorbid MDD (GAD+MDD+), 2) GAD without comorbid MDD (GAD+MDD-), 3) controls (GAD-MDD-). ANCOVA models were used. Results Of those patients with GAD+MDD+ (n = 559), 436 (78.0%) had PPS, compared with GAD+MDD- (249 of 422, 59%) and controls (95 of 336, 28.3%). Functioning worsened in both GAD groups in presence of PPS (SDS least squares mean total score: 16.1 vs. 9.8, p < 0.0001, GAD+MDD+; 14.3 vs. 8.2, p < 0.0001, GAD+MDD-). The presence of PPS was significantly associated with less productivity. Conclusions Functional impairment related to the presence of PPS was relevant. Clinical implications should be considered. PMID:21510887

  16. The effects of combination therapy with dutasteride plus tamsulosin on clinical outcomes in men with symptomatic BPH: 4-year post hoc analysis of European men in the CombAT study.

    PubMed

    Haillot, O; Fraga, A; Maciukiewicz, P; Pushkar, D; Tammela, T; Höfner, K; Chantada, V; Gagnier, P; Morrill, B

    2011-12-01

    CombAT (Combination of Avodart and Tamsulosin) was a randomised, double-blind study in men (n=4844) aged ≥ 50 years with a clinical diagnosis of BPH. Patients were randomised to daily tamsulosin 0.4 mg, dutasteride 0.5 mg or both for 4 years. The primary endpoint was time to acute urinary retention (AUR) or BPH-related surgery. Secondary endpoints included BPH clinical progression, symptoms and maximum urinary flow rate. A post hoc analysis of data from the European subgroup was conducted. A total of 2925 men were randomised to treatment in Europe as part of CombAT (tamsulosin, n=972; dutasteride, n=970; combination, n=983). Combination therapy significantly reduced the relative risk of AUR or BPH-related surgery compared with either monotherapy at 4 years, and also significantly reduced the risk of BPH clinical progression. Combination therapy also provided significantly greater symptom improvement than either monotherapy at 4 years. Safety and tolerability of dutasteride plus tamsulosin was consistent with previous experience of this combination and with the monotherapies. These data provide further evidence to support the use of long-term combination therapy (dutasteride plus tamsulosin) in men with moderate-to-severe lower urinary tract symptoms because of BPH and prostatic enlargement. The results in the European subgroup are generally consistent with those in the overall study population.

  17. Inter-core lab variability in analyzing quantitative coronary angiography for bifurcation lesions: a post-hoc analysis of a randomized trial.

    PubMed

    Grundeken, Maik J; Ishibashi, Yuki; Généreux, Philippe; LaSalle, Laura; Iqbal, Javaid; Wykrzykowska, Joanna J; Morel, Marie-Angèle; Tijssen, Jan G; de Winter, Robbert J; Girasis, Chrysafios; Garcia-Garcia, Hector M; Onuma, Yoshinobu; Leon, Martin B; Serruys, Patrick W

    2015-02-01

    This study sought to evaluate inter-core lab variability in quantitative coronary angiography (QCA) analysis of bifurcation lesions. QCA of bifurcation lesions is challenging. To date there are no data available on the inter-core lab variability of bifurcation QCA analysis. The randomized Tryton IDE (Tryton Pivotal IDE Coronary Bifurcation Trial) compared the Tryton Side Branch Stent (Tryton Medical, Durham, North Carolina) with balloon angioplasty as side branch treatment. QCA was performed in an angiographic subcohort (n = 326) at 9-month follow-up. Inter-core lab variability of QCA analysis between the Cardiovascular Research Foundation and the Cardialysis core labs was evaluated before and after alignment of the used QCA methodology using angiographic data derived from this angiographic follow-up cohort. In the original analysis, before alignment of QCA methodology, the mean difference between the core labs (bias) was large for all QCA parameters with wide 95% limits of agreement (1.96 × SD of the bias), indicating marked variability. The bias of the key angiographic endpoint of the Tryton trial, in-segment percentage diameter stenosis (%DS) of the side branch, was 5.5% (95% limits of agreement: -26.7% to 37.8%). After reanalysis, the bias of the in-segment %DS of the side branch reduced to 1.8% (95% limits of agreement: -16.7% to 20.4%). Importantly, after alignment of the 2 core labs, there was no longer a difference between both treatment groups (%DS of the side branch: treatment group A vs. group B: 34.4 ± 19.4% vs. 32.4 ± 16.1%, p = 0.340). Originally, a marked inter-core lab variability of bifurcation QCA analysis was found. After alignment of methodology, inter-core lab variability decreased considerably and impacted angiographic trial results. This latter finding emphasizes the importance of using the same methodology among different core labs worldwide. (Tryton Pivotal Prospective, Single Blind, Randomized Controlled Study to Evaluate the Safety

  18. Shuttle-run synchronization in mobile ad hoc networks

    NASA Astrophysics Data System (ADS)

    Ma, Sheng-Fei; Bi, Hong-Jie; Zou, Yong; Liu, Zong-Hua; Guan, Shu-Guang

    2015-06-01

    In this work, we study the collective dynamics of phase oscillators in a mobile ad hoc network whose topology changes dynamically. As the network size or the communication radius of individual oscillators increases, the topology of the ad hoc network first undergoes percolation, forming a giant cluster, and then gradually achieves global connectivity. It is shown that oscillator mobility generally enhances the coherence in such networks. Interestingly, we find a new type of phase synchronization/clustering, in which the phases of the oscillators are distributed in a certain narrow range, while the instantaneous frequencies change signs frequently, leading to shuttle-run-like motion of the oscillators in phase space. We conduct a theoretical analysis to explain the mechanism of this synchronization and obtain the critical transition point.

  19. Distributed Reinforcement Learning Approach for Vehicular Ad Hoc Networks

    NASA Astrophysics Data System (ADS)

    Wu, Celimuge; Kumekawa, Kazuya; Kato, Toshihiko

    In Vehicular Ad hoc Networks (VANETs), general purpose ad hoc routing protocols such as AODV cannot work efficiently due to the frequent changes in network topology caused by vehicle movement. This paper proposes a VANET routing protocol QLAODV (Q-Learning AODV) which suits unicast applications in high mobility scenarios. QLAODV is a distributed reinforcement learning routing protocol, which uses a Q-Learning algorithm to infer network state information and uses unicast control packets to check the path availability in a real time manner in order to allow Q-Learning to work efficiently in a highly dynamic network environment. QLAODV is favored by its dynamic route change mechanism, which makes it capable of reacting quickly to network topology changes. We present an analysis of the performance of QLAODV by simulation using different mobility models. The simulation results show that QLAODV can efficiently handle unicast applications in VANETs.

  20. Pooled post hoc analysis of population pharmacokinetics of oxycodone and acetaminophen following a single oral dose of biphasic immediate-release/extended-release oxycodone/acetaminophen tablets

    PubMed Central

    Franke, Ryan M; Morton, Terri; Devarakonda, Krishna

    2015-01-01

    This analysis evaluated the single-dose population pharmacokinetics (PK) of biphasic immediate-release (IR)/extended-release (ER) oxycodone (OC)/acetaminophen (APAP) 7.5/325 mg tablets administered under fasted conditions and the effects of a meal on their single-dose population PK. Data were pooled from four randomized, single-dose crossover trials enrolling healthy adult (18–55 years old) participants (three trials) and nondependent recreational users of prescription opioids (one trial) with a body weight of ≥59 kg. Participants received IR/ER OC/APAP 7.5/325 mg tablets in single doses of 7.5/325 mg (one tablet), 15/650 mg (two tablets), or 30/1,300 mg (four tablets) under fasted or fed conditions. Six variables were examined: sex, race, age, weight, height, and body mass index. Single-dose population PK was analyzed using first-order conditional estimation methods. A total of 151 participants were included in the analysis under fasted conditions, and 31 participants were included in the fed analysis. Under fasted conditions, a 10% change in body weight was accompanied by ~7.5% change in total body clearance (CL/F) and volume of distribution (V/F) of OC and APAP. Black participants had 17.3% lower CL/F and a 16.9% lower V/F of OC compared with white participants. Under fed conditions, the absorption rate constant of OC and APAP decreased significantly, although there was no effect on CL/F and V/F. Considering that the recommended dose for IR/ER OC/APAP 7.5/325 mg tablets is two tablets every 12 hours, adjustments of <50% are not clinically relevant. Dose adjustment may be necessary for large deviations from average body weight, but the small PK effects associated with race and consumption of a meal are not clinically relevant. PMID:26316698

  1. Pooled post hoc analysis of population pharmacokinetics of oxycodone and acetaminophen following a single oral dose of biphasic immediate-release/extended-release oxycodone/acetaminophen tablets.

    PubMed

    Franke, Ryan M; Morton, Terri; Devarakonda, Krishna

    2015-01-01

    This analysis evaluated the single-dose population pharmacokinetics (PK) of biphasic immediate-release (IR)/extended-release (ER) oxycodone (OC)/acetaminophen (APAP) 7.5/325 mg tablets administered under fasted conditions and the effects of a meal on their single-dose population PK. Data were pooled from four randomized, single-dose crossover trials enrolling healthy adult (18-55 years old) participants (three trials) and nondependent recreational users of prescription opioids (one trial) with a body weight of ≥59 kg. Participants received IR/ER OC/APAP 7.5/325 mg tablets in single doses of 7.5/325 mg (one tablet), 15/650 mg (two tablets), or 30/1,300 mg (four tablets) under fasted or fed conditions. Six variables were examined: sex, race, age, weight, height, and body mass index. Single-dose population PK was analyzed using first-order conditional estimation methods. A total of 151 participants were included in the analysis under fasted conditions, and 31 participants were included in the fed analysis. Under fasted conditions, a 10% change in body weight was accompanied by ~7.5% change in total body clearance (CL/F) and volume of distribution (V/F) of OC and APAP. Black participants had 17.3% lower CL/F and a 16.9% lower V/F of OC compared with white participants. Under fed conditions, the absorption rate constant of OC and APAP decreased significantly, although there was no effect on CL/F and V/F. Considering that the recommended dose for IR/ER OC/APAP 7.5/325 mg tablets is two tablets every 12 hours, adjustments of <50% are not clinically relevant. Dose adjustment may be necessary for large deviations from average body weight, but the small PK effects associated with race and consumption of a meal are not clinically relevant.

  2. Post hoc analysis of the efficacy and safety of desvenlafaxine 50 mg/day in a randomized, placebo-controlled study of perimenopausal and postmenopausal women with major depressive disorder.

    PubMed

    Kornstein, Susan G; Clayton, Anita; Bao, Weihang; Guico-Pabia, Christine J

    2014-08-01

    This post hoc analysis assessed the efficacy of desvenlafaxine 50 mg/day for treating major depressive disorder in perimenopausal versus postmenopausal women enrolled in a 10-week, double-blind, placebo-controlled study. Perimenopausal and postmenopausal women (40-70 y) diagnosed with major depressive disorder were randomly assigned to receive desvenlafaxine 50 mg/day or placebo. Changes from baseline in the primary efficacy variable (17-item Hamilton Rating Scale for Depression [HAM-D17] score, week 8) and in other secondary efficacy variables (Sheehan Disability Scale and Menopause Rating Scale) were analyzed using analysis of covariance with treatment, region, and baseline in the model. Clinical Global Impressions-Improvement Scale was analyzed with the Cochran-Mantel-Haenszel test. Response and remission rates were evaluated using logistic regression with treatment, region, and baseline HAM-D17 in the model. Of 426 women (desvenlafaxine, n = 216; placebo, n = 210) included in this analysis, 135 (32%) were perimenopausal and 291 (68%) were postmenopausal at baseline. In both subgroups, improvement from baseline in HAM-D17 scores was significantly greater for desvenlafaxine 50 mg/day than for placebo. Menopause status and time since menopause did not significantly affect HAM-D17 total score. The drug-placebo difference in Sheehan Disability Scale scores was significant in perimenopausal women (-9.3 vs. -5.1, P < 0.001) but not in postmenopausal women (-8.8 vs. -8.1). Menopause Rating Scale and Clinical Global Impressions-Improvement Scale scores were significantly improved with desvenlafaxine in postmenopausal women. Desvenlafaxine 50 mg/day is effective in treating depression in both perimenopausal and postmenopausal women. Placebo response on measures of functional impairment is lower in perimenopausal women than in postmenopausal women, resulting in a greater apparent treatment benefit with desvenlafaxine among perimenopausal women.

  3. The Effect of Sitagliptin on the Regression of Carotid Intima-Media Thickening in Patients with Type 2 Diabetes Mellitus: A Post Hoc Analysis of the Sitagliptin Preventive Study of Intima-Media Thickness Evaluation

    PubMed Central

    Katakami, Naoto; Shiraiwa, Toshihiko; Yoshii, Hidenori; Gosho, Masahiko; Shimomura, Iichiro; Watada, Hirotaka

    2017-01-01

    Background. The effect of dipeptidyl peptidase-4 (DPP-4) inhibitors on the regression of carotid IMT remains largely unknown. The present study aimed to clarify whether sitagliptin, DPP-4 inhibitor, could regress carotid intima-media thickness (IMT) in insulin-treated patients with type 2 diabetes mellitus (T2DM). Methods. This is an exploratory analysis of a randomized trial in which we investigated the effect of sitagliptin on the progression of carotid IMT in insulin-treated patients with T2DM. Here, we compared the efficacy of sitagliptin treatment on the number of patients who showed regression of carotid IMT of ≥0.10 mm in a post hoc analysis. Results. The percentages of the number of the patients who showed regression of mean-IMT-CCA (28.9% in the sitagliptin group versus 16.4% in the conventional group, P = 0.022) and left max-IMT-CCA (43.0% in the sitagliptin group versus 26.2% in the conventional group, P = 0.007), but not right max-IMT-CCA, were higher in the sitagliptin treatment group compared with those in the non-DPP-4 inhibitor treatment group. In multiple logistic regression analysis, sitagliptin treatment significantly achieved higher target attainment of mean-IMT-CCA ≥0.10 mm and right and left max-IMT-CCA ≥0.10 mm compared to conventional treatment. Conclusions. Our data suggested that DPP-4 inhibitors were associated with the regression of carotid atherosclerosis in insulin-treated T2DM patients. This study has been registered with the University Hospital Medical Information Network Clinical Trials Registry (UMIN000007396). PMID:28250768

  4. Voice Communications over 802.11 Ad Hoc Networks: Modeling, Optimization and Call Admission Control

    NASA Astrophysics Data System (ADS)

    Xu, Changchun; Xu, Yanyi; Liu, Gan; Liu, Kezhong

    Supporting quality-of-service (QoS) of multimedia communications over IEEE 802.11 based ad hoc networks is a challenging task. This paper develops a simple 3-D Markov chain model for queuing analysis of IEEE 802.11 MAC layer. The model is applied for performance analysis of voice communications over IEEE 802.11 single-hop ad hoc networks. By using the model, we finish the performance optimization of IEEE MAC layer and obtain the maximum number of voice calls in IEEE 802.11 ad hoc networks as well as the statistical performance bounds. Furthermore, we design a fully distributed call admission control (CAC) algorithm which can provide strict statistical QoS guarantee for voice communications over IEEE 802.11 ad hoc networks. Extensive simulations indicate the accuracy of the analytical model and the CAC scheme.

  5. How to monitor pregnancies complicated by fetal growth restriction and delivery before 32 weeks: post-hoc analysis of TRUFFLE study.

    PubMed

    Ganzevoort, W; Mensing Van Charante, N; Thilaganathan, B; Prefumo, F; Arabin, B; Bilardo, C M; Brezinka, C; Derks, J B; Diemert, A; Duvekot, J J; Ferrazzi, E; Frusca, T; Hecher, K; Marlow, N; Martinelli, P; Ostermayer, E; Papageorghiou, A T; Schlembach, D; Schneider, K T M; Todros, T; Valcamonico, A; Visser, G H A; Van Wassenaer-Leemhuis, A; Lees, C C; Wolf, H

    2017-06-01

    In the recent TRUFFLE study, it appeared that, in pregnancies complicated by fetal growth restriction (FGR) between 26 and 32 weeks' gestation, monitoring of the fetal ductus venosus (DV) waveform combined with computed cardiotocography (CTG) to determine timing of delivery increased the chance of infant survival without neurological impairment. However, concerns with the interpretation were raised, as DV monitoring appeared to be associated with a non-significant increase in fetal death, and some infants were delivered after 32 weeks, at which time the study protocol no longer applied. This secondary sensitivity analysis of the TRUFFLE study focuses on women who delivered before 32 completed weeks' gestation and analyzes in detail the cases of fetal death. Monitoring data of 317 pregnancies with FGR that delivered before 32 weeks were analyzed, excluding those with absent outcome data or inevitable perinatal death. Women were allocated randomly to one of three groups of indication for delivery according to the following monitoring strategies: (1) reduced fetal heart rate short-term variation (STV) on CTG; (2) early changes in fetal DV waveform; and (3) late changes in fetal DV waveform. Primary outcome was 2-year survival without neurological impairment. The association of the last monitoring data before delivery and infant outcome was assessed by multivariable analysis. Two-year survival without neurological impairment occurred more often in the two DV groups (both 83%) than in the CTG-STV group (77%), however, the difference was not statistically significant (P = 0.21). Among the surviving infants in the DV groups, 93% were free of neurological impairment vs 85% of surviving infants in the CTG-STV group (P = 0.049). All fetal deaths (n = 7) occurred in the groups with DV monitoring. Of the monitoring parameters obtained shortly before fetal death in these seven cases, an abnormal CTG was observed in only one case. Multivariable regression analysis of

  6. Effects of body weight on tolerability of rivastigmine transdermal patch: a post-hoc analysis of a double-blind trial in patients with Alzheimer disease.

    PubMed

    Lee, Jae-Hong; Sevigny, Jeff

    2011-01-01

    The rationale for the development of the rivastigmine transdermal patch was to improve upon an efficacious therapy by mitigating certain adverse events, such as nausea and vomiting. This may be particularly important in Alzheimer disease patients with low body weights, who may be more susceptible to these adverse events. This analysis compared the effect of body weight on tolerability in Alzheimer disease patients receiving rivastigmine capsules or rivastigmine patch. Using data from a 24-week trial, adverse events and discontinuations were evaluated in patients stratified on the basis of extreme low weight (<50 kg), medium weight (50 to 80 kg), and high weight (>80 kg) at baseline. Rivastigmine patch was generally well tolerated, regardless of patient body weight. Among patients receiving rivastigmine patch, lower body weight, as stratified, was not associated with a higher adverse event rate; however, there was an association between a higher adverse event rate and low body weight among patients receiving rivastigmine capsules. Discontinuations because of adverse events were not directly related to weight. A lower incidence of adverse events was apparent with transdermal delivery of rivastigmine compared with oral administration.

  7. Changes in anxiety and depression symptoms associated to the outcome of MOH: A post-hoc analysis of the Comoestas Project.

    PubMed

    Bottiroli, Sara; Allena, Marta; Sances, Grazia; De Icco, Roberto; Avenali, Micol; Fadic, Ricardo; Katsarava, Zaza; Lainez, Miguel Ja; Goicochea, Maria Teresa; Jensen, Rigmor Højland; Nappi, Giuseppe; Tassorelli, Cristina

    2017-01-01

    Aims To evaluate the impact of treatment success on depression and anxiety symptoms in medication-overuse headache (MOH) and whether depression and anxiety can be predictors of treatment outcome. Methods All consecutive patients entering the detoxification program were analysed in a prospective, non-randomised fashion over a six-month period. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale. Results A total of 663 MOH patients were evaluated, and 492 completed the entire protocol. Of these, 287 ceased overuse and reverted to an episodic pattern (responders) and 23 relapsed into overuse. At the final evaluation, the number of patients with depressive symptoms was reduced by 63.2% among responders ( p < 0.001) and did not change in relapsers ( p = 0.13). Anxious symptomatology was reduced by 43.1% in responders ( ps < 0.001) and did not change in relapsers ( p = 0.69). At the multivariate analysis, intake of a prophylactic drug and absence of symptoms of depression at six months emerged as prognostic factors for being a responder (OR 2.406; p = 0.002 and OR 1.989; p = 0.019 respectively), while lack of antidepressant drugs and presence of symptoms of depression at six months were prognostic factors for relapse into overuse (OR 3.745; p = 0.004 and OR 3.439; p = 0.031 respectively). Conclusions Symptomatology referred to affective state and anxiety can be significantly reduced by the treatment of MOH. Baseline levels of depression and anxiety do not generally predict the outcome at six months. Their persistence may represent a trait of patients with a negative outcome, rather than the consequence of a treatment failure.

  8. Effects of levomilnacipran ER on noradrenergic symptoms, anxiety symptoms, and functional impairment in adults with major depressive disorder: Post hoc analysis of 5 clinical trials.

    PubMed

    Blier, Pierre; Gommoll, Carl; Chen, Changzheng; Kramer, Kenneth

    2017-03-01

    To evaluate the effects of levomilnacipran extended-release (LVM-ER; 40-120mg/day) on noradrenergic (NA) and anxiety-related symptoms in adults with major depressive disorder (MDD) and explore the relationship between these symptoms and functional impairment. Data were pooled from 5 randomized, double-blind, placebo-controlled trials (N=2598). Anxiety and NA Cluster scores were developed by adding selected item scores from the Montgomery-Åsberg Depression Rating Scale (MADRS) and 17-item Hamilton Depression Rating Scale (HAMD17). A path analysis was conducted to estimate the direct effects of LVM-ER on functional impairment (Sheehan Disability Scale [SDS] total score) and the indirect effects through changes in NA and Anxiety Cluster scores. Mean improvements from baseline in NA and Anxiety Cluster scores were significantly greater with LVM-ER versus placebo (both P<0.001), as were the response rates (≥50% score improvement): NA Cluster (44% vs 34%; odds ratio=1.56; P<0.0001); Anxiety Cluster (39% vs 36%; odds ratio=1.19; P=0.041). Mean improvement in SDS total score was also significantly greater with LVM-ER versus placebo (-7.3 vs -5.6; P<0.0001). LVM-ER had an indirect effect on change in SDS total score that was mediated more strongly through NA Cluster score change (86%) than Anxiety Cluster score change (18%); the direct effect was negligible. NA and Anxiety Cluster scores, developed based on the face validity of individual MADRS and HAMD17 items, were not predefined as efficacy outcomes in any of the studies. In adults with MDD, LVM-ER indirectly improved functional impairment mainly through improvements in NA symptoms and less so via anxiety symptoms. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  9. Predictive factors of radiological progression after 2 years of remission-steered treatment in early arthritis patients: a post hoc analysis of the IMPROVED study

    PubMed Central

    Akdemir, Gülşah; Verheul, Marije K; Heimans, Lotte; Wevers-de Boer, Kirsten V C; Goekoop-Ruiterman, Yvonne P M; van Oosterhout, Maikel; Harbers, Joop B; Bijkerk, Casper; Steup-Beekman, Gerda M; Lard, Leroy R; Huizinga, Tom W J; Trouw, Leendert A; Allaart, Cornelia F

    2016-01-01

    Objectives To identify predictive factors of radiological progression in early arthritis patients treated by remission-steered treatment. Methods In the IMPROVED study, 610 patients with early rheumatoid arthritis (RA) or undifferentiated arthritis (UA) were treated with methotrexate (MTX) and a tapered high dose of prednisone. Patients in early remission (disease activity score (DAS) <1.6 after 4 months) tapered prednisone to zero. Patients not in early remission were randomised to arm 1: MTX plus hydroxychloroquine, sulfasalazine and prednisone, or to arm 2: MTX plus adalimumab. Predictors of radiological progression (≥0.5 Sharp/van der Heijde score; SHS) after 2 years were assessed using logistic regression analysis. Results Median (IQR) SHS progression in 488 patients was 0 (0–0) point, without differences between RA or UA patients or between treatment arms. In only 50/488 patients, the SHS progression was ≥0.5: 33 (66%) were in the early DAS remission group, 9 (18%) in arm 1, 5 (10%) in arm 2, 3 (6%) in the outside of protocol group. Age (OR (95% CI): 1.03 (1.00 to 1.06)) and the combined presence of anticarbamylated protein antibodies (anti-CarP) and anticitrullinated protein antibodies (ACPA) (2.54 (1.16 to 5.58)) were independent predictors for SHS progression. Symptom duration <12 weeks showed a trend. Conclusions After 2 years of remission steered treatment in early arthritis patients, there was limited SHS progression in only a small group of patients. Numerically, patients who had achieved early DAS remission had more SHS progression than other patients. Positivity for both anti-CarP and ACPA and age were independently associated with SHS progression. Trial registration numbers ISRCTN Register number 11916566 and EudraCT number 2006 06186-16. PMID:26925251

  10. The Combination of Elevated Triglycerides and Abnormal Fasting Glucose Increases Risk of Cerebral Infarction in Patients With Mild to Moderate Hypercholesterolemia: A Post Hoc Analysis of the MEGA Study.

    PubMed

    Nakagami, Tomoko; Nishimura, Rimei; Sone, Hirohito; Tajima, Naoko

    2015-03-01

    While triglycerides (TGs) and diabetes increase the risk of cardiovascular disease (CVD), their combined effects have not been quantified. We explored the combined effect of elevated TGs and glucose on CVD in a post hoc analysis of the large-scale Management of Elevated Cholesterol in the Primary Prevention Group of Adult Japanese (MEGA) Study. In the MEGA Study, 8214 patients with mild to moderate hypercholesterolemia were randomly allocated to the diet alone group or diet plus pravastatin group and followed for 5 years. Of those, 7832 patients included in the intention-to-treat analysis were stratified into 4 groups: abnormal fasting glucose (AFG) plus high TGs, high TGs alone, AFG alone, and normal fasting glucose plus normal TGs (reference). Cox proportional hazard models were used to compare the incidence of and mortality from CVD in the 4 groups. Incidence of CVD and coronary heart disease was significantly higher in the groups with AFG alone (hazard ratio [HR], 2.02 and 3.38; P < .01, respectively) and AFG plus high TGs (HR, 2.87 and 3.87; P < .01, respectively) than the reference group. A similar relation was found in models adjusting for high-density lipoprotein cholesterol (HDL-C). Although the incidence of cerebral infarction was significantly higher only in the group with AFG plus high TGs (HR, 2.16; P = .01), it was marginally significantly higher than the reference group after adjustment for HDL-C (HR, 1.86; P = .06). Diet plus pravastatin treatment reduced the risk of cerebral infarction by 66% in the group with AFG plus high TGs (P = .03). Our findings contribute to the formulation of the hypothesis that patients with hypercholesterolemia having AFG plus high TGs have an increased risk of cerebral infarction. These are compatible with the result from the main study that patients with hypercholesterolemia randomized to diet plus pravastatin had a reduced risk of cerebral infarction. © The Author(s) 2014.

  11. β-Lactam/β-lactam inhibitor combinations for the treatment of bacteremia due to extended-spectrum β-lactamase-producing Escherichia coli: a post hoc analysis of prospective cohorts.

    PubMed

    Rodríguez-Baño, Jesús; Navarro, María Dolores; Retamar, Pilar; Picón, Encarnación; Pascual, Álvaro

    2012-01-15

    Extended-spectrum ß-lactamase-producing Escherichia coli (ESBL-EC) is an important cause of invasive infections. Alternatives to carbapenems--considered the drugs of choice--are needed because of the emergence of carbapenemase-producing enterobacteria. The efficacy of ß-lactam/ß-lactam inhibitors (BLBLI) in such infections is controversial. The authors performed a post hoc analysis of patients with bloodstream infections due to ESBL-EC from 6 published prospective cohorts. Mortality and length of hospital stay in patients treated with an active BLBLI (amoxicillin-clavulanic acid [AMC] and piperacillin-tazobactam [PTZ]) or carbapenem were compared in 2 cohorts: the empirical therapy cohort (ETC) and the definitive therapy cohort (DTC). Confounding was controlled by multivariate analysis; for patients in the ETC, a propensity score for receiving carbapenem was also used. The ETC included 103 patients (BLBLI, 72; carbapenem, 31), and the DTC included 174 (BLBLI, 54; carbapenem, 120). Mortality rates at day 30 for those treated with BLBLI versus carbapenems were 9.7% versus 19.4% for the ETC and 9.3% versus 16.7% for the DTC, respectively (P > .2, log-rank test). After adjustment for confounders, no association was found between either empirical therapy with BLBLI (adjusted hazard ratio [HR], 1.14; 95% confidence interval [CI], .29-4.40; P = .84) or definitive therapy (adjusted HR, 0.76; 95% CI, .28-2.07; P = .5) and increased mortality. Furthermore, BLBLI therapy, with respect to carbapenem, was not found to influence length of hospital stay. These results suggest that AMC and PTZ are suitable alternatives to carbapenems for treating patients with bloodstream infections due to ESBL-EC if active in vitro and would be particularly useful as definitive therapy.

  12. Comparison of steady-state plasma concentrations of armodafinil and modafinil late in the day following morning administration: post hoc analysis of two randomized, double-blind, placebo-controlled, multiple-dose studies in healthy male subjects.

    PubMed

    Darwish, Mona; Kirby, Mary; Hellriegel, Edward T

    2009-01-01

    Armodafinil, the R- and longer-lasting isomer of modafinil, may maintain higher plasma drug concentrations compared with racemic modafinil because of stereospecific differences in elimination of its isomers. This analysis set out to compare the steady-state pharmacokinetic profiles of armodafinil and modafinil on a milligram-to-milligram basis following once-daily administration. A post hoc analysis of two multiple-dose pharmacokinetic studies in healthy male subjects aged 18-50 years was conducted to compare dose-normalized (200 mg/day) plasma drug concentration and pharmacokinetic data for subjects in each study who completed 7 days of once-daily (morning) administration of armodafinil (n = 34) or modafinil (n = 18). Dose-normalized plasma concentrations of armodafinil on day 7 were higher than those of modafinil, with the greatest differences being observed later in the day. Across the 24-hour dose interval, plasma drug concentration fluctuation and swing were 28% and 42% less, respectively, with armodafinil than with modafinil. In addition, average late-day (3 pm to 7 pm after an 8 am dosing) plasma drug concentrations and partial values for the area under the plasma concentration versus time curve for 7-11 hours after dosing were both 44% higher with armodafinil. At steady state, armodafinil produces consistently higher plasma drug concentrations late in the day than modafinil when compared on a milligram-to-milligram basis. The distinct pharmacokinetic profile of armodafinil compared with that of the racemate may result in fundamentally different durations of action. These differences between the two medications cannot be made equivalent by increasing the dose of the racemate without introducing potential safety concerns.

  13. Phase 2a Randomized Clinical Trial: Safety and Post Hoc Analysis of Subretinal rAAV.sFLT-1 for Wet Age-related Macular Degeneration.

    PubMed

    Constable, Ian J; Pierce, Cora M; Lai, Chooi-May; Magno, Aaron L; Degli-Esposti, Mariapia A; French, Martyn A; McAllister, Ian L; Butler, Steve; Barone, Samuel B; Schwartz, Steven D; Blumenkranz, Mark S; Rakoczy, Elizabeth P

    2016-12-01

    We present the results of a Phase 2a randomized controlled trial investigating the safety, and secondary endpoints of subretinal rAAV.sFLT-1 gene therapy in patients with active wet age-related macular degeneration (wAMD). All patients (n=32), (ClinicalTrials.gov; NCT01494805), received ranibizumab injections at baseline and week 4, and thereafter according to prespecified criteria. Patients in the gene therapy group (n=21) received rAAV.sFLT-1 (1×10(11)vg). All patients were assessed every 4weeks to the week 52 primary endpoint. Ocular adverse events (AEs) in the rAAV.sFLT-1 group were mainly procedure related and self-resolved. All 11 phakic patients in the rAAV.sFLT-1 group showed progression of cataract following vitrectomy. No systemic safety signals were observed and none of the serious AEs were associated with rAAV.sFLT-1. AAV2 capsid was not detected and rAAV.sFLT-1 DNA was detected transiently in the tears of 13 patients. ELISPOT analysis did not identify any notable changes in T-cell response. In the rAAV.sFLT-1 group 12 patients had neutralizing antibodies (nAb) to AAV2. There was no change in sFLT-1 levels in bodily fluids. In the rAAV.sFLT-1 group, Best Corrected Visual Acuity (BCVA) improved by a median of 1.0 (IQR: -3.0 to 9.0) Early Treatment Diabetic Retinopathy Study (ETDRS) letters from baseline compared to a median of -5.0 (IQR: -17.5 to 1.0) ETDRS letters change in the control group. Twelve (57%) patients in the rAAV.sFLT-1 group maintained or improved vision compared to 4 (36%) in the control group. The median number of ranibizumab retreatments was 2.0 (IQR: 1.0 to 6.0) for the gene therapy group compared to 4.0 (IQR: 3.5 to 4.0) for the control group. Interpretation rAAV.sFLT-1 combined with the option for co-treatment appears to be a safe and promising approach to the treatment of wAMD. National Health and Medical Research Council of Australia (AP1010405), Lions Eye Institute, Perth Australia, Avalanche Biotechnologies, Menlo Pk, CA, USA

  14. Relationships Between Functional Outcomes and Symptomatic Improvement in Atomoxetine-Treated Adult Patients with Attention-Deficit/Hyperactivity Disorder: Post Hoc Analysis of an Integrated Database.

    PubMed

    De Bruyckere, Katrien; Bushe, Chris; Bartel, Christoph; Berggren, Lovisa; Kan, Cornelis C; Dittmann, Ralf W

    2016-06-01

    Atomoxetine treatment is associated with improvements in functional outcomes in patients with attention-deficit/hyperactivity disorder (ADHD), although relationships between improvements in these outcomes and reductions in ADHD symptoms have not been comprehensively investigated in adults. The aim of this study was to assess relationships between functional outcomes and ADHD symptoms (primary objective), and to assess time courses of changes in functional outcomes from baseline to weeks 10 and 24 (secondary objective). We analyzed data pooled from seven Eli Lilly-sponsored placebo-controlled trials of atomoxetine in adults with ADHD that had Conners' Adult ADHD Rating Scales-Investigator Rated: Screening Version (CAARS-Inv:SV) total scores and functional outcome data at baseline and at week 10. Two trials also had these data at week 24. Patients were included in these pooled analyses if they had a CAARS-Inv:SV total score at baseline and at one or more post-baseline visits at weeks 10 or 24, or had post-baseline scores that would allow missing scores at weeks 10 or 24 to be imputed. To address the primary objective, changes in functional outcomes during treatment with atomoxetine versus placebo were assessed using last observation carried forward (LOCF) analysis of covariance (ANCOVA) and mixed-effects model repeated measures (MMRM) analysis, and correlations between score changes in CAARS-Inv:SV total and functional outcomes were assessed using Spearman's rank correlation coefficient (r) at weeks 10 and 24. The secondary objective was addressed using MMRM. At baseline, patients generally had moderately severe or worse ADHD symptoms (based on CAARS-Inv:SV total scores) and impaired functional outcomes (based on Adult ADHD Quality-of-Life [AAQoL], Behavior Rating Inventory of Executive Function-Adult Version [BRIEF-A], Sheehan Disability Scale [SDS], and 36-item Short-Form Health Survey [SF-36] scores). These baseline characteristics were comparable in the

  15. Association of the magnitude of weight loss and changes in physical fitness with long-term cardiovascular disease outcomes in overweight or obese people with type 2 diabetes: a post-hoc analysis of the Look AHEAD randomised clinical trial.

    PubMed

    Gregg, Edward; Jakicic, John; Blackburn, George; Bloomquist, Paul; Bray, George; Clark, Jeanne; Coday, Mace; Curtis, Jeffrey; Egan, Caitlin; Evans, Mary; Foreyt, John; Foster, Gary; Hazuda, Helen; Hill, James; Horton, Edward; Hubbard, Van; Jeffery, Robert; Johnson, Karen; Kitabchi, Abbas; Knowler, William; Kriska, Andrea; Lang, Wei; Lewis, Cora; Montez, Maria; Nathan, David; Neiberg, Rebecca; Patricio, Jennifer; Peters, Anne; Pi-Sunyer, Xavier; Pownall, Henry; Redmon, Bruce; Regensteiner, Judith; Rejeski, Jack; Ribisl, Paul; Safford, Monika; Stewart, Kerry; Trence, Dace; Wadden, Thomas; Wing, Rena; Yanovski, Susan

    2016-11-01

    Findings from the Look AHEAD trial showed no significant reductions in the primary outcome of cardiovascular disease incidence in adults with type 2 diabetes randomly assigned to an intensive lifestyle intervention for weight loss compared with those randomly assigned to diabetes support and education (control). We examined whether the incidence of cardiovascular disease in Look AHEAD varied by changes in weight or fitness. Look AHEAD was a randomised clinical trial done at 16 clinical sites in the USA, recruiting patients from Aug 22, 2001, to April 30, 2004. In the trial, 5145 overweight or obese adults aged 45-76 years with type 2 diabetes were assigned (1:1) to an intensive lifestyle intervention or diabetes support and education. In this observational, post-hoc analysis, we examined the association of magnitude of weight loss and fitness change over the first year with incidence of cardiovascular disease. The primary outcome of the trial and of this analysis was a composite of death from cardiovascular causes, non-fatal acute myocardial infarction, non-fatal stroke, or admission to hospital for angina. The secondary outcome included the same indices plus coronary artery bypass grafting, carotid endartectomy, percutaneous coronary intervention, hospitalisation for congestive heart failure, peripheral vascular disease, or total mortality. We adjusted analyses for baseline differences in weight or fitness, demographic characteristics, and risk factors for cardiovascular disease. The Look AHEAD trial is registered with ClinicalTrials.gov, number NCT00017953. For the analyses related to weight change, we excluded 311 ineligible participants, leaving a population of 4834; for the analyses related to fitness change, we excluded 739 participants, leaving a population of 4406. In analyses of the full cohort (ie, combining both study groups), over a median 10·2 years of follow-up (IQR 9·5-10·7), individuals who lost at least 10% of their bodyweight in the first year

  16. Development of opioid-induced constipation: post hoc analysis of data from a 12-week prospective, open-label, blinded-endpoint streamlined study in low-back pain patients treated with prolonged-release WHO step III opioids

    PubMed Central

    Ueberall, Michael A; Mueller-Schwefe, Gerhard HH

    2015-01-01

    Background Opioid-induced constipation is the most prevalent patient complaint associated with longer-term opioid use and interferes with analgesic efficacy, functionality, quality of life, and patient compliance. Objectives We aimed to compare the effects of prolonged-release (PR) oxycodone plus PR naloxone (OXN) vs PR oxycodone (OXY) vs PR morphine (MOR) on bowel function under real-life conditions in chronic low-back pain patients refractory to World Health Organization (WHO) step I and/or II analgesics. Research design and methods This was a post hoc analysis of the complete data set from a prospective, randomized, open-label, blinded endpoint (PROBE) streamlined study (German pain study registry: 2012-0012-05; European Union Drug Regulating Authorities Clinical Trials [EudraCT]: 2012-001317-16), carried out in 88 centers in Germany, where a total of 901 patients requiring WHO step III opioids to treat low-back pain were enrolled and prospectively observed for 3 months. Opioid allocation was based on either optional randomization (n=453) or physician decision (n=448). In both groups, treatment doses could be adjusted as per the German prescribing information, and physicians were free to address all side effects and tolerability issues as usual. The primary endpoint was the proportion of patients maintaining normal bowel function throughout the complete treatment period, assessed with the Bowel Function Index (BFI). Secondary analyses addressed absolute and relative BFI changes, complete spontaneous bowel movements, use of laxatives, treatment emergent adverse events, analgesic effects, and differences between randomized vs nonrandomized patient groups. Results BFI changed significantly with all three WHO step III treatments, however significantly less with OXN vs OXY and MOR despite a significantly higher use of laxatives with the latter ones (P<0.001). The percentage of patients who maintained normal BFI scores despite opioid treatment was 54.5% (164/301) with

  17. Effect of a reduction in uric acid on renal outcomes during losartan treatment: a post hoc analysis of the reduction of endpoints in non-insulin-dependent diabetes mellitus with the Angiotensin II Antagonist Losartan Trial.

    PubMed

    Miao, Yan; Ottenbros, Stefan A; Laverman, Goos D; Brenner, Barry M; Cooper, Mark E; Parving, Hans-Henrik; Grobbee, Diederick E; Shahinfar, Shahnaz; de Zeeuw, Dick; Lambers Heerspink, Hiddo J

    2011-07-01

    Emerging data show that increased serum uric acid (SUA) concentration is an independent risk factor for end-stage renal disease. Treatment with the antihypertensive drug losartan lowers SUA. Whether reductions in SUA during losartan therapy are associated with renoprotection is unclear. We therefore tested this hypothesis. In a post hoc analysis of 1342 patients with type 2 diabetes mellitus and nephropathy participating in the Reduction of Endpoints in Non-Insulin-Dependent Diabetes Mellitus With the Angiotensin II Antagonist Losartan Trial, we determined the relationship between month 6 change in SUA and renal endpoints, defined as a doubling of serum creatinine or end-stage renal disease. Baseline SUA was 6.7 mg/dL in placebo and losartan-treated subjects. During the first 6 months, losartan lowered SUA by -0.16 mg/dL (95% CI: -0.30 to -0.01; P=0.031) as compared with placebo. The risk of renal events was decreased by 6% (95% CI: 10% to 3%) per 0.5-mg/dL decrement in SUA during the first 6 months. This effect was independent of other risk markers, including estimate glomerular filtration rate and albuminuria. Adjustment of the overall treatment effects for SUA attenuated losartan's renoprotective effect from 22% (95% CI: 6% to 35%) to 17% (95% CI: 1% to 31%), suggesting that approximately one fifth of losartan's renoprotective effect could be attributed to its effect on SUA. Losartan lowers SUA levels compared with placebo treatment in patients with type 2 diabetes mellitus and nephropathy. The degree of reduction in SUA is subsequently associated with the degree in long-term renal risk reduction and explains part of losartan's renoprotective effect. These findings support the view that SUA may be a modifiable risk factor for renal disease.

  18. Dose-Escalation Study of Thoracic Radiotherapy in Combination With Pemetrexed Plus Cisplatin in Japanese Patients With Locally Advanced Nonsquamous Non-Small Cell Lung Cancer: A Post Hoc Analysis of Survival and Recurrent Sites.

    PubMed

    Niho, Seiji; Nokihara, Hiroshi; Nihei, Keiji; Akimoto, Tetsuo; Sumi, Minako; Ito, Yoshinori; Yoh, Kiyotaka; Goto, Koichi; Ohmatsu, Hironobu; Horinouchi, Hidehito; Yamamoto, Noboru; Sekine, Ikuo; Kubota, Kaoru; Ohe, Yuichiro; Tamura, Tomohide

    2016-04-01

    We performed a post hoc analysis of progression-free survival (PFS), overall survival (OS), and recurrent sites in patients with locally advanced nonsquamous non-small cell lung cancer who were enrolled in a phase I trial of combination chemotherapy consisting of pemetrexed plus cisplatin with concurrent thoracic radiotherapy. Patients received pemetrexed (500 mg/m²) plus cisplatin (75 mg/m²) on day 1 every 3 weeks for 3 cycles plus concurrent thoracic radiotherapy consisting of 60 Gy (n=6) or 66 Gy (n=12); 4 to 6 weeks thereafter, patients received consolidation treatment with pemetrexed (500 mg/m) every 3 weeks for up to 3 cycles. We reviewed the medial records to collect data on progression, recurrent sites, late toxicity, and survival. No late radiation morbidity was observed. Thirteen patients (72%) exhibited disease progression: 8 patients had distant metastases, 8 patients had local recurrence (within the radiation field [n=6], outside the radiation field [n=2], and both [n=1]), and 3 patients had local recurrence plus distant metastases. The median PFS was 10.5 months (95% confidence interval [CI], 8.8-12.3), and the 3-year PFS rate was 28% (95% CI, 7.0-48.6). Ten of the 18 patients died of lung cancer. The median follow-up time for the censored cases was 42.8 months (range, 38.1 to 52.9 mo). The median OS was 27.3 months (95% CI, 13.1-41.6), and the 3-year OS rate was 50% (95% CI, 26.9-73.1). The median PFS and OS in our study were comparable to those of historical chemoradiotherapy controls.

  19. Dose and aging effect on patients reported treatment benefit switching from the first overactive bladder therapy with tolterodine ER to fesoterodine: post-hoc analysis from an observational and retrospective study.

    PubMed

    Castro-Diaz, David; Miranda, Pilar; Sanchez-Ballester, Francisco; Lizarraga, Isabel; Arumí, Daniel; Rejas, Javier

    2012-07-26

    Previous randomized studies have demonstrated that fesoterodine significantly improves the Overactive Bladder (OAB) symptoms and their assessment by patients compared with tolterodine extended-release (ER). This study aimed to assess the effect of aging and dose escalation on patient-reported treatment benefit, after changing their first Overactive Bladder (OAB) therapy with tolterodine-ER to fesoterodine in daily clinical practice. A post-hoc analysis of data from a retrospective, cross-sectional and observational study was performed in a cohort of 748 OAB adults patients (OAB-V8 score ≥8), who switched to fesoterodine from their first tolterodine-ER-based therapy within the 3-4 months before study visit. Effect of fesoterodine doses (4 mg vs. 8 mg) and patient age (<65 yr vs. ≥65 yr) were assessed. Patient reported treatment benefit [Treatment Benefit Scale (TBS)] and physician assessment of improvement with change [Clinical Global Impression of Improvement subscale (CGI-I)] were recorded. Treatment satisfaction, degree of worry, bother and interference with daily living activities due to urinary symptoms were also assessed. Improvements were not affected by age. Fesoterodine 8 mg vs. 4 mg provides significant improvements in terms of treatment benefit [TBS 97.1% vs. 88.4%, p < 0.001; CGI-I 95.8% vs. 90.8% p < 0.05)], degree of worry, bother and interference with daily-living activities related to OAB symptoms (p <0.05). A change from tolterodine ER therapy to fesoterodine with dose escalation to 8 mg in symptomatic OAB patients, seems to be associated with greater improvement in terms of both patient-reported-treatment benefit and clinical global impression of change. Improvement was not affected by age.

  20. Dose and aging effect on patients reported treatment benefit switching from the first overactive bladder therapy with tolterodine ER to fesoterodine: post-hoc analysis from an observational and retrospective study

    PubMed Central

    2012-01-01

    Background Previous randomized studies have demonstrated that fesoterodine significantly improves the Overactive Bladder (OAB) symptoms and their assessment by patients compared with tolterodine extended-release (ER). This study aimed to assess the effect of aging and dose escalation on patient-reported treatment benefit, after changing their first Overactive Bladder (OAB) therapy with tolterodine-ER to fesoterodine in daily clinical practice. Methods A post-hoc analysis of data from a retrospective, cross-sectional and observational study was performed in a cohort of 748 OAB adults patients (OAB-V8 score ≥8), who switched to fesoterodine from their first tolterodine-ER-based therapy within the 3–4 months before study visit. Effect of fesoterodine doses (4 mg vs. 8 mg) and patient age (<65 yr vs. ≥65 yr) were assessed. Patient reported treatment benefit [Treatment Benefit Scale (TBS)] and physician assessment of improvement with change [Clinical Global Impression of Improvement subscale (CGI-I)] were recorded. Treatment satisfaction, degree of worry, bother and interference with daily living activities due to urinary symptoms were also assessed. Results Improvements were not affected by age. Fesoterodine 8 mg vs. 4 mg provides significant improvements in terms of treatment benefit [TBS 97.1% vs. 88.4%, p < 0.001; CGI-I 95.8% vs. 90.8% p < 0.05)], degree of worry, bother and interference with daily-living activities related to OAB symptoms (p <0.05). Conclusions A change from tolterodine ER therapy to fesoterodine with dose escalation to 8 mg in symptomatic OAB patients, seems to be associated with greater improvement in terms of both patient-reported-treatment benefit and clinical global impression of change. Improvement was not affected by age. PMID:22834707

  1. Effect of baseline exercise capacity on outcomes in patients with stable coronary heart disease (a post hoc analysis of the clinical outcomes utilizing revascularization and aggressive drug evaluation trial).

    PubMed

    Padala, Santosh K; Sidhu, Mandeep S; Hartigan, Pamela M; Maron, David J; Teo, Koon K; Spertus, John A; Mancini, G B John; Sedlis, Steven P; Chaitman, Bernard R; Heller, Gary V; Weintraub, William S; Boden, William E

    2015-11-15

    The impact of baseline exercise capacity on clinical outcomes in patients with stable ischemic heart disease randomized to an initial strategy of optimal medical therapy (OMT) with or without percutaneous coronary intervention (PCI) in the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial has not been studied. A post hoc analysis was performed in 1,052 patients of COURAGE (PCI + OMT: n = 527, OMT: n = 525) who underwent exercise treadmill testing at baseline. Patients were categorized into 2 exercise capacity groups based on metabolic equivalents (METs) achieved during baseline exercise treadmill testing (<7 METs: n = 464, ≥7 METs: n = 588) and were followed for a median of 4.6 years. The primary composite end point of death or myocardial infarction was similar in the PCI + OMT group and the OMT group for patients with exercise capacity <7 METs (19.1% vs 16.1%, p = 0.31) and ≥7 METs (13.3% vs 10.3%, p = 0.27). After adjusting for baseline covariates, the hazard ratio (99% confidence interval) for the primary end point for the PCI + OMT group versus the OMT group was 1.42 (0.90 to 2.23, p = 0.05) and for the exercise capacity subgroups of ≥7 METs and <7 METs was 0.75 (0.46 to 1.22, p = 0.13). There was no statistically significant interaction between the original treatment arm allocation (PCI + OMT vs OMT) and baseline exercise capacity. In conclusion, there was no difference in the long-term clinical outcomes in patients with exercise capacity <7 METs compared with ≥7 METs, irrespective of whether they were assigned to initial PCI. Patients with exercise capacity <7 METs did not derive a proportionately greater clinical benefit from PCI + OMT compared with those patients who received OMT alone. Published by Elsevier Inc.

  2. Sustained uremic toxin control improves renal and cardiovascular outcomes in patients with advanced renal dysfunction: post-hoc analysis of the Kremezin Study against renal disease progression in Korea

    PubMed Central

    Cha, Ran-hui; Kang, Shin Wook; Park, Cheol Whee; Cha, Dae Ryong; Na, Ki Young; Kim, Sung Gyun; Yoon, Sun Ae; Kim, Sejoong; Han, Sang Youb; Park, Jung Hwan; Chang, Jae Hyun; Lim, Chun Soo; Kim, Yon Su

    2017-01-01

    Background We investigated the long-term effect of AST-120, which has been proposed as a therapeutic option against renal disease progression, in patients with advanced chronic kidney disease (CKD). Methods We performed post-hoc analysis with a per-protocol group of the K-STAR study (Kremezin study against renal disease progression in Korea) that randomized participants into an AST-120 and a control arm. Patients in the AST-120 arm were given 6 g of AST-120 in three divided doses, and those in both arms received standard conventional treatment. Results The two arms did not differ significantly in the occurrence of composite primary outcomes (log-rank P = 0.41). For AST-120 patients with higher compliance, there were fewer composite primary outcomes: intermediate tertile hazard ratio (HR) 0.62, 95% confidence interval (CI) 0.38 to 1.01, P = 0.05; highest tertile HR 0.436, 95% CI 0.25 to 0.76, P = 0.003. The estimated glomerular filtration rate level was more stable in the AST-120 arm, especially in diabetic patients. At one year, the AST-120-induced decrease in the serum indoxyl sulfate concentration inversely correlated with the occurrence of composite primary outcomes: second tertile HR 1.59, 95% CI 0.82 to 3.07, P = 0.17; third tertile HR 2.11, 95% CI 1.07 to 4.17, P = 0.031. Furthermore, AST-120 showed a protective effect against the major cardiovascular adverse events (HR 0.51, 95% CI 0.26 to 0.99, P = 0.046). Conclusion Long-term use of AST-120 has potential for renal protection, especially in diabetic patients, as well as cardiovascular benefits. Reduction of the serum indoxyl sulfate level may be used to identify patients who would benefit from AST-120 administration. PMID:28392999

  3. In search of optimal lithium levels and olanzapine doses in the long-term treatment of bipolar I disorder. A post-hoc analysis of the maintenance study by Tohen et al. 2005.

    PubMed

    Severus, W E; Lipkovich, I A; Licht, R W; Young, A H; Greil, W; Ketter, T; Deberdt, W; Tohen, M

    2010-12-01

    The aim of this study was to investigate whether lower lithium levels (LoLi) or olanzapine doses (LoOL) are risk factors for future mood episodes in patients with bipolar I disorder. A post-hoc analysis of the olanzapine-lithium-maintenance study [31] was performed using proportional hazards Cox regression models and marginal structural models (MSMs), adjusting for non-random assignments of dose during treatment. The LoLi group (<0.6 mmol/L) had a significantly increased risk of manic/mixed (hazard ratio [HR]=1.96, p=0.042), but not depressive (HR=2.11, p=0.272) episodes, compared to the combined medium (0.6-0.79 mmol/L) and high lithium level (≥0.8 mmol/L) groups. There was no significant difference in risk between the two higher lithium level groups (0.6-0.79 mmol/L; ≥0.8 mmol/L) for new manic/mixed (HR=0.96, p=0.893) or depressive (HR=0.95, p=0.922) episodes. The LoOL group (<10mg/day) showed a significantly increased risk of depressive (HR=2.24, p=0.025) episodes compared to the higher olanzapine (HiOL) dose group (HiOL: 10-20 mg/day), while there was no statistically significant difference in risk for manic/mixed episodes between the two groups (HR=0.94, p=0.895). Lithium levels≥0.6 mmol/L and olanzapine doses≥10mg/day may be necessary for optimal protection against manic/mixed or depressive episodes, respectively in patients with bipolar I disorder. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  4. Patient-reported treatment satisfaction and budget impact with rivaroxaban vs. standard therapy in elective cardioversion of atrial fibrillation: a post hoc analysis of the X-VeRT trial.

    PubMed

    Hohnloser, Stefan H; Cappato, Riccardo; Ezekowitz, Michael D; Evers, Thomas; Sahin, Kurtulus; Kirchhof, Paulus; Meng, Isabelle Ling; van Eickels, Martin; Camm, A John

    2016-02-01

    We compared patient-reported treatment satisfaction and the economic impact of anticoagulation therapy with rivaroxaban vs. vitamin K antagonists (VKAs) in patients with non-valvular atrial fibrillation undergoing elective cardioversion procedures. The current study is a post hoc analysis of the prospective, multicentre X-VeRT (EXplore the efficacy and safety of once-daily oral riVaroxaban for the prevention of caRdiovascular events in subjects with non-valvular aTrial fibrillation scheduled for cardioversion) trial. Patient-reported treatment satisfaction with anticoagulation therapy was assessed using the Treatment Satisfaction Questionnaire for Medication version II in seven countries (US, UK, Canada, Germany, France, Italy, and the Netherlands). An economic model was also developed to estimate the impact of postponed cardioversions for two countries (UK and Italy). This model estimated the total costs of cardioversion, taking into consideration the costs for drug therapy (including extended treatment duration due to cardioversion postponement), international normalized ratio monitoring of VKAs, the cardioversion procedure, and rescheduling the procedure. These costs were linked to the respective X-VeRT study data to estimate the total costs. Patients receiving rivaroxaban in the delayed cardioversion group had significantly higher scores for Convenience, Effectiveness, and Global satisfaction (81.74 vs. 65.78; 39.41 vs. 32.95; and 82.07 vs. 66.74, respectively; P < 0.0001). Based on the total patient population included in the treatment satisfaction substudy (n = 632) in the delayed cardioversion group in X-VeRT, the use of rivaroxaban was estimated to result in a saving of £421 and €360 per patient in UK and Italian settings, respectively. The use of rivaroxaban in the setting of cardioversion resulted in greater patient satisfaction and cost savings, compared with that of VKA. © The Author 2015. Published by Oxford University Press on behalf of the

  5. Does education level affect the efficacy of a community based salt reduction program? - A post-hoc analysis of the China Rural Health Initiative Sodium Reduction Study (CRHI-SRS).

    PubMed

    Wang, Xin; Li, Xian; Vaartjes, Ilonca; Neal, Bruce; Bots, Michiel L; Hoes, Arno W; Wu, Yangfeng

    2016-08-11

    Whether educational level influences the effects of health education is not clearly defined. This study examined whether the impact of a community-based dietary salt reduction program was affected by the level of education of participants. The China Rural Health Initiative Sodium Reduction Study (CRHI-SRS) was a cluster-randomized controlled trial conducted in 120 villages from five Northern Chinese provinces. The intervention comprised a village-wide health education program and availability of salt substitute at village shops. 24-h urine samples were collected among 1903 participants for primary evaluation of the intervention effect. A post-hoc analysis was done to explore for heterogeneity of intervention effects by education level using generalized estimating equations. All models were adjusted for age, sex, body mass index and province. Daily salt intake was lower in intervention than in control at all educational levels with no evidence of a difference in the effect of the intervention across different levels of education. P value for the interaction term between education level and the intervention was 0.35. There was likewise no evidence of an interaction for effects of the intervention on potassium intake (p = 0.71), the sodium to potassium ratio (p = 0.07), or knowledge and behaviors related to salt (all p > 0.05). The study suggests that the effects of the intervention were achieved regardless of the level of education and that the intervention should therefore be broadly effective in rural Chinese populations. The trial was registered with clinicaltrial.gov ( NCT01259700 ).

  6. initial angiotensin receptor blockade-induced decrease in albuminuria is associated with long-term renal outcome in type 2 diabetic patients with microalbuminuria: a post hoc analysis of the IRMA-2 trial.

    PubMed

    Hellemons, Merel E; Persson, Frederik; Bakker, Stephan J L; Rossing, Peter; Parving, Hans-Henrik; De Zeeuw, Dick; Lambers Heerspink, Hiddo J

    2011-09-01

    We aimed to investigate the individual impact of initial responses in urinary albumin excretion (UAE) and systolic blood pressure (SBP) to angiotensin II receptor blocker (ARB) treatment on long-term renal outcome in patients with type 2 diabetes and microalbuminuria. In a post hoc analysis of the Irbesartan in Patients with Type 2 Diabetes and Microalbuminuria (IRMA)-2 trial we first assessed the individual variability in UAE and SBP response (0-6 months) in 531 subjects. Subsequently, we analyzed the individual effect of both response parameters on renal outcome defined as change in estimated glomerular filtration rate (eGFR) during 2 years of follow-up. The median reductions in UAE and SBP in the population were -18% and -11 mmHg, respectively. In irbesartan-treated patients, 85 (24.4%) had a robust (>median) reduction in UAE but not in SBP (discordant SBP response) and 67 (19.3%) had a robust (>median) reduction in SBP but not in UAE (discordant UAE response). The degree of reduction in UAE was independently associated with the rate of eGFR decline (P = 0.0037). SBP showed a similar trend (P = 0.087). The relation between a larger UAE reduction and a slower rate of renal function decline was present in both cohorts with a SBP change above and below the median. Within an individual, UAE response to ARB therapy may be discordant from SBP response. The initial change in UAE was independently associated with eGFR slope; the more UAE reduction the less eGFR decline, irrespective of the SBP change. These results suggest that in microalbuminuric patients with type 2 diabetes, UAE should be monitored after initiation of therapy and a separate target for renoprotective therapy.

  7. Anomaly Detection Techniques for Ad Hoc Networks

    ERIC Educational Resources Information Center

    Cai, Chaoli

    2009-01-01

    Anomaly detection is an important and indispensable aspect of any computer security mechanism. Ad hoc and mobile networks consist of a number of peer mobile nodes that are capable of communicating with each other absent a fixed infrastructure. Arbitrary node movements and lack of centralized control make them vulnerable to a wide variety of…

  8. Anomaly Detection Techniques for Ad Hoc Networks

    ERIC Educational Resources Information Center

    Cai, Chaoli

    2009-01-01

    Anomaly detection is an important and indispensable aspect of any computer security mechanism. Ad hoc and mobile networks consist of a number of peer mobile nodes that are capable of communicating with each other absent a fixed infrastructure. Arbitrary node movements and lack of centralized control make them vulnerable to a wide variety of…

  9. Space-Time Processing for Tactical Mobile Ad Hoc Networks

    DTIC Science & Technology

    2008-08-01

    Maximization in Multi-User, MIMO Channels with Linear Processing...58 2.9 Using Feedback in Ad Hoc Networks....................................................................65 2.10 Feedback MIMO ...in MIMO Ad Hoc Interference Networks.......................................................................................................75 2.12

  10. Safety of daily teriparatide treatment: a post hoc analysis of a Phase III study to investigate the possible association of teriparatide treatment with calcium homeostasis in patients with serum procollagen type I N-terminal propeptide elevation

    PubMed Central

    Yamamoto, Takanori; Tsujimoto, Mika; Sowa, Hideaki

    2015-01-01

    Objective Serum procollagen type I N-terminal propeptide (PINP), a representative marker of bone anabolic action, is strongly related to bone mineral density during teriparatide therapy. This post hoc study analyzed data from a Phase III study (ClinicalTrials.gov identifier NCT00433160) to determine if there was an association between serum PINP elevation and serum calcium concentration or calcium metabolism-related disorders. Research design and methods Japanese subjects with osteoporosis at high risk of fracture were randomized 2:1 to teriparatide 20 μg/day (n=137) or placebo (n=70) for a 12-month double-blind treatment period, followed by 12 months of open-label teriparatide treatment of all subjects. Main outcome measures Serum PINP levels were measured at baseline, and after 1, 3, 6, 12, 18, and 24 months of treatment. Serum calcium levels were measured at baseline, and after 1, 3, 6, 9, 12, 15, 18, 21, and 24 months of treatment. Results Serum PINP increased from baseline to 1 month of treatment and then remained high through 24 months. Twenty-eight of 195 subjects experienced PINP elevations >200 μg/L during teriparatide treatment. Serum calcium concentration in both the teriparatide and placebo groups remained within the normal range. There was no clinically relevant difference in serum calcium concentration between subjects with PINP >200 μg/L and subjects with PINP ≤200 μg/L. Two subjects experienced hypercalcemia and recovered without altering teriparatide treatment. Adverse events possibly related to calcium metabolism disorders included periarthritis calcarea (one subject) and chondrocalcinosis pyrophosphate (two subjects), but neither was accompanied with a significant increase in PINP or serum calcium concentration. Conclusion Although the moderate size of this study prevented statistical analysis of any potential association between calcium metabolism-related disorders and elevated PINP, this analysis suggests that there was no association

  11. Effect of ELOM-080 on exacerbations and symptoms in COPD patients with a chronic bronchitis phenotype - a post-hoc analysis of a randomized, double-blind, placebo-controlled clinical trial.

    PubMed

    Beeh, Kai-Michael; Beier, Jutta; Candler, Henning; Wittig, Thomas

    2016-01-01

    Treating symptoms and preventing exacerbations are key components of chronic obstructive pulmonary disease (COPD) long-term management. Recently, a more tailored treatment approach has been proposed, in particular for two well-established clinical phenotypes, frequent exacerbators and chronic bronchitis-dominant COPD. ELOM-080 has demonstrated clinical efficacy in treating symptoms and preventing exacerbations in subjects with chronic bronchitis. However, little is known about the potential effects of ELOM-080 in COPD patients. To evaluate the effect on exacerbation, cough sputum, and general state of health of long-term treatment with ELOM-080 in COPD patients with an exacerbation history and chronic bronchitis. We performed a post-hoc analysis of a randomized, double-blinded, placebo-controlled parallel-group clinical trial of a 6-month treatment with ELOM-080 (3×300 mg) in patients with chronic bronchitis and concomitant COPD. The primary outcome was the proportion of subjects with at least one exacerbation over the 6-month study period. Secondary outcomes included the total number of exacerbations (ie, cumulative occurrence of exacerbations during the study period) and the proportion of acute exacerbations necessitating an antibiotic treatment, monthly evaluations of sputum and cough symptoms, and the general state of health and a safety analysis. Of 260 randomized subjects, 64 patients fulfilled the inclusion criteria for COPD (ELOM-080: 35, placebo: 29). Compared to placebo, ELOM-080 reduced the percentage of subjects with at least one exacerbation (29% versus 55%, P=0.031) and a reduction in the overall occurrence of exacerbations (ELOM-080: 10, placebo: 21, P=0.012) during the winter season. The percentage of asymptomatic or mildly symptomatic patients (sputum/expectoration and cough) was consistently higher in the ELOM-080 group compared to placebo, with statistical significant differences after 2 and 3 months of treatment (2 months: ELOM-080 25%, placebo

  12. Effect of ELOM-080 on exacerbations and symptoms in COPD patients with a chronic bronchitis phenotype – a post-hoc analysis of a randomized, double-blind, placebo-controlled clinical trial

    PubMed Central

    Beeh, Kai-Michael; Beier, Jutta; Candler, Henning; Wittig, Thomas

    2016-01-01

    Background Treating symptoms and preventing exacerbations are key components of chronic obstructive pulmonary disease (COPD) long-term management. Recently, a more tailored treatment approach has been proposed, in particular for two well-established clinical phenotypes, frequent exacerbators and chronic bronchitis-dominant COPD. ELOM-080 has demonstrated clinical efficacy in treating symptoms and preventing exacerbations in subjects with chronic bronchitis. However, little is known about the potential effects of ELOM-080 in COPD patients. Aim To evaluate the effect on exacerbation, cough sputum, and general state of health of long-term treatment with ELOM-080 in COPD patients with an exacerbation history and chronic bronchitis. Methods We performed a post-hoc analysis of a randomized, double-blinded, placebo-controlled parallel-group clinical trial of a 6-month treatment with ELOM-080 (3×300 mg) in patients with chronic bronchitis and concomitant COPD. The primary outcome was the proportion of subjects with at least one exacerbation over the 6-month study period. Secondary outcomes included the total number of exacerbations (ie, cumulative occurrence of exacerbations during the study period) and the proportion of acute exacerbations necessitating an antibiotic treatment, monthly evaluations of sputum and cough symptoms, and the general state of health and a safety analysis. Results Of 260 randomized subjects, 64 patients fulfilled the inclusion criteria for COPD (ELOM-080: 35, placebo: 29). Compared to placebo, ELOM-080 reduced the percentage of subjects with at least one exacerbation (29% versus 55%, P=0.031) and a reduction in the overall occurrence of exacerbations (ELOM-080: 10, placebo: 21, P=0.012) during the winter season. The percentage of asymptomatic or mildly symptomatic patients (sputum/expectoration and cough) was consistently higher in the ELOM-080 group compared to placebo, with statistical significant differences after 2 and 3 months of treatment

  13. Health-related quality of life effects of enzalutamide in patients with metastatic castration-resistant prostate cancer: an in-depth post hoc analysis of EQ-5D data from the PREVAIL trial.

    PubMed

    Devlin, Nancy; Herdman, Michael; Pavesi, Marco; Phung, De; Naidoo, Shevani; Beer, Tomasz M; Tombal, Bertrand; Loriot, Yohann; Ivanescu, Cristina; Parli, Teresa; Balk, Mark; Holmstrom, Stefan

    2017-06-23

    The effect of enzalutamide on health-related quality of life (HRQoL) in the PREVAIL trial in chemotherapy-naïve men with metastatic castration-resistant prostate cancer was analyzed using the generic EQ-5D instrument. Patients received oral enzalutamide 160 mg/day (n = 872) or placebo (n = 845). EQ-5D index and EQ-5D visual analogue scale (EQ-5D VAS) scores were evaluated at baseline, week 13, and every 12 weeks until week 61 due to sample size reduction thereafter. Changes on individual dimensions were assessed, and Paretian Classification of Health Change (PCHC) and time-to-event analyses were conducted. With enzalutamide, EQ-5D index and EQ-5D VAS scores declined more slowly versus placebo and time to diverge from full health was prolonged. Average decline in EQ-5D index (-0.042 vs. -0.070; P < .0001) and EQ-5D VAS (-1.3 vs. -4.4; P < .0001) was significantly smaller with enzalutamide. There were significant (P < .05) between-group differences favoring enzalutamide in Pain/Discomfort to week 37, Anxiety/Depression at week 13, and Usual Activities at week 25, but no significant differences for Mobility and Self-care. The PCHC analysis showed more enzalutamide patients reporting improvement than placebo patients at weeks 13, 25, and 49 (all P < .05) and week 37 (P = .0512). Enzalutamide was superior (P ≤ .0003) to placebo for time to diverge from full health and time to first deterioration on Pain/Discomfort and Anxiety/Depression dimensions. This in-depth post hoc analysis showed that enzalutamide delayed HRQoL deterioration and had beneficial effects on several HRQoL domains, including Pain/Discomfort and the proportion of patients in full health, compared with placebo, and may help to support future analyses of this type. NCT01212991.

  14. AD Hoc Study on Human Robot Interface Issues

    DTIC Science & Technology

    2002-09-01

    ARMY SCIENCE BOARD AD HOC STUDY ON HUMAN ROBOT INTERFACE ISSUES FINAL REPORT SEPTEMBER 2002 Distribution: Approved for...conclusions contained in this report are those of the 2002 Ad Hoc Study Panel on “Human- Robot Interface Issues” and do not necessarily reflect the official...DATES COVERED Army Science Board – 2002 Ad Hoc Study 4. TITLE AND SUBTITLE AD HOC STUDY ON HUMAN ROBOT INTERFACE ISSUES 6. AUTHOR(S) Study

  15. 14 CFR 1203.903 - Ad hoc committees.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Ad hoc committees. 1203.903 Section 1203... NASA Information Security Program Committee § 1203.903 Ad hoc committees. The Chairperson is authorized to establish such ad hoc panels or subcommittees as may be necessary in the conduct of the...

  16. 14 CFR 1203.903 - Ad hoc committees.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Ad hoc committees. 1203.903 Section 1203.903... Information Security Program Committee § 1203.903 Ad hoc committees. The Chairperson is authorized to establish such ad hoc panels or subcommittees as may be necessary in the conduct of the Committee's work....

  17. 21 CFR 14.90 - Ad hoc advisory committee members.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Ad hoc advisory committee members. 14.90 Section... PUBLIC HEARING BEFORE A PUBLIC ADVISORY COMMITTEE Members of Advisory Committees § 14.90 Ad hoc advisory committee members. In selecting members of an ad hoc advisory committee, the Commissioner may use...

  18. 21 CFR 14.90 - Ad hoc advisory committee members.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Ad hoc advisory committee members. 14.90 Section... PUBLIC HEARING BEFORE A PUBLIC ADVISORY COMMITTEE Members of Advisory Committees § 14.90 Ad hoc advisory committee members. In selecting members of an ad hoc advisory committee, the Commissioner may use...

  19. Quantum load balancing in ad hoc networks

    NASA Astrophysics Data System (ADS)

    Hasanpour, M.; Shariat, S.; Barnaghi, P.; Hoseinitabatabaei, S. A.; Vahid, S.; Tafazolli, R.

    2017-06-01

    This paper presents a novel approach in targeting load balancing in ad hoc networks utilizing the properties of quantum game theory. This approach benefits from the instantaneous and information-less capability of entangled particles to synchronize the load balancing strategies in ad hoc networks. The quantum load balancing (QLB) algorithm proposed by this work is implemented on top of OLSR as the baseline routing protocol; its performance is analyzed against the baseline OLSR, and considerable gain is reported regarding some of the main QoS metrics such as delay and jitter. Furthermore, it is shown that QLB algorithm supports a solid stability gain in terms of throughput which stands a proof of concept for the load balancing properties of the proposed theory.

  20. Supporting Dynamic Ad hoc Collaboration Capabilities

    SciTech Connect

    Agarwal, Deborah A.; Berket, Karlo

    2003-07-14

    Modern HENP experiments such as CMS and Atlas involve as many as 2000 collaborators around the world. Collaborations this large will be unable to meet often enough to support working closely together. Many of the tools currently available for collaboration focus on heavy-weight applications such as videoconferencing tools. While these are important, there is a more basic need for tools that support connecting physicists to work together on an ad hoc or continuous basis. Tools that support the day-to-day connectivity and underlying needs of a group of collaborators are important for providing light-weight, non-intrusive, and flexible ways to work collaboratively. Some example tools include messaging, file-sharing, and shared plot viewers. An important component of the environment is a scalable underlying communication framework. In this paper we will describe our current progress on building a dynamic and ad hoc collaboration environment and our vision for its evolution into a HENP collaboration environment.

  1. DAWN: Dynamic Ad-hoc Wireless Network

    DTIC Science & Technology

    2016-06-19

    wireless communication networks . To accomplish this, DAWN adopts a very different approach than those followed in the past and summarized above. DAWN...wireless communication networks . The members of DAWN investigated difference aspects of wireless mobile ad hoc networks (MANET). The views, opinions and/or... communication networks . To accomplish this, DAWN adopts a very different approach than those followed in the past and summarized above. DAWN

  2. Aspirin Use and Incident Cardiovascular Disease, Kidney Failure, and Death in Stable Kidney Transplant Recipients: A Post Hoc Analysis of the Folic Acid for Vascular Outcome Reduction in Transplantation (FAVORIT) Trial

    PubMed Central

    Dad, Taimur; Tighiouart, Hocine; Joseph, Alin; Bostom, Andrew; Carpenter, Myra; Hunsicker, Lawrence; Kusek, John W.; Pfeffer, Marc; Levey, Andrew S.; Weiner, Daniel E.

    2016-01-01

    Background Cardiovascular disease (CVD) is the leading cause of death in kidney transplant recipients. Whether aspirin may reduce the risk for CVD, death, and kidney failure outcomes is uncertain. Study Design Post hoc cohort analysis of FAVORIT, a randomized trial examining the effect of homocysteine-lowering vitamins on CVD in kidney transplant recipients. Setting & Participants Prevalent adult kidney transplant recipients with hyperhomocysteinemia and stable kidney function from the United States, Canada, and Brazil participating in FAVORIT, with no known history of CVD. Predictor Aspirin use, with aspirin users matched to nonusers using a propensity score. Outcomes Incident CVD events, kidney failure, all-cause mortality, a composite of CVD events or mortality, and a composite of kidney failure or mortality. Cox proportional hazards models with a robust variance to account for the correlation in outcomes within matched pairs were sequentially adjusted for demographic, clinical, and laboratory characteristics to assess the association between aspirin use and events. Results 981 aspirin users were matched to 981 nonusers. During a 4-year mean follow up, there were 225 CVD events, 200 deaths, 126 kidney failure events, 301 composite kidney failure or mortality events, and 324 composite CVD or mortality events. Adjusted models showed no significant difference associated with aspirin use in risk for CVD events, all-cause mortality, kidney failure, composite of kidney failure or mortality, or composite of primary CVD events or mortality (HRs of 1.20 [95% CI, 0.92–1.58], 0.92 [95% CI, 0.69–1.23], 1.19 [95% CI, 0.81–1.74], 1.03 [0.82–1.31], and 1.11 [95% CI, 0.88–1.38], respectively). Limitations We did not examine dose or continued use of aspirin after randomization. CVD history is dependent on participant report at baseline. Aspirin use was non–randomly assigned. Conclusions Aspirin use is not associated with reduced risk for incident CVD, all

  3. Effect of ferric carboxymaltose on serum phosphate and C-terminal FGF23 levels in non-dialysis chronic kidney disease patients: post-hoc analysis of a prospective study

    PubMed Central

    2013-01-01

    Background Some parenteral iron therapies have been found to be associated with hypophosphatemia. The mechanism of the decrease in serum phosphate is unknown. The aim of this study is to examine the effect of IV ferric carboxymaltose(FCM) on phosphate metabolism and FGF23 levels in patients with chronic kidney disease(CKD). Methods This is a post-hoc analysis of a prospective study carried out in 47 non-dialysis CKD patients with iron-deficiency anaemia who received a single 1000 mg injection of FCM. Markers of mineral metabolism (calcium, phosphate, 1,25-dihydroxyvitamin D, PTH and FGF23[c-terminal]) were measured prior to FCM administration and at week 3 and week 12 after FCM administration. Based on the measured levels of serum phosphate at week 3, patiens were classified as hypophosphatemic or non-hypophosphatemic. Results Serum phosphate levels decreased significantly three weeks after FCM administration and remained at lower levels at week 12 (4.24 ± 0.84 vs 3.69 ± 1.10 vs 3.83 ± 0.68 mg/dL, respectively, p < 0.0001. Serum calcium, PTH and 1,25-dihydroxyvitamin D did not change over the course of the study. Serum FGF23 decreased significantly from 442(44.9-4079.2) at baseline to 340(68.5-2603.3) at week 3 and 191.6(51.3-2465.9) RU/mL at week 12, p < 0.0001. Twelve patients were non-hypophosphatemic and 35 hypophosphatemic. FGF23 levels decreased in both groups, whereas no changes were documented in any of the other mineral parameters. Conclusions In non-dialysis CKD patients, FCM induces reduction in serum phosphate levels that persists for three months. FCM causes a significant decrease in FGF23 levels without changes to other bone metabolism parameters. PMID:23902731

  4. Influence of preinfarction angina and coronary collateral blood flow on the efficacy of remote ischaemic conditioning in patients with ST segment elevation myocardial infarction: post hoc subgroup analysis of a randomised controlled trial

    PubMed Central

    Pryds, Kasper; Bøttcher, Morten; Sloth, Astrid Drivsholm; Munk, Kim; Rahbek Schmidt, Michael; Bøtker, Hans Erik

    2016-01-01

    Objectives Remote ischaemic conditioning (RIC) confers cardioprotection in patients with ST segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). We investigated whether preinfarction angina and coronary collateral blood flow (CCBF) to the infarct-related artery modify the efficacy of RIC. Design Post hoc subgroup analysis of a randomised controlled trial. Participants A total of 139 patients with STEMI randomised to treatment with pPCI or RIC+pPCI. Interventions RIC was performed prior to pPCI as four cycles of 5 min upper arm ischaemia and reperfusion with a blood pressure cuff. Primary outcome measure Myocardial salvage index (MSI) assessed by single-photon emission computerised tomography. We evaluated the efficacy of RIC in subgroups of patients with or without preinfarction angina or CCBF. Results Of 139 patients included in the study, 109 had available data for preinfarction angina status and 54 had preinfarction angina. Among 83 patients with Thrombolysis In Myocardial Infarction flow 0/1 on arrival, 43 had CCBF. Overall, RIC+pPCI increased median MSI compared with pPCI alone (0.75 vs 0.56, p=0.045). Mean MSI did not differ between patients with and without preinfarction angina in either the pPCI alone (0.58 and 0.57; 95% CI −0.17 to 0.19, p=0.94) or the RIC+pPCI group (0.66 and 0.69; 95% CI −0.18 to 0.10, p=0.58). Mean MSI did not differ between patients with and without CCBF in the pPCI alone group (0.51 and 0.55; 95% CI −0.20 to 0.13, p=0.64), but was increased in patients with CCBF versus without CCBF in the RIC+pPCI group (0.75 vs 0.58; 95% CI 0.03 to 0.31, p=0.02; effect modification from CCBF on the effect of RIC on MSI, p=0.06). Conclusions Preinfarction angina did not modify the efficacy of RIC in patients with STEMI undergoing pPCI. CCBF to the infarct-related artery seems to be of importance for the cardioprotective efficacy of RIC. Trial registration number NCT00435266, Post

  5. Efficacy and Tolerability of Delayed-release Dimethyl Fumarate in Black, Hispanic, and Asian Patients with Relapsing-Remitting Multiple Sclerosis: Post Hoc Integrated Analysis of DEFINE and CONFIRM.

    PubMed

    Fox, Robert J; Gold, Ralf; Phillips, J Theodore; Okwuokenye, Macaulay; Zhang, Annie; Marantz, Jing L

    2017-08-02

    Clinical course and treatment response may vary according to race/ethnicity in multiple sclerosis (MS) patients. Delayed-release dimethyl fumarate (DMF; also known as gastro-resistant DMF) demonstrated significant efficacy and a favorable benefit-risk profile in relapsing-remitting MS (RRMS) patients in the 2-year phase III DEFINE/CONFIRM studies. In this post hoc analysis of integrated data from DEFINE/CONFIRM, we assessed clinical efficacy and safety/tolerability in black, Hispanic, and Asian patients treated with DMF 240 mg twice daily (approved dosage) or placebo. Eligible patients were 18-55 years of age with an Expanded Disability Status Scale score of 0-5.0. In the integrated intention-to-treat population, 769 and 771 patients were treated with DMF or placebo, respectively, of whom 10 and 19 were black, 31 and 23 were Hispanic, and 66 and 70 were Asian. In the black, Hispanic, and Asian subgroups, DMF was associated with lower annualized relapse rates at 2 years compared with placebo [rate ratio (95% confidence interval (CI)), 0.05 (0.00-1.07); 0.31 (0.10-0.95); and 0.64 (0.30-1.34), respectively]. The percentage of black, Hispanic, and Asian patients with 12-week confirmed disability progression was lower with DMF (43%, 8%, and 20%, respectively) compared with placebo [57%, 30%, and 25%, respectively; hazard ratio (95% CI), 0.53 (0.02-1.39); 0.17 (0.00-0.60); and 0.71 (0.32-1.58), respectively]. The safety/tolerability profile of DMF was generally consistent with that in the overall population of DEFINE/CONFIRM. The incidence of adverse events leading to treatment discontinuation in black, Hispanic, and Asian patients was 2/10, 2/31, and 3/66, respectively, with DMF, and 2/19, 1/23, and 8/70, respectively, with placebo. DMF may be an efficacious treatment with a favorable benefit-risk profile in black, Hispanic, and Asian patients with RRMS. Further clinical studies are needed to characterize differences in MS presentation and treatment outcomes across

  6. Effects of non-invasive vagus nerve stimulation on attack frequency over time and expanded response rates in patients with chronic cluster headache: a post hoc analysis of the randomised, controlled PREVA study.

    PubMed

    Gaul, Charly; Magis, Delphine; Liebler, Eric; Straube, Andreas

    2017-12-01

    In the PREVention and Acute treatment of chronic cluster headache (PREVA) study, attack frequency reductions from baseline were significantly more pronounced with non-invasive vagus nerve stimulation plus standard of care (nVNS + SoC) than with SoC alone. Given the intensely painful and frequent nature of chronic cluster headache attacks, additional patient-centric outcomes, including the time to and level of therapeutic response, were evaluated in a post hoc analysis of the PREVA study. After a 2-week baseline phase, 97 patients with chronic cluster headache entered a 4-week randomised phase to receive nVNS + SoC (n = 48) or SoC alone (n = 49). All 92 patients who continued into a 4-week extension phase received nVNS + SoC. Compared with SoC alone, nVNS + SoC led to a significantly lower mean weekly attack frequency by week 2 of the randomised phase; the attack frequency remained significantly lower in the nVNS + SoC group through week 3 of the extension phase (P < 0.02). Attack frequencies in the nVNS + SoC group were significantly lower at all study time points than they were at baseline (P < 0.05). Response rates were significantly greater with nVNS + SoC than with SoC alone when response was defined as attack frequency reductions of ≥25%, ≥50%, and ≥75% from baseline (≥25% and ≥50%, P < 0.001; ≥75%, P = 0.009). The 100% response rate was 8% with nVNS + SoC and 0% with SoC alone. Prophylactic nVNS led to rapid, significant, and sustained reductions in chronic cluster headache attack frequency within 2 weeks after its addition to SoC and was associated with significantly higher ≥25%, ≥50%, and ≥75% response rates than SoC alone. The rapid decrease in weekly attack frequency justifies a 4-week trial period to identify responders to nVNS, with a high degree of confidence, among patients with chronic cluster headache.

  7. Effects of Folic Acid Therapy on the New-Onset Proteinuria in Chinese Hypertensive Patients: A Post Hoc Analysis of the Renal Substudy of CSPPT (China Stroke Primary Prevention Trial).

    PubMed

    Li, Youbao; Liang, Min; Wang, Guobao; Wang, Binyan; He, Mingli; Tang, Genfu; Yin, Delu; Xu, Xin; Huo, Yong; Cui, Yimin; Hou, Fan Fan; Qin, Xianhui

    2017-08-01

    We aimed to test the hypothesis that treatment with enalapril and folic acid is more effective in preventing new-onset proteinuria than enalapril alone among hypertensive patients. This is a post hoc analysis of the renal substudy of the CSPPT (China Stroke Primary Prevention Trial). A total of 13 071 eligible participants without proteinuria were randomized to receive a double-blind daily treatment of a single tablet containing 10-mg enalapril and 0.8-mg folic acid (n=6511) or 10-mg enalapril alone (n=6560). The primary outcome was new-onset proteinuria, defined as a urine dipstick reading of ≥1+ at the exit visit. Secondary outcomes included a composite of the primary outcome and all-cause death and the annual rate of estimated glomerular filtration rate decline. After a median 4.4 years of treatment, the primary event occurred in 213 (3.9%) and 188 (3.5%) participants, respectively, in the enalapril and the enalapril-folic acid group (odds ratio, 0.90; 95% confidence interval, 0.74-1.11). However, among participants with diabetes mellitus at baseline, folic acid therapy resulted in a significant reduction in the risk for the primary event (3.7% in the enalapril-folic acid group versus 7.4% in the enalapril group; odds ratio, 0.48; 95% confidence interval, 0.29-0.81) and the composite event (odds ratio, 0.62; 95% confidence interval, 0.42-0.92) and a 55% slower annual rate of estimated glomerular filtration rate decline (0.5% versus 1.1% per year; P=0.002). Among those without diabetes mellitus at baseline, there were no between-group differences in all the outcomes. In conclusion, enalapril-folic acid therapy, compared with enalapril alone, significantly reduced the development of proteinuria in diabetic patients with hypertension. URL: http://www.ClinicalTrials.gov. Unique identifier: NCT00794885. © 2017 American Heart Association, Inc.

  8. Post-hoc analysis of vitamin D status and reduced risk of preterm birth in two vitamin D pregnancy cohorts compared with South Carolina March of Dimes 2009-2011 rates.

    PubMed

    Wagner, C L; Baggerly, C; McDonnell, S; Baggerly, K A; French, C B; Baggerly, L; Hamilton, S A; Hollis, B W

    2016-01-01

    Two vitamin D pregnancy supplementation trials were recently undertaken in South Carolina: The NICHD (n=346) and Thrasher Research Fund (TRF, n=163) studies. The findings suggest increased dosages of supplemental vitamin D were associated with improved health outcomes of both mother and newborn, including risk of preterm birth (<37 weeks gestation). How that risk was associated with 25(OH)D serum concentration, a better indicator of vitamin D status than dosage, by race/ethnic group and the potential impact in the community was not previously explored. While a recent IOM report suggested a concentration of 20 ng/mL should be targeted, more recent work suggests optimal conversion of 25(OH)D-1,25(OH)2D takes place at 40 ng/mL in pregnant women. Post-hoc analysis of the relationship between 25(OH)D concentration and preterm birth rates in the NICHD and TRF studies with comparison to Charleston County, South Carolina March of Dimes (CC-MOD) published rates of preterm birth to assess potential risk reduction in the community. Using the combined cohort datasets (n=509), preterm birth rates both for the overall population and for the subpopulations achieving 25(OH)D concentrations of ≤20 ng/mL, >20 to <40 ng/mL, and ≥40 ng/mL were calculated; subpopulations broken down by race/ethnicity were also examined. Log-binomial regression was used to test if an association between 25(OH)D serum concentration and preterm birth was present when adjusted for covariates; locally weighted regression (LOESS) was used to explore the relationship between 25(OH)D concentration and gestational age (weeks) at delivery in more detail. These rates were compared with 2009-2011 CC-MOD data to assess potential risk reductions in preterm birth. Women with serum 25(OH)D concentrations ≥40 ng/mL (n=233) had a 57% lower risk of preterm birth compared to those with concentrations ≤20 ng/mL [n=82; RR=0.43, 95% confidence interval (CI)=0.22,0.83]; this lower risk was essentially unchanged after

  9. Safety and efficacy of the combination of the glucagon-like peptide-1 receptor agonist liraglutide with an oral antidiabetic drug in Japanese patients with type 2 diabetes: post hoc analysis of a randomized, 52-week, open-label, parallel-group trial.

    PubMed

    Kiyosue, Arihiro; Seino, Yutaka; Nishijima, Keiji; Bosch-Traberg, Heidrun; Kaku, Kohei

    2017-10-06

    The aim of this post hoc analysis was to investigate the safety and efficacy of liraglutide in combination with one oral antidiabetic drug (OAD) across different OAD classes. This was a post hoc analysis using data from a 52-week, open-label, parallel-group trial, in which patients with type 2 diabetes inadequately controlled with a single OAD (α-glucosidase inhibitor, glinide, metformin or thiazolidinedione) were randomized to either pre-trial OAD in combination with liraglutide 0.9 mg/day (liraglutide group) or pre-trial OAD in combination with an additional OAD (additional OAD group). The primary outcome investigated in this post hoc analysis was incidence of adverse events (AEs). The proportions of patients experiencing AEs across the different groups of pre-trial OADs were comparable between liraglutide and additional OAD (α-glucosidase inhibitor 74.6% vs 70.0%; glinide 93.1% vs 87.1%; metformin 91.8% vs 87.1%; thiazolidinedione 86.2% vs 96.4%, respectively). Minor hypoglycemia was infrequent (seven episodes in two patients randomized to liraglutide, and two episodes in two patients randomized to additional OAD). Mean reduction in glycated hemoglobin (HbA1c) appeared greater with liraglutide therapy, estimated mean treatment difference (95% confidence interval [CI]) for liraglutide versus additional OAD ranging from -0.14% (-0.48;0.21) [-1.5 mmol/mol (-5.2;2.3)] to -0.44% (-0.79;-0.09) [-4.8 mmol/mol (-8.6;-1.0)]. This analysis suggests that Japanese patients on OAD monotherapy may benefit from a greater improvement in glycemic control, without impacting tolerability, by combining their OAD with liraglutide rather than another OAD, regardless of which OAD monotherapy they are receiving. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  10. Ad Hoc Classification of Radiology Reports

    PubMed Central

    Aronow, David B.; Fangfang, Feng; Croft, W. Bruce

    1999-01-01

    Objective: The task of ad hoc classification is to automatically place a large number of text documents into nonstandard categories that are determined by a user. The authors examine the use of statistical information retrieval techniques for ad hoc classification of dictated mammography reports. Design: The authors' approach is the automated generation of a classification algorithm based on positive and negative evidence that is extracted from relevance-judged documents. Test documents are sorted into three conceptual bins: membership in a user-defined class, exclusion from the user-defined class, and uncertain. Documentation of absent findings through the use of negation and conjunction, a hallmark of interpretive test results, is managed by expansion and tokenization of these phrases. Measurements: Classifier performance is evaluated using a single measure, the F measure, which provides a weighted combination of recall and precision of document sorting into true positive and true negative bins. Results: Single terms are the most effective text feature in the classification profile, with some improvement provided by the addition of pairs of unordered terms to the profile. Excessive iterations of automated classifier enhancement degrade performance because of overtraining. Performance is best when the proportions of relevant and irrelevant documents in the training collection are close to equal. Special handling of negation phrases improves performance when the number of terms in the classification profile is limited. Conclusions: The ad hoc classifier system is a promising approach for the classification of large collections of medical documents. NegExpander can distinguish positive evidence from negative evidence when the negative evidence plays an important role in the classification. PMID:10495099

  11. Energy Efficient Probabilistic Broadcasting for Mobile Ad-Hoc Network

    NASA Astrophysics Data System (ADS)

    Kumar, Sumit; Mehfuz, Shabana

    2017-06-01

    In mobile ad-hoc network (MANETs) flooding method is used for broadcasting route request (RREQ) packet from one node to another node for route discovery. This is the simplest method of broadcasting of RREQ packets but it often results in broadcast storm problem, originating collisions and congestion of packets in the network. A probabilistic broadcasting is one of the widely used broadcasting scheme for route discovery in MANETs and provides solution for broadcasting storm problem. But it does not consider limited energy of the battery of the nodes. In this paper, a new energy efficient probabilistic broadcasting (EEPB) is proposed in which probability of broadcasting RREQs is calculated with respect to remaining energy of nodes. The analysis of simulation results clearly indicate that an EEPB route discovery scheme in ad-hoc on demand distance vector (AODV) can increase the network lifetime with a decrease in the average power consumption and RREQ packet overhead. It also decreases the number of dropped packets in the network, in comparison to other EEPB schemes like energy constraint gossip (ECG), energy aware gossip (EAG), energy based gossip (EBG) and network lifetime through energy efficient broadcast gossip (NEBG).

  12. Energy Efficient Probabilistic Broadcasting for Mobile Ad-Hoc Network

    NASA Astrophysics Data System (ADS)

    Kumar, Sumit; Mehfuz, Shabana

    2016-08-01

    In mobile ad-hoc network (MANETs) flooding method is used for broadcasting route request (RREQ) packet from one node to another node for route discovery. This is the simplest method of broadcasting of RREQ packets but it often results in broadcast storm problem, originating collisions and congestion of packets in the network. A probabilistic broadcasting is one of the widely used broadcasting scheme for route discovery in MANETs and provides solution for broadcasting storm problem. But it does not consider limited energy of the battery of the nodes. In this paper, a new energy efficient probabilistic broadcasting (EEPB) is proposed in which probability of broadcasting RREQs is calculated with respect to remaining energy of nodes. The analysis of simulation results clearly indicate that an EEPB route discovery scheme in ad-hoc on demand distance vector (AODV) can increase the network lifetime with a decrease in the average power consumption and RREQ packet overhead. It also decreases the number of dropped packets in the network, in comparison to other EEPB schemes like energy constraint gossip (ECG), energy aware gossip (EAG), energy based gossip (EBG) and network lifetime through energy efficient broadcast gossip (NEBG).

  13. Decentralized Time Geography for Ad-Hoc Collaborative Planning

    NASA Astrophysics Data System (ADS)

    Raubal, Martin; Winter, Stephan; Dorr, Christopher

    For an autonomous physical agent, such as a moving robot or a person with their mobile device, performing a task in a spatio-temporal environment often requires interaction with other agents. In this paper we study ad-hoc collaborative planning between these autonomous peers. We introduce the notion of decentralized time geography, which differs from the traditional time-geographic framework by taking into account limited local knowledge. This allows agents to perform a space-time analysis within a time-geographic framework that represents local knowledge in a distributed environment as required for ad-hoc coordinated action between agents in physical space. More specifically, we investigate the impact of general agent movement, replacement seeking, and location and goal-directed behavior of the initiating agent on the outcome of the collaborative planning. Empirical tests in a multi-agent simulation framework provide both a proof of concept and specific results for different combinations of agent density and communication radius.

  14. Longitudinal assessment of estimated glomerular filtration rate in apparently healthy adults: a post hoc analysis from the JUPITER study (justification for the use of statins in prevention: an intervention trial evaluating rosuvastatin).

    PubMed

    Vidt, Donald G; Ridker, Paul M; Monyak, John T; Schreiber, Martin J; Cressman, Michael D

    2011-06-01

    Serum creatinine-based estimates of glomerular filtration rate (eGFR) are frequently used to identify patients with chronic kidney disease and assess cardiovascular risk both in clinical trials and in clinical practice. Although change in eGFR may be useful to assess change in renal function in patients with chronic kidney disease, the utility of serum creatinine-based eGFR is uncertain, particularly among individuals with normal or only mildly impaired renal function. The goal of this study was to examine the relationship between baseline serum creatinine and eGFR, as well as changes in these parameters, in apparently healthy adults in a post hoc analysis of data obtained in participants in the JUPITER study (Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin). JUPITER was a randomized study of rosuvastatin 20 mg versus placebo in apparently healthy adults with high-sensitivity C-reactive protein levels ≥ 2.0 mg/L, LDL-C <130 mg/dL, and serum creatinine ≤ 2.0 mg/dL. Changes from baseline in serum creatinine and eGFR, based on the Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, were assessed in the entire population and in subsets classified according to baseline eGFR status. Baseline characteristics of the 16,279 JUPITER study participants (mean age, 66 years; 62% men; 72% white; and 58% with a history of hypertension) who had both a baseline and ≥ 1 postbaseline serum creatinine measurement were similar to the entire population of 17,802 patients who entered the trial. The mean age of the study population was 66 years, 62% were men, 72% were white, and 58% had a history of hypertension. Mean (SD) serum creatinine increased from baseline by 0.08 (0.16) mg/dL and 0.09 (0.14) mg/dL in the rosuvastatin and placebo groups, respectively (P = 0.001) at year 1 and by 0.09 (0.18) and 0.10 (0.16) mg/dL (P = 0.0045) at the final visit. Reductions in

  15. Effects of canagliflozin, a sodium glucose co-transporter 2 inhibitor, on blood pressure and markers of arterial stiffness in patients with type 2 diabetes mellitus: a post hoc analysis.

    PubMed

    Pfeifer, Michael; Townsend, Raymond R; Davies, Michael J; Vijapurkar, Ujjwala; Ren, Jimmy

    2017-02-27

    Physiologic determinants, such as pulse pressure [difference between systolic blood pressure (SBP) and diastolic BP (DBP)], mean arterial pressure (2/3 DBP + 1/3 SBP), and double product [beats per minute (bpm) × SBP], are linked to cardiovascular outcomes. The effects of canagliflozin, a sodium glucose co-transporter 2 (SGLT2) inhibitor, on pulse pressure, mean arterial pressure, and double product were assessed in patients with type 2 diabetes mellitus (T2DM). This post hoc analysis was based on pooled data from four 26-week, randomized, double-blind, placebo-controlled studies evaluating canagliflozin in patients with T2DM (N = 2313) and a 6-week, randomized, double-blind, placebo-controlled, ambulatory BP monitoring (ABPM) study evaluating canagliflozin in patients with T2DM and hypertension (N = 169). Changes from baseline in SBP, DBP, pulse pressure, mean arterial pressure, and double product were assessed using seated BP measurements (pooled studies) or averaged 24-h BP assessments (ABPM study). Safety was assessed based on adverse event reports. In the pooled studies, canagliflozin 100 and 300 mg reduced SBP (-4.3 and -5.0 vs -0.3 mmHg) and DBP (-2.5 and -2.4 vs -0.6 mmHg) versus placebo at week 26. Reductions in pulse pressure (-1.8 and -2.6 vs 0.2 mmHg), mean arterial pressure (-3.1 and -3.3 vs -0.5 mmHg), and double product (-381 and -416 vs -30 bpm × mmHg) were also seen with canagliflozin 100 and 300 mg versus placebo. In the ABPM study, canagliflozin 100 and 300 mg reduced mean 24-h SBP (-4.5 and -6.2 vs -1.2 mmHg) and DBP (-2.2 and -3.2 vs -0.3 mmHg) versus placebo at week 6. Canagliflozin 300 mg provided reductions in pulse pressure (-3.3 vs -0.8 mmHg) and mean arterial pressure (-4.2 vs -0.6 mmHg) compared with placebo, while canagliflozin 100 mg had more modest effects on these parameters. Canagliflozin was generally well tolerated in both study populations. Canagliflozin improved all three cardiovascular physiologic

  16. Evaluation of Potentially Prolactin-Related Adverse Events and Sexual Maturation in Adolescents with Schizophrenia Treated with Paliperidone Extended-Release (ER) for 2 Years: A Post Hoc Analysis of an Open-Label Multicenter Study.

    PubMed

    Gopal, Srihari; Lane, Rosanne; Nuamah, Isaac; Copenhaver, Margaret; Singh, Jaskaran; Hough, David; Bach, Mark; Savitz, Adam

    2017-06-28

    Elevated prolactin levels (hyperprolactinemia) are a frequent adverse effect of antipsychotic medications, especially in young populations. Prolonged hyperprolactinemia may affect sexual functioning and the onset and progression of puberty. This study assessed potentially prolactin-related treatment-emergent adverse events (PPRL-TEAEs) and sexual maturation during long-term treatment of adolescents with paliperidone extended-release (ER). This post hoc analysis of a 2-year open-label multicenter study (NCT00488319) included patients of either sex aged 12-17 years at study enrollment, diagnosed with schizophrenia (Diagnostic and Statistical Manual of Mental Disorders, 4th edition [DSM-IV]) for ≥1 year, who had received one or more adequate antipsychotic treatment prior to enrollment but had not responded sufficiently. Patients were initially treated with 6 mg/day paliperidone ER and further titrated between 1.5 and 12 mg/day based on clinical response and tolerability. The primary objective was to determine the relationship between characteristics (including sex, age at study entry, ethnicity, geographic region, age at diagnosis, duration of illness, number of prior hospitalizations, serum prolactin, and baseline Tanner stages) and onset or risk of PPRL-TEAEs. The secondary objective was to assess sexual maturation during long-term treatment with paliperidone ER. In total, 400 patients were enrolled in the study and 184 patients completed the 2-year study; the majority were boys (61%), White (66%), and aged >14 years at study enrolment (73%) with mean (standard deviation [SD]) body mass index (BMI) of 21.96 (4.375) kg/m(2) at baseline. Girls (18.5%) had a higher incidence of PPRL-TEAEs than did boys (3.3%). Most of these events were mild to moderate in severity, and none were serious; four patients discontinued the study due to PPRL-TEAEs. Mean prolactin levels in the total population of boys and girls increased early during treatment then stabilized with time

  17. Cooperative Multi-Agent Systems in Mobile Ad Hoc Networks

    DTIC Science & Technology

    2006-01-01

    COOPERATIVE MULTI - AGENT SYSTEMS IN MOBILE AD HOC NETWORKS Joseph P. Macker William Chao Myriam Abramson Ian Downard Information Technology Division...are, mobile ad hoc networking (MANET) and Multi - Agent Systems (MAS). Despite their value in enabling more autonomous network system operation...2006 to 00-00-2006 4. TITLE AND SUBTITLE Cooperative Multi - Agent Systems in Mobile Ad Hoc Networks 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c

  18. The Stability of Post Hoc Model Modifications in Covariance Structure Models.

    ERIC Educational Resources Information Center

    Hutchinson, Susan R.

    The work of R. MacCallum et al. (1992) was extended by examining chance modifications through a Monte Carlo simulation. The stability of post hoc model modifications was examined under varying sample size, model complexity, and severity of misspecification using 2- and 4-factor oblique confirmatory factor analysis (CFA) models with four and eight…

  19. Worm epidemics in wireless ad hoc networks

    NASA Astrophysics Data System (ADS)

    Nekovee, Maziar

    2007-06-01

    A dramatic increase in the number of computing devices with wireless communication capability has resulted in the emergence of a new class of computer worms which specifically target such devices. The most striking feature of these worms is that they do not require Internet connectivity for their propagation but can spread directly from device to device using a short-range radio communication technology, such as WiFi or Bluetooth. In this paper, we develop a new model for epidemic spreading of these worms and investigate their spreading in wireless ad hoc networks via extensive Monte Carlo simulations. Our studies show that the threshold behaviour and dynamics of worm epidemics in these networks are greatly affected by a combination of spatial and temporal correlations which characterize these networks, and are significantly different from the previously studied epidemics in the Internet.

  20. Ad hoc vs. Non-ad hoc Percutaneous Coronary Intervention Strategies in Patients With Stable Coronary Artery Disease.

    PubMed

    Toyota, Toshiaki; Morimoto, Takeshi; Shiomi, Hiroki; Ando, Kenji; Ono, Koh; Shizuta, Satoshi; Kato, Takao; Saito, Naritatsu; Furukawa, Yutaka; Nakagawa, Yoshihisa; Horie, Minoru; Kimura, Takeshi

    2017-03-24

    Few studies have evaluated the prevalence and clinical outcomes of ad hoc percutaneous coronary intervention (PCI), performing diagnostic coronary angiography and PCI in the same session, in stable coronary artery disease (CAD) patients.Methods and Results:From the CREDO-Kyoto PCI/CABG registry cohort-2, 6,943 patients were analyzed as having stable CAD and undergoing first PCI. Ad hoc PCI and non-ad hoc PCI were performed in 1,722 (24.8%) and 5,221 (75.1%) patients, respectively. The cumulative 5-year incidence and adjusted risk for all-cause death were not significantly different between the 2 groups (15% vs. 15%, P=0.53; hazard ratio: 1.15, 95% confidence interval: 0.98-1.35, P=0.08). Ad hoc PCI relative to non-ad hoc PCI was associated with neutral risk for myocardial infarction, any coronary revascularization, and bleeding, but was associated with a trend towards lower risk for stroke (hazard ratio: 0.78, 95% confidence interval: 0.60-1.02, P=0.06). Ad hoc PCI in stable CAD patients was associated with at least comparable 5-year clinical outcomes as with non-ad hoc PCI. Considering patients' preference and the cost-saving, the ad hoc PCI strategy might be a safe and attractive option for patients with stable CAD, although the prevalence of ad hoc PCI was low in the current study population.

  1. Remote Upload of Evidence over Mobile Ad Hoc Networks

    NASA Astrophysics Data System (ADS)

    Ray, Indrajit

    In this work, we report on one aspect of an autonomous robot-based digital evidence acquisition system that we are developing. When forensic investigators operate within a hostile environment they may use remotely operated unmanned devices to gather digital evidence. These systems periodically upload the evidence to a remote central server using a mobile ad hoc network. In such cases, large pieces of information need to be fragmented and transmitted in an appropriate manner. To support proper forensic analysis, certain properties must ensured for each fragment of evidence — confidentiality during communication, authenticity and integrity of the data, and, most importantly, strong evidence of membership for fragments. This paper describes a framework to provide these properties for the robot-based evidence acquisition system under development.

  2. Receiver-Based Ad Hoc On Demand Multipath Routing Protocol for Mobile Ad Hoc Networks

    PubMed Central

    Al-Nahari, Abdulaziz; Mohamad, Mohd Murtadha

    2016-01-01

    Decreasing the route rediscovery time process in reactive routing protocols is challenging in mobile ad hoc networks. Links between nodes are continuously established and broken because of the characteristics of the network. Finding multiple routes to increase the reliability is also important but requires a fast update, especially in high traffic load and high mobility where paths can be broken as well. The sender node keeps re-establishing path discovery to find new paths, which makes for long time delay. In this paper we propose an improved multipath routing protocol, called Receiver-based ad hoc on demand multipath routing protocol (RB-AOMDV), which takes advantage of the reliability of the state of the art ad hoc on demand multipath distance vector (AOMDV) protocol with less re-established discovery time. The receiver node assumes the role of discovering paths when finding data packets that have not been received after a period of time. Simulation results show the delay and delivery ratio performances are improved compared with AOMDV. PMID:27258013

  3. Assured Resource Sharing in Ad-Hoc Collaboration

    SciTech Connect

    Ahn, Gail-Joon

    2015-12-19

    The project seeks an innovative framework to enable users to access and selectively share resources in distributed environments, enhancing the scalability of information sharing. We have investigated secure sharing & assurance approaches for ad-hoc collaboration, focused on Grids, Clouds, and ad-hoc network environments.

  4. Assured Information Sharing for Ad-Hoc Collaboration

    ERIC Educational Resources Information Center

    Jin, Jing

    2009-01-01

    Collaborative information sharing tends to be highly dynamic and often ad hoc among organizations. The dynamic natures and sharing patterns in ad-hoc collaboration impose a need for a comprehensive and flexible approach to reflecting and coping with the unique access control requirements associated with the environment. This dissertation…

  5. Assured Information Sharing for Ad-Hoc Collaboration

    ERIC Educational Resources Information Center

    Jin, Jing

    2009-01-01

    Collaborative information sharing tends to be highly dynamic and often ad hoc among organizations. The dynamic natures and sharing patterns in ad-hoc collaboration impose a need for a comprehensive and flexible approach to reflecting and coping with the unique access control requirements associated with the environment. This dissertation…

  6. 14 CFR § 1203.903 - Ad hoc committees.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false Ad hoc committees. § 1203.903 Section § 1203.903 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INFORMATION SECURITY PROGRAM NASA Information Security Program Committee § 1203.903 Ad hoc committees. The Chairperson is...

  7. 14 CFR 1203.903 - Ad hoc committees.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Ad hoc committees. 1203.903 Section 1203.903 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INFORMATION SECURITY PROGRAM NASA Information Security Program Committee § 1203.903 Ad hoc committees. The Chairperson is authorized...

  8. 14 CFR 1203.903 - Ad hoc committees.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Ad hoc committees. 1203.903 Section 1203.903 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INFORMATION SECURITY PROGRAM NASA Information Security Program Committee § 1203.903 Ad hoc committees. The Chairperson is authorized...

  9. IPv6 Autoconfiguration for Mobile Ad-Hoc Networks: AUTOLSR

    DTIC Science & Technology

    2010-09-01

    IPv6 Autoconfiguration for Mobile Ad-Hoc Networks: AUTOLSR Cédric Adjih1, Amina Meraihi1, Pascale Minet1 and Thierry Plesse2 1Hipercom Project-Team...September 2010 « IPv6 Autoconfiguration for Mobile Ad-Hoc Networks AUTOLSR » Cedric Adjih1, Amina Meraihi1, Pascale Minet1 and Thierry Plesse2

  10. Enhanced Weight based DSR for Mobile Ad Hoc Networks

    NASA Astrophysics Data System (ADS)

    Verma, Samant; Jain, Sweta

    2011-12-01

    Routing in ad hoc network is a great problematic, since a good routing protocol must ensure fast and efficient packet forwarding, which isn't evident in ad hoc networks. In literature there exists lot of routing protocols however they don't include all the aspects of ad hoc networks as mobility, device and medium constraints which make these protocols not efficient for some configuration and categories of ad hoc networks. Thus in this paper we propose an improvement of Weight Based DSR in order to include some of the aspects of ad hoc networks as stability, remaining battery power, load and trust factor and proposing a new approach Enhanced Weight Based DSR.

  11. Enhanced WWTP effluent organic matter removal in hybrid ozonation-coagulation (HOC) process catalyzed by Al-based coagulant.

    PubMed

    Jin, Xin; Jin, Pengkang; Hou, Rui; Yang, Lei; Wang, Xiaochang C

    2017-04-05

    A novel hybrid ozonation-coagulation (HOC) process was developed for application in wastewater reclamation. In this process, ozonation and coagulation occurred simultaneously within a single unit. Compared with the conventional pre-ozonation-coagulation process, the HOC process exhibited much better performance in removing dissolved organic matters. In particular, the maximal organic matters removal efficiency was obtained at the ozone dosage of 1mgO3/mg DOC at each pH value (pH 5, 7 and 9). In order to interpret the mechanism of the HOC process, ozone decomposition was monitored. The results indicated that ozone decomposed much faster in the HOC process. Moreover, by using the reagent of O3-resistant hydroxyl radical (OH) probe compound, para-chlorobenzoic acid (pCBA), and electron paramagnetic resonance (EPR) analysis, it was observed that the HOC process generated higher content of OH compared with pre-ozonation process. This indicates that the OH oxidation reaction as the key step can be catalyzed and enhanced by Al-based coagulants and their hydrolyzed products in this developed process. Thus, based on the catalytic effects of Al-based coagulants on ozonation, the HOC process provides a promising alternative to the conventional technology for wastewater reclamation in terms of higher efficiency. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Spontaneous Ad Hoc Mobile Cloud Computing Network

    PubMed Central

    Lacuesta, Raquel; Sendra, Sandra; Peñalver, Lourdes

    2014-01-01

    Cloud computing helps users and companies to share computing resources instead of having local servers or personal devices to handle the applications. Smart devices are becoming one of the main information processing devices. Their computing features are reaching levels that let them create a mobile cloud computing network. But sometimes they are not able to create it and collaborate actively in the cloud because it is difficult for them to build easily a spontaneous network and configure its parameters. For this reason, in this paper, we are going to present the design and deployment of a spontaneous ad hoc mobile cloud computing network. In order to perform it, we have developed a trusted algorithm that is able to manage the activity of the nodes when they join and leave the network. The paper shows the network procedures and classes that have been designed. Our simulation results using Castalia show that our proposal presents a good efficiency and network performance even by using high number of nodes. PMID:25202715

  13. Spontaneous ad hoc mobile cloud computing network.

    PubMed

    Lacuesta, Raquel; Lloret, Jaime; Sendra, Sandra; Peñalver, Lourdes

    2014-01-01

    Cloud computing helps users and companies to share computing resources instead of having local servers or personal devices to handle the applications. Smart devices are becoming one of the main information processing devices. Their computing features are reaching levels that let them create a mobile cloud computing network. But sometimes they are not able to create it and collaborate actively in the cloud because it is difficult for them to build easily a spontaneous network and configure its parameters. For this reason, in this paper, we are going to present the design and deployment of a spontaneous ad hoc mobile cloud computing network. In order to perform it, we have developed a trusted algorithm that is able to manage the activity of the nodes when they join and leave the network. The paper shows the network procedures and classes that have been designed. Our simulation results using Castalia show that our proposal presents a good efficiency and network performance even by using high number of nodes.

  14. The efficacy and tolerability of a fixed combination of acetylsalicylic acid, paracetamol, and caffeine in patients with severe headache: a post-hoc subgroup analysis from a multicentre, randomized, double-blind, single-dose, placebo-controlled parallel group study.

    PubMed

    Diener, H C; Peil, H; Aicher, B

    2011-10-01

    We investigated efficacy and tolerability of two tablets of the fixed combination of 250 mg acetylsalicylic acid (ASA) + 200 mg paracetamol + 50 mg caffeine (Thomapyrin) in comparison to two tablets of placebo in a post-hoc analysis of a subgroup of patients with severe headache. Patients where included if they were used to treating their episodic tension-type headache or migraine attacks with non-prescription analgesics and reported a history of headache attacks characterized by at least severe pain and greatly impaired usual daily activities and treated headaches with pain intensity of at least 48 mm assessed on a 100-mm visual analogue scale and associated with greatly impaired usual daily activities. For the primary endpoint 'time to 50% pain relief' in this intention-to-treat subset (n = 179 patients), the fixed combination of ASA, paracetamol, and caffeine was statistically significantly superior to placebo (p = 0.0008). The superior efficacy of the triple combination could also be shown for all secondary endpoints such as time until reduction of pain intensity to 10 mm, weighted sum of pain intensity difference (%SPIDweighted), extent of impairment of daily activities, and global assessment of efficacy. Both treatments were well tolerated. The incidence of adverse events observed was low. The results for this subgroup analysis are consistent with respect to all endpoints and to the patients with non-severe headache and the overall patient population. As with all post-hoc subgroup analyses, the findings are hypothesis generating only and must be interpreted with caution. The results of this subgroup analysis confirm that the fixed combination of ASA (250 mg), paracetamol (200 mg), and caffeine (50 mg) is effective and well tolerated in a broad spectrum from mild to severe migraine and tension-type headache severity independently of the headache diagnosis.

  15. On Throughput Improvement of Wireless Ad Hoc Networks with Hidden Nodes

    NASA Astrophysics Data System (ADS)

    Choi, Hong-Seok; Lim, Jong-Tae

    In this letter, we present the throughput analysis of the wireless ad hoc networks based on the IEEE 802.11 MAC (Medium Access Control). Especially, our analysis includes the case with the hidden node problem so that it can be applied to the multi-hop networks. In addition, we suggest a new channel access control algorithm to maximize the network throughput and show the usefulness of the proposed algorithm through simulations.

  16. Validity of using ad hoc methods to analyze secondary traits in case-control association studies.

    PubMed

    Yung, Godwin; Lin, Xihong

    2016-12-01

    Case-control association studies often collect from their subjects information on secondary phenotypes. Reusing the data and studying the association between genes and secondary phenotypes provide an attractive and cost-effective approach that can lead to discovery of new genetic associations. A number of approaches have been proposed, including simple and computationally efficient ad hoc methods that ignore ascertainment or stratify on case-control status. Justification for these approaches relies on the assumption of no covariates and the correct specification of the primary disease model as a logistic model. Both might not be true in practice, for example, in the presence of population stratification or the primary disease model following a probit model. In this paper, we investigate the validity of ad hoc methods in the presence of covariates and possible disease model misspecification. We show that in taking an ad hoc approach, it may be desirable to include covariates that affect the primary disease in the secondary phenotype model, even though these covariates are not necessarily associated with the secondary phenotype. We also show that when the disease is rare, ad hoc methods can lead to severely biased estimation and inference if the true disease model follows a probit model instead of a logistic model. Our results are justified theoretically and via simulations. Applied to real data analysis of genetic associations with cigarette smoking, ad hoc methods collectively identified as highly significant (P<10-5) single nucleotide polymorphisms from over 10 genes, genes that were identified in previous studies of smoking cessation. © 2016 WILEY PERIODICALS, INC.

  17. Initial Report of the Deans Cyber Warfare Ad Hoc Committee

    DTIC Science & Technology

    2011-12-22

    in a cyber warfare environment. Among the more notable recent developments have been the establishment of a new Cyber Warfare Command (USCYBERCOM) at...information-warfare-centric organization. Clearly, future Naval Academy graduates will be expected to know more about cyber warfare than those we have...graduated in the past. The Academic Dean and Provost tasked an ad hoc committeethe Cyber Warfare ad hoc Committeeto examine how USNA can best ensure that

  18. Modeling Terrain Impact on Mobile Ad Hoc Networks (MANET) Connectivity

    DTIC Science & Technology

    2014-05-01

    Modeling Terrain Impact on Mobile Ad Hoc Networks ( MANET ) Connectivity Lance Joneckis Corinne Kramer David Sparrow David Tate I N S T I T U T E F...SUBTITLE Modeling Terrain Impact on Mobile Ad Hoc Networks ( MANET ) Connectivity 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6...U.S. Government pursuant to the copyright license under the clause at DFARS 252.227-7013 (a)(16) [Sep 2011]. Modeling terrain impact on MANET

  19. Trust Management in Mobile Ad Hoc Networks for Bias Minimization and Application Performance Maximization

    DTIC Science & Technology

    2014-02-26

    analysis Application-level trust optimization Reliability assessment a b s t r a c t Trust management for mobile ad hoc networks ( MANETs ) has emerged as...this paper we address the performance issue of trust management protocol design for MANETs in two important areas: trust bias minimization and...application performance maximization. By means of a novel model- based approach to model the ground truth status of mobile nodes in MANETs as the basis for

  20. Comparison of efficacy and safety of two starting insulin regimens in non-Asian, Asian Indian, and East Asian patients with type 2 diabetes: a post hoc analysis of the PARADIGM study

    PubMed Central

    Ji, Linong; Min, Kyung Wan; Oliveira, Juliana; Lew, Thomas; Duan, Ran

    2016-01-01

    Objective The objective of this study was to explore the efficacy and safety of insulin lispro mix 25 (25% insulin lispro and 75% insulin lispro protamine suspension [LM25]) or insulin glargine plus insulin lispro (G+L) in insulin-naïve patients with type 2 diabetes from different racial/ethnic groups. Methods Three subgroups from the PARADIGM study were analyzed post hoc: non-Asian (n=130), Asian Indian (n=106), and East Asian (n=89). Results All subgroups recorded glycated hemoglobin (HbA1c) reductions: non-Asian (LM25, −2.07%; G+L, −2.05%), Asian Indian (LM25, −1.75%; G+L, −1.60%), and East Asian (LM25, −2.03%; G+L, −1.76%); end point HbA1c values were higher in Asian Indians and East Asians than in non-Asians. Fewer Asian Indians (LM25, 43.2%; G+L, 29.2%) and East Asians (LM25, 37.5%; G+L, 36.1%) reached HbA1c <7% versus non-Asians (LM25, 51.7%; G+L, 48.1%); differences were not significant (P=0.12 and P=0.06, respectively). The mean total daily insulin dose (U/kg) for non-Asians was 0.67 (LM25) and 0.61 (G+L), for Asian Indians was 0.91 (LM25) and 0.90 (G+L), and for East Asians was 0.53 (LM25) and 0.59 (G+L). The ratio of mealtime to total insulin dose in the G+L arm for non-Asians was 0.19±0.23, for Asian Indians was 0.33±0.25, and for East Asians was 0.34±0.27. Overall incidence (%) of hypoglycemia in non-Asians was 94.1 (LM25) and 91.8 (G+L), in Asian Indians was 90.4 (LM25) and 88.5 (G+L), and in East Asians was 69.8 (LM25) and 77.3 (G+L). Conclusion Asian Indians showed least improvement in glycemic HbA1c reduction despite greater insulin use. East Asians and non-Asians achieved similar HbA1c reduction in the LM25 arm with a lower rate of hypoglycemia. Asians required more mealtime insulin coverage than non-Asians. This study added important insight into the effect of ethnicity on insulin treatment outcomes in patients with type 2 diabetes. PMID:27563254

  1. An Optimal CDS Construction Algorithm with Activity Scheduling in Ad Hoc Networks.

    PubMed

    Penumalli, Chakradhar; Palanichamy, Yogesh

    2015-01-01

    A new energy efficient optimal Connected Dominating Set (CDS) algorithm with activity scheduling for mobile ad hoc networks (MANETs) is proposed. This algorithm achieves energy efficiency by minimizing the Broadcast Storm Problem [BSP] and at the same time considering the node's remaining energy. The Connected Dominating Set is widely used as a virtual backbone or spine in mobile ad hoc networks [MANETs] or Wireless Sensor Networks [WSN]. The CDS of a graph representing a network has a significant impact on an efficient design of routing protocol in wireless networks. Here the CDS is a distributed algorithm with activity scheduling based on unit disk graph [UDG]. The node's mobility and residual energy (RE) are considered as parameters in the construction of stable optimal energy efficient CDS. The performance is evaluated at various node densities, various transmission ranges, and mobility rates. The theoretical analysis and simulation results of this algorithm are also presented which yield better results.

  2. Tri-Squared Mean Cross Comparative Analysis: An Advanced Post Hoc Qualitative and Quantitative Metric for a More In-Depth Examination of the Initial Research Outcomes of the Tri-Square Test

    ERIC Educational Resources Information Center

    Osler, James Edward

    2013-01-01

    This monograph provides an epistemological rational for the design of an advanced novel analysis metric. The metric is designed to analyze the outcomes of the Tri-Squared Test. This methodology is referred to as: "Tri-Squared Mean Cross Comparative Analysis" (given the acronym TSMCCA). Tri-Squared Mean Cross Comparative Analysis involves…

  3. Innovative research of AD HOC network mobility model

    NASA Astrophysics Data System (ADS)

    Chen, Xin

    2017-08-01

    It is difficult for researchers of AD HOC network to conduct actual deployment during experimental stage as the network topology is changeable and location of nodes is unfixed. Thus simulation still remains the main research method of the network. Mobility model is an important component of AD HOC network simulation. It is used to describe the movement pattern of nodes in AD HOC network (including location and velocity, etc.) and decides the movement trail of nodes, playing as the abstraction of the movement modes of nodes. Therefore, mobility model which simulates node movement is an important foundation for simulation research. In AD HOC network research, mobility model shall reflect the movement law of nodes as truly as possible. In this paper, node generally refers to the wireless equipment people carry. The main research contents include how nodes avoid obstacles during movement process and the impacts of obstacles on the mutual relation among nodes, based on which a Node Self Avoiding Obstacle, i.e. NASO model is established in AD HOC network.

  4. Serum Bicarbonate and Kidney Disease Progression and Cardiovascular Outcome in Patients With Diabetic Nephropathy: A Post Hoc Analysis of the RENAAL (Reduction of End Points in Non-Insulin-Dependent Diabetes With the Angiotensin II Antagonist Losartan) Study and IDNT (Irbesartan Diabetic Nephropathy Trial).

    PubMed

    Schutte, Elise; Lambers Heerspink, Hiddo J; Lutgers, Helen L; Bakker, Stephan J L; Vart, Priya; Wolffenbuttel, Bruce H R; Umanath, Kausik; Lewis, Julia B; de Zeeuw, Dick; Gansevoort, Ron T

    2015-09-01

    Low serum bicarbonate level has been reported to be an independent predictor of kidney function decline and mortality in patients with chronic kidney disease. Mechanisms underlying low serum bicarbonate levels may differ in patients with and without diabetes. We aimed to specifically investigate the association of serum bicarbonate level with kidney disease progression and cardiovascular outcome in a cohort of patients with type 2 diabetes and nephropathy. Post hoc analysis of 2 multicenter randomized controlled trials. 2,628 adults with type 2 diabetes and nephropathy. Serum bicarbonate level. Incidence of: (1) end-stage renal disease (ESRD), (2) ESRD or doubling of serum creatinine level, (3) all-cause mortality, (4) cardiovascular events (fatal/nonfatal stroke/myocardial infarction), and (5) heart failure. Serum bicarbonate was measured at baseline as total carbon dioxide. Associations of baseline serum bicarbonate level with end points were investigated using Cox regression models. Serum bicarbonate levels were studied as a continuous variable and stratified in quartiles. Follow-up was 2.8±1.0 (SD) years. Cox regression analyses showed that serum bicarbonate level had inverse associations with incident ESRD (HR, 0.91; 95% CI, 0.89-0.93; P<0.001) and incidence of the combined end point of ESRD or serum creatinine doubling (HR, 0.94; 95% CI, 0.92-0.96; P<0.001). These associations were independent of age, sex, and cardiovascular risk factors, but disappeared after adjustment for baseline estimated glomerular filtration rate (all P>0.05). Analysis of bicarbonate quartiles showed similar results for the quartile with the lowest bicarbonate (≤21 mEq/L) versus the quartile with normal bicarbonate levels (24-26 mEq/L). There was no association of bicarbonate level with cardiovascular events and heart failure. Post hoc analysis and single measurement of serum bicarbonate. In this cohort of patients with type 2 diabetes with nephropathy, serum bicarbonate level

  5. Auto-configuration protocols in mobile ad hoc networks.

    PubMed

    Villalba, Luis Javier García; Matesanz, Julián García; Orozco, Ana Lucila Sandoval; Díaz, José Duván Márquez

    2011-01-01

    The TCP/IP protocol allows the different nodes in a network to communicate by associating a different IP address to each node. In wired or wireless networks with infrastructure, we have a server or node acting as such which correctly assigns IP addresses, but in mobile ad hoc networks there is no such centralized entity capable of carrying out this function. Therefore, a protocol is needed to perform the network configuration automatically and in a dynamic way, which will use all nodes in the network (or part thereof) as if they were servers that manage IP addresses. This article reviews the major proposed auto-configuration protocols for mobile ad hoc networks, with particular emphasis on one of the most recent: D2HCP. This work also includes a comparison of auto-configuration protocols for mobile ad hoc networks by specifying the most relevant metrics, such as a guarantee of uniqueness, overhead, latency, dependency on the routing protocol and uniformity.

  6. How to Bootstrap Security for Ad-Hoc Network: Revisited

    NASA Astrophysics Data System (ADS)

    Shin, Wook; Gunter, Carl A.; Kiyomoto, Shinsaku; Fukushima, Kazuhide; Tanaka, Toshiaki

    There are various network-enabled and embedded computers deployed around us. Although we can get enormous conveniences by connecting them together, it is difficult to securely associate them in an ad-hoc manner. The difficulties originate from authentication and key distribution problems among devices that are strangers to each other. In this paper, we review the existing ways of initiating secure communication for ad-hoc network devices, and propose another solution. Exploiting Pairing-based cryptography and the notion of location-limited channel, the proposed solution bootstraps security conveniently and efficiently. Further, it supports ownership enforcement and key-escrow.

  7. Routing Protocol of Sparse Urban Vehicular Ad Hoc Networks

    NASA Astrophysics Data System (ADS)

    Li, Huxiong

    Vehicular ad hoc network (VANET) is an application of mobile ad hoc technology in transportation systems, it has become an important part of ITS. Since multi-hop link is hard to set up in sparse VANET, a traffic-aware routing (TAR) protocol is proposed which estimates vehicle average neighbors (VAN) of roads by exchanging beacon messages between encounter vehicles. Road with high VAN is preferred to be selected as part of forwarding path at intersection. Packets are forwarded to the next intersection in road in a greedy manner. Simulations show that TAR outperforms the compared protocols in terms of both packet delivery ratio and average end-to-end delay.

  8. What is the Problem of Ad Hoc Hypotheses?

    NASA Astrophysics Data System (ADS)

    Bamford, Greg

    The received view of an ad hochypothesis is that it accounts for only the observation(s) it was designed to account for, and so non-ad hocness is generally held to be necessary or important for an introduced hypothesis or modification to a theory. Attempts by Popper and several others to convincingly explicate this view, however, prove to be unsuccessful or of doubtful value, and familiar and firmer criteria for evaluating the hypotheses or modified theories so classified are characteristically available. These points are obscured largely because the received view fails to adequately separate psychology from methodology or to recognise ambiguities in the use of ''ad hoc_''.

  9. Multichannel MAC Layer In Mobile Ad—Hoc Network

    NASA Astrophysics Data System (ADS)

    Logesh, K.; Rao, Samba Siva

    2010-11-01

    This paper we presented the design objectives and technical challenges in Multichannel MAC protocols in Mobile Ad-hoc Network. In IEEE 802.11 a/b/g standards allow use of multiple channels, only a single channel is popularly used, due to the lack of efficient protocols that enable use of Multiple Channels. Even though complex environments in ad hoc networks require a combined control of physical (PHY) and medium access control (MAC) layers resources in order to optimize performance. And also we discuss the characteristics of cross-layer frame and give a multichannel MAC approach.

  10. Capacity-Delay Trade-Off in Collaborative Hybrid Ad-Hoc Networks with Coverage Sensing

    PubMed Central

    Chen, Lingyu; Luo, Wenbin; Liu, Chen; Hong, Xuemin; Shi, Jianghong

    2017-01-01

    The integration of ad hoc device-to-device (D2D) communications and open-access small cells can result in a networking paradigm called hybrid the ad hoc network, which is particularly promising in delivering delay-tolerant data. The capacity-delay performance of hybrid ad hoc networks has been studied extensively under a popular framework called scaling law analysis. These studies, however, do not take into account aspects of interference accumulation and queueing delay and, therefore, may lead to over-optimistic results. Moreover, focusing on the average measures, existing works fail to give finer-grained insights into the distribution of delays. This paper proposes an alternative analytical framework based on queueing theoretic models and physical interference models. We apply this framework to study the capacity-delay performance of a collaborative cellular D2D network with coverage sensing and two-hop relay. The new framework allows us to fully characterize the delay distribution in the transform domain and pinpoint the impacts of coverage sensing, user and base station densities, transmit power, user mobility and packet size on the capacity-delay trade-off. We show that under the condition of queueing equilibrium, the maximum throughput capacity per device saturates to an upper bound of 0.7239 λb/λu bits/s/Hz, where λb and λu are the densities of base stations and mobile users, respectively. PMID:28134769

  11. Providing Location Security in Vehicular Ad Hoc Networks

    ERIC Educational Resources Information Center

    Yan, Gongjun

    2010-01-01

    Location is fundamental information in Vehicular Ad-hoc Networks (VANETs). Almost all VANET applications rely on location information. Therefore it is of importance to ensure location information integrity, meaning that location information is original (from the generator), correct (not bogus or fabricated) and unmodified (value not changed). We…

  12. Resource Allocation in MIMO-Based Ad Hoc Networks

    DTIC Science & Technology

    2011-03-01

    Multiple - Input Multiple - Output ( MIMO ...Hoc Networks Peng Wang∗, John Matyjas† and Michael Medley† †Air Force Research Lab, Rome, NY Abstract— Multiple - Input Multiple - Output ( MIMO ) commu... input multiple - output systems, capacity optimization, joint routing, scheduling and power control. 16. SECURITY CLASSIFICATION OF: 17. LIMITATION

  13. Ad Hoc Technical Committee for Vocational Agriculture. Final Report.

    ERIC Educational Resources Information Center

    Indiana State Commission on Vocational and Technical Education, Indianapolis.

    The goal of the Ad Hoc Technical Committee for Vocational Agriculture in Indiana was to develop a model and recommendations that would result in improved student knowledge and skills for the present and future, address labor market needs, and promote program excellence at all levels of education. The committee developed recommendations for…

  14. 14 CFR § 1203.1002 - Ad hoc committees.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false Ad hoc committees. § 1203.1002 Section § 1203.1002 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INFORMATION SECURITY PROGRAM Special Access Programs (SAP) and Sensitive Compartmented Information (SCI) Programs...

  15. Theoretical spectroscopic parameters for isotopic variants of HCO(+) and HOC().

    PubMed

    Mladenović, Mirjana

    2017-09-21

    Theoretical spectroscopic parameters are derived for all isotopologues of HCO(+) and HOC(+) involving H, D, (16)O, (17)O, (18)O, (12)C, and (13)C by means of a two-step procedure. Full-dimensional rovibrational calculations are first carried out to obtain numerically exact rovibrational energies for J = 0-15 in both parities. Effective spectroscopic constants for the vibrational ground state, ν1, ν2, and ν3 are determined by fitting the calculated rovibrational energies to appropriate spectroscopic Hamiltonians. Combining our vibration-rotation corrections with the available experimental ground-state rotational constants, we also derive the new estimate for the equilibrium structure of HCO(+), re(CH) = 1.091 98 Å and re(CO) = 1.105 62 Å, and for the equilibrium structure of HOC(+), re(HO) = 0.990 48 Å and re(CO) = 1.154 47 Å. Regarding the spectroscopic parameters, our estimates are in excellent agreement with available experimental results for the isotopic variants of both HCO(+) and HOC(+): the agreement for the rotational constants Bv is within 3 MHz, for the quartic centrifugal distortion constants Dv within 1 kHz, and for the effective ℓ-doubling constants qv within 2 MHz. We thus expect that our results can provide useful assistance in analyzing expected observations of the rare isotopologues of HCO(+) and HOC(+) that are not yet experimentally known.

  16. Project "Freestyle": Ad Hoc: Fast-Turn-Around Evaluation.

    ERIC Educational Resources Information Center

    Smith, Karen

    Project "Freestyle" involved the development of prototypical television materials and a comic book intended to combat sex-role stereotyping in career-related attitudes of nine to twelve-year-old children. At various times during the early developmental stages of "Freestyle" materials, "ad hoc fast-turn-around" formative evaluations were conducted.…

  17. Providing Location Security in Vehicular Ad Hoc Networks

    ERIC Educational Resources Information Center

    Yan, Gongjun

    2010-01-01

    Location is fundamental information in Vehicular Ad-hoc Networks (VANETs). Almost all VANET applications rely on location information. Therefore it is of importance to ensure location information integrity, meaning that location information is original (from the generator), correct (not bogus or fabricated) and unmodified (value not changed). We…

  18. 14 CFR § 1203.803 - Ad hoc committees.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false Ad hoc committees. § 1203.803 Section § 1203.803 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INFORMATION SECURITY PROGRAM Delegation of Authority To Make Determinations in Original Classification Matters § 1203.803 Ad...

  19. Adaptive Power Control MAC in Wireless Ad Hoc Networks

    NASA Astrophysics Data System (ADS)

    Choi, Hong-Seok; Byun, Hee-Jung; Lim, Jong-Tae

    In this letter, we suggest APMAC (Adaptive Power Control MAC) for wireless ad hoc networks. APMAC is based on the single channel environment and improves the throughput and the energy efficiency simultaneously. Furthermore, the APMAC prevents the unfair channel starvation among the transmission pairs. We verify the performance of the APMAC through simulations.

  20. Theoretical spectroscopic parameters for isotopic variants of HCO+ and HOC+

    NASA Astrophysics Data System (ADS)

    Mladenović, Mirjana

    2017-09-01

    Theoretical spectroscopic parameters are derived for all isotopologues of HCO+ and HOC+ involving H, D, 16O, 17O, 18O, 12C, and 13C by means of a two-step procedure. Full-dimensional rovibrational calculations are first carried out to obtain numerically exact rovibrational energies for J = 0-15 in both parities. Effective spectroscopic constants for the vibrational ground state, ν1, ν2, and ν3 are determined by fitting the calculated rovibrational energies to appropriate spectroscopic Hamiltonians. Combining our vibration-rotation corrections with the available experimental ground-state rotational constants, we also derive the new estimate for the equilibrium structure of HCO+, re(CH) = 1.091 98 Å and re(CO) = 1.105 62 Å, and for the equilibrium structure of HOC+, re(HO) = 0.990 48 Å and re(CO) = 1.154 47 Å. Regarding the spectroscopic parameters, our estimates are in excellent agreement with available experimental results for the isotopic variants of both HCO+ and HOC+: the agreement for the rotational constants Bv is within 3 MHz, for the quartic centrifugal distortion constants Dv within 1 kHz, and for the effective ℓ -doubling constants qv within 2 MHz. We thus expect that our results can provide useful assistance in analyzing expected observations of the rare isotopologues of HCO+ and HOC+ that are not yet experimentally known.

  1. Effusion of hydrophobic organic compounds (HOCs) from fog droplets

    SciTech Connect

    Lee, W.M.; Tsay, C.

    1998-12-31

    In this study, the effects of surface-active substances, pH and salt on the effusion of HOCs from droplets were investigated. An HOCs-effusion reactor was established for experiments. N-octane was used for the HOCs and Sodium Dodecyl Sulfate (SDS) was selected as the surface-active substance. A correction factor to mass exchange constant, defined as the deviation of exchange constant of n-octane in fog phase from that in planar aqueous phase was used to quantify the effects of surface-active substance, pH, and salt concentration on the effusion rate of HOCs from fog droplets by a modified double-layer diffusion model. The results showed that surface-active substances, SDS cab decrease the effusion rate of n-octane from fog droplets by about 40%--62% and the values of were in the range of 0.382 to 0.609. The salt, sodium chloride, at the concentration of 1.00 {times} 10{sup {minus}3} [M] can further decrease the mass transfer rate of n-octane from fog droplets because the values changed from 0.590 to 0.368, so that the effusion rate was further decrease by salt. When pH values were between 5.60 and 2.00, values varied from 0.609 to 0.367 at SDS concentration of 1.00 x 10{sup 3}[M]. This indicated that the effusion rate of HOCs from fog droplets decreased with decreasing pH value.

  2. The Decrement of Hemoglobin Concentration with Angiotensin II Receptor Blocker Treatment Is Correlated with the Reduction of Albuminuria in Non-Diabetic Hypertensive Patients: Post-Hoc Analysis of ESPECIAL Trial.

    PubMed

    An, Jung Nam; Hwang, Jin Ho; Lee, Jung Pyo; Chin, Ho Jun; Kim, Sejoong; Kim, Dong Ki; Kim, Suhnggwon; Park, Jung Hwan; Shin, Sung Joon; Lee, Sang Ho; Choi, Bum Soon; Lim, Chun Soo

    2015-01-01

    Blockade of the renin-angiotensin-aldosterone system exhibits a renoprotective effect; however, blockade of this system may also decrease hemoglobin (Hb) and erythropoietin (EPO) levels. We evaluated the correlation between reduced albuminuria and decreased hemoglobin concentrations after treatment with an angiotensin II receptor blocker (ARB). Two hundred forty-five non-diabetic hypertensive participants with established albuminuria and relatively preserved renal function were treated with an ARB (40 mg/day olmesartan) for eight weeks. Subsequent changes in various clinical parameters, including Hb, EPO, and albuminuria, were analyzed following treatment. After the 8-week treatment with an ARB, Hb and EPO levels significantly decreased. Patients with a greater decrease in Hb exhibited a greater reduction in 24-hour urinary albumin excretion compared with patients with less of a decrease or no decrease in Hb, whereas no associations with a decline in renal function and EPO levels were noted. Multivariate logistic regression analysis demonstrated a correlation between the reduction of urine albumin excretion and the decrease in Hb levels (after natural logarithm transformation, adjusted odds ratio 1.76, 95% confidence interval 1.21-2.56, P = 0.003). Linear regression analysis also supported this positive correlation (Pearson correlation analysis; R = 0.24, P < 0.001). Decreased Hb concentrations following ARB treatment were positively correlated with reduced albuminuria in non-diabetic hypertensive patients, regardless of decreased blood pressure and EPO levels or renal function decline.

  3. Ad hoc CubeSat constellations: Secondary launch coverage and distribution

    NASA Astrophysics Data System (ADS)

    Marinan, A.; Nicholas, A.; Cahoy, K.

    The primary purpose of a constellation is to obtain global measurements with improved spatial and temporal resolution. The small size, low cost, standardized form factor, and increasing availability of commercial parts for CubeSats make them ideal for use in constellations. However, without taking advantage of secondary payload opportunities, it would be costly to launch and distribute a CubeSat constellation into a specific configuration. A cost-effective way to launch a constellation of CubeSats is via consecutive secondary payload launch opportunities, but the resulting constellation would be an ad hoc mix of orbit parameters. We focus on the feasibility of cobbling together constellation-like functionality from multiple secondary payload opportunities. Each participating CubeSat (or set of CubeSats) per launch could have completely different orbital parameters, even without propulsion onboard the CubeSats or intermediate transfer carriers. We look at the ground coverages that could be obtained for a constellation of five to six orbital planes with one to six satellites in each plane. We analyze past and announced future launch opportunities for CubeSats, including launch platforms supported by the NASA Educational Launch of Nanosatellites (ELaNa). We consider combinations of possible launch locations and temporal spacings over the course of one year and simulate the resulting ground coverage patterns and revisit times for an ad hoc constellation using these launch opportunities. We perform this analysis for two separate case studies - one with only US launches and one with both US and non-US opportunities - and vary the number of satellites per orbital plane. Typical CubeSat mission lifetimes and deorbit times for low-altitude orbits are included in these analyses. The ad hoc constellation results are compared to coverage from uniformly-placed LEO constellations and are quantified in terms of revisit time, time to 100% global coverage, and response time. For mu

  4. Determination of endogenous concentration of γ-hydroxybutyric acid (GHB) in hair through an ad hoc GC-MS analysis: A study on a wide population and influence of gender and age.

    PubMed

    Vaiano, Fabio; Serpelloni, Giovanni; Furlanetto, Sandra; Palumbo, Diego; Mari, Francesco; Fioravanti, Alessia; Bertol, Elisabetta

    2016-01-25

    γ-Hydroxybutyric acid (GHB) spread for recreational purposes or as "rape drug" represents a hard issue for forensic toxicologists due to its endogenous nature. It is clear that an actual and reliable discrimination between basal and exogenous levels is mandatory to achieve a correct evaluation of conscious/unconscious administration. This research aimed to study the GHB baseline in hair samples, collected from 150 volunteers, non-consumers of any drugs of abuse, in order to evaluate if a generic cut-off value could be accepted, also focusing on potential influences of gender and age. The analysis consisted of an overnight incubation with NaOH at 56 °C, liquid-liquid extraction with ethylacetate and trimethylsylil derivatization. Detection was carried out through gas chromatography-mass spectrometry in single ion monitoring (m/z 233, 234, 147 for GHB; m/z 239, 240 and 147 for GHB-d6). The endogenous amount in "blank" hair was estimated by the standard addition method. Concentration range was 0.279-2.839 ng/mg. In males, the average GHB levels were higher than in females (0.829 vs 0.596 ng/mg, respectively), especially in the first age category (<30 years, 1.008 vs 0.606 ng/mg, respectively). Age influences on GHB levels seemed to be different among the two sexes: in male population concentrations were higher <30 (1.008 ng/mg) and similar in the other age ranges (0.762 ng/mg, 30-50; 0.763 ng/mg, >50); in female, quite similar levels were registered throughout all the age categories (0.606 ng/mg, <30; 0.536 ng/mg, 30-50; 0.691 ng/mg, >50). Further study should be performed on GHB physiology in order to better understand these differences among ages and genders. Moreover, we demonstrated that for hair analysis a cut-off reference value is not strictly mandatory, underlining the great interpretative valence of segmental analysis.

  5. Impact of hypotension and low cerebral perfusion pressure on outcomes in children treated with hypothermia therapy following severe traumatic brain injury: a post hoc analysis of the Hypothermia Pediatric Head Injury Trial.

    PubMed

    Hutchison, James S; Frndova, Helena; Lo, Tsz-Yan M; Guerguerian, Anne-Marie

    2010-01-01

    Hypotension and low cerebral perfusion pressure are known to be associated with unfavorable outcome in children and adults with traumatic brain injury. Using the database from a previously published, randomized controlled trial of 24 h of hypothermia therapy in children with severe traumatic brain injury, we compared the number of patients with hypotension or low cerebral perfusion pressure between the hypothermia therapy and normothermia groups. We also determined the association between these physiologic insults and unfavorable outcome using regression analysis. There were more patients with episodes of hypotension or low cerebral perfusion pressure in the hypothermia therapy group than in the normothermia group. These physiologic insults were associated with unfavorable outcome in both intervention groups. Hypotension and low cerebral perfusion pressure should be anticipated and prevented in future trials of hypothermia therapy in patients with traumatic brain injury. Copyright © 2011 S. Karger AG, Basel.

  6. The effect of galantamine on brain atrophy rate in subjects with mild cognitive impairment is modified by apolipoprotein E genotype: post-hoc analysis of data from a randomized controlled trial

    PubMed Central

    2014-01-01

    Introduction The aim of this investigation was to assess the effect of galantamine, an acetylcholinesterase inhibitor and allosteric modulator of nicotinic receptors, on brain atrophy in individuals with mild cognitive impairment (MCI), and to assess effect modification by apolipoprotein E (APOE) genotype. Methods We used data from the Galantamine-International-11 (Gal-Int-11) trial, a 24-month, randomized, double blind, placebo-controlled, flexible-dose (16 to 24 mg daily) study in patients with MCI. Brain magnetic resonance imaging (MRI), including a 3-dimensional T1-weighted gradient echo volumetric sequence, was performed at screening and at 24 months. We recorded whole brain and hippocampal volumes, and calculated annual atrophy rates. Linear regression analysis was used to calculate adjusted mean differences in the rate of whole brain and hippocampal atrophy, between MCI patients treated with galantamine and with placebo. Additionally, we performed stratified analyses according to APOE genotype. Results Data from 364 MCI patients with 24-month MRI data (galantamine, n = 176; placebo, n = 188) were included in the volumetric analysis. Subjects treated with galantamine demonstrated a lower rate of whole brain atrophy compared to those treated with placebo (adjusted mean difference 0.18% per year (95% confidence interval (CI) 0.04; 0.30)). Stratified analyses according to APOE genotype, showed that this effect was confined to patients who carried an APOE ϵ4 allele (adjusted mean difference 0.28% per year (95% CI 0.07; 0.50)). Rates of hippocampal atrophy did not differ significantly between study groups. Conclusions Patients with MCI who were treated with galantamine demonstrated a lower rate of whole brain atrophy, but not of hippocampal atrophy, over a 24-month treatment period, compared to those treated with placebo. This protective effect of galantamine on whole brain atrophy rate in MCI was only present in APOE ϵ4 carriers. PMID:25478019

  7. Anti-citrullinated peptide antibodies are the strongest predictor of clinically relevant radiographic progression in rheumatoid arthritis patients achieving remission or low disease activity: A post hoc analysis of a nationwide cohort in Japan

    PubMed Central

    Okada, Akitomo; Fukuda, Takaaki; Hidaka, Toshihiko; Ishii, Tomonori; Ueki, Yukitaka; Kodera, Takao; Nakashima, Munetoshi; Takahashi, Yuichi; Honda, Seiyo; Horai, Yoshiro; Watanabe, Ryu; Okuno, Hiroshi; Aramaki, Toshiyuki; Izumiyama, Tomomasa; Takai, Osamu; Miyashita, Taiichiro; Sato, Shuntaro; Kawashiri, Shin-ya; Iwamoto, Naoki; Ichinose, Kunihiro; Tamai, Mami; Origuchi, Tomoki; Nakamura, Hideki; Aoyagi, Kiyoshi; Eguchi, Katsumi; Kawakami, Atsushi

    2017-01-01

    Objectives To determine prognostic factors of clinically relevant radiographic progression (CRRP) in patients with rheumatoid arthritis (RA) achieving remission or low disease activity (LDA) in clinical practice. Methods Using data from a nationwide, multicenter, prospective study in Japan, we evaluated 198 biological disease-modifying antirheumatic drug (bDMARD)-naïve RA patients who were in remission or had LDA at study entry after being treated with conventional synthetic DMARDs (csDMARDs). CRRP was defined as the yearly progression of modified total Sharp score (mTSS) >3.0 U. We performed a multiple logistic regression analysis to explore the factors to predict CRRP at 1 year. We used receiver operating characteristic (ROC) curve to estimate the performance of relevant variables for predicting CRRP. Results The mean Disease Activity Score in 28 joints-erythrocyte sedimentation rate (DAS28-ESR) was 2.32 ± 0.58 at study entry. During the 1-year observation, remission or LDA persisted in 72% of the patients. CRRP was observed in 7.6% of the patients. The multiple logistic regression analysis revealed that the independent variables to predict the development of CRRP were: anti-citrullinated peptide antibodies (ACPA) positivity at baseline (OR = 15.2, 95%CI 2.64–299), time-integrated DAS28-ESR during the 1 year post-baseline (7.85-unit increase, OR = 1.83, 95%CI 1.03–3.45), and the mTSS at baseline (13-unit increase, OR = 1.22, 95%CI 1.06–1.42). Conclusions ACPA positivity was the strongest independent predictor of CRRP in patients with RA in remission or LDA. Physicians should recognize ACPA as a poor-prognosis factor regarding the radiographic outcome of RA, even among patients showing a clinically favorable response to DMARDs. PMID:28505163

  8. Monotherapy with indacaterol once daily reduces the rate of exacerbations in patients with moderate-to-severe COPD: Post-hoc pooled analysis of 6 months data from three large phase III trials.

    PubMed

    Wedzicha, Jadwiga A; Buhl, Roland; Lawrence, David; Young, David

    2015-01-01

    In patients with COPD, exacerbations are associated with poor quality of life and may shorten survival. Prevention of exacerbations is, therefore, a key objective in COPD management. Indacaterol, a once-daily ultra-long-acting β2-agonist, has been shown to reduce exacerbations in various studies. This pooled analysis evaluated the effect of indacaterol on exacerbations versus placebo. Six-month data were pooled from three randomized, double-blind, and placebo-controlled studies: indacaterol 300 μg versus placebo (1 year); indacaterol 150 μg and 300 μg versus placebo (6 months); and indacaterol 150 μg versus placebo (6 months). All treatments were administered once daily. Data from other treatment groups were excluded. All three studies enrolled patients aged ≥40 years with moderate-to-severe COPD and smoking history ≥20 pack-years. Time to exacerbation and exacerbation rate were analyzed. Overall, the pooled data set included 2716 patients (indacaterol 150 μg [n = 746], indacaterol 300 μg [n = 819], placebo [n = 1151]). Both indacaterol doses 150 and 300 μg significantly reduced the COPD exacerbation rates compared with placebo (Rate ratios, RR [95% Confidence Interval, CI]: 0.69 [0.55-0.87], 0.71 [95% CI: 0.57-0.88] respectively; both p = 0.002). Over 6 months, indacaterol 150 and 300 μg also significantly prolonged the time to first moderate-to-severe exacerbation versus placebo (Hazard ratios, HR [95% CI]: 0.74: [0.59-0.93], p = 0.009; 0.73 [0.59-0.90], p = 0.004, respectively). At months 3 and 6, clinically relevant improvements in lung function versus placebo were observed with indacaterol 150 μg (Least squares mean treatment differences: Month 3 = 170 mL; Month 6 = 160 mL) and 300 μg (170 mL at both time-points; all p < 0.001). In this pooled analysis, both indacaterol doses, 150 and 300 μg, were associated with significant reductions in exacerbations and significant improvements in bronchodilation versus placebo. The results suggest once

  9. Developing a Conceptual Unmanned Aerial Vehicle Communications Mobile AD Hoc Network Simulation Model

    DTIC Science & Technology

    2002-06-01

    Elizabeth Royer described the Ad Hoc On-Demand Distance Vector (AODV) routing protocol as “providing quick and efficient route establishment between...Network.” Thesis, Naval Postgraduate School, December 2000. 8. Das, Samir R., Perkins, Charles E., and Royer, Elizabeth M. “ The Ad-hoc On-Demand...Lidong. “Securing Ad Hoc Networks.” Paper Cornell University, Itaca, New York, NY. 16. Corson , Scott S., and Macker, J. “Mobile Ad Hoc

  10. Antihypertensive efficacy and safety of olmesartan medoxomil and ramipril in elderly mild to moderate essential hypertensive patients with or without metabolic syndrome: a pooled post hoc analysis of two comparative trials.

    PubMed

    Omboni, Stefano; Malacco, Ettore; Mallion, Jean-Michel; Volpe, Massimo

    2012-12-01

    Two recent identically designed trials (one Italian and one European multinational) have compared the head-to-head efficacy and safety of the angiotensin II receptor blocker olmesartan medoxomil and the angiotensin converting enzyme inhibitor ramipril, in elderly patients with essential hypertension. The aim of the present study was to assess the antihypertensive efficacy of olmesartan and ramipril in elderly patients with hypertension, with or without metabolic syndrome, by performing a pooled analysis of data from the two head-to-head trials. After a 2-week, placebo wash-out, 1,453 treated or untreated elderly hypertensive patients aged 65-89 years [with sitting office diastolic blood pressure (DBP) 90-109 mmHg and/or sitting office systolic BP (SBP) 140-179 mmHg] were randomized to 12-weeks of double-blind treatment with olmesartan 10 mg or ramipril 2.5 mg once daily. Treatment could be up-titrated to 20 and 40 mg for olmesartan, and 5 and 10 mg for ramipril, after the first 2 and 6 weeks, respectively, in patients with inadequately controlled BP (BP ≥ 140/90 mmHg for non-diabetics and ≥ 130/80 mmHg for diabetics). Office BP was measured at randomization and after 2, 6 and 12 weeks of treatment. 24-h ambulatory BP recordings were obtained at randomization and after 12 weeks. Of the 1,426 patients in the intent-to-treat analysis, 735 (51.5 %) had metabolic syndrome (olmesartan, n = 372; ramipril, n = 363). After 12 weeks of treatment, baseline-adjusted office BP reductions were greater (p < 0.05) with olmesartan (SBP 17.0 mmHg; 95% CI 18.4, 15.6; DBP 9.6 mmHg; 95% CI 10.4, 8.8) than with ramipril (SBP 14.7 mmHg; 95% CI 16.1, 13.2; DBP 8.4 mmHg; 95% CI 9.2, 7.6) in patients with metabolic syndrome. In these patients, BP normalization rates were also greater with olmesartan than with ramipril (46.0 vs. 35.8%, p < 0.01). Similarly, in patients without metabolic syndrome, the antihypertensive efficacy of olmesartan was also significantly (p < 0.05) better than

  11. French adults' cognitive performance after daily supplementation with antioxidant vitamins and minerals at nutritional doses: a post hoc analysis of the Supplementation in Vitamins and Mineral Antioxidants (SU.VI.MAX) trial.

    PubMed

    Kesse-Guyot, Emmanuelle; Fezeu, Léopold; Jeandel, Claude; Ferry, Monique; Andreeva, Valentina; Amieva, Hélène; Hercberg, Serge; Galan, Pilar

    2011-09-01

    Antioxidant properties of some vitamins and trace elements may help to prevent cognitive decline. The aim of the current study was to estimate the long-term effects of antioxidant nutrient supplementation on the cognitive performance of participants in the Supplementation in Vitamins and Mineral Antioxidants (SU.VI.MAX) study 6 y after the end of the trial. This study included 4447 French participants aged 45-60 y who were enrolled in the SU.VI.MAX study (1994-2002), which was a double-blind, placebo-controlled, randomized trial. From 1994 to 2002, participants received daily vitamin C (120 mg), β-carotene (6 mg), vitamin E (30 mg), selenium (100 μg), and zinc (20 mg) in combination or as a placebo. In 2007-2009, the cognitive performance of participants was assessed with 4 neuropsychological tests (6 tasks). Principal components analysis (PCA) was performed to identify cognitive-function summary scores. Associations between antioxidant supplementation and cognitive functions, in the full sample and by subgroups, were estimated through ANOVA and expressed as mean differences and 95% CIs. Subgroup analyses were performed according to baseline characteristics. Subjects receiving active antioxidant supplementation had better episodic memory scores (mean difference: 0.61; 95% CI: 0.02, 1.20). PCA indicated 2 factors that were interpreted as showing verbal memory and executive functioning. Verbal memory was improved by antioxidant supplementation only in subjects who were nonsmokers or who had low serum vitamin C concentrations at baseline. This study supports the role of an adequate antioxidant nutrient status in the preservation of verbal memory under certain conditions. This trial was registered at clinicaltrials.gov as NCT00272428.

  12. Effects of tadalafil on nighttime voiding (nocturia) in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia: a post hoc analysis of pooled data from four randomized, placebo-controlled clinical studies.

    PubMed

    Oelke, Matthias; Weiss, Jeffrey P; Mamoulakis, Charalampos; Cox, David; Ruff, Dustin; Viktrup, Lars

    2014-10-01

    The phosphodiesterase type 5 inhibitor tadalafil is approved for the treatment of signs and symptoms of benign prostatic hyperplasia (BPH). While tadalafil significantly improves overall lower urinary tract symptoms suggestive of BPH (LUTS/BPH), improvements in nocturia were not significant in individual studies. We therefore sought to further assess nocturia based on data integrated from four tadalafil registrational studies. Data were integrated from four randomized, placebo-controlled, double-blind, 12-week registrational studies of tadalafil for LUTS/BPH. Nocturia was assessed as nighttime voiding frequency using the International Prostate Symptom Score question 7 (IPSS Q7). Efficacy results were analyzed using analysis of covariance. For the tadalafil 5 mg once daily (N = 752) and placebo (N = 748) groups, baseline characteristics were well balanced, and the overall severity of nocturia per mean IPSS Q7 was 2.3 ± 1.2. The mean treatment change was -0.4 with placebo and -0.5 with tadalafil; the least-squares mean (standard error) treatment difference was -0.2 (0.05), p = 0.002. For patients receiving placebo and tadalafil, respectively, the proportion with improved nocturnal frequency was 41.3 and 47.5 %, with no change was 44.8 and 41.0 %, and with worsening was 13.9 and 11.5 %. A statistically significant improvement in nocturnal frequency was seen with tadalafil over placebo; however, the treatment difference was small and not considered clinically meaningful. Further studies using voiding diaries and excluding patients with nocturnal polyuria would be needed to more precisely estimate the impact of tadalafil on nocturia associated with LUTS/BPH.

  13. Can the spinal instability neoplastic score prior to spinal radiosurgery predict compression fractures following stereotactic spinal radiosurgery for metastatic spinal tumor?: a post hoc analysis of prospective phase II single-institution trials.

    PubMed

    Lee, Sun-Ho; Tatsui, Claudio E; Ghia, Amol J; Amini, Behrang; Li, Jing; Zavarella, Salvatore M; Tannir, Nizar M; Brown, Paul D; Rhines, Laurence D

    2016-02-01

    The aim of this study was to determine the predictability of vertebral compression fracture (VCF) development applying the spinal instability neoplastic score (SINS) prior to delivery of stereotactic spinal radiosurgery (SSRS) for spinal metastases. From two prospective cohorts of SSRS for spinal metastases, we selected patients with a low degree of cord compression or cauda equine from C3 to S1 and analyzed 79 patients enrolled according to binary SINS criteria. The primary endpoint was the development of a de novo VCF or progression of an existing fracture after SSRS. We identified 32 fractures (40.5%): 19 de novo and 13 progressive. The mean time to fracture after SSRT was 3.3 months (range, 0.4-34.1 months). In 41 patients with low SINS (0-6), 7 patients (17.1%) developed a fracture after SSRS. In 38 patients with high SINS (7-12), 25 (65.8%) developed a fracture. Among the 32 fractures, 15 were symptomatic. Patients with high SINS were more likely to experience symptomatic fractures (31.6%) than were patients with lower SINS (7.4%). On univariate and multivariate analysis, 24-month fracture-free rates were 78.7 and 33.7% in low and high SINS group, respectively and high SINS was found to be a significant risk factor for VCFs and symptomatic fractures (respectively, HR 5.6, p = 0.04; HR 5.3, p = 0.01). SINS is a useful tool for predicting the development of VCF after SSRS for spinal metastases. Prophylactic cement augmentation should not be considered for patients with lower SINS, since the risk of fracture is low.

  14. Risk stratification with the use of serial N-terminal pro-B-type natriuretic peptide measurements during admission and early after discharge in heart failure patients: post hoc analysis of the PRIMA study.

    PubMed

    Eurlings, Luc W; Sanders-van Wijk, Sandra; van Kraaij, Dave J W; van Kimmenade, Roland; Meeder, Joan G; Kamp, Otto; van Dieijen-Visser, Marja P; Tijssen, Jan G P; Brunner-La Rocca, Hans-Peter; Pinto, Yigal M

    2014-12-01

    The aim of this work was to assess the prognostic value of absolute N-terminal-pro-B-type natriuretic peptide (NT-proBNP) concentration in combination with changes during admission because of acute heart failure (AHF) and early after hospital discharge. In AHF, readmission and mortality rates are high. Identifying those at highest risk for events early after hospital discharge might help to select patients in need of intensive outpatient monitoring. We evaluated the prognostic value of NT-proBNP concentration on admission, at discharge, 1 month after hospital discharge and change over time in 309 patients included in the PRIMA (Can PRo-brain-natriuretic peptide guided therapy of chronic heart failure IMprove heart fAilure morbidity and mortality?) study. Primary outcome measures were mortality and the combined end point of heart failure (HF) readmission or mortality. In a multivariate Cox regression analysis, change in NT-proBNP concentration during admission, change from discharge to 1 month after discharge, and the absolute NT-proBNP concentration at 1 month after discharge were of independent prognostic value for both end points (hazard ratios for HF readmission or mortality: 1.71, 95% confidence interval [CI] 1.13-2.60, Wald 6.4 [P = .011] versus 2.71, 95% CI 1.76-4.17, Wald 20.5 [P < .001] versus 1.81, 95% CI 1.13-2.89, Wald 6.1 [P = .014], respectively. Knowledge of change in NT-proBNP concentration during admission because of AHF in combination with change early after discharge and the absolute NT-proBNP concentration at 1 month after discharge allows accurate risk stratification. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Performance Impacts of Lower-Layer Cryptographic Methods in Mobile Wireless Ad Hoc Networks

    SciTech Connect

    VAN LEEUWEN, BRIAN P.; TORGERSON, MARK D.

    2002-10-01

    In high consequence systems, all layers of the protocol stack need security features. If network and data-link layer control messages are not secured, a network may be open to adversarial manipulation. The open nature of the wireless channel makes mobile wireless mobile ad hoc networks (MANETs) especially vulnerable to control plane manipulation. The objective of this research is to investigate MANET performance issues when cryptographic processing delays are applied at the data-link layer. The results of analysis are combined with modeling and simulation experiments to show that network performance in MANETs is highly sensitive to the cryptographic overhead.

  16. Validity, reliability, and clinical importance of change in a 0-10 numeric rating scale measure of spasticity: a post hoc analysis of a randomized, double-blind, placebo-controlled trial.

    PubMed

    Farrar, John T; Troxel, Andrea B; Stott, Colin; Duncombe, Paul; Jensen, Mark P

    2008-05-01

    The measurement of spasticity as a symptom of neurologic disease is an area of growing interest. Clinician-rated measures of spasticity purport to be objective but do not measure the patient's experience and may not be sensitive to changes that are meaningful to the patient. In a patient with clinical spasticity, the best judge of the perceived severity of the symptom is the patient. The aim of this study was to assess the validity and reliability, and determine the clinical importance, of change on a 0-10 numeric rating scale (NRS) as a patient-rated measure of the perceived severity of spasticity. Using data from a large,randomized, doubleblind, placebo-controlled study of an endocannabinoid system modulator in patients with multiple sclerosis-related spasticity, we evaluated the test-retest reliability and comparison-based validity of a patient-reported 0-10 NRS measure of spasticity severity with the Ashworth Scale and Spasm Frequency Scale. We estimated the level of change from baseline on the 0-10 NRS spasticity scale that constituted a clinically important difference (CID) and a minimal CID (MCID) as anchored to the patient's global impression of change (PGIC). Data from a total of 189 patients were included in this assessment (114 women, 75 men; mean age, 49.1 years). The test-retest reliability analysis found an interclass correlation coefficient of 0.83 (P < 0.001) between 2 measures of the 0-10 NRS spasticity scores recorded over a 7- to 14-day period before randomization. A significant correlation was found between change on 0-10 NRS and change in the Spasm Frequency Scale (r = 0.63; P < 0.001), and a moderate correlation was found between the change on 0-10 NRS and the PGIC (r = 0.47; P < 0.001). A reduction of approximately 30% in the spasticity 0-10 NRS score best represented the CID and a change of 18% the MCID. The measurement of the symptom of spasticity using a patient-rated 0-10 NRS was found to be both reliable and valid. The definitions of CID

  17. Quality measure attainment with dapagliflozin plus metformin extended-release as initial combination therapy in patients with type 2 diabetes: a post hoc pooled analysis of two clinical studies

    PubMed Central

    Bell, Kelly F; Katz, Arie; Sheehan, John J

    2016-01-01

    Background The use of quality measures attempts to improve safety and health outcomes and to reduce costs. In two Phase III trials in treatment-naive patients with type 2 diabetes, dapagliflozin 5 or 10 mg/d as initial combination therapy with metformin extended-release (XR) significantly reduced glycated hemoglobin (A1C) from baseline to 24 weeks and allowed higher proportions of patients to achieve A1C <7% vs dapagliflozin or metformin monotherapy. Objective A pooled analysis of data from these two studies assessed the effect of dapagliflozin 5 or 10 mg/d plus metformin XR (combination therapy) compared with placebo plus metformin XR (metformin monotherapy) on diabetes quality measures. Quality measures include laboratory measures of A1C and low-density lipoprotein cholesterol (LDL-C) as well as vital status measures of blood pressure (BP) and body mass index (BMI). The proportion of patients achieving A1C, BP, and LDL-C individual and composite measures was assessed, as was the proportion with baseline BMI ≥25 kg/m2 who lost ≥4.5 kg. Subgroup analyses by baseline BMI were also performed. Results A total of 194 and 211 patients were treated with dapagliflozin 5- or 10-mg/d combination therapy, respectively, and 409 with metformin monotherapy. Significantly higher proportions of patients achieved A1C ≤6.5%, <7%, or <8% with combination therapy vs metformin monotherapy (P<0.02). Significantly higher proportions of patients achieved BP <140/90 mmHg (P<0.02 for each dapagliflozin dose) and BP <130/80 mmHg (P<0.02 with dapagliflozin 5 mg/d only) with combination therapy vs metformin monotherapy. Similar proportions (29%–33%) of patients had LDL-C <100 mg/dL across treatment groups. A higher proportion of patients with baseline BMI ≥25 kg/m2 lost ≥4.5 kg with combination therapy. Combination therapy had a more robust effect on patients with higher baseline BMI. Conclusion Initial combination therapy with dapagliflozin 5 or 10 mg/d and metformin improved

  18. Role of timing and dose of energy received in patients with acute lung injury on mortality in the Intensive Nutrition in Acute Lung Injury Trial (INTACT): a post hoc analysis.

    PubMed

    Braunschweig, Carol L; Freels, Sally; Sheean, Patricia M; Peterson, Sarah J; Perez, Sandra Gomez; McKeever, Liam; Lateef, Omar; Gurka, David; Fantuzzi, Giamila

    2017-02-01

    Our trial INTACT (Intensive Nutrition in Acute Lung Injury Trial) was designed to compare the impact of feeding from acute lung injury (ALI) diagnosis to hospital discharge, an interval that, to our knowledge, has not yet been explored. It was stopped early because participants who were randomly assigned to energy intakes at nationally recommended amounts via intensive medical nutrition therapy experienced significantly higher mortality hazards than did those assigned to standard nutrition support care that provided energy at 55% of recommended concentrations. We assessed the influence of dose and timing of feeding on hospital mortality. Participants (n = 78) were dichotomized as died or discharged alive. Associations between the energy and protein received overall, early (days 1-7), and late (days ≥8) and the hazards of hospital mortality were evaluated between groups with multivariable analysis methods. Higher overall energy intake predicted significantly higher mortality (OR: 1.14, 95% CI: 1.02, 1.27). Among participants enrolled for ≥8 d (n = 66), higher early energy intake significantly increased the HR for mortality (HR: 1.17, 95% CI: 1.07, 1.28), whereas higher late energy intake was significantly protective (HR: 0.91, 95% CI: 0.83, 1.0). Results were similar for early but not late protein (grams per kilogram) exposure (early-exposure HR: 8.9, 95% CI: 2.3, 34.3; late-exposure HR: 0.15, 95% CI: 0.02, 1.1). Threshold analyses indicated early mean intakes ≥18 kcal/kg significantly increased subsequent mortality. Providing kilocalories per kilogram or grams of protein per kilogram early post-ALI diagnosis at recommended levels was associated with significantly higher hazards for mortality, whereas higher late energy intakes reduced mortality hazards. This time-varying effect violated the Cox proportionality assumption, indicating that feeding trials in similar populations should extend beyond 7 d and use time-varying statistical methods. Future trials are

  19. Prognostic Impact of Diabetes and Prediabetes on Survival Outcomes in Patients With Chronic Heart Failure: A Post-Hoc Analysis of the GISSI-HF (Gruppo Italiano per lo Studio della Sopravvivenza nella Insufficienza Cardiaca-Heart Failure) Trial.

    PubMed

    Dauriz, Marco; Targher, Giovanni; Temporelli, Pier Luigi; Lucci, Donata; Gonzini, Lucio; Nicolosi, Gian Luigi; Marchioli, Roberto; Tognoni, Gianni; Latini, Roberto; Cosmi, Franco; Tavazzi, Luigi; Maggioni, Aldo Pietro

    2017-07-05

    The independent prognostic impact of diabetes mellitus (DM) and prediabetes mellitus (pre-DM) on survival outcomes in patients with chronic heart failure has been investigated in observational registries and randomized, clinical trials, but the results have been often inconclusive or conflicting. We examined the independent prognostic impact of DM and pre-DM on survival outcomes in the GISSI-HF (Gruppo Italiano per lo Studio della Sopravvivenza nella Insufficienza Cardiaca-Heart Failure) trial. We assessed the risk of all-cause death and the composite of all-cause death or cardiovascular hospitalization over a median follow-up period of 3.9 years among the 6935 chronic heart failure participants of the GISSI-HF trial, who were stratified by presence of DM (n=2852), pre-DM (n=2013), and non-DM (n=2070) at baseline. Compared with non-DM patients, those with DM had remarkably higher incidence rates of all-cause death (34.5% versus 24.6%) and the composite end point (63.6% versus 54.7%). Conversely, both event rates were similar between non-DM patients and those with pre-DM. Cox regression analysis showed that DM, but not pre-DM, was associated with an increased risk of all-cause death (adjusted hazard ratio, 1.43; 95% CI, 1.28-1.60) and of the composite end point (adjusted hazard ratio, 1.23; 95% CI, 1.13-1.32), independently of established risk factors. In the DM subgroup, higher hemoglobin A1c was also independently associated with increased risk of both study outcomes (all-cause death: adjusted hazard ratio, 1.21; 95% CI, 1.02-1.43; and composite end point: adjusted hazard ratio, 1.14; 95% CI, 1.01-1.29, respectively). Presence of DM was independently associated with poor long-term survival outcomes in patients with chronic heart failure. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00336336. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  20. Managing daily intensive care activities: An observational study concerning ad hoc decision making of charge nurses and intensivists

    PubMed Central

    2011-01-01

    Introduction Management of daily activities in ICUs is challenging. ICU shift leaders, charge nurses and intensivists have to make several immediate ad hoc decisions to enable the fluent flow of ICU activities. Even though the management of ICU activities is quite well delineated by international consensus guidelines, we know only a little about the content of the real clinical decision making of ICU shift leaders. Methods We conducted an observational study with the think-aloud technique to describe the ad hoc decision making of ICU shift leaders. The study was performed in two university-affiliated hospital ICUs. Twelve charge nurses and eight intensivists were recruited. Observations were recorded and transcribed for qualitative content analysis using the protocol analysis method. The software program NVivo 7 was used to manage the data. The interrater agreement was assessed with percentages and by Cohen's κ. Results We identified 463 ad hoc decisions made by the charge nurses and 444 made by the intensivists. During our data collection time, this breaks down to over 230 immediately made decisions per day (24 hours). We divided the ad hoc decision making of ICU shift leaders into two types: process-focused and situation-focused. Process-focused decision making included more permanent information, such as human resources, know-how and material resources, whereas situation-focused decision making included decisions about single events, such as patient admission. We named eight different categories for ICU ad hoc decision making: (1) adverse events, (2) diagnostics, (3) human resources and know-how, (4) material resources, (5) patient admission, (6) patient discharge, (7) patient information and vital signs and (8) special treatments. Conclusions ICU shift leaders make a great number of complex ad hoc decisions throughout the day. Often this decision making involves both intensivists and charge nurses. It forms a bundle that requires versatile, immediate

  1. 75 FR 15742 - NASA Advisory Council; Ad-Hoc Task Force on Planetary Defense; Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-30

    ... SPACE ADMINISTRATION NASA Advisory Council; Ad-Hoc Task Force on Planetary Defense; Meeting AGENCY... Administration announces a meeting of the Ad-Hoc Task Force on Planetary Defense of the NASA Advisory Council... include: Ad-Hoc Task Force on Planetary Defense Terms of Reference. NASA Near Earth Object (NEO)...

  2. 29 CFR 1912.11 - Terms of ad hoc committee members.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 7 2011-07-01 2011-07-01 false Terms of ad hoc committee members. 1912.11 Section 1912.11..., DEPARTMENT OF LABOR (CONTINUED) ADVISORY COMMITTEES ON STANDARDS Organizational Matters § 1912.11 Terms of ad hoc committee members. Each member of an ad hoc advisory committee shall serve for such period as...

  3. 75 FR 43565 - NASA Advisory Council; Ad-Hoc Task Force on Planetary Defense; Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-26

    ... SPACE ADMINISTRATION NASA Advisory Council; Ad-Hoc Task Force on Planetary Defense; Meeting AGENCY... Administration announces a two-part meeting of the Ad-Hoc Task Force on Planetary Defense of the NASA Advisory...@nasa.gov . SUPPLEMENTARY INFORMATION: The agenda topic is: Drafting of the Ad-Hoc Task Force...

  4. 29 CFR 1912.11 - Terms of ad hoc committee members.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 7 2010-07-01 2010-07-01 false Terms of ad hoc committee members. 1912.11 Section 1912.11..., DEPARTMENT OF LABOR (CONTINUED) ADVISORY COMMITTEES ON STANDARDS Organizational Matters § 1912.11 Terms of ad hoc committee members. Each member of an ad hoc advisory committee shall serve for such period as...

  5. Dynamic Control of Service Delivery for Ad Hoc Systems

    DTIC Science & Technology

    2006-10-01

    solutions for Localisation of mobile entities and propagation of information for routing the service in a mobile environment. Ad hoc Data Dissemination...available on the topology, the configuration of the network (SLA, user profiles, …), the localisation of the users in order to deliver the services...services. HCDR sub-networks are based on Adhoc technologies. • The enhanced civilian radio sub-networks (S- WIFI , S-WIMAX) : These technologies will

  6. Space-Time Processing for Tactical Mobile Ad Hoc Networks

    DTIC Science & Technology

    2009-08-01

    The overall performance attainable by a mobile ad hoc network depends fundamentally on the MIMO channel characteristics . During the past year the...propagation environment and an aperture within which the antennas must reside [1]. However, achieving these characteristics is difficult if not...determine the current distribution of Aperture 1 using the Covariance Method and compute the diversity gain obtained using the radiation characteristics

  7. Decentralized session initiation protocol solution in ad hoc networks

    NASA Astrophysics Data System (ADS)

    Han, Lu; Jin, Zhigang; Shu, Yantai; Dong, Linfang

    2006-10-01

    With the fast development of ad hoc networks, SIP has attracted more and more attention in multimedia service. This paper proposes a new architecture to provide SIP service for ad hoc users, although there is no centralized SIP server deployed. In this solution, we provide the SIP service by the introduction of two nodes: Designated SIP Server (DS) and its Backup Server (BDS). The nodes of ad hoc network designate DS and BDS when they join the session nodes set and when some pre-defined events occur. A new sip message type called REGISTRAR is presented so nodes can send others REGISTRAR message to declare they want to be DS. According to the IP information taken in the message, an algorithm works like the election of DR and BDR in OSPF protocol is used to vote DS and BDS SIP servers. Naturally, the DS will be replaced by BDS when the DS is down for predicable or unpredictable reasons. To facilitate this, the DS should register to the BDS and transfer a backup of the SIP users' database. Considering the possibility DS or BDS may abruptly go down, a special policy is given. When there is no DS and BDS, a new election procedure is triggered just like the startup phase. The paper also describes how SIP works normally in the decentralized model as well as the evaluation of its performance. All sessions based on SIP in ad hoc such as DS voting have been tested in the real experiments within a 500m*500m square area where about 30 random nodes are placed.

  8. MWAHCA: a multimedia wireless ad hoc cluster architecture.

    PubMed

    Diaz, Juan R; Lloret, Jaime; Jimenez, Jose M; Sendra, Sandra

    2014-01-01

    Wireless Ad hoc networks provide a flexible and adaptable infrastructure to transport data over a great variety of environments. Recently, real-time audio and video data transmission has been increased due to the appearance of many multimedia applications. One of the major challenges is to ensure the quality of multimedia streams when they have passed through a wireless ad hoc network. It requires adapting the network architecture to the multimedia QoS requirements. In this paper we propose a new architecture to organize and manage cluster-based ad hoc networks in order to provide multimedia streams. Proposed architecture adapts the network wireless topology in order to improve the quality of audio and video transmissions. In order to achieve this goal, the architecture uses some information such as each node's capacity and the QoS parameters (bandwidth, delay, jitter, and packet loss). The architecture splits the network into clusters which are specialized in specific multimedia traffic. The real system performance study provided at the end of the paper will demonstrate the feasibility of the proposal.

  9. MAC Protocol for Ad Hoc Networks Using a Genetic Algorithm

    PubMed Central

    Elizarraras, Omar; Panduro, Marco; Méndez, Aldo L.

    2014-01-01

    The problem of obtaining the transmission rate in an ad hoc network consists in adjusting the power of each node to ensure the signal to interference ratio (SIR) and the energy required to transmit from one node to another is obtained at the same time. Therefore, an optimal transmission rate for each node in a medium access control (MAC) protocol based on CSMA-CDMA (carrier sense multiple access-code division multiple access) for ad hoc networks can be obtained using evolutionary optimization. This work proposes a genetic algorithm for the transmission rate election considering a perfect power control, and our proposition achieves improvement of 10% compared with the scheme that handles the handshaking phase to adjust the transmission rate. Furthermore, this paper proposes a genetic algorithm that solves the problem of power combining, interference, data rate, and energy ensuring the signal to interference ratio in an ad hoc network. The result of the proposed genetic algorithm has a better performance (15%) compared to the CSMA-CDMA protocol without optimizing. Therefore, we show by simulation the effectiveness of the proposed protocol in terms of the throughput. PMID:25140339

  10. Auto-Configuration Protocols in Mobile Ad Hoc Networks

    PubMed Central

    Villalba, Luis Javier García; Matesanz, Julián García; Orozco, Ana Lucila Sandoval; Díaz, José Duván Márquez

    2011-01-01

    The TCP/IP protocol allows the different nodes in a network to communicate by associating a different IP address to each node. In wired or wireless networks with infrastructure, we have a server or node acting as such which correctly assigns IP addresses, but in mobile ad hoc networks there is no such centralized entity capable of carrying out this function. Therefore, a protocol is needed to perform the network configuration automatically and in a dynamic way, which will use all nodes in the network (or part thereof) as if they were servers that manage IP addresses. This article reviews the major proposed auto-configuration protocols for mobile ad hoc networks, with particular emphasis on one of the most recent: D2HCP. This work also includes a comparison of auto-configuration protocols for mobile ad hoc networks by specifying the most relevant metrics, such as a guarantee of uniqueness, overhead, latency, dependency on the routing protocol and uniformity. PMID:22163814

  11. MWAHCA: A Multimedia Wireless Ad Hoc Cluster Architecture

    PubMed Central

    Diaz, Juan R.; Jimenez, Jose M.; Sendra, Sandra

    2014-01-01

    Wireless Ad hoc networks provide a flexible and adaptable infrastructure to transport data over a great variety of environments. Recently, real-time audio and video data transmission has been increased due to the appearance of many multimedia applications. One of the major challenges is to ensure the quality of multimedia streams when they have passed through a wireless ad hoc network. It requires adapting the network architecture to the multimedia QoS requirements. In this paper we propose a new architecture to organize and manage cluster-based ad hoc networks in order to provide multimedia streams. Proposed architecture adapts the network wireless topology in order to improve the quality of audio and video transmissions. In order to achieve this goal, the architecture uses some information such as each node's capacity and the QoS parameters (bandwidth, delay, jitter, and packet loss). The architecture splits the network into clusters which are specialized in specific multimedia traffic. The real system performance study provided at the end of the paper will demonstrate the feasibility of the proposal. PMID:24737996

  12. Post hoc analysis of the PATRICIA randomized trial of the efficacy of human papillomavirus type 16 (HPV-16)/HPV-18 AS04-adjuvanted vaccine against incident and persistent infection with nonvaccine oncogenic HPV types using an alternative multiplex type-specific PCR assay for HPV DNA.

    PubMed

    Struyf, Frank; Colau, Brigitte; Wheeler, Cosette M; Naud, Paulo; Garland, Suzanne; Quint, Wim; Chow, Song-Nan; Salmerón, Jorge; Lehtinen, Matti; Del Rosario-Raymundo, M Rowena; Paavonen, Jorma; Teixeira, Júlio C; Germar, Maria Julieta; Peters, Klaus; Skinner, S Rachel; Limson, Genara; Castellsagué, Xavier; Poppe, Willy A J; Ramjattan, Brian; Klein, Terry D; Schwarz, Tino F; Chatterjee, Archana; Tjalma, Wiebren A A; Diaz-Mitoma, Francisco; Lewis, David J M; Harper, Diane M; Molijn, Anco; van Doorn, Leen-Jan; David, Marie-Pierre; Dubin, Gary

    2015-02-01

    The efficacy of the human papillomavirus type 16 (HPV-16)/HPV-18 AS04-adjuvanted vaccine against cervical infections with HPV in the Papilloma Trial against Cancer in Young Adults (PATRICIA) was evaluated using a combination of the broad-spectrum L1-based SPF10 PCR-DNA enzyme immunoassay (DEIA)/line probe assay (LiPA25) system with type-specific PCRs for HPV-16 and -18. Broad-spectrum PCR assays may underestimate the presence of HPV genotypes present at relatively low concentrations in multiple infections, due to competition between genotypes. Therefore, samples were retrospectively reanalyzed using a testing algorithm incorporating the SPF10 PCR-DEIA/LiPA25 plus a novel E6-based multiplex type-specific PCR and reverse hybridization assay (MPTS12 RHA), which permits detection of a panel of nine oncogenic HPV genotypes (types 16, 18, 31, 33, 35, 45, 52, 58, and 59). For the vaccine against HPV types 16 and 18, there was no major impact on estimates of vaccine efficacy (VE) for incident or 6-month or 12-month persistent infections when the MPTS12 RHA was included in the testing algorithm versus estimates with the protocol-specified algorithm. However, the alternative testing algorithm showed greater sensitivity than the protocol-specified algorithm for detection of some nonvaccine oncogenic HPV types. More cases were gained in the control group than in the vaccine group, leading to higher point estimates of VE for 6-month and 12-month persistent infections for the nonvaccine oncogenic types included in the MPTS12 RHA assay (types 31, 33, 35, 45, 52, 58, and 59). This post hoc analysis indicates that the per-protocol testing algorithm used in PATRICIA underestimated the VE against some nonvaccine oncogenic HPV types and that the choice of the HPV DNA testing methodology is important for the evaluation of VE in clinical trials. (This study has been registered at ClinicalTrials.gov under registration no. NCT00122681.).

  13. Tolerability and Outcomes of First-Line Pemetrexed-Cisplatin Followed by Gefitinib Maintenance Therapy Versus Gefitinib Monotherapy in Korean Patients with Advanced Nonsquamous Non-small Cell Lung Cancer: A Post Hoc Descriptive Subgroup Analysis of a Randomized, Phase 3 Trial.

    PubMed

    Kang, Jin Hyoung; Ahn, Myung-Ju; Kim, Dong-Wan; Cho, Eun Kyung; Kim, Joo-Hang; Shin, Sang Won; Wang, Xin; Kim, Jong Seok; Orlando, Mauro; Park, Keunchil

    2016-04-01

    We recently reported on a randomized, open-label, phase 3 trial comparing pemetrexed-cisplatin chemotherapy followed by gefitinib maintenance therapy (PC/G) with gefitinib monotherapy in patients with non-small cell lung cancer (NSCLC). Here, we report on a post hoc subgroup analysis of that study assessing the demographics and disposition of the Korean patient subgroup, and comparing the tolerability of PC/G and gefitinib monotherapy and the tumor response with respect to epidermal growth factor receptor (EGFR) status. Patients, who were ≥ 18 years, chemonaïve, Korean, light ex-smokers/never-smokers with advanced NSCLC, were randomly assigned (1:1) to PC/G or gefitinib monotherapy. Treatment-emergent adverse events (TEAEs) were graded, and tumor response was measured as change in lesion sum from baseline at best response. The study was registered with ClinicalTrials. gov, NCT01017874. Overall, 111 Korean patients were treated (PC/G, 51; gefitinib, 60). Between-arm characteristics were balanced and similar to those of the overall population. Treatment discontinuations due to adverse events were low (PC/G: 1, 2.0%; gefitinib: 7, 11.7%). Overall, 92 patients (82.9%) reported ≥ 1 TEAE (PC/G, 44; gefitinib, 48); few patients (PC/G, 16; gefitinib, 7) reported severe TEAEs; the most frequent was neutropenia (PC/G arm) and elevated alanine aminotransferase (gefitinib arm). The lesion sum was decreased by PC/G treatment in most patients, regardless of EGFR mutation status, while gefitinib monotherapy reduced the lesion sum in EGFR-positive patients but had no effect in EGFR-negative patients. Our results confirm that both PC/G and gefitinib were well tolerated in Korean patients, regardless of EGFR status; however, patients with EGFR wild-type NSCLC may not benefit from gefitinib monotherapy.

  14. Cross-Layered Security Analysis of Wireless Ad Hoc Networks

    DTIC Science & Technology

    2004-12-01

    protocols and link state routing (e.g. secure OLSR ) versus distance vector routing (e.g. SAODV). Some of the routing attacks are launched from the MAC...that pose the greatest security threats when controlled by the adversary. 3.1 Outsiders Outsiders are attackers that do not have any compromised...attempt to jam the communications channel, they can create a wormhole, and as an extreme attack , we assume they can eliminate nodes from the network

  15. Performance Analysis of Mobile Ad Hoc Networking Routing Protocols

    DTIC Science & Technology

    2004-12-01

    process of establishing the DAG is similar to the query and reply process as proposed in a light-weight mobile routing (LMR) [ Corson 1995]. Upon link...2004. [RIP RFC] RIP Version 2 RFC Website. http://www.faqs.org/rfcs/rfc2453.html accessed on 1 October 2004. [Royer 1999] Elizabeth M. Royer & C

  16. T2AR: trust-aware ad-hoc routing protocol for MANET.

    PubMed

    Dhananjayan, Gayathri; Subbiah, Janakiraman

    2016-01-01

    Secure data transfer against the malicious attacks is an important issue in an infrastructure-less independent network called mobile ad-hoc network (MANET). Trust assurance between MANET nodes is the key parameter in the high-security provision under dynamic topology variations and open wireless constraints. But, the malicious behavior of nodes reduces the trust level of the nodes that leads to an insecure data delivery. The increase in malicious attacks causes the excessive energy consumption that leads to a reduction of network lifetime. The lack of positional information update of the nodes in ad-hoc on-demand vector (AODV) protocol during the connection establishment offers less trust level between the nodes. Hence, the trust rate computation using energy and mobility models and its update are the essential tasks for secure data delivery. This paper proposes a trust-aware ad-hoc routing (T2AR) protocol to improve the trust level between the nodes in MANET. The proposed method modifies the traditional AODV routing protocol with the constraints of trust rate, energy, mobility based malicious behavior prediction. The packet sequence ID matching from the log reports of neighbor nodes determine the trust rate that avoids the malicious report generation. Besides, the direct and indirect trust observation schemes utilization increases the trust level. Besides, the received signal strength indicator utilization determines the trusted node is within the communication range or not. The comparative analysis between the proposed T2AR with the existing methods such as TRUNCMAN, RBT, GR, FBR and DICOTIDS regarding the average end-to-end delay, throughput, false positives, packet delivery ratio shows the effectiveness of T2AR in the secure MANET environment design.

  17. Dynamic fair node spectrum allocation for ad hoc networks using random matrices

    NASA Astrophysics Data System (ADS)

    Rahmes, Mark; Lemieux, George; Chester, Dave; Sonnenberg, Jerry

    2015-05-01

    Dynamic Spectrum Access (DSA) is widely seen as a solution to the problem of limited spectrum, because of its ability to adapt the operating frequency of a radio. Mobile Ad Hoc Networks (MANETs) can extend high-capacity mobile communications over large areas where fixed and tethered-mobile systems are not available. In one use case with high potential impact, cognitive radio employs spectrum sensing to facilitate the identification of allocated frequencies not currently accessed by their primary users. Primary users own the rights to radiate at a specific frequency and geographic location, while secondary users opportunistically attempt to radiate at a specific frequency when the primary user is not using it. We populate a spatial radio environment map (REM) database with known information that can be leveraged in an ad hoc network to facilitate fair path use of the DSA-discovered links. Utilization of high-resolution geospatial data layers in RF propagation analysis is directly applicable. Random matrix theory (RMT) is useful in simulating network layer usage in nodes by a Wishart adjacency matrix. We use the Dijkstra algorithm for discovering ad hoc network node connection patterns. We present a method for analysts to dynamically allocate node-node path and link resources using fair division. User allocation of limited resources as a function of time must be dynamic and based on system fairness policies. The context of fair means that first available request for an asset is not envied as long as it is not yet allocated or tasked in order to prevent cycling of the system. This solution may also save money by offering a Pareto efficient repeatable process. We use a water fill queue algorithm to include Shapley value marginal contributions for allocation.

  18. Overview of the INEX 2008 Ad Hoc Track

    NASA Astrophysics Data System (ADS)

    Kamps, Jaap; Geva, Shlomo; Trotman, Andrew; Woodley, Alan; Koolen, Marijn

    This paper gives an overview of the INEX 2008 Ad Hoc Track. The main goals of the Ad Hoc Track were two-fold. The first goal was to investigate the value of the internal document structure (as provided by the XML mark-up) for retrieving relevant information. This is a continuation of INEX 2007 and, for this reason, the retrieval results are liberalized to arbitrary passages and measures were chosen to fairly compare systems retrieving elements, ranges of elements, and arbitrary passages. The second goal was to compare focused retrieval to article retrieval more directly than in earlier years. For this reason, standard document retrieval rankings have been derived from all runs, and evaluated with standard measures. In addition, a set of queries targeting Wikipedia have been derived from a proxy log, and the runs are also evaluated against the clicked Wikipedia pages. The INEX 2008 Ad Hoc Track featured three tasks: For the Focused Task a ranked-list of non-overlapping results (elements or passages) was needed. For the Relevant in Context Task non-overlapping results (elements or passages) were returned grouped by the article from which they came. For the Best in Context Task a single starting point (element start tag or passage start) for each article was needed. We discuss the results for the three tasks, and examine the relative effectiveness of element and passage retrieval. This is examined in the context of content only (CO, or Keyword) search as well as content and structure (CAS, or structured) search. Finally, we look at the ability of focused retrieval techniques to rank articles, using standard document retrieval techniques, both against the judged topics as well as against queries and clicks from a proxy log.

  19. Ubiquitous and Secure Certificate Service for Wireless Ad Hoc Network

    NASA Astrophysics Data System (ADS)

    Ge, Meng; Lam, Kwok-Yan; Li, Jianbin; Chung, Siu-Leung

    Wireless ad hoc network is one of the most suitable platforms for providing communication services to support mobile applications in public areas where no fixed communication infrastructure exists. However, due to the open nature of wireless links and lack of security infrastructure in an ad hoc network environment, applications operating on ad hoc network platforms are subjected to non-trivial security challenges. Asymmetric key management, which is widely adopted to be an effective basis for security services in an open network environment, typically plays a crucial role in meeting the security requirements of such applications. In this paper, we propose a secure asymmetric key management scheme, the Ubiquitous and Secure Certificate Service (USCS), which is based on a variant of the Distributed Certificate Authority (DCA) - the Fully Distributed Certificate Authority (FDCA). Similar to FDCA, USCS introduces the presence of 1-hop neighbors which hold shares of DCA's private signature key, and can collaborate to issue certificates, thereby providing asymmetric key management service. Both USCS and FDCA aim to achieve higher availability than the basic DCA scheme; however, USCS is more secure than FDCA in that the former achieves high availability by distributing existing shares to new members, rather than generating new shares as the FDCA scheme does. In order to realise the high availability potential of USCS, a share selection algorithm is also proposed. Experimental results demonstrated that USCS is a more secure approach of the DCA scheme in that it can achieve stronger security than FDCA while attaining high availability similar to that of FDCA. Experiments also showed that USCS incurs only moderate communication overheads.

  20. Stochastic does not equal ad hoc. [theories of lunar origin

    NASA Technical Reports Server (NTRS)

    Hartmann, W. K.

    1984-01-01

    Some classes of influential events in solar system history are class-predictable but not event-predictable. Theories of lunar origin should not ignore class-predictable stochastic events. Impacts and close encounters with large objects during planet formation are class-predictable. These stochastic events, such as large impacts that triggered ejection of Earth-mantle material into a circum-Earth cloud, should not be rejected as ad hoc. A way to deal with such events scientifically is to investigate their consequences; if it can be shown that they might produce the Moon, they become viable concepts in theories of lunar origin.

  1. Scalable Architecture for Multihop Wireless ad Hoc Networks

    NASA Technical Reports Server (NTRS)

    Arabshahi, Payman; Gray, Andrew; Okino, Clayton; Yan, Tsun-Yee

    2004-01-01

    A scalable architecture for wireless digital data and voice communications via ad hoc networks has been proposed. Although the details of the architecture and of its implementation in hardware and software have yet to be developed, the broad outlines of the architecture are fairly clear: This architecture departs from current commercial wireless communication architectures, which are characterized by low effective bandwidth per user and are not well suited to low-cost, rapid scaling in large metropolitan areas. This architecture is inspired by a vision more akin to that of more than two dozen noncommercial community wireless networking organizations established by volunteers in North America and several European countries.

  2. Ad Hoc Selection of Voice over Internet Streams

    NASA Technical Reports Server (NTRS)

    Macha, Mitchell G. (Inventor); Bullock, John T. (Inventor)

    2008-01-01

    A method and apparatus for a communication system technique involving ad hoc selection of at least two audio streams is provided. Each of the at least two audio streams is a packetized version of an audio source. A data connection exists between a server and a client where a transport protocol actively propagates the at least two audio streams from the server to the client. Furthermore, software instructions executable on the client indicate a presence of the at least two audio streams, allow selection of at least one of the at least two audio streams, and direct the selected at least one of the at least two audio streams for audio playback.

  3. Ad Hoc Selection of Voice over Internet Streams

    NASA Technical Reports Server (NTRS)

    Macha, Mitchell G. (Inventor); Bullock, John T. (Inventor)

    2014-01-01

    A method and apparatus for a communication system technique involving ad hoc selection of at least two audio streams is provided. Each of the at least two audio streams is a packetized version of an audio source. A data connection exists between a server and a client where a transport protocol actively propagates the at least two audio streams from the server to the client. Furthermore, software instructions executable on the client indicate a presence of the at least two audio streams, allow selection of at least one of the at least two audio streams, and direct the selected at least one of the at least two audio streams for audio playback.

  4. Approximate ad-hoc query engine for simulation data

    SciTech Connect

    Abdulla, G; Baldwin, C; Critchlow, T; Kamimura, R; Lozares, I; Musick, R; Tang, N; Lee, B S; Snapp, R

    2001-02-01

    In this paper, we describe AQSim, an ongoing effort to design and implement a system to manage terabytes of scientific simulation data. The goal of this project is to reduce data storage requirements and access times while permitting ad-hoc queries using statistical and mathematical models of the data. In order to facilitate data exchange between models based on different representations, we are evaluating using the ASCI common data model which is comprised of several layers of increasing semantic complexity. To support queries over the spatial-temporal mesh structured data we are in the process of defining and implementing a grammar for MeshSQL.

  5. Clinical teacher training--maximising the 'ad hoc' teaching encounter.

    PubMed

    Molodysky, Eugen

    2007-12-01

    Classically, the patient is absent when the learner makes an 'ad hoc' corridor enquiry of their supervisor. This teaching encounter challenges the supervisor to ensure that the educational benefit is not limited by the brevity of the encounter. Focusing on some of the critical steps or teaching skills involved in the learning process increases the efficiency and effectiveness of this type of teaching encounter. Educationalists have provided models to optimise this fleeting corridor enquiry. This article presents a range of scripted clinical teaching scenarios that demonstrate the sound educational theory and principles underlying one such model--the 'one minute preceptor' or 'five step microskills model' of clinical teaching.

  6. Ground-based observations and AD HOC models

    NASA Astrophysics Data System (ADS)

    Ground based observations of B stars in the visible, the infrared, and the radio region are described along with the ad hoc models proposed to interpret them. It is shown that these observations refer essentially to the photosphere and to the regions of the outer atmosphere where the gas is cool and at low velocity. The characteristics of the variability of the continuous and line spectrum are examined in general and in the cases of individual stars. Finally, linear polarization in the B stars is discussed.

  7. An HOC approach for patterns using Gray-Scott model

    NASA Astrophysics Data System (ADS)

    Kalita, Jiten C.

    2017-07-01

    In this paper, we propose a high order compact (HOC) scheme for the unsteady two-dimensional reaction diffusion equations which is second order accurate in time and fourth order accurate in space. The scheme is specifically designed to tackle problems in pattern formation arising frequently in Mathematical Biology, modelled by the Gray-Scott model. By converting the reaction-diffusion equations into a pure diffusion equation, we obtain an unconditionally stable convergent implicit scheme. To validate the scheme, it is applied to two problems on pattern formation. Our computed results are compared with existing numerical ones and excellent match is obtained in all the cases.

  8. A Multihop Key Agreement Scheme for Wireless Ad Hoc Networks Based on Channel Characteristics

    PubMed Central

    Yu, Nenghai

    2013-01-01

    A number of key agreement schemes based on wireless channel characteristics have been proposed recently. However, previous key agreement schemes require that two nodes which need to agree on a key are within the communication range of each other. Hence, they are not suitable for multihop wireless networks, in which nodes do not always have direct connections with each other. In this paper, we first propose a basic multihop key agreement scheme for wireless ad hoc networks. The proposed basic scheme is resistant to external eavesdroppers. Nevertheless, this basic scheme is not secure when there exist internal eavesdroppers or Man-in-the-Middle (MITM) adversaries. In order to cope with these adversaries, we propose an improved multihop key agreement scheme. We show that the improved scheme is secure against internal eavesdroppers and MITM adversaries in a single path. Both performance analysis and simulation results demonstrate that the improved scheme is efficient. Consequently, the improved key agreement scheme is suitable for multihop wireless ad hoc networks. PMID:23766725

  9. A multihop key agreement scheme for wireless ad hoc networks based on channel characteristics.

    PubMed

    Hao, Zhuo; Zhong, Sheng; Yu, Nenghai

    2013-01-01

    A number of key agreement schemes based on wireless channel characteristics have been proposed recently. However, previous key agreement schemes require that two nodes which need to agree on a key are within the communication range of each other. Hence, they are not suitable for multihop wireless networks, in which nodes do not always have direct connections with each other. In this paper, we first propose a basic multihop key agreement scheme for wireless ad hoc networks. The proposed basic scheme is resistant to external eavesdroppers. Nevertheless, this basic scheme is not secure when there exist internal eavesdroppers or Man-in-the-Middle (MITM) adversaries. In order to cope with these adversaries, we propose an improved multihop key agreement scheme. We show that the improved scheme is secure against internal eavesdroppers and MITM adversaries in a single path. Both performance analysis and simulation results demonstrate that the improved scheme is efficient. Consequently, the improved key agreement scheme is suitable for multihop wireless ad hoc networks.

  10. Adaptive link-layer intelligence for enhanced ad hoc networking

    NASA Astrophysics Data System (ADS)

    MacLennan, James; Walburg, Bill; Nevins, Larry; Hartup, David

    2005-05-01

    Networked radio systems that utilize self-forming, fault tolerant techniques offer needed communication functions for Homeland Security and Law Enforcement agencies. The use of an ad hoc mesh network architecture solves some of the problems inherent to the wireless physical layer such as interferers, multi-path fading, shadowing, and loss of line-of-site. These effects severely limit the performance of current 802.11 wireless network implementations. This paper describes the use of Adaptive Link-layer Intelligence for Enhanced ad hoc Networking. This technology enhances recognition and characterization of sources of wireless channel perturbations and predicts their effects on wireless link quality. Identifying and predicting channel problems at the link level improves dynamic route discovery, circumvents channel disruptions before they cause a link failure, and increases communications reliability and data rate. First Responders, Homeland Security, and Law Enforcement agencies operating in locations lacking infrastructure, such as Urban Search and Rescue (USAR) operations, can benefit from increased communications reliability in highly impaired channels that are typical in disaster response scenarios.

  11. Post Hoc Analysis of the PATRICIA Randomized Trial of the Efficacy of Human Papillomavirus Type 16 (HPV-16)/HPV-18 AS04-Adjuvanted Vaccine against Incident and Persistent Infection with Nonvaccine Oncogenic HPV Types Using an Alternative Multiplex Type-Specific PCR Assay for HPV DNA

    PubMed Central

    Colau, Brigitte; Wheeler, Cosette M.; Naud, Paulo; Garland, Suzanne; Quint, Wim; Chow, Song-Nan; Salmerón, Jorge; Lehtinen, Matti; Del Rosario-Raymundo, M. Rowena; Paavonen, Jorma; Teixeira, Júlio C.; Germar, Maria Julieta; Peters, Klaus; Skinner, S. Rachel; Limson, Genara; Castellsagué, Xavier; Poppe, Willy A. J.; Ramjattan, Brian; Klein, Terry D.; Schwarz, Tino F.; Chatterjee, Archana; Tjalma, Wiebren A. A.; Diaz-Mitoma, Francisco; Lewis, David J. M.; Harper, Diane M.; Molijn, Anco; van Doorn, Leen-Jan; David, Marie-Pierre; Dubin, Gary

    2014-01-01

    The efficacy of the human papillomavirus type 16 (HPV-16)/HPV-18 AS04-adjuvanted vaccine against cervical infections with HPV in the Papilloma Trial against Cancer in Young Adults (PATRICIA) was evaluated using a combination of the broad-spectrum L1-based SPF10 PCR-DNA enzyme immunoassay (DEIA)/line probe assay (LiPA25) system with type-specific PCRs for HPV-16 and -18. Broad-spectrum PCR assays may underestimate the presence of HPV genotypes present at relatively low concentrations in multiple infections, due to competition between genotypes. Therefore, samples were retrospectively reanalyzed using a testing algorithm incorporating the SPF10 PCR-DEIA/LiPA25 plus a novel E6-based multiplex type-specific PCR and reverse hybridization assay (MPTS12 RHA), which permits detection of a panel of nine oncogenic HPV genotypes (types 16, 18, 31, 33, 35, 45, 52, 58, and 59). For the vaccine against HPV types 16 and 18, there was no major impact on estimates of vaccine efficacy (VE) for incident or 6-month or 12-month persistent infections when the MPTS12 RHA was included in the testing algorithm versus estimates with the protocol-specified algorithm. However, the alternative testing algorithm showed greater sensitivity than the protocol-specified algorithm for detection of some nonvaccine oncogenic HPV types. More cases were gained in the control group than in the vaccine group, leading to higher point estimates of VE for 6-month and 12-month persistent infections for the nonvaccine oncogenic types included in the MPTS12 RHA assay (types 31, 33, 35, 45, 52, 58, and 59). This post hoc analysis indicates that the per-protocol testing algorithm used in PATRICIA underestimated the VE against some nonvaccine oncogenic HPV types and that the choice of the HPV DNA testing methodology is important for the evaluation of VE in clinical trials. (This study has been registered at ClinicalTrials.gov under registration no. NCT00122681.) PMID:25540273

  12. A User Authentication Scheme Based on Elliptic Curves Cryptography for Wireless Ad Hoc Networks

    PubMed Central

    Chen, Huifang; Ge, Linlin; Xie, Lei

    2015-01-01

    The feature of non-infrastructure support in a wireless ad hoc network (WANET) makes it suffer from various attacks. Moreover, user authentication is the first safety barrier in a network. A mutual trust is achieved by a protocol which enables communicating parties to authenticate each other at the same time and to exchange session keys. For the resource-constrained WANET, an efficient and lightweight user authentication scheme is necessary. In this paper, we propose a user authentication scheme based on the self-certified public key system and elliptic curves cryptography for a WANET. Using the proposed scheme, an efficient two-way user authentication and secure session key agreement can be achieved. Security analysis shows that our proposed scheme is resilient to common known attacks. In addition, the performance analysis shows that our proposed scheme performs similar or better compared with some existing user authentication schemes. PMID:26184224

  13. A User Authentication Scheme Based on Elliptic Curves Cryptography for Wireless Ad Hoc Networks.

    PubMed

    Chen, Huifang; Ge, Linlin; Xie, Lei

    2015-07-14

    The feature of non-infrastructure support in a wireless ad hoc network (WANET) makes it suffer from various attacks. Moreover, user authentication is the first safety barrier in a network. A mutual trust is achieved by a protocol which enables communicating parties to authenticate each other at the same time and to exchange session keys. For the resource-constrained WANET, an efficient and lightweight user authentication scheme is necessary. In this paper, we propose a user authentication scheme based on the self-certified public key system and elliptic curves cryptography for a WANET. Using the proposed scheme, an efficient two-way user authentication and secure session key agreement can be achieved. Security analysis shows that our proposed scheme is resilient to common known attacks. In addition, the performance analysis shows that our proposed scheme performs similar or better compared with some existing user authentication schemes.

  14. Extending Service Area of IEEE 802.11 Ad Hoc Networks

    NASA Astrophysics Data System (ADS)

    Choi, Woo-Yong

    2012-06-01

    According to the current IEEE 802.11 wireless LAN standards, IEEE 802.11 ad hoc networks have the limitation that all STAs (Stations) are in the one-hop transmission range of each other. In this paper, to alleviate the limitation of IEEE 802.11 ad hoc networks we propose the efficient method for selecting the most appropriate pseudo AP (Access Point) from among the set of ad hoc STAs and extending the service area of IEEE 802.11 ad hoc networks by the pseudo AP's relaying the internal traffic of IEEE 802.11 ad hoc networks. Numerical examples show that the proposed method significantly extends the service area of IEEE 802.11 ad hoc networks.

  15. Trust recovery model of Ad Hoc network based on identity authentication scheme

    NASA Astrophysics Data System (ADS)

    Liu, Jie; Huan, Shuiyuan

    2017-05-01

    Mobile Ad Hoc network trust model is widely used to solve mobile Ad Hoc network security issues. Aiming at the problem of reducing the network availability caused by the processing of malicious nodes and selfish nodes in mobile Ad Hoc network routing based on trust model, an authentication mechanism based on identity authentication mobile Ad Hoc network is proposed, which uses identity authentication to identify malicious nodes, And trust the recovery of selfish nodes in order to achieve the purpose of reducing network congestion and improving network quality. The simulation results show that the implementation of the mechanism can effectively improve the network availability and security.

  16. Intelligent routing protocol for ad hoc wireless network

    NASA Astrophysics Data System (ADS)

    Peng, Chaorong; Chen, Chang Wen

    2006-05-01

    A novel routing scheme for mobile ad hoc networks (MANETs), which combines hybrid and multi-inter-routing path properties with a distributed topology discovery route mechanism using control agents is proposed in this paper. In recent years, a variety of hybrid routing protocols for Mobile Ad hoc wireless networks (MANETs) have been developed. Which is proactively maintains routing information for a local neighborhood, while reactively acquiring routes to destinations beyond the global. The hybrid protocol reduces routing discovery latency and the end-to-end delay by providing high connectivity without requiring much of the scarce network capacity. On the other side the hybrid routing protocols in MANETs likes Zone Routing Protocol still need route "re-discover" time when a route between zones link break. Sine the topology update information needs to be broadcast routing request on local zone. Due to this delay, the routing protocol may not be applicable for real-time data and multimedia communication. We utilize the advantages of a clustering organization and multi-routing path in routing protocol to achieve several goals at the same time. Firstly, IRP efficiently saves network bandwidth and reduces route reconstruction time when a routing path fails. The IRP protocol does not require global periodic routing advertisements, local control agents will automatically monitor and repair broke links. Secondly, it efficiently reduces congestion and traffic "bottlenecks" for ClusterHeads in clustering network. Thirdly, it reduces significant overheads associated with maintaining clusters. Fourthly, it improves clusters stability due to dynamic topology changing frequently. In this paper, we present the Intelligent Routing Protocol. First, we discuss the problem of routing in ad hoc networks and the motivation of IRP. We describe the hierarchical architecture of IRP. We describe the routing process and illustrate it with an example. Further, we describe the control manage

  17. Opportunistic Channel Scheduling for Ad Hoc Networks with Queue Stability

    NASA Astrophysics Data System (ADS)

    Dong, Lei; Wang, Yongchao

    2015-03-01

    In this paper, a distributed opportunistic channel access strategy in ad hoc network is proposed. We consider the multiple sources contend for the transmission opportunity, the winner source decides to transmit or restart contention based on the current channel condition. Owing to real data assumption at all links, the decision still needs to consider the stability of the queues. We formulate the channel opportunistic scheduling as a constrained optimization problem which maximizes the system average throughput with the constraints that the queues of all links are stable. The proposed optimization model is solved by Lyapunov stability in queueing theory. The successive channel access problem is decoupled into single optimal stopping problem at every frame and solved with Lyapunov algorithm. The threshold for every frame is different, and it is derived based on the instantaneous queue information. Finally, computer simulations are conducted to demonstrate the validity of the proposed strategy.

  18. Undilatable Stent Neoatherosclerosis Treated with Ad Hoc Rotational Atherectomy

    PubMed Central

    Koutouzis, Michael; Maniotis, Christos; Tsiafoutis, Ioannis; Argyriou, Mihalis

    2017-01-01

    A middle age woman with known ischemic heart disease and old stents in proximal left anterior descending coronary artery (LAD) was admitted to Coronary Care Unit with acute coronary syndrome. The coronary angiography showed one vessel disease with significant restenosis within the previously implanted stents. The lesion was tough and remained undilatable despite high pressure balloon inflation. Eventually, the balloon ruptured creating a massive dissection of the LAD beginning immediately after the distal part of the undilatable lesion. We proceeded with a challenging ad hoc rotational atherectomy of the lesion and finally stenting of the lesion. In-stent restenosis many years after stent implantation is considered to be mainly due to neoatheromatosis compared to intimal hyperplasia, making lesion treatment more difficult and unpredictable. PMID:28168062

  19. Topology for efficient information dissemination in ad-hoc networking

    NASA Technical Reports Server (NTRS)

    Jennings, E.; Okino, C. M.

    2002-01-01

    In this paper, we explore the information dissemination problem in ad-hoc wirless networks. First, we analyze the probability of successful broadcast, assuming: the nodes are uniformly distributed, the available area has a lower bould relative to the total number of nodes, and there is zero knowledge of the overall topology of the network. By showing that the probability of such events is small, we are motivated to extract good graph topologies to minimize the overall transmissions. Three algorithms are used to generate topologies of the network with guaranteed connectivity. These are the minimum radius graph, the relative neighborhood graph and the minimum spanning tree. Our simulation shows that the relative neighborhood graph has certain good graph properties, which makes it suitable for efficient information dissemination.

  20. Realistic Mobility Modeling for Vehicular Ad Hoc Networks

    NASA Astrophysics Data System (ADS)

    Akay, Hilal; Tugcu, Tuna

    2009-08-01

    Simulations used for evaluating the performance of routing protocols for Vehicular Ad Hoc Networks (VANET) are mostly based on random mobility and fail to consider individual behaviors of the vehicles. Unrealistic assumptions about mobility produce misleading results about the behavior of routing protocols in real deployments. In this paper, a realistic mobility modeling tool, Mobility for Vehicles (MOVE), which considers the basic mobility behaviors of vehicles, is proposed for a more accurate evaluation. The proposed model is tested against the Random Waypoint (RWP) model using AODV and OLSR protocols. The results show that the mobility model significantly affects the number of nodes within the transmission range of a node, the volume of control traffic, and the number of collisions. It is shown that number of intersections, grid size, and node density are important parameters when dealing with VANET performance.

  1. Ad hoc committee on global climate issues: Annual report

    USGS Publications Warehouse

    Gerhard, L.C.; Hanson, B.M.B.

    2000-01-01

    The AAPG Ad Hoc Committee on Global Climate Issues has studied the supposition of human-induced climate change since the committee's inception in January 1998. This paper details the progress and findings of the committee through June 1999. At that time there had been essentially no geologic input into the global climate change debate. The following statements reflect the current state of climate knowledge from the geologic perspective as interpreted by the majority of the committee membership. The committee recognizes that new data could change its conclusions. The earth's climate is constantly changing owing to natural variability in earth processes. Natural climate variability over recent geological time is greater than reasonable estimates of potential human-induced greenhouse gas changes. Because no tool is available to test the supposition of human-induced climate change and the range of natural variability is so great, there is no discernible human influence on global climate at this time.

  2. Topology for efficient information dissemination in ad-hoc networking

    NASA Technical Reports Server (NTRS)

    Jennings, E.; Okino, C. M.

    2002-01-01

    In this paper, we explore the information dissemination problem in ad-hoc wirless networks. First, we analyze the probability of successful broadcast, assuming: the nodes are uniformly distributed, the available area has a lower bould relative to the total number of nodes, and there is zero knowledge of the overall topology of the network. By showing that the probability of such events is small, we are motivated to extract good graph topologies to minimize the overall transmissions. Three algorithms are used to generate topologies of the network with guaranteed connectivity. These are the minimum radius graph, the relative neighborhood graph and the minimum spanning tree. Our simulation shows that the relative neighborhood graph has certain good graph properties, which makes it suitable for efficient information dissemination.

  3. Topology Control in Large-Scale High Dynamic Mobile Ad-Hoc Networks

    NASA Astrophysics Data System (ADS)

    El-Habbal, Mohamed; Rückert, Ulrich; Witkowski, Ulf

    We present our contribution in projects related to ad-hoc networking using different routing protocols and hardware platforms, showing our results and new solutions regarding topology control and routing protocols. We mainly focus on our work in the GUARDIANS EU-project, where as a main disaster scenario a large industrial warehouse on fire is assumed. The paper presents the simulation results for the routing protocols ACR, DSR and EDSR, as well as the implementation of down-scaled demos for supporting the autonomous team of robots as well as the human squad team with robust communication coverage. Various hardware platforms were used in the demos for distance measurement, based on laser range finder and radio communication with time of flight analysis.

  4. Infrared spectra of two isomers of protonated carbonyl sulfide (HOCS+ and HSCO+) and t-HOCS in solid para-hydrogen

    NASA Astrophysics Data System (ADS)

    Tsuge, Masashi; Lee, Yuan-Pern

    2016-10-01

    We report infrared (IR) spectra of HOCS+, HSCO+, t-HOCS, and other species produced on electron bombardment of a mixture of carbonyl sulfide (OCS) and para-hydrogen (p-H2) during deposition at 3.2 K. After maintenance of the matrix in darkness for 15 h, the intensities of absorption features of HOCS+ at 2945.9 (ν1), 1875.3 (ν2), and 1041.9 (ν3) cm-1 and those of HSCO+ at 2506.9 (ν1) and 2074.2 (ν2) cm-1 decreased through neutralization with trapped electrons. Lines observed at 3563.4, 1394.8, and 1199.0 cm-1, which decreased slightly in intensity after maintenance in darkness and were nearly depleted after irradiation at 373 nm, are assigned to a t-HOCS radical. The corresponding spectra of their 13C- and D-isotopologues were observed. The IR spectra of HSCO+ and t-HOCS and those of modes ν2 and ν3 of HOCS+ are new. The assignments were made according to the expected chemical behavior and a comparison of experimental and calculated wavenumbers and 13C- and D-isotopic shifts. The wavenumber of the OH stretching mode (2945.9 cm-1) of HOCS+ in solid p-H2 is significantly red-shifted from that (3435.16 cm-1) reported for gaseous HOCS+; this shift is attributed to partial sharing of a proton between OCS and H2. The corresponding p-H2 induced shift is small in HSCO+ because of a much weaker interaction between HSCO+ and H2.

  5. A Token Ring Protocol for Dynamic Ad-hoc Wireless Environments

    SciTech Connect

    Top, P; Kohlhepp, V; Dowla, F

    2005-09-30

    A wireless ad-hoc networking protocol is presented. The protocol is designed to be flexible, easy to use and adaptable to a wide variety of potential applications. The primary considerations in design are small code size, guaranteed bandwidth access, limited delay, and error resilience in a highly dynamic ad-hoc environment. These considerations are achieved through the use of token ring protocol.

  6. 32 CFR 2800.7 - Designation of chairperson for Ad Hoc Committees.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Designation of chairperson for Ad Hoc Committees... VICE PRESIDENT OF THE UNITED STATES SECURITY PROCEDURES § 2800.7 Designation of chairperson for Ad Hoc Committees. The Counsel to the Vice President is designated as the responsible official to chair Ad...

  7. 32 CFR 2800.7 - Designation of chairperson for Ad Hoc Committees.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 6 2011-07-01 2011-07-01 false Designation of chairperson for Ad Hoc Committees... VICE PRESIDENT OF THE UNITED STATES SECURITY PROCEDURES § 2800.7 Designation of chairperson for Ad Hoc Committees. The Counsel to the Vice President is designated as the responsible official to chair Ad...

  8. Typicality Mediates Performance during Category Verification in Both Ad-Hoc and Well-Defined Categories

    ERIC Educational Resources Information Center

    Sandberg, Chaleece; Sebastian, Rajani; Kiran, Swathi

    2012-01-01

    Background: The typicality effect is present in neurologically intact populations for natural, ad-hoc, and well-defined categories. Although sparse, there is evidence of typicality effects in persons with chronic stroke aphasia for natural and ad-hoc categories. However, it is unknown exactly what influences the typicality effect in this…

  9. Saccharomyces Cerevisiae Hoc1, a Suppressor of Pkc1, Encodes a Putative Glycosyltransferase

    PubMed Central

    Neiman, A. M.; Mhaiskar, V.; Manus, V.; Galibert, F.; Dean, N.

    1997-01-01

    The Saccharomyces cerevisiae gene PKC1 encodes a protein kinase C isozyme that regulates cell wall synthesis. Here we describe the characterization of HOC1, a gene identified by its ability to suppress the cell lysis phenotype of pkc1-371 cells. The HOC1 gene (Homologous to OCH1) is predicted to encode a type II integral membrane protein that strongly resembles Och1p, an α-1,6-mannosyltransferase. Immunofluorescence studies localized Hoc1p to the Golgi apparatus. While overexpression of HOC1 rescued the pkc1-371 temperature-sensitive cell lysis phenotype, disruption of HOC1 lowered the restrictive temperature of the pkc1-371 allele. Disruption of HOC1 also resulted in hypersensitivity to Calcofluor White and hygromycin B, phenotypes characteristic of defects in cell wall integrity and protein glycosylation, respectively. The function of HOC1 appears to be distinct from that of OCH1. Taken together, these results suggest that HOC1 encodes a Golgi-localized putative mannosyltransferase required for the proper construction of the cell wall. PMID:9055074

  10. Typicality Mediates Performance during Category Verification in Both Ad-Hoc and Well-Defined Categories

    ERIC Educational Resources Information Center

    Sandberg, Chaleece; Sebastian, Rajani; Kiran, Swathi

    2012-01-01

    Background: The typicality effect is present in neurologically intact populations for natural, ad-hoc, and well-defined categories. Although sparse, there is evidence of typicality effects in persons with chronic stroke aphasia for natural and ad-hoc categories. However, it is unknown exactly what influences the typicality effect in this…

  11. A reanalysis of the HCO(+)/HOC(+) abundance ratio in dense interstellar clouds

    NASA Technical Reports Server (NTRS)

    Jarrold, M. F.; Bowers, M. T.; Defrees, D. J.; Mclean, A. D.; Herbst, E.

    1986-01-01

    New theoretical and experimental results have prompted a reinvestigation of the HCO(+)/HOC(+) abundance ratio in dense interstellar clouds. These results pertain principally but not exclusively to the reaction between HOC(+) and H2, which was previously calculated by DeFrees et al. (1984) to possess a large activation energy barrier. New calculations, reported here, indicate that this activation energy barrier is quite small and may well be zero. In addition, experimental results at higher energy and temperature indicate strongly that the reaction proceeds efficiently at interstellar temperatures. If HOC(+) does indeed react efficiently with H2 in interstellar clouds, the calculated HCO(+)/HOC(+) abundance ratio rises to a substantially greater value under standard dense cloud conditions than is deduced via the tentative observation of HOC(+) in Sgr B2.

  12. Post hoc pattern matching: assigning significance to statistically defined expression patterns in single channel microarray data

    PubMed Central

    Hulshizer, Randall; Blalock, Eric M

    2007-01-01

    Background Researchers using RNA expression microarrays in experimental designs with more than two treatment groups often identify statistically significant genes with ANOVA approaches. However, the ANOVA test does not discriminate which of the multiple treatment groups differ from one another. Thus, post hoc tests, such as linear contrasts, template correlations, and pairwise comparisons are used. Linear contrasts and template correlations work extremely well, especially when the researcher has a priori information pointing to a particular pattern/template among the different treatment groups. Further, all pairwise comparisons can be used to identify particular, treatment group-dependent patterns of gene expression. However, these approaches are biased by the researcher's assumptions, and some treatment-based patterns may fail to be detected using these approaches. Finally, different patterns may have different probabilities of occurring by chance, importantly influencing researchers' conclusions about a pattern and its constituent genes. Results We developed a four step, post hoc pattern matching (PPM) algorithm to automate single channel gene expression pattern identification/significance. First, 1-Way Analysis of Variance (ANOVA), coupled with post hoc 'all pairwise' comparisons are calculated for all genes. Second, for each ANOVA-significant gene, all pairwise contrast results are encoded to create unique pattern ID numbers. The # genes found in each pattern in the data is identified as that pattern's 'actual' frequency. Third, using Monte Carlo simulations, those patterns' frequencies are estimated in random data ('random' gene pattern frequency). Fourth, a Z-score for overrepresentation of the pattern is calculated ('actual' against 'random' gene pattern frequencies). We wrote a Visual Basic program (StatiGen) that automates PPM procedure, constructs an Excel workbook with standardized graphs of overrepresented patterns, and lists of the genes comprising

  13. Assessment of interbreeding and introgression of farm genes into a small Scottish Atlantic salmon Salmo salar stock: ad hoc samples - ad hoc results?

    PubMed

    Verspoor, E; Knox, D; Marshall, S

    2016-12-01

    An eclectic set of tissues and existing data, including purposely collected samples, spanning 1997-2006, was used in an ad hoc assessment of hybridization and introgression of farmed wild Atlantic salmon Salmo salar in the small Loch na Thull (LnT) catchment in north-west Scotland. The catchment is in an area of marine farm production and contains freshwater smolt rearing cages. The LnT S. salar stock was found to be genetically distinctive from stocks in neighbouring rivers and, despite regular reports of feral farm S. salar, there was no evidence of physical or genetic mixing. This cannot be completely ruled out, however, and low level mixing with other local wild stocks has been suggested. The LnT population appeared underpinned by relatively smaller effective number of breeders (Neb ) and showed relatively low levels of genetic diversity, consistent with a small effective population size. Small sample sizes, an incomplete farm baseline and the use of non-diagnostic molecular markers, constrain the power of the analysis but the findings strongly support the LnT catchment having a genetically distinct wild S. salar population little affected by interbreeding with feral farm escapes. © 2016 The Fisheries Society of the British Isles.

  14. Awareness of Emerging Wireless Technologies: Ad-hoc and Personal Area Networks Standards and Emerging Technologies (Sensibilisation a l’emergence des technologies sans fil: technologies emergeantes et normes de reseaux personnels et ad-hoc)

    DTIC Science & Technology

    2007-04-01

    Projet Hipercom – INRIA Rocquencourt. [14] Performance analysis of OLSR Multipoint Relay flooding in two ad hoc wireless network models N°4260...comporter la dénomination « RTO » ou « AGARD » selon le cas, suivi du numéro de série. Des informations analogues, telles que le titre est la date de...RTO » ou « AGARD » selon le cas, suivie du numéro de série (par exemple AGARD-AG-315). Des informations analogues, telles que le titre et la date

  15. Journey from Mobile Ad Hoc Networks to Wireless Mesh Networks

    NASA Astrophysics Data System (ADS)

    Wang, Junfang; Xie, Bin; Agrawal, Dharma P.

    A wireless mesh network (WMN) is a particular type of mobile ad hoc network (MANET), which aims to provide ubiquitous high bandwidth access for a large number of users. A pure MANET is dynamically formed by mobile devices without the requirement of any existing infrastructure or prior network configuration. Similar to MANETs, a WMN also has the ability of self-organization, self-discovering, self-healing, and self-configuration. However, a WMN is typically a collection of stationary mesh routers (MRs) with each employing multiple radios. Some MRs have wired connections and act as the Internet gateways (IGWs) to provide Internet connectivity for other MRs. These new features of WMNs over MANETs enable them to be a promising alternative for high broadband Internet access. In this chapter, we elaborate on the evolution from MANETs to WMNs and provide a comprehensive understanding of WMNs from theoretical aspects to practical protocols, while comparing it with MANETs. In particular, we focus on the following critical issues with respect to WMN deployment: Network Capacity, Positioning Technique, Fairness Transmission and Multiradio Routing Protocols. We end this chapter with some open problems and future directions in WMNs.

  16. Algorithmic aspects of topology control problems for ad hoc networks

    SciTech Connect

    Liu, R.; Lloyd, E. L.; Marathe, M. V.; Ramanathan, R.; Ravi, S. S.

    2002-01-01

    Topology control problems are concerned with the assignment of power values to nodes of an ad hoc network so that the power assignment leads to a graph topology satisfying some specified properties. This paper considers such problems under several optimization objectives, including minimizing the maximum power and minimizing the total power. A general approach leading to a polynomial algorithm is presented for minimizing maximum power for a class of graph properties, called monotone properties. The difficulty of generalizing the approach to properties that are not monoione is pointed out. Problems involving the minimization of total power are known to be NP-complete even for simple graph properties. A general approach that leads to an approximation algorithm for minimizing the total power for some monotone properties is presented. Using this approach, a new approximation algorithm for the problem of minimizing the total power for obtaining a 2-node-connected graph is obtained. It is shown that this algorithm provides a constant performance guarantee. Experimental results from an implementation of the approximation algorithm are also presented.

  17. Detecting and isolating malicious nodes in wireless ad hoc networks

    NASA Astrophysics Data System (ADS)

    Li, Fanzhi; Jassim, Sabah

    2007-04-01

    Malicious nodes can seriously impair the performance of wireless ad hoc networks as a result of different actions such as packet dropping. Secure routes are shortest paths on which every node on the route is trusted even if unknown. Secure route discovery requires the adoption of mechanisms of associating trust to nodes. Most existing secure route discovery mechanisms rely on shared keys and digital signature. In the absence of central nodes that act as certification authority, such protocols suffer from heavy computational burden and are vulnerable to malicious attacks. In this paper we shall review existing techniques for secure routing and propose to complement route finding with creditability scores. Each node would have a credit list for its neighbors. Each node monitors its neighbors' pattern of delivering packets and regularly credits are reviewed and updated accordingly. Unlike most existing schemes the focus of our work is based on post route discovery stage, i.e. when packets are transmitted on discovered routes. The level of trust in any route will be based on the credits associated with the neighbors belonging to the discovered route. We shall evaluate the performance of the proposed scheme by modifying our simulation system so that each node has a dynamic changing "credit list" for its neighbors' behavior. We shall conduct a series of simulations with and without the proposed scheme and compare the results. We will demonstrate that the proposed mechanism is capable of isolating malicious nodes and thereby counteracting black hole attacks.

  18. Resistivity tomography of Pointe du Hoc cliffs for stability assessment

    NASA Astrophysics Data System (ADS)

    Udphuay, S.; Everett, M. E.; Warden, R.

    2008-12-01

    Pointe du Hoc WWII battlefield overlooking the English Channel in western Normandy, France, is an important cultural resource, being an integral component of the June 6 1944 D-Day invasion. Two major buildings, the forward observation post (OP) and Col. Rudder's command post (RCP), are now perched perilously close to the cliff's edge owing to six decades of cliff retreat. Geophysical surveys were carried out in March 2008 to investigate the risk of cliff failure and to inform possible geotechnical remediation strategies with a final goal toward re-opening the observation post that is now closed to visitors. The geophysical surveying is accomplished by high-resolution resistivity tomography, conducted in extreme topography and in the midst of dense cultural clutter. The results of the OP tomography indicate that the highest mass movement hazard is associated with the marine caverns at the base of the cliff at the point of strongest wave attack. These caverns occupy the future site of a sea arch which will threaten the OP building. There is a high probability of a soil wedge failure on the east facing cliff edge close to the OP building. Such a failure could damage or destroy the building. The possibility of a sudden catastrophic failure along any one of these fractures cannot be ruled out. The greatest risk at the RCP site, which is under less immediate threat, is associated with soil wedge failures at the top of the cliffs.

  19. Data management issues in mobile ad hoc networks

    PubMed Central

    HARA, Takahiro

    2017-01-01

    Research on mobile ad hoc networks (MANETs) has become a hot research topic since the middle 1990’s. Over the first decade, most research focused on networking techniques, ignoring data management issues. We, however, realized early the importance of data management in MANETs, and have been conducting studies in this area for 15 years. In this review, we summarize some key technical issues related to data management in MANETs, and the studies we have done in addressing these issues, which include placement of data replicas, update management, and query processing with security management. The techniques proposed in our studies have been designed with deep considerations of MANET features including network partitioning, node participation/disappearance, limited network bandwidth, and energy efficiency. Our studies published in early 2000’s have developed a new research field as data management in MANETs. Also, our recent studies are expected to be significant guidelines of new research directions. We conclude the review by discussing some future directions for research. PMID:28496052

  20. Z306 molecular contamination ad hoc committee results

    NASA Technical Reports Server (NTRS)

    Golden, Johnny L.

    1992-01-01

    LDEF external surfaces which did not receive significant amounts of atomic oxygen were observed to be coated with a brown contamination, apparently the result of a condensed organic residue darkened due to UV radiation exposure. During the initial Materials Special Investigation Group (MSIG) Meeting after LDEF deintegration, held in Seattle - July 1990, this organic contamination was the subject of much discussion. The amount of contamination was thought to be significant and its source was immediately believed to be the Z306 black thermal control coating used to coat the entire inner surface of LDEF. Due to the size of the structure, it was not feasible to bake-out the coating. However, initial data on the contamination film was confusing in that significant amounts of silicon was observed by several different researchers. Silicon (from silicone) was not expected to be a potential outgassing product of the Z306 polyurethane coating. To investigate the connection between external contamination and the interior paint, a MSIG ad hoc committee was formed.

  1. Data management issues in mobile ad hoc networks.

    PubMed

    Hara, Takahiro

    2017-01-01

    Research on mobile ad hoc networks (MANETs) has become a hot research topic since the middle 1990's. Over the first decade, most research focused on networking techniques, ignoring data management issues. We, however, realized early the importance of data management in MANETs, and have been conducting studies in this area for 15 years. In this review, we summarize some key technical issues related to data management in MANETs, and the studies we have done in addressing these issues, which include placement of data replicas, update management, and query processing with security management. The techniques proposed in our studies have been designed with deep considerations of MANET features including network partitioning, node participation/disappearance, limited network bandwidth, and energy efficiency. Our studies published in early 2000's have developed a new research field as data management in MANETs. Also, our recent studies are expected to be significant guidelines of new research directions. We conclude the review by discussing some future directions for research.

  2. Performance Improvement in Geographic Routing for Vehicular Ad Hoc Networks

    PubMed Central

    Kaiwartya, Omprakash; Kumar, Sushil; Lobiyal, D. K.; Abdullah, Abdul Hanan; Hassan, Ahmed Nazar

    2014-01-01

    Geographic routing is one of the most investigated themes by researchers for reliable and efficient dissemination of information in Vehicular Ad Hoc Networks (VANETs). Recently, different Geographic Distance Routing (GEDIR) protocols have been suggested in the literature. These protocols focus on reducing the forwarding region towards destination to select the Next Hop Vehicles (NHV). Most of these protocols suffer from the problem of elevated one-hop link disconnection, high end-to-end delay and low throughput even at normal vehicle speed in high vehicle density environment. This paper proposes a Geographic Distance Routing protocol based on Segment vehicle, Link quality and Degree of connectivity (SLD-GEDIR). The protocol selects a reliable NHV using the criteria segment vehicles, one-hop link quality and degree of connectivity. The proposed protocol has been simulated in NS-2 and its performance has been compared with the state-of-the-art protocols: P-GEDIR, J-GEDIR and V-GEDIR. The empirical results clearly reveal that SLD-GEDIR has lower link disconnection and end-to-end delay, and higher throughput as compared to the state-of-the-art protocols. It should be noted that the performance of the proposed protocol is preserved irrespective of vehicle density and speed. PMID:25429415

  3. Ad-Hoc Queries over Document Collections - A Case Study

    NASA Astrophysics Data System (ADS)

    Löser, Alexander; Lutter, Steffen; Düssel, Patrick; Markl, Volker

    We discuss the novel problem of supporting analytical business intelligence queries over web-based textual content, e.g., BI-style reports based on 100.000's of documents from an ad-hoc web search result. Neither conventional search engines nor conventional Business Intelligence and ETL tools address this problem, which lies at the intersection of their capabilities. "Google Squared" or our system GOOLAP.info, are examples of these kinds of systems. They execute information extraction methods over one or several document collections at query time and integrate extracted records into a common view or tabular structure. Frequent extraction and object resolution failures cause incomplete records which could not be joined into a record answering the query. Our focus is the identification of join-reordering heuristics maximizing the size of complete records answering a structured query. With respect to given costs for document extraction we propose two novel join-operations: The multi-way CJ-operator joins records from multiple relationships extracted from a single document. The two-way join-operator DJ ensures data density by removing incomplete records from results. In a preliminary case study we observe that our join-reordering heuristics positively impact result size, record density and lower execution costs.

  4. Objectivity in confirmation: post hoc monsters and novel predictions.

    PubMed

    Votsis, Ioannis

    2014-03-01

    The aim of this paper is to put in place some cornerstones in the foundations for an objective theory of confirmation by considering lessons from the failures of predictivism. Discussion begins with a widely accepted challenge, to find out what is needed in addition to the right kind of inferential-semantical relations between hypothesis and evidence to have a complete account of confirmation, one that gives a definitive answer to the question whether hypotheses branded as "post hoc monsters" can be confirmed. The predictivist view is then presented as a way to meet this challenge. Particular attention is paid to Worrall's version of predictivism, as it appears to be the most sophisticated of the lot. It is argued that, despite its faults, his view turns our heads in the right direction by attempting to remove contingent considerations from confirmational matters. The demand to remove such considerations becomes the first of four cornerstones. Each cornerstone is put in place with the aim to steer clear of the sort of failures that plague various kinds of predictivism. In the process, it becomes obvious that the original challenge is wrongheaded and in need of revision. The paper ends with just such a revision.

  5. Random Time Identity Based Firewall In Mobile Ad hoc Networks

    NASA Astrophysics Data System (ADS)

    Suman, Patel, R. B.; Singh, Parvinder

    2010-11-01

    A mobile ad hoc network (MANET) is a self-organizing network of mobile routers and associated hosts connected by wireless links. MANETs are highly flexible and adaptable but at the same time are highly prone to security risks due to the open medium, dynamically changing network topology, cooperative algorithms, and lack of centralized control. Firewall is an effective means of protecting a local network from network-based security threats and forms a key component in MANET security architecture. This paper presents a review of firewall implementation techniques in MANETs and their relative merits and demerits. A new approach is proposed to select MANET nodes at random for firewall implementation. This approach randomly select a new node as firewall after fixed time and based on critical value of certain parameters like power backup. This approach effectively balances power and resource utilization of entire MANET because responsibility of implementing firewall is equally shared among all the nodes. At the same time it ensures improved security for MANETs from outside attacks as intruder will not be able to find out the entry point in MANET due to the random selection of nodes for firewall implementation.

  6. Studying synaptic efficiency by post-hoc immunolabelling

    PubMed Central

    2013-01-01

    Background In terms of vesicular recycling, synaptic efficiency is a key determinant of the fidelity of synaptic transmission. The ability of a presynaptic terminal to reuse its vesicular content is thought to be a signature of synaptic maturity and this process depends on the activity of several proteins that govern exo/endocytosis. Upon stimulation, individual terminals in networks of cultured cerebellar granule neurons exhibit heterogeneous exocytic responses, which reflect the distinct states of maturity and plasticity intrinsic to individual synaptic terminals. This dynamic scenario serves as the substrate for processes such as scaling, plasticity and synaptic weight redistribution. Presynaptic strength has been associated with the activity of several types of proteins, including the scaffolding proteins that form the active zone cytomatrix and the proteins involved in presynaptic exocytosis. Methods We have combined fluorescence imaging techniques using the styryl dye FM1-43 in primary cultures of cerebellar granule cells with subsequent post-hoc immunocytochemistry in order to study synaptic efficiency in terms of vesicular release. We describe a protocol to easily quantify these results with minimal user intervention. Results In this study we describe a technique that specifically correlates presynaptic activity with the levels of presynaptic markers. This method involves the use of the styryl dye FM1-43 to estimate the release capacity of a synaptic terminal, and the subsequent post-hoc immunolabelling of thousands of individual nerve terminals. We observed a strong correlation between the release capacity of the nerve terminal and the levels of the RIM1α but not the Munc13-1 protein in the active zone. Conclusions Our findings support those of previous studies and point out to RIM1α as a crucial factor in determining synaptic efficiency. These results also demonstrate that this technique is a useful tool to analyse the molecular differences

  7. Preferential survival in models of complex ad hoc networks

    NASA Astrophysics Data System (ADS)

    Kong, Joseph S.; Roychowdhury, Vwani P.

    2008-05-01

    There has been a rich interplay in recent years between (i) empirical investigations of real-world dynamic networks, (ii) analytical modeling of the microscopic mechanisms that drive the emergence of such networks, and (iii) harnessing of these mechanisms to either manipulate existing networks, or engineer new networks for specific tasks. We continue in this vein, and study the deletion phenomenon in the web by the following two different sets of websites (each comprising more than 150,000 pages) over a one-year period. Empirical data show that there is a significant deletion component in the underlying web networks, but the deletion process is not uniform. This motivates us to introduce a new mechanism of preferential survival (PS), where nodes are removed according to the degree-dependent deletion kernel, D(k)∝k, with α≥0. We use the mean-field rate equation approach to study a general dynamic model driven by Preferential Attachment (PA), Double PA (DPA), and a tunable PS (i.e., with any α>0), where c nodes ( c<1) are deleted per node added to the network, and verify our predictions via large-scale simulations. One of our results shows that, unlike in the case of uniform deletion (i.e., where α=0), the PS kernel when coupled with the standard PA mechanism, can lead to heavy-tailed power-law networks even in the presence of extreme turnover in the network. Moreover, a weak DPA mechanism, coupled with PS, can help to make the network even more heavy-tailed, especially in the limit when deletion and insertion rates are almost equal, and the overall network growth is minimal. The dynamics reported in this work can be used to design and engineer stable ad hoc networks and explain the stability of the power-law exponents observed in real-world networks.

  8. On mobile wireless ad hoc IP video transports

    NASA Astrophysics Data System (ADS)

    Kazantzidis, Matheos

    2006-05-01

    Multimedia transports in wireless, ad-hoc, multi-hop or mobile networks must be capable of obtaining information about the network and adaptively tune sending and encoding parameters to the network response. Obtaining meaningful metrics to guide a stable congestion control mechanism in the transport (i.e. passive, simple, end-to-end and network technology independent) is a complex problem. Equally difficult is obtaining a reliable QoS metrics that agrees with user perception in a client/server or distributed environment. Existing metrics, objective or subjective, are commonly used after or before to test or report on a transmission and require access to both original and transmitted frames. In this paper, we propose that an efficient and successful video delivery and the optimization of overall network QoS requires innovation in a) a direct measurement of available and bottleneck capacity for its congestion control and b) a meaningful subjective QoS metric that is dynamically reported to video sender. Once these are in place, a binomial -stable, fair and TCP friendly- algorithm can be used to determine the sending rate and other packet video parameters. An adaptive mpeg codec can then continually test and fit its parameters and temporal-spatial data-error control balance using the perceived QoS dynamic feedback. We suggest a new measurement based on a packet dispersion technique that is independent of underlying network mechanisms. We then present a binomial control based on direct measurements. We implement a QoS metric that is known to agree with user perception (MPQM) in a client/server, distributed environment by using predetermined table lookups and characterization of video content.

  9. A Multi-User Game-Theoretical Multipath Routing Protocol to Send Video-Warning Messages over Mobile Ad Hoc Networks

    PubMed Central

    Mezher, Ahmad Mohamad; Igartua, Mónica Aguilar; de la Cruz Llopis, Luis J.; Segarra, Esteve Pallarès; Tripp-Barba, Carolina; Urquiza-Aguiar, Luis; Forné, Jordi; Gargallo, Emilio Sanvicente

    2015-01-01

    The prevention of accidents is one of the most important goals of ad hoc networks in smart cities. When an accident happens, dynamic sensors (e.g., citizens with smart phones or tablets, smart vehicles and buses, etc.) could shoot a video clip of the accident and send it through the ad hoc network. With a video message, the level of seriousness of the accident could be much better evaluated by the authorities (e.g., health care units, police and ambulance drivers) rather than with just a simple text message. Besides, other citizens would be rapidly aware of the incident. In this way, smart dynamic sensors could participate in reporting a situation in the city using the ad hoc network so it would be possible to have a quick reaction warning citizens and emergency units. The deployment of an efficient routing protocol to manage video-warning messages in mobile Ad hoc Networks (MANETs) has important benefits by allowing a fast warning of the incident, which potentially can save lives. To contribute with this goal, we propose a multipath routing protocol to provide video-warning messages in MANETs using a novel game-theoretical approach. As a base for our work, we start from our previous work, where a 2-players game-theoretical routing protocol was proposed to provide video-streaming services over MANETs. In this article, we further generalize the analysis made for a general number of N players in the MANET. Simulations have been carried out to show the benefits of our proposal, taking into account the mobility of the nodes and the presence of interfering traffic.Finally, we also have tested our approach in a vehicular ad hoc network as an incipient start point to develop a novel proposal specifically designed for VANETs. PMID:25897496

  10. A Multi-User Game-Theoretical Multipath Routing Protocol to Send Video-Warning Messages over Mobile Ad Hoc Networks.

    PubMed

    Mezher, Ahmad Mohamad; Igartua, Mónica Aguilar; de la Cruz Llopis, Luis J; Pallarès Segarra, Esteve; Tripp-Barba, Carolina; Urquiza-Aguiar, Luis; Forné, Jordi; Sanvicente Gargallo, Emilio

    2015-04-17

    The prevention of accidents is one of the most important goals of ad hoc networks in smart cities. When an accident happens, dynamic sensors (e.g., citizens with smart phones or tablets, smart vehicles and buses, etc.) could shoot a video clip of the accident and send it through the ad hoc network. With a video message, the level of seriousness of the accident could be much better evaluated by the authorities (e.g., health care units, police and ambulance drivers) rather than with just a simple text message. Besides, other citizens would be rapidly aware of the incident. In this way, smart dynamic sensors could participate in reporting a situation in the city using the ad hoc network so it would be possible to have a quick reaction warning citizens and emergency units. The deployment of an efficient routing protocol to manage video-warning messages in mobile Ad hoc Networks (MANETs) has important benefits by allowing a fast warning of the incident, which potentially can save lives. To contribute with this goal, we propose a multipath routing protocol to provide video-warning messages in MANETs using a novel game-theoretical approach. As a base for our work, we start from our previous work, where a 2-players game-theoretical routing protocol was proposed to provide video-streaming services over MANETs. In this article, we further generalize the analysis made for a general number of N players in the MANET. Simulations have been carried out to show the benefits of our proposal, taking into account the mobility of the nodes and the presence of interfering traffic. Finally, we also have tested our approach in a vehicular ad hoc network as an incipient start point to develop a novel proposal specifically designed for VANETs.

  11. A group based key sharing and management algorithm for vehicular ad hoc networks.

    PubMed

    Khan, Zeeshan Shafi; Moharram, Mohammed Morsi; Alaraj, Abdullah; Azam, Farzana

    2014-01-01

    Vehicular ad hoc networks (VANETs) are one special type of ad hoc networks that involves vehicles on roads. Typically like ad hoc networks, broadcast approach is used for data dissemination. Blind broadcast to each and every node results in exchange of useless and irrelevant messages and hence creates an overhead. Unicasting is not preferred in ad-hoc networks due to the dynamic topology and the resource requirements as compared to broadcasting. Simple broadcasting techniques create several problems on privacy, disturbance, and resource utilization. In this paper, we propose media mixing algorithm to decide what information should be provided to each user and how to provide such information. Results obtained through simulation show that fewer number of keys are needed to share compared to simple broadcasting. Privacy is also enhanced through this approach.

  12. A Group Based Key Sharing and Management Algorithm for Vehicular Ad Hoc Networks

    PubMed Central

    Moharram, Mohammed Morsi; Azam, Farzana

    2014-01-01

    Vehicular ad hoc networks (VANETs) are one special type of ad hoc networks that involves vehicles on roads. Typically like ad hoc networks, broadcast approach is used for data dissemination. Blind broadcast to each and every node results in exchange of useless and irrelevant messages and hence creates an overhead. Unicasting is not preferred in ad-hoc networks due to the dynamic topology and the resource requirements as compared to broadcasting. Simple broadcasting techniques create several problems on privacy, disturbance, and resource utilization. In this paper, we propose media mixing algorithm to decide what information should be provided to each user and how to provide such information. Results obtained through simulation show that fewer number of keys are needed to share compared to simple broadcasting. Privacy is also enhanced through this approach. PMID:24587749

  13. 32 CFR 2800.7 - Designation of chairperson for Ad Hoc Committees.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... VICE PRESIDENT OF THE UNITED STATES SECURITY PROCEDURES § 2800.7 Designation of chairperson for Ad Hoc Committees. The Counsel to the Vice President is designated as the responsible official to chair Ad...

  14. 32 CFR 2800.7 - Designation of chairperson for Ad Hoc Committees.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... VICE PRESIDENT OF THE UNITED STATES SECURITY PROCEDURES § 2800.7 Designation of chairperson for Ad Hoc Committees. The Counsel to the Vice President is designated as the responsible official to chair Ad...

  15. 32 CFR 2800.7 - Designation of chairperson for Ad Hoc Committees.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... VICE PRESIDENT OF THE UNITED STATES SECURITY PROCEDURES § 2800.7 Designation of chairperson for Ad Hoc Committees. The Counsel to the Vice President is designated as the responsible official to chair Ad...

  16. A Joint Performance-Vulnerability Metric Framework for Designing Ad Hoc Routing Protocols

    DTIC Science & Technology

    2010-11-01

    network is deployed in a hostile envi- ronment, different paths between nodes may provide varying levels of resilience to adversarial attack . Therefore, in...efficient and resilient to attack . We give an example that measures resilience to key exposure in ad hoc networks and demonstrate the feasibility of our...include Optimal Link-State Routing ( OLSR ), Dynamic Source Routing (DSR), and Ad hoc On-demand Distance Vector (AODV) routing. A survey of current

  17. Ad-Hoc Sensor Networks for Maritime Interdiction Operations and Regional Security

    DTIC Science & Technology

    2012-09-01

    to examine how unstructured sensor networks, known also as ad-hoc sensor networks, can effectively support maritime interdiction operations and...thesis is to examine how unstructured sensor networks, known also as ad-hoc sensor networks, can effectively support maritime interdiction operations...Electromagnetic EIRP Effective Isotropic Radiated Power EO Electro –Optical FOI Swedish Defense Research Agency GGB Golden Gate Bridge GPRS General Packet

  18. Algorithmic, LOCS and HOCS (chemistry) exam questions: performance and attitudes of college students

    NASA Astrophysics Data System (ADS)

    Zoller, Uri

    2002-02-01

    The performance of freshmen biology and physics-mathematics majors and chemistry majors as well as pre- and in-service chemistry teachers in two Israeli universities on algorithmic (ALG), lower-order cognitive skills (LOCS), and higher-order cognitive skills (HOCS) chemistry exam questions were studied. The driving force for the study was an interest in moving science and chemistry instruction from an algorithmic and factual recall orientation dominated by LOCS, to a decision-making, problem-solving and critical system thinking approach, dominated by HOCS. College students' responses to the specially designed ALG, LOCS and HOCS chemistry exam questions were scored and analysed for differences and correlation between the performance means within and across universities by the questions' category. This was followed by a combined student interview - 'speaking aloud' problem solving session for assessing the thinking processes involved in solving these types of questions and the students' attitudes towards them. The main findings were: (1) students in both universities performed consistently in each of the three categories in the order of ALG > LOCS > HOCS; their 'ideological' preference, was HOCS > algorithmic/LOCS, - referred to as 'computational questions', but their pragmatic preference was the reverse; (2) success on algorithmic/LOCS does not imply success on HOCS questions; algorithmic questions constitute a category on its own as far as students success in solving them is concerned. Our study and its results support the effort being made, worldwide, to integrate HOCS-fostering teaching and assessment strategies and, to develop HOCS-oriented science-technology-environment-society (STES)-type curricula within science and chemistry education.

  19. Improving English and Chinese Ad-hoc Retrieval: Tipster Text Phase 3

    DTIC Science & Technology

    1998-10-01

    IMPROVING ENGLISH AND CHINESE AD-HOC RETRIEVAL: TIPSTER TEXT PHASE 3 FINAL REPORT Kui-Lam Kwok Computer Science Department, Queens College, CUNY...all past TREC experiments with consistently superior results. Since 1996, we have also participated in the TIPSTER Text Phase 3 program. This...COVERED 00-00-1998 to 00-00-1998 4. TITLE AND SUBTITLE Improving English and Chinese Ad-hoc Retrieval: TIPSTER Text Phase 3 Final Report 5a

  20. Characterizing the Interaction Between Routing and MAC Protocols in Ad-Hoc Networks

    SciTech Connect

    Barrett, C. L.; Drozda, M.; Marathe, A.; Marathe, M. V.

    2002-01-01

    We empirically study the effect of mobility on the performance of protocols designed for wireless ad-hoc networks. An important objective is to study the interaction of the Routing and MAC layer protocols under different mobility parameters. We use three basic mobility models: grid mobility model, random waypoint model, and exponential correlated random model. The performance of protocols is measured in terms of (i) latency, (ii) throughput, (iii) number of packets received, (iv) long term fairness and (v) number of control packets at the MAC and routing layer level. Three different commonly studied routing protocols are used: AODV, DSR and LAR1. Similarly three well known MAC protocols are used: MACA, 802.1 1 and CSMA. Our main contribution is simulation based experiments coupled with rigorous statistical analysis to characterize the interaction of MAC layer protocols with routing layer protocols in ad-hoc networks. From the results, we can conclude the following: e No single MAC or Routing protocol dominated the other protocols in their class. Probably more interestingly, no MAURouting protocol combination was better than other combinations over all scenarios and response variables. 0 In general, it is not meaningful to speak about a MAC or a routing protocol in isolation. Presence of interaction leads to trade-offs between the amount of control packets generated by each layer. The results raise the possibility of improving the performance of a particular MAC layer protocol by using a cleverly designed routing protocol or vice-versa. Thus in order to improve the performanceof a communication network, it is important to study the entire protocol stack as a single algorithmic construct; optimizing individual layers in the seven layer OS1 stack will not yield performance improvements beyond a point. A methodological contribution of this paper is the use of statistical methods such as analysis of variance (ANOVA), to characterize the interaction between the protocols

  1. Delay-dependent asymptotic stability of mobile ad-hoc networks: A descriptor system approach

    NASA Astrophysics Data System (ADS)

    Yang, Juan; Yang, Dan; Huang, Bin; Zhang, Xiao-Hong; Luo, Jian-Lu

    2014-07-01

    In order to analyze the capacity stability of the time-varying-propagation and delay-dependent of mobile ad-hoc networks (MANETs), in this paper, a novel approach is proposed to explore the capacity asymptotic stability for the delay-dependent of MANETs based on non-cooperative game theory, where the delay-dependent conditions are explicitly taken into consideration. This approach is based on the Lyapunov—Krasovskii stability theory for functional differential equations and the linear matrix inequality (LMI) technique. A corresponding Lyapunov—Krasovskii functional is introduced for the stability analysis of this system with use of the descriptor and “neutral-type” model transformation without producing any additional dynamics. The delay-dependent stability criteria are derived for this system. Conditions are given in terms of linear matrix inequalities, and for the first time referred to neutral systems with the time-varying propagation and delay-dependent stability for capacity analysis of MANETs. The proposed criteria are less conservative since they are based on an equivalent model transformation. Furthermore, we also provide an effective and efficient iterative algorithm to solve the constrained stability control model. Simulation experiments have verified the effectiveness and efficiency of our algorithm.

  2. Interference Drop Scheme: Enhancing QoS Provision in Multi-Hop Ad Hoc Networks

    NASA Astrophysics Data System (ADS)

    Luo, Chang-Yi; Komuro, Nobuyoshi; Takahashi, Kiyoshi; Kasai, Hiroyuki; Ueda, Hiromi; Tsuboi, Toshinori

    Ad hoc networking uses wireless technologies to construct networks with no physical infrastructure and so are expected to provide instant networking in areas such as disaster recovery sites and inter-vehicle communication. Unlike conventional wired networks services, services in ad hoc networks are easily disrupted by the frequent changes in traffic and topology. Therefore, solutions to assure the Quality of Services (QoS) in ad hoc networks are different from the conventional ones used in wired networks. In this paper, we propose a new queue management scheme, Interference Drop Scheme (IDS) for ad hoc networks. In the conventional queue management approaches such as FIFO (First-in First-out) and RED (Random Early Detection), a queue is usually managed by a queue length limit. FIFO discards packets according to the queue limit, and RED discards packets in an early and random fashion. IDS, on the other hand, manages the queue according to wireless interference time, which increases as the number of contentions in the MAC layer increases. When there are many MAC contentions, IDS discards TCP data packets. By observing the interference time and discarding TCP data packets, our simulation results show that IDS improves TCP performance and reduces QoS violations in UDP in ad hoc networks with chain, grid, and random topologies. Our simulation results also demonstrate that wireless interference time is a better metric than queue length limit for queue management in multi-hop ad hoc networks.

  3. Design of multilevel heterogeneous ad-hoc wireless networks with UAVs

    NASA Astrophysics Data System (ADS)

    Gu, Daniel L.; Gerla, Mario; Ly, Henry; Xu, Kaixin; Kong, Jiejun; Hong, Xiaoyan

    2001-10-01

    Multi-Layer Ad Hoc Wireless Networks with UAVs is an ideal infrastructure to establish a rapidly deployable wireless communication system any time any where in the world for military applications. In this paper, we review the research we have done so far for our heterogeneous solution. First of all, we proposed the infrastructure of Multi-level Heterogeneous Ad-Hoc Wireless Network with UAVs. Second, we developed a new MAC layer protocol, Centralized Intelligent Channel Assigned Multiple Access (C-ICAMA), for ground mobile backbone nodes to access UAV. Third, we extended HSR (Hierarchical State Routing) to this Multi-Level Heterogeneous Ad-Hoc Wireless Network. Due to the intrinsic limitations of Extended HSR, we extended the Landmark Ad Hoc Routing (LANMAR) as our forth step. Security is a critical issue for mobile ad-hoc wireless networks, especially for military applications. We developed an embedded distributed security protocol and integrated with this heterogeneous hierarchical ad hoc wireless networks in our fifth step. Therefore, the hierarchical multi-layer approach is the most desirable approach to achieve routing scalability in multi-hop wireless networks.

  4. Ad hoc percutaneous coronary intervention: a consensus statement from the Society for Cardiovascular Angiography and Interventions.

    PubMed

    Blankenship, James C; Gigliotti, Osvaldo S; Feldman, Dmitriy N; Mixon, Timothy A; Patel, Rajan A G; Sorajja, Paul; Yakubov, Steven J; Chambers, Charles E

    2013-04-01

    Percutaneous coronary interventions (PCI) may be performed during the same session as diagnostic catheterization (ad hoc PCI) or at a later session (delayed PCI). Randomized trials comparing these strategies have not been performed; cohort studies have not identified consistent differences in safety or efficacy between the two strategies. Ad hoc PCI has increased in prevalence over the past decade and is the default strategy for treating acute coronary syndromes. However, questions about its appropriateness for some patients with stable symptoms have been raised by the results of recent large trials comparing PCI to medical therapy or bypass surgery. Ad hoc PCI for stable ischemic heart disease requires preprocedural planning, and reassessment after diagnostic angiography must be performed to ensure its appropriateness. Patients may prefer ad hoc PCI because it is convenient. Payers may prefer ad hoc PCI because it is cost-efficient. The majority of data confirm equivalent outcomes in ad hoc versus delayed PCI. However, there are some situations in which delayed PCI may be safer or yield better outcomes. This document reviews patient subsets and clinical situations in which one strategy is preferable over the other. Copyright © 2012 Wiley Periodicals, Inc.

  5. Sketching Awareness: A Participatory Study to Elicit Designs for Supporting Ad Hoc Emergency Medical Teamwork

    PubMed Central

    Kusunoki, Diana; Sarcevic, Aleksandra; Zhang, Zhan; Yala, Maria

    2014-01-01

    Prior CSCW research on awareness in clinical settings has mostly focused on higher-level team coordination spanning across longer-term trajectories at the department and inter-department levels. In this paper, we offer a perspective on what awareness means within the context of an ad hoc, time- and safety-critical medical setting by looking at teams treating severely ill patients with urgent needs. We report findings from four participatory design workshops conducted with emergency medicine clinicians at two regional emergency departments. Workshops were developed to elicit design ideas for information displays that support awareness in emergency medical situations. Through analysis of discussions and clinicians’ sketches of information displays, we identified five features of teamwork that can be used as a foundation for supporting awareness from the perspective of clinicians. Based on these findings, we contribute rich descriptions of four facets of awareness that teams manage during emergency medical situations: team member awareness, elapsed time awareness, teamwork-oriented and patient-driven task awareness, and overall progress awareness. We then discuss these four awareness types in relation to awareness facets found in the CSCW literature. PMID:25870498

  6. Ad Hoc modeling, expert problem solving, and R&T program evaluation

    NASA Technical Reports Server (NTRS)

    Silverman, B. G.; Liebowitz, J.; Moustakis, V. S.

    1983-01-01

    A simplified cost and time (SCAT) analysis program utilizing personal-computer technology is presented and demonstrated in the case of the NASA-Goddard end-to-end data system. The difficulties encountered in implementing complex program-selection and evaluation models in the research and technology field are outlined. The prototype SCAT system described here is designed to allow user-friendly ad hoc modeling in real time and at low cost. A worksheet constructed on the computer screen displays the critical parameters and shows how each is affected when one is altered experimentally. In the NASA case, satellite data-output and control requirements, ground-facility data-handling capabilities, and project priorities are intricately interrelated. Scenario studies of the effects of spacecraft phaseout or new spacecraft on throughput and delay parameters are shown. The use of a network of personal computers for higher-level coordination of decision-making processes is suggested, as a complement or alternative to complex large-scale modeling.

  7. Ad Hoc modeling, expert problem solving, and R&T program evaluation

    NASA Technical Reports Server (NTRS)

    Silverman, B. G.; Liebowitz, J.; Moustakis, V. S.

    1983-01-01

    A simplified cost and time (SCAT) analysis program utilizing personal-computer technology is presented and demonstrated in the case of the NASA-Goddard end-to-end data system. The difficulties encountered in implementing complex program-selection and evaluation models in the research and technology field are outlined. The prototype SCAT system described here is designed to allow user-friendly ad hoc modeling in real time and at low cost. A worksheet constructed on the computer screen displays the critical parameters and shows how each is affected when one is altered experimentally. In the NASA case, satellite data-output and control requirements, ground-facility data-handling capabilities, and project priorities are intricately interrelated. Scenario studies of the effects of spacecraft phaseout or new spacecraft on throughput and delay parameters are shown. The use of a network of personal computers for higher-level coordination of decision-making processes is suggested, as a complement or alternative to complex large-scale modeling.

  8. A Game Theory Algorithm for Intra-Cluster Data Aggregation in a Vehicular Ad Hoc Network.

    PubMed

    Chen, Yuzhong; Weng, Shining; Guo, Wenzhong; Xiong, Naixue

    2016-02-19

    Vehicular ad hoc networks (VANETs) have an important role in urban management and planning. The effective integration of vehicle information in VANETs is critical to traffic analysis, large-scale vehicle route planning and intelligent transportation scheduling. However, given the limitations in the precision of the output information of a single sensor and the difficulty of information sharing among various sensors in a highly dynamic VANET, effectively performing data aggregation in VANETs remains a challenge. Moreover, current studies have mainly focused on data aggregation in large-scale environments but have rarely discussed the issue of intra-cluster data aggregation in VANETs. In this study, we propose a multi-player game theory algorithm for intra-cluster data aggregation in VANETs by analyzing the competitive and cooperative relationships among sensor nodes. Several sensor-centric metrics are proposed to measure the data redundancy and stability of a cluster. We then study the utility function to achieve efficient intra-cluster data aggregation by considering both data redundancy and cluster stability. In particular, we prove the existence of a unique Nash equilibrium in the game model, and conduct extensive experiments to validate the proposed algorithm. Results demonstrate that the proposed algorithm has advantages over typical data aggregation algorithms in both accuracy and efficiency.

  9. Emergency Situation Prediction Mechanism: A Novel Approach for Intelligent Transportation System Using Vehicular Ad Hoc Networks

    PubMed Central

    Gokulakrishnan, P.

    2015-01-01

    In Indian four-lane express highway, millions of vehicles are travelling every day. Accidents are unfortunate and frequently occurring in these highways causing deaths, increase in death toll, and damage to infrastructure. A mechanism is required to avoid such road accidents at the maximum to reduce the death toll. An Emergency Situation Prediction Mechanism, a novel and proactive approach, is proposed in this paper for achieving the best of Intelligent Transportation System using Vehicular Ad Hoc Network. ESPM intends to predict the possibility of occurrence of an accident in an Indian four-lane express highway. In ESPM, the emergency situation prediction is done by the Road Side Unit based on (i) the Status Report sent by the vehicles in the range of RSU and (ii) the road traffic flow analysis done by the RSU. Once the emergency situation or accident is predicted in advance, an Emergency Warning Message is constructed and disseminated to all vehicles in the area of RSU to alert and prevent the vehicles from accidents. ESPM performs well in emergency situation prediction in advance to the occurrence of an accident. ESPM predicts the emergency situation within 0.20 seconds which is comparatively less than the statistical value. The prediction accuracy of ESPM against vehicle density is found better in different traffic scenarios. PMID:26065014

  10. A Game Theory Algorithm for Intra-Cluster Data Aggregation in a Vehicular Ad Hoc Network

    PubMed Central

    Chen, Yuzhong; Weng, Shining; Guo, Wenzhong; Xiong, Naixue

    2016-01-01

    Vehicular ad hoc networks (VANETs) have an important role in urban management and planning. The effective integration of vehicle information in VANETs is critical to traffic analysis, large-scale vehicle route planning and intelligent transportation scheduling. However, given the limitations in the precision of the output information of a single sensor and the difficulty of information sharing among various sensors in a highly dynamic VANET, effectively performing data aggregation in VANETs remains a challenge. Moreover, current studies have mainly focused on data aggregation in large-scale environments but have rarely discussed the issue of intra-cluster data aggregation in VANETs. In this study, we propose a multi-player game theory algorithm for intra-cluster data aggregation in VANETs by analyzing the competitive and cooperative relationships among sensor nodes. Several sensor-centric metrics are proposed to measure the data redundancy and stability of a cluster. We then study the utility function to achieve efficient intra-cluster data aggregation by considering both data redundancy and cluster stability. In particular, we prove the existence of a unique Nash equilibrium in the game model, and conduct extensive experiments to validate the proposed algorithm. Results demonstrate that the proposed algorithm has advantages over typical data aggregation algorithms in both accuracy and efficiency. PMID:26907272

  11. Emergency Situation Prediction Mechanism: A Novel Approach for Intelligent Transportation System Using Vehicular Ad Hoc Networks.

    PubMed

    Ganeshkumar, P; Gokulakrishnan, P

    2015-01-01

    In Indian four-lane express highway, millions of vehicles are travelling every day. Accidents are unfortunate and frequently occurring in these highways causing deaths, increase in death toll, and damage to infrastructure. A mechanism is required to avoid such road accidents at the maximum to reduce the death toll. An Emergency Situation Prediction Mechanism, a novel and proactive approach, is proposed in this paper for achieving the best of Intelligent Transportation System using Vehicular Ad Hoc Network. ESPM intends to predict the possibility of occurrence of an accident in an Indian four-lane express highway. In ESPM, the emergency situation prediction is done by the Road Side Unit based on (i) the Status Report sent by the vehicles in the range of RSU and (ii) the road traffic flow analysis done by the RSU. Once the emergency situation or accident is predicted in advance, an Emergency Warning Message is constructed and disseminated to all vehicles in the area of RSU to alert and prevent the vehicles from accidents. ESPM performs well in emergency situation prediction in advance to the occurrence of an accident. ESPM predicts the emergency situation within 0.20 seconds which is comparatively less than the statistical value. The prediction accuracy of ESPM against vehicle density is found better in different traffic scenarios.

  12. An adaptive neural swarm approach for intrusion defense in ad hoc networks

    NASA Astrophysics Data System (ADS)

    Cannady, James

    2011-06-01

    Wireless sensor networks (WSN) and mobile ad hoc networks (MANET) are being increasingly deployed in critical applications due to the flexibility and extensibility of the technology. While these networks possess numerous advantages over traditional wireless systems in dynamic environments they are still vulnerable to many of the same types of host-based and distributed attacks common to those systems. Unfortunately, the limited power and bandwidth available in WSNs and MANETs, combined with the dynamic connectivity that is a defining characteristic of the technology, makes it extremely difficult to utilize traditional intrusion detection techniques. This paper describes an approach to accurately and efficiently detect potentially damaging activity in WSNs and MANETs. It enables the network as a whole to recognize attacks, anomalies, and potential vulnerabilities in a distributive manner that reflects the autonomic processes of biological systems. Each component of the network recognizes activity in its local environment and then contributes to the overall situational awareness of the entire system. The approach utilizes agent-based swarm intelligence to adaptively identify potential data sources on each node and on adjacent nodes throughout the network. The swarm agents then self-organize into modular neural networks that utilize a reinforcement learning algorithm to identify relevant behavior patterns in the data without supervision. Once the modular neural networks have established interconnectivity both locally and with neighboring nodes the analysis of events within the network can be conducted collectively in real-time. The approach has been shown to be extremely effective in identifying distributed network attacks.

  13. Typicality Mediates Performance during Category Verification in Both Ad-hoc and Well-defined Categories

    PubMed Central

    Sandberg, Chaleece; Sebastian, Rajani; Kiran, Swathi

    2012-01-01

    Background The typicality effect is present in neurologically intact populations for natural, ad-hoc, and well-defined categories. Although sparse, there is evidence of typicality effects in persons with chronic stroke aphasia for natural and ad-hoc categories. However, it is unknown exactly what influences the typicality effect in this population. Aims The present study explores the possible contributors to the typicality effect in persons with aphasia by analyzing and comparing data from both normal and language-disordered populations, from persons with aphasia with more semantic impairment versus those with less semantic impairment, and from two types of categories with very different boundary structure (ad-hoc vs. well-defined). Methods and procedures A total of 40 neurologically healthy adults (20 older, 20 younger) and 35 persons with aphasia (20 LSI (less-semantically impaired) patients, 15 MSI (more-semantically impaired) patients) participated in the study. Participants completed one of two tasks: either category verification for ad-hoc categories or category verification for well-defined categories. Outcomes and Results Neurologically healthy participants showed typicality effects for both ad-hoc and well-defined categories. MSI patients showed a typicality effect for well-defined categories, but not for ad-hoc categories, whereas LSI patients showed a typicality effect for ad-hoc categories, but not for well-defined categories. Conclusions These results suggest that the degree of semantic impairment mediates the typicality effect in persons with aphasia depending on the structure of the category. PMID:22261305

  14. Predicting impact of multi-paths on phase change in map-based vehicular ad hoc networks

    NASA Astrophysics Data System (ADS)

    Rahmes, Mark; Lemieux, George; Sonnenberg, Jerome; Chester, David B.

    2014-05-01

    Dynamic Spectrum Access, which through its ability to adapt the operating frequency of a radio, is widely believed to be a solution to the limited spectrum problem. Mobile Ad Hoc Networks (MANETs) can extend high capacity mobile communications over large areas where fixed and tethered-mobile systems are not available. In one use case with high potential impact cognitive radio employs spectrum sensing to facilitate identification of allocated frequencies not currently accessed by their primary users. Primary users own the rights to radiate at a specific frequency and geographic location, secondary users opportunistically attempt to radiate at a specific frequency when the primary user is not using it. We quantify optimal signal detection in map based cognitive radio networks with multiple rapidly varying phase changes and multiple orthogonal signals. Doppler shift occurs due to reflection, scattering, and rapid vehicle movement. Path propagation as well as vehicle movement produces either constructive or destructive interference with the incident wave. Our signal detection algorithms can assist the Doppler spread compensation algorithm by deciding how many phase changes in signals are present in a selected band of interest. Additionally we can populate a spatial radio environment map (REM) database with known information that can be leveraged in an ad hoc network to facilitate Dynamic Spectrum Access. We show how topography can help predict the impact of multi-paths on phase change, as well as about the prediction from dense traffic areas. Utilization of high resolution geospatial data layers in RF propagation analysis is directly applicable.

  15. A Decentralized VPN Service over Generalized Mobile Ad-Hoc Networks

    NASA Astrophysics Data System (ADS)

    Fujita, Sho; Shima, Keiichi; Uo, Yojiro; Esaki, Hiroshi

    We present a decentralized VPN service that can be built over generalized mobile ad-hoc networks (Generalized MANETs), in which topologies can be represented as a time-varying directed multigraph. We address wireless ad-hoc networks and overlay ad-hoc networks as instances of Generalized MANETs. We first propose an architecture to operate on various kinds of networks through a single set of operations. Then, we design and implement a decentralized VPN service on the proposed architecture. Through the development and operation of a prototype system we implemented, we found that the proposed architecture makes the VPN service applicable to each instance of Generalized MANETs, and that the VPN service makes it possible for unmodified applications to operate on the networks.

  16. Energetics of the protonation of CO - Implications for the observation of HOC(+) in dense interstellar clouds

    NASA Technical Reports Server (NTRS)

    Dixon, D.; Komornicki, A.; Kraemer, W. P.

    1984-01-01

    A number of molecular species on the H3CO(+) energy hypersurface is examined. Ab initio molecular orbital theory is used to determine the structures and relative energetics of the two isomers of HCO(+) and HOC(+) together with the affinity of CO for protonation at either end. The proton affinities of H2 and H2CO are also examined. The calculations are performed using large basis sets and include the effects of electron correlation. The calculated vibrational frequencies are used to correct for zero point energy differences. The results show that the proton affinities of H2 and CO to form HOC(+) are within 1 kcal of each other. The calculations demonstrate that there is no thermodynamic driving force to form HOC(+) in collisions of H3(+) with CO, and that the formation of HCO(+) in such collisions is very exoergic. A plausible mechanism is suggested to explain the differences observed between the laboratory and the interstellar medium.

  17. Fuzzy Multiple Metrics Link Assessment for Routing in Mobile Ad-Hoc Network

    NASA Astrophysics Data System (ADS)

    Soo, Ai Luang; Tan, Chong Eng; Tay, Kai Meng

    2011-06-01

    In this work, we investigate on the use of Sugeno fuzzy inference system (FIS) in route selection for mobile Ad-Hoc networks (MANETs). Sugeno FIS is introduced into Ad-Hoc On Demand Multipath Distance Vector (AOMDV) routing protocol, which is derived from its predecessor, Ad-Hoc On Demand Distance Vector (AODV). Instead of using the conventional way that considering only a single metric to choose the best route, our proposed fuzzy decision making model considers up to three metrics. In the model, the crisp inputs of the three parameters are fed into an FIS and being processed in stages, i.e., fuzzification, inference, and defuzzification. Finally, after experiencing all the stages, a single value score is generated from the combination metrics, which will be used to measure all the discovered routes credibility. Results obtained from simulations show a promising improvement as compared to AOMDV and AODV.

  18. Time geography for ad-hoc shared-ride trip planning in mobile geosensor networks

    NASA Astrophysics Data System (ADS)

    Raubal, Martin; Winter, Stephan; Teβmann, Sven; Gaisbauer, Christian

    Ad-hoc shared-ride trip planning in an urban environment is a complex task within a non-deterministic transportation network. Mobile geosensor networks provide the technical environment for realizing ad-hoc shared-ride trip planning: Network nodes are autonomous agents that interact locally by ad-hoc short-range communication and arrange for shared rides. In a mobile geosensor network, communication costs are critical because of constraints regarding bandwidth, available energy, and memory. This paper introduces spatio-temporal concepts from time geography, which can be employed during the planning process to significantly reduce communication costs. We will integrate network-based algorithms and different wayfinding strategies to assist both shared-ride clients and hosts in finding optimal travel assignments. Multi-agent geosimulation in a real street network is used to demonstrate the applicability of the approach and quantitatively confirm the theoretically foreseen reduction in communication costs.

  19. A high-precision ab initio determination of the equilibrium geometry and force field of HOC(+)

    NASA Technical Reports Server (NTRS)

    Defrees, D. J.; Bunker, P. R.; Binkley, J. S.; Mclean, A. D.

    1987-01-01

    The results of an ab initio molecular orbital investigation of the isoformyl cation, HOC(+), shape are reported. The effects of expanding the basis set to near the Hartree-Fock limit and of electron correlation were examined, and the results indicate that near the Hartree-Fock limit the HOC(+) is linear. An analytic potential function is presented, from which the calculated rotational energies are only 0.03 percent different from the experimental values. This represents a nearly two orders of magnitude reduction in error from earlier work.

  20. Reliable on-demand multicast routing with congestion control in wireless ad hoc networks

    NASA Astrophysics Data System (ADS)

    Tang, Ken; Gerla, Mario

    2001-07-01

    In this paper, we address the congestion control multicast routing problem in wireless ad hoc networks through the medium access control (MAC) layer. We first introduce the Broadcast Medium Window (BMW) MAC protocol, which provides reliable delivery to broadcast packets at the MAC layer. We then extend the wireless On-Demand Multicast Routing Protocol (ODMRP) to facilitate congestion control in ad hoc networks using BMW. Through simulation, we show that ODMRP with congestion control adapts well to multicast sources that are aggressive in data transmissions.

  1. A high-precision ab initio determination of the equilibrium geometry and force field of HOC(+)

    NASA Technical Reports Server (NTRS)

    Defrees, D. J.; Bunker, P. R.; Binkley, J. S.; Mclean, A. D.

    1987-01-01

    The results of an ab initio molecular orbital investigation of the isoformyl cation, HOC(+), shape are reported. The effects of expanding the basis set to near the Hartree-Fock limit and of electron correlation were examined, and the results indicate that near the Hartree-Fock limit the HOC(+) is linear. An analytic potential function is presented, from which the calculated rotational energies are only 0.03 percent different from the experimental values. This represents a nearly two orders of magnitude reduction in error from earlier work.

  2. Performance Evaluation of Ad Hoc Routing Protocols in a Swarm of Autonomous Unmanned Aerial Vehicles

    DTIC Science & Technology

    2007-03-01

    research in mobile, ad hoc routing protocols. Broch , et al. performed a simulation comparison of the DSDV, DSR, AODV and Temporally-Ordered...July 6, 2005. [Bel58] R. Bellman, “On a Routing Problem,” in Quarterly of Applied Mathematics, 16(1), pp.87-90, 1958. [BJM04] J. Broch , D. B...vol. AD- A404703, 2002. [BMJ98] J. Broch , D. A. Maltz, D. B. Johnson, Y. Hu and J. Jetcheva, “A performance comparison of multi-hop wireless ad hoc

  3. Routing Protocols to Minimize the Number of Route Disconnections for Communication in Mobile Ad Hoc Networks

    DTIC Science & Technology

    2009-09-01

    Broch , "DSR: The Dynamic Source Routing Protocol for Multi-hop Wireless Ad hoc Networks," in Ad hoc Networking, Chapter 5, C. E. Perkins, Eds. Addison...Project Report: 09/23/2008 to 09/22/2009 W911NF-08-2-0061 References [I] J. Broch , D. A. Maltz, D. B. Johnson, Y. C. Hu and J. Jetcheva, "A...and Mobile Computing, Vol. 2, pp. 723 - 726, Sept. 2005. [4] D. B. Johnson, D. A. Maltz and J. Broch , "DSR: The Dynamic Source Routing Protocol for

  4. Exploring the Role of Ad Hoc Grassroots Organizations Providing Humanitarian Aid on Lesvos, Greece

    PubMed Central

    Kitching, George Tjensvoll; J. Haavik, Hanne; Tandstad, Birgit J.; Zaman, Muhammad; Darj, Elisabeth

    2016-01-01

    Introduction: Syrian refugees displaced into Turkey have attempted high-risk sea migrations to reach safer destinations in Europe, most often initially arriving on the Greek island of Lesvos. These refugees were often in need of basic humanitarian assistance that has been provided in part by a new category of ad hoc grassroots organizations (AHGOs). The aim of this study was to understand the internal and external operations of these AHGOs and their role on Lesvos. Methods: The experiences of AHGOs were investigated through a qualitative research design utilizing semi-structured interviews with organization leaders and spokespersons. AHGOs identified through media and social media sources as new Lesvos-specific organizations were purposively invited to complete an interview over phone, Skype or email. Data analysis of the transcribed interviews was performed by Systematic Text Condensation. Results: Forty-one organizations were contacted and 13 interviews were conducted. Most organizations were formed in autumn 2015 responding to the greater influx of refugees and migrants at that time and reported an absence of professional humanitarian agencies providing aid on Lesvos. Three categories emerged from the material. Features of organizations; Features of volunteers and; Evolution of AHGOs. The organizations perceived themselves capable of evaluating needs, mobilizing resources, funding and providing quick response. The volunteers came with limited humanitarian experience and from a wide variety of nationalities and professional backgrounds, and the organizations developed while on Lesvos. Discussion: Knowledge from our findings of AHGOs response to this complex disaster on Lesvos could be utilized in future catastrophes. We conclude that AHGOs may prove effective at providing humanitarian aid in a surge response when international non-governmental organizations are unable to respond quickly. In future complex disasters AHGOs should be recognized as new humanitarian

  5. Using "HOCS-Centered Learning" as a Pathway to Promote Science Teachers' Metacognitive Development

    ERIC Educational Resources Information Center

    Leou, Mary; Abder, Pamela; Riordan, Megan; Zoller, Uri

    2006-01-01

    An element of current reform in science education worldwide is the shift from the dominant traditional algorithmic lower-order cognitive skills (LOCS) teaching, to the higher-order cognitive skills (HOCS)-promoting learning; that is, the development of students' capabilities including those of question asking (QA), critical/system thinking (CST),…

  6. Using Dominating Sets to Improve the Performance of Mobile Ad Hoc Networks

    DTIC Science & Technology

    2005-09-01

    Communications Research Group (CCRG) directed by J.J., and students (Cintia, Nacho, Kumar and Venkatesh ) in Katia’s lab for their fellowship. I cannot...wireless conference, pages 156–162, 2002. [41] Katia Obraczka, Kumar Viswanath , and Gene Tsudik. Flooding for reliable multicast in multi-hop ad hoc

  7. Report of the ad hoc Committee on Women Studies, College of Arts and Sciences.

    ERIC Educational Resources Information Center

    Washington Univ., Seattle. Coll. of Arts and Sciences.

    The ad hoc Committee on Women Studies at the University of Washington recommends that a program of women's studies be instituted to permit rigorous academic study in the area. The program would be composed of: (1) an introductory core course; (2) four upper-division courses; (3) a significant amount of study (approximately 35 credits) in a single…

  8. Using "HOCS-Centered Learning" as a Pathway to Promote Science Teachers' Metacognitive Development

    ERIC Educational Resources Information Center

    Leou, Mary; Abder, Pamela; Riordan, Megan; Zoller, Uri

    2006-01-01

    An element of current reform in science education worldwide is the shift from the dominant traditional algorithmic lower-order cognitive skills (LOCS) teaching, to the higher-order cognitive skills (HOCS)-promoting learning; that is, the development of students' capabilities including those of question asking (QA), critical/system thinking (CST),…

  9. An Architecture for Enabling Migration of Tactical Networks to Future Flexible Ad Hoc WBWF

    DTIC Science & Technology

    2010-09-01

    stratum From PHY to radio Ad Hoc routing IP and legacy compatible Facilities for securing WBWF protocols Interfaces with OAM for local and remote ...OTA) supervision Support of (optional) GNSS interface (positioning and synchronisation features) Non Access Stratum Access Stratum W F D o m...through Security SAPs Management Plane : Local and remote management of equipment, radio interface, network guarantees proper configuration and

  10. Post-Hoc IRT Equating of Previously Administered English Tests for Comparison of Test Scores

    ERIC Educational Resources Information Center

    Saida, Chisato; Hattori, Tamaki

    2008-01-01

    Despite growing concerns about declining scholastic abilities of Japanese students throughout Japan prior to the implementation of the revised Courses of Study in 2002, little empirical evidence was available at that time to support this perceived decline in academic performance. This research describes post-hoc IRT equating of previously…

  11. Work, Family, and Community: Summary Proceedings of an Ad Hoc Committee.

    ERIC Educational Resources Information Center

    Hayes, Cheryl D., Ed.

    These proceedings contain summaries of five working group discussions and a discussion of suggestions for future research from an ad hoc meeting on Work, Family, and Community (Fedruary 21-22, 1980) in Washington, D.C. The meeting had these objectives: (1) to identify salient policy and research issues associated with changing patterns of labor…

  12. A Comprehensive Performance Comparison of On-Demand Routing Protocols in Mobile Ad-Hoc Networks

    NASA Astrophysics Data System (ADS)

    Khan, Jahangir; Hayder, Syed Irfan

    Mobile ad hoc network is an autonomous system of mobile nodes connected by wireless links. Each node operates not only as an end system, but also as a router to forward packets. The nodes are free to move about and organize themselves on a fly. In this paper we focus on the performance of the on-demand routing protocols such as DSR and AODV in ad-hoc networks. We have observed the performance change of each protocol through simulation with varying the data in intermediate nodes and to compare data throughput in each mobile modes of each protocol to analyze the packet fraction for application data. The objective of this work is to evaluate two routing protocols such as On-demand behavior, namely, Ad hoc Demand Distance vector (AODV) and Dynamic Source Routing (DSR), for wireless ad hoc networks based on performance of intermediate nodes for the delivery of data form source to destination and vice versa in order to compare the efficiency of throughput in the neighbors nodes. To overcome we have proposed OPNET simulator for performance comparison of hop to hop delivery of data packet in autonomous system.

  13. The 5th Meeting of the Ad Hoc Panel on Terminal Configured Vehicles

    NASA Technical Reports Server (NTRS)

    1977-01-01

    A report of the fifth meeting of the NASA Research and Technology Advisory Council, Ad Hoc panel on Terminal Configured Vehicles is presented. Some of the following topics were discussed; (1) microwave landing systems; (2) whole word computer system status; (3) flight path angle control: (4) VTOL approaches and landing technology; and (5) simulation study in wind shear.

  14. Final Report of the IAG AD Hoc Working Group on Global Change

    NASA Technical Reports Server (NTRS)

    Dickey, Jean O.

    1995-01-01

    None given. Paper gives final report of the IAG ad hoc working group on global change. They made three main recommendations to the group: 1. the post of and IAG liaison or representative to the IGBP should be established. 2. A new core program,.

  15. Work, Family, and Community: Summary Proceedings of an Ad Hoc Committee.

    ERIC Educational Resources Information Center

    Hayes, Cheryl D., Ed.

    These proceedings contain summaries of five working group discussions and a discussion of suggestions for future research from an ad hoc meeting on Work, Family, and Community (Fedruary 21-22, 1980) in Washington, D.C. The meeting had these objectives: (1) to identify salient policy and research issues associated with changing patterns of labor…

  16. Combining Infrastructure and Ad Hoc Collaboration for Data Management in Mobile Wireless Networks

    DTIC Science & Technology

    2005-01-01

    Elizabeth M. Royer. "Ad hoc On-Demand Distance Vector Routing." Proceedings of the 2nd IEEE Workshop on Mobile Computing Systems and Applications...Charles Perkins, ACM SIGCOMM󈨢 Conference on Communications Architectures, Protocols and Applications 22. Vincent D. Park and M. Scott Corson , A

  17. Reputation-Based Internet Protocol Security: A Multilayer Security Framework for Mobile Ad Hoc Networks

    DTIC Science & Technology

    2010-09-01

    opportunity to pursue this degree while working in our organization. I must also thank Dr. Rusty O. Baldwin and Mr. Juan Lopez , both whom provided...Intrusion Detection in Mobile Ad Hoc Networks”. Wireless/Mobile Network Security, 170–196, 2006. 7. Ariza-Quintana, A., E. Casilari, and A.T. Cabrera

  18. Report of the Ad Hoc Committee on Religious and Cultural Celebrations in the Library.

    ERIC Educational Resources Information Center

    Rathemacher, Andree; Grubman, Sheila Black; Lahiri, Amar; Gilton, Donna; Sharif, Mohammed

    The charge of the University of Rhode Island's Ad Hoc Committee on Religious and Cultural Celebrations in the Library was to: investigate all opportunities for the library to educate the campus community about religious and cultural holidays; consider all the major religions of the world and the possibility of having displays for the symbols of…

  19. Protocols for Detection and Removal of Wormholes for Secure Routing and Neighborhood Creation in Wireless Ad Hoc Networks

    ERIC Educational Resources Information Center

    Hayajneh, Thaier Saleh

    2009-01-01

    Wireless ad hoc networks are suitable and sometimes the only solution for several applications. Many applications, particularly those in military and critical civilian domains (such as battlefield surveillance and emergency rescue) require that ad hoc networks be secure and stable. In fact, security is one of the main barriers to the extensive use…

  20. Protocols for Detection and Removal of Wormholes for Secure Routing and Neighborhood Creation in Wireless Ad Hoc Networks

    ERIC Educational Resources Information Center

    Hayajneh, Thaier Saleh

    2009-01-01

    Wireless ad hoc networks are suitable and sometimes the only solution for several applications. Many applications, particularly those in military and critical civilian domains (such as battlefield surveillance and emergency rescue) require that ad hoc networks be secure and stable. In fact, security is one of the main barriers to the extensive use…

  1. 76 FR 71308 - Codex Alimentarius Commission: Meeting of the Ad Hoc Intergovernmental Codex Task Force on Animal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Food Safety and Inspection Service Codex Alimentarius Commission: Meeting of the Ad Hoc... United States (U.S.) positions that will be discussed at the 6th Session of the Ad Hoc...

  2. Rural nurse to nurse practitioner: an ad hoc process.

    PubMed

    Carryer, Jenny; Boddy, Julie; Budge, Claire

    2011-03-01

    Despite a 10-year history of nurse practitioner (NP) development in New Zealand (NZ) there is no formalised or universal process for ensuring the transition of willing nurses to NP status. This unmet need is of particular interest in the rural context where workforce issues are paramount. The aim of this study was to explore the transition from rural nurse to NP in NZ. A qualitative descriptive survey was sent to all NZ nurses with a rural address. Ninety-two questionnaires were returned, of which 21 respondents were working in a rural location and aiming to become an NP. Data analysis included description of demographic data and thematic analysis of open-ended question responses. Four themes encompassed the experiences of the 21 potential NP candidates: uncertainty about opportunities for employment as an NP and legislative and funding barriers for NP practice; support or resistance from GPs and nurse colleagues, self-doubt, and the importance of mentoring; difficulties with the NP authorisation process; and meeting the NP competencies within the challenges imposed by rural location. At the systems level of workforce design, stronger linkages between policy development, investment, employment creation, funding streams, professional regulation and overall communication require attention.

  3. Ad hoc methods for accurate determination of Bader's atomic boundary

    NASA Astrophysics Data System (ADS)

    Polestshuk, Pavel M.

    2013-08-01

    In addition to the recently published triangulation method [P. M. Polestshuk, J. Comput. Chem. 34, 206 (2013)], 10.1002/jcc.23121, two new highly accurate approaches, ZFSX and SINTY, for the integration over an atomic region covered by a zero-flux surface (zfs) were developed and efficiently interfaced into the TWOE program. ZFSX method was realized as three independent modules (ZFSX-1, ZFSX-3, and ZFSX-5) handling interatomic surfaces of a different complexity. Details of algorithmic implementation of ZFSX and SINTY are discussed. A special attention to an extended analysis of errors in calculations of atomic properties is paid. It was shown that uncertainties in zfs determination caused by ZFSX and SINTY approaches contribute negligibly (less than 10-6 a.u.) to the total atomic integration errors. Moreover, the new methods are able to evaluate atomic integrals with a reasonable time and can be universally applied for the systems of any complexity. It is suggested, therefore, that ZFSX and SINTY can be regarded as benchmark methods for the computation of any Quantum Theory of Atoms in Molecules atomic property.

  4. Report of ad hoc OTEC cold water pipe committee

    SciTech Connect

    Barr, R.; Giannotti, J.; Deuchler, W.; Scotti, R.; Stadter, J.; Walsh, J. P.; Weiss, R.

    1980-02-01

    Now that the design work on the pilot plant is scheduled to start in the near future, DOE has considered it essential that an overall look be taken at the cold water pipe design process. The VSE Corporation, in its role as a support contractor to DOE, was tasked to organize a small study group to answer the question, Where do we stand on the verification of the computer models of the cold water pipe response by experimental measurements. The committee has studied all the available results of the cold water pipe development program. This report summarizes those results. The development and present capabilities of the computer programs used to calculate the response of a cold water pipe attached to a platform under known at-sea conditions are discussed. The various cold water pipe designs that have been done using the computer programs are summarized. The experiments that have been conducted up to the present time to measure the response of cold water pipes at-sea and in experimental tanks are described. The results of these experiments are presented. The experimental results are compared with the predictions made with the analytical computer programs. Conclusions drawn as a result of this analysis are presented and some recommendations are made. (WHK)

  5. Ad hoc methods for accurate determination of Bader's atomic boundary.

    PubMed

    Polestshuk, Pavel M

    2013-08-07

    In addition to the recently published triangulation method [P. M. Polestshuk, J. Comput. Chem. 34, 206 (2013)], two new highly accurate approaches, ZFSX and SINTY, for the integration over an atomic region covered by a zero-flux surface (zfs) were developed and efficiently interfaced into the TWOE program. ZFSX method was realized as three independent modules (ZFSX-1, ZFSX-3, and ZFSX-5) handling interatomic surfaces of a different complexity. Details of algorithmic implementation of ZFSX and SINTY are discussed. A special attention to an extended analysis of errors in calculations of atomic properties is paid. It was shown that uncertainties in zfs determination caused by ZFSX and SINTY approaches contribute negligibly (less than 10(-6) a.u.) to the total atomic integration errors. Moreover, the new methods are able to evaluate atomic integrals with a reasonable time and can be universally applied for the systems of any complexity. It is suggested, therefore, that ZFSX and SINTY can be regarded as benchmark methods for the computation of any Quantum Theory of Atoms in Molecules atomic property.

  6. An Ad-Hoc Adaptive Pilot Model for Pitch Axis Gross Acquisition Tasks

    NASA Technical Reports Server (NTRS)

    Hanson, Curtis E.

    2012-01-01

    An ad-hoc algorithm is presented for real-time adaptation of the well-known crossover pilot model and applied to pitch axis gross acquisition tasks in a generic fighter aircraft. Off-line tuning of the crossover model to human pilot data gathered in a fixed-based high fidelity simulation is first accomplished for a series of changes in aircraft dynamics to provide expected values for model parameters. It is shown that in most cases, for this application, the traditional crossover model can be reduced to a gain and a time delay. The ad-hoc adaptive pilot gain algorithm is shown to have desirable convergence properties for most types of changes in aircraft dynamics.

  7. PNNI routing support for ad hoc mobile networking: The multilevel case

    SciTech Connect

    Martinez, L.; Sholander, P.; Tolendino, L.

    1998-01-01

    This contribution extends the Outside Nodal Hierarchy List (ONHL) procedures described in ATM Forum Contributions 97-0766 and 97-0933. These extensions allow multiple mobile networks to form either an ad hoc network or an extension of a fixed PNNI infrastructure. A previous contribution (97-1073) covered the simplest case where the top-most Logical Group Nodes (LGNs), in those mobile networks, all resided at the same level in a PNNI hierarchy. This contribution covers the more general case wherein those top-most LGNs may reside at different PNNI hierarchy levels. Both of the SNL contributions consider flat ad hoc network architectures in the sense that each mobile network always participates in the PNNI hierarchy at the pre-configured level of its top-most LGN.

  8. Accurate ab initio quartic force fields for the ions HCO(+) and HOC(+)

    NASA Technical Reports Server (NTRS)

    Martin, J. M. L.; Taylor, Peter R.; Lee, Timothy J.

    1993-01-01

    The quartic force fields of HCO(+) and HOC(+) have been computed using augmented coupled cluster methods and basis sets of spdf and spdfg quality. Calculations on HCN, CO, and N2 have been performed to assist in calibrating the computed results. Going from an spdf to an spdfg basis shortens triple bonds by about 0.004 A, and increases the corresponding harmonic frequency by 10-20/cm, leaving bond distances about 0.003 A too long and triple bond stretching frequencies about 5/cm too low. Accurate estimates for the bond distances, fundamental frequencies, and thermochemical quantities are given. HOC(+) lies 37.8 +/- 0.5 kcal/mol (0 K) above HCO(+); the classical barrier height for proton exchange is 76.7 +/- 1.0 kcal/mol.

  9. The Ad Hoc process to strengthen the framework convention on climate change

    SciTech Connect

    Ramakrishna, K.; Deutz, A.M.; Jacobsen, L.A.

    1995-11-01

    The Woods Hole Research Center convened an International Conference on The Ad Hoc Process to Strengthen the Framework Convention on Climate Change in Woods Hole, MA, on October 7-9, 1995. The conference was conducted to examine the prospects for successful adoption of a protocol to the Framework Convention on Climate Change by 1997. In preparation for the Second session of the Ad Hoc Group on the Berlin Mandate, several governmental and nongovernmental representatives met in Woods Hole to discuss the process and possible outcome of the Berlin Mandate negotiations for a protocol or other legal instrument to strengthen the Convention. The conference was by invitation and all participants attended in their personal capacities.

  10. Valid randomization-based p-values for partially post hoc subgroup analyses

    PubMed Central

    Lee, Joseph J.; Rubin, Donald B.

    2015-01-01

    By ‘partially post-hoc’ subgroup analyses, we mean analyses that compare existing data from a randomized experiment—from which a subgroup specification is derived—to new, subgroup-only experimental data. We describe a motivating example in which partially post hoc subgroup analyses instigated statistical debate about a medical device’s efficacy. We clarify the source of such analyses’ invalidity and then propose a randomization-based approach for generating valid posterior predictive p-values for such partially post hoc subgroups. Lastly, we investigate the approach’s operating characteristics in a simple illustrative setting through a series of simulations, showing that it can have desirable properties under both null and alternative hypotheses. PMID:25959735

  11. An optimized node-disjoint multipath routing scheme in mobile ad hoc

    NASA Astrophysics Data System (ADS)

    Yu, Yang; Liang, Mangui; Liu, Zhiyu

    2016-02-01

    In mobile ad hoc networks (MANETs), link failures are caused frequently because of node’s mobility and use of unreliable wireless channels for data transmission. Multipath routing strategy can cope with the problem of the traffic overloads while balancing the network resource consumption. In the paper, an optimized node-disjoint multipath routing (ONMR) protocol based on ad hoc on-demand vector (AODV) is proposed to establish effective multipath to enhance the network reliability and robustness. The scheme combines the characteristics of reverse AODV (R-AODV) strategy and on-demand node-disjoint multipath routing protocol to determine available node-disjoint routes with minimum routing control overhead. Meanwhile, it adds the backup routing strategy to make the process of data salvation more efficient in case of link failure. The results obtained through various simulations show the effectiveness of the proposed scheme in terms of route availability, control overhead and packet delivery ratio.

  12. PNNI routing support for ad hoc mobile networking: A flat architecture

    SciTech Connect

    Martinez, L.; Sholander, P.; Tolendino, L.

    1997-12-01

    This contribution extends the Outside Nodal Hierarchy List (ONHL) procedures described in ATM Form Contribution 97-0766. These extensions allow multiple mobile networks to form either an ad hoc network or an extension of a fixed PNNI infrastructure. This contribution covers the simplest case where the top-most Logical Group Nodes (LGNs), in those mobile networks, all reside at the same level in a PNNI hierarchy. Future contributions will cover the general case where those top-most LGNs reside at different hierarchy levels. This contribution considers a flat ad hoc network architecture--in the sense that each mobile network always participates in the PNNI hierarchy at the preconfigured level of its top-most LGN.

  13. Design of free patterns of nanocrystals with ad hoc features via templated dewetting

    NASA Astrophysics Data System (ADS)

    Aouassa, M.; Berbezier, I.; Favre, L.; Ronda, A.; Bollani, M.; Sordan, R.; Delobbe, A.; Sudraud, P.

    2012-07-01

    Design of monodisperse ultra-small nanocrystals (NCs) into large scale patterns with ad hoc features is demonstrated. The process makes use of solid state dewetting of a thin film templated through alloy liquid metal ion source focused ion beam (LMIS-FIB) nanopatterning. The solid state dewetting initiated at the edges of the patterns controllably creates the ordering of NCs with ad hoc placement and periodicity. The NC size is tuned by varying the nominal thickness of the film while their position results from the association of film retraction from the edges of the lay out and Rayleigh-like instability. The use of ultra-high resolution LMIS-FIB enables to produce monocrystalline NCs with size, periodicity, and placement tunable as well. It provides routes for the free design of nanostructures for generic applications in nanoelectronics.

  14. Vehicular ad hoc network for a surveillance system using multifrequency band enhancement

    NASA Astrophysics Data System (ADS)

    Bunruangses, Montree; Sunat, Khamron; Mitatha, Somsak; Yupapin, Preecha P.

    2010-09-01

    We present a new design of a surveillance system via a vehicular ad hoc network (VANET) integrated by a 3-G or 4-G cellular wireless network. We propose dense wavelength division multiplexing wavelength enhancement for increasing the channel capacity and signal security. Increase in the number of channels can be obtained by increasing the wavelength density. Signal security is introduced by a specific wavelength filter controlled by the central operator. Optical communication wavelength enhancement is reviewed. The advantage of this proposed system is that it can easily be implemented and incorporated into the existing communication link in either a cellular or ad hoc wireless system, where signal security and hence privacy can be provided.

  15. Reliable energy-aware routing with unreliable links in ad hoc networks

    NASA Astrophysics Data System (ADS)

    Bao, Yanru; Shu, Yantai; Wang, Xin; Yu, Li

    2007-09-01

    Since most ad hoc mobile devices today operate on batteries, energy-aware routings and power control techniques in wireless networks have drawn considerable research interests recently. This paper presents a reliable energy-aware routing algorithm (REARP) for unreliable ad hoc networks. The lifetime of the whole network and the energy cost for each packet are considered simultaneously in the routing processes of the REARP. Different from the formers, the energy cost of the link layer retransmission is also computed into the total energy consumption. Moreover, the REARP appropriately adjusts the transmission power by systematically integrating the reliability and power control techniques. We conducted extensive simulations to evaluate the performance of the new routing algorithms compared to a number of existing routing algorithms.

  16. Post-hoc power estimation in large-scale multiple testing problems

    PubMed Central

    Zehetmayer, Sonja; Posch, Martin

    2010-01-01

    Background The statistical power or multiple Type II error rate in large scale multiple testing problems as, for example, in gene expression microarray experiments, depends on typically unknown parameters and is therefore difficult to assess a priori. However, it has been suggested to estimate the multiple Type II error rate post-hoc, based on the observed data. Methods We consider a class of post-hoc estimators that are functions of the estimated proportion of true null hypotheses among all hypotheses. Numerous estimators for this proportion have been proposed and we investigate the statistical properties of the derived multiple Type II error rate estimators in an extensive simulation study. Results The performance of the estimators in terms of the mean squared error depends sensitively on the distributional scenario. Estimators based on empirical distributions of the null hypotheses are superior in the presence of strongly correlated test statistics. PMID:20189938

  17. Enhancements for distributed certificate authority approaches for mobile wireless ad hoc networks.

    SciTech Connect

    Van Leeuwen, Brian P.; Michalski, John T.; Anderson, William Erik

    2003-12-01

    Mobile wireless ad hoc networks that are resistant to adversarial manipulation are necessary for distributed systems used in military and security applications. Critical to the successful operation of these networks, which operate in the presence of adversarial stressors, are robust and efficient information assurance methods. In this report we describe necessary enhancements for a distributed certificate authority (CA) used in secure wireless network architectures. Necessary cryptographic algorithms used in distributed CAs are described and implementation enhancements of these algorithms in mobile wireless ad hoc networks are developed. The enhancements support a network's ability to detect compromised nodes and facilitate distributed CA services. We provide insights to the impacts the enhancements will have on network performance with timing diagrams and preliminary network simulation studies.

  18. On knowledge transfer management as a learning process for ad hoc teams

    NASA Astrophysics Data System (ADS)

    Iliescu, D.

    2017-08-01

    Knowledge management represents an emerging domain becoming more and more important. Concepts like knowledge codification and personalisation, knowledge life-cycle, social and technological dimensions, knowledge transfer and learning management are integral parts. Focus goes here in the process of knowledge transfer for the case of ad hoc teams. The social dimension of knowledge transfer plays an important role. No single individual actors involved in the process, but a collective one, representing the organisation. It is critically important for knowledge to be managed from the life-cycle point of view. A complex communication network needs to be in place to supports the process of knowledge transfer. Two particular concepts, the bridge tie and transactive memory, would eventually enhance the communication. The paper focuses on an informational communication platform supporting the collaborative work on knowledge transfer. The platform facilitates the creation of a topic language to be used in knowledge modelling, storage and reuse, by the ad hoc teams.

  19. Forming an ad-hoc nearby storage, based on IKAROS and social networking services

    NASA Astrophysics Data System (ADS)

    Filippidis, Christos; Cotronis, Yiannis; Markou, Christos

    2014-06-01

    We present an ad-hoc "nearby" storage, based on IKAROS and social networking services, such as Facebook. By design, IKAROS is capable to increase or decrease the number of nodes of the I/O system instance on the fly, without bringing everything down or losing data. IKAROS is capable to decide the file partition distribution schema, by taking on account requests from the user or an application, as well as a domain or a Virtual Organization policy. In this way, it is possible to form multiple instances of smaller capacity higher bandwidth storage utilities capable to respond in an ad-hoc manner. This approach, focusing on flexibility, can scale both up and down and so can provide more cost effective infrastructures for both large scale and smaller size systems. A set of experiments is performed comparing IKAROS with PVFS2 by using multiple clients requests under HPC IOR benchmark and MPICH2.

  20. A Method for Online Testing by HOC (Higher Order Crossings)-Processes.

    DTIC Science & Technology

    1986-01-01

    produces its zero-crossings and higher order zero-crossings sequentially in time is studied, illustrated, and applied in white noise testing.-- IA I-N ~y...crossing rates of higher order differences of the time series. In this paper we examine the dynamic process by which a time series and its higher order...from the original time series by repeated differencing. Such processes will be called higher order crossings rate processes or simply HOC-processes

  1. A Method for Online Testing by HOC (Higher Order Crossings)-Processes,

    DTIC Science & Technology

    1987-11-01

    7 D-N1tlg376 fA METHOD FOR ONLINE TESTIN BY HOC ( HIGHER ORDER / CROSSINGS)-PROCESSES(U) MARYLAND UNJY COLLEGE PRKI DEPT OF MATHEMATICS M BERGER ET...series produces Its zero-crossings and higher order zero-crossings sequentially in time is studied, Illustrated, and applied in white noise testing... higher order differences of the time series. In I this paper we examine the dynamic process by which a time series and its higher order differences

  2. History of the Standing Joint Force Headquarters for Elimination (SJFHQ-E): No More Ad Hoc

    DTIC Science & Technology

    2014-05-22

    Approved for Public Release; Distribution is Unlimited THE HISTORY OF THE STANDING JOINT FORCE HEADQUARTERS FOR ELIMINATION (SJFHQ-E): “NO MORE AD... Elimination (SJFHQ-E): “No More Ad Hoc” Approved by: __________________________________, Monograph Director Daniel G. Cox, Ph.D...THE HISTORY OF THE STANDING JOINT FORCE HEADQUARTERS FOR ELIMINATION (SJFHQ-E): “NO MORE AD HOC,” by LTC Kristofer D. Hopkins, U.S. Army, 54 pages

  3. Modelling of Medium Access Control (MAC) Protocols for Mobile Ad-Hoc Networks

    DTIC Science & Technology

    2005-06-01

    Slot IP Internet Protocol LAN Local Area Network MAC Medium Access Control MACAW Medium Access Protocol for Wireless LANs MANET Mobile Ad-hoc...Unforced state – It waits after entering the state until it is invoked by another process or an interrupt. It is in dark grey on this report, and red ... green in OPNET. A MAC process model is built for general initialisations of the MAC module, and to invoke the selected MAC protocol process model

  4. Interoperable Security, Routing and Quality of Service for Ad-Hoc Network Mobility

    DTIC Science & Technology

    2006-12-01

    Vector (AODV) [1], Dynamic Source Routing (DSR), Optimized Link State Routing ( OLSR ) [2], and Topology Broadcast Based on Reverse Path Forwarding... OLSR and TBRPF, do provide shortest-path routing and more extensive topology information, but at the cost of high control overhead for topology...e.g. OLSR [2], the Core Extraction Distributed Ad-hoc Routing (CEDAR) protocol [6], and the simple gateway protocol proposed by Wu and Li [7], OSPF

  5. Network Size and Connectivity in Mobile and Stationary Ad Hoc Networks

    DTIC Science & Technology

    2014-05-01

    mobile ad hoc networks ( MANETs ) is that routes consisting of multiple hops will be available to connect those nodes that lack line-of- sight connectivity...The practical utility of MANET depends on this assumption being true and, for a mobile network, remaining true during mobility. In previous work...terrain will affect MANETs when nodes move. It does not incorporate any speci- fics about network management or routing beyond assuming a fixed routing

  6. Effects of Data Replication on Data Exfiltration in Mobile Ad Hoc Networks Utilizing Reactive Protocols

    DTIC Science & Technology

    2015-03-01

    that file replication can increase data survivability in a system where the amount of data generated exceeds the capability to ex-filtrate the data, but...traditional, fixed infrastructure network creates an abundance of factors to examine. Such factors in- clude overhead from network routing and file system...distinctions critical. This thesis will focus primarily on FANETs, but will use the term MANET to generalize all mobile ad hoc networks, unless noted

  7. Interactive Operations for Visualization of Ad-Hoc Sensor System Domains

    DTIC Science & Technology

    2005-11-01

    Interactive Operations for Visualization of Ad-hoc Sensor System Domains Mark A. Livingston and Evan V. Herbst Virtual Reality Laboratory Naval...sensing technologies in the field. Future enhancements may include airborne relays, improved sensors, and new types of sensors, but we do not want to...operations implemented thus far use only the first three variables; the others are included for compatibility of format and potential future use. The

  8. Connecting the Edge: Mobile Ad-Hoc Networks (MANETs) for Network Centric Warfare

    DTIC Science & Technology

    2007-04-01

    general conquer the enemy whenever they move and their achievements surpass those of ordinary men is foreknowledge.” Sun-Tzu, The Art of War...earliest days of warfare. In The Art of War, Sun-Tzu makes frequent mention of the importance of withholding knowledge of intent or disposition of...Hoc Networking - the Art of Networking without a Network." Ericsson Review 4 (2000): 248-63. Ghosh, Anup. "Defending Warfighter Networks." Paper

  9. EGPS: An Efficient Privacy Preserving Scheme for Vehicular ad hoc Networks

    NASA Astrophysics Data System (ADS)

    Zhao, Baokang; Su, Xiangyu; Su, Jinshu; Song, Ziming; Sun, Yipin; Tao, Jing; Tang, Yong; Chen, Shuhui; Zhao, Guohong; Chen, Yijiao

    2010-09-01

    In this paper, we propose EGPS, an efficient privacy preserving scheme for vehicular ad hoc networks. The EGPS scheme is based on a very efficient group signature and Identity Based Cryptography(IBC) techniques. Several security properties of EGPS, including the correctness and unforgeability have been proved. Furthermore, EGPS is also proved to be more efficient than GSIS, which is currently one of the best state-of-the-art VANET privacy preserving schemes.

  10. Adaptive Demand-Driven Multicast Routing in Multi-Hop Wireless Ad Hoc Networks

    DTIC Science & Technology

    2004-05-06

    16] L. Ji and M. S. Corson . A Lightweight Adaptive Multicast Algorithm. In Proceedings of IEEE GLOBECOM ’98, pages 1036–1042, December 1998. [17] L...Ji and M. S. Corson . Differential Destination Multicast (DDM) Specification. Internet- Draft, draft-ietf-manet-ddm-00.txt, July 2000. Work in...3 [30] Charles E. Perkins, Elizabeth M. Royer, and Samir R. Das. Ad Hoc On Demand Distance Vector (AODV) Routing. Internet-Draft, draft-ietf-manet

  11. A Performance Comparison of On-Demand Multicast Routing Protocols for Ad Hoc Networks

    DTIC Science & Technology

    2004-12-15

    33–44, October 2001. [10] L. Ji and M. S. Corson . A Lightweight Adaptive Multicast Algorithm. In Proceedings of IEEE GLOBECOM ’98, pages 1036–1042...December 1998. [11] L. Ji and M. S. Corson . Differential Destination Multicast (DDM) Specification. Internet- Draft, draft-ietf-manet-ddm-00.txt, July... Elizabeth M. Royer and Charles E. Perkins. Multicast Operation of the Ad-hoc On- Demand Distance Vector Routing Protocol. In Proceedings of the Fifth

  12. Systematic lossy error protection for video transmission over wireless ad hoc networks

    NASA Astrophysics Data System (ADS)

    Zhu, Xiaoqing; Rane, Shantanu; Girod, Bernd

    2005-07-01

    Wireless ad hoc networks present a challenge for error-resilient video transmission, since node mobility and multipath fading result in time-varying link qualities in terms of packet loss ratio and available bandwidth. In this paper, we propose to use a systematic lossy error protection (SLEP) scheme for video transmission over wireless ad hoc networks. The transmitted video signal has two parts-a systematic portion consisting of a video sequence transmitted without channel coding over an error-prone channel, and error protection information consisting of a bitstream generated by Wyner-Ziv encoding of the video sequence. Using an end-to-end video distortion model in conjunction with online estimates of packet loss ratio and available bandwidth, the optimal Wyner-Ziv description can be selected dynamically according to current channel conditions. The scheme can also be applied to choose one path for transmission from amongst multiple candidate routes with varying available bandwidths and packet loss ratios, so that the expected end-to-end video distortion is maximized. Experimental results of video transmission over a simulated ad hoc wireless network shows that the proposed SLEP scheme outperforms the conventional application layer FEC approach in that it provides graceful degradation of received video quality over a wider range of packet loss ratios and is less susceptible to inaccuracy in the packet loss ratio estimation.

  13. Cross-Layer Service Discovery Mechanism for OLSRv2 Mobile Ad Hoc Networks

    PubMed Central

    Vara, M. Isabel; Campo, Celeste

    2015-01-01

    Service discovery plays an important role in mobile ad hoc networks (MANETs). The lack of central infrastructure, limited resources and high mobility make service discovery a challenging issue for this kind of network. This article proposes a new service discovery mechanism for discovering and advertising services integrated into the Optimized Link State Routing Protocol Version 2 (OLSRv2). In previous studies, we demonstrated the validity of a similar service discovery mechanism integrated into the previous version of OLSR (OLSRv1). In order to advertise services, we have added a new type-length-value structure (TLV) to the OLSRv2 protocol, called service discovery message (SDM), according to the Generalized MANET Packet/Message Format defined in Request For Comments (RFC) 5444. Each node in the ad hoc network only advertises its own services. The advertisement frequency is a user-configurable parameter, so that it can be modified depending on the user requirements. Each node maintains two service tables, one to store information about its own services and another one to store information about the services it discovers in the network. We present simulation results, that compare our service discovery integrated into OLSRv2 with the one defined for OLSRv1 and with the integration of service discovery in Ad hoc On-demand Distance Vector (AODV) protocol, in terms of service discovery ratio, service latency and network overhead. PMID:26205272

  14. Cross-Layer Service Discovery Mechanism for OLSRv2 Mobile Ad Hoc Networks.

    PubMed

    Vara, M Isabel; Campo, Celeste

    2015-07-20

    Service discovery plays an important role in mobile ad hoc networks (MANETs). The lack of central infrastructure, limited resources and high mobility make service discovery a challenging issue for this kind of network. This article proposes a new service discovery mechanism for discovering and advertising services integrated into the Optimized Link State Routing Protocol Version 2 (OLSRv2). In previous studies, we demonstrated the validity of a similar service discovery mechanism integrated into the previous version of OLSR (OLSRv1). In order to advertise services, we have added a new type-length-value structure (TLV) to the OLSRv2 protocol, called service discovery message (SDM), according to the Generalized MANET Packet/Message Format defined in Request For Comments (RFC) 5444. Each node in the ad hoc network only advertises its own services. The advertisement frequency is a user-configurable parameter, so that it can be modified depending on the user requirements. Each node maintains two service tables, one to store information about its own services and another one to store information about the services it discovers in the network. We present simulation results, that compare our service discovery integrated into OLSRv2 with the one defined for OLSRv1 and with the integration of service discovery in Ad hoc On-demand Distance Vector (AODV) protocol, in terms of service discovery ratio, service latency and network overhead.

  15. Ad Hoc Categories and False Memories: Memory Illusions for Categories Created On-the-Spot.

    PubMed

    Soro, Jerônimo C; Ferreira, Mário B; Semin, Gün R; Mata, André; Carneiro, Paula

    2017-04-06

    Three experiments were designed to test whether experimentally created ad hoc associative networks evoke false memories. We used the DRM (Deese, Roediger, McDermott) paradigm with lists of ad hoc categories composed of exemplars aggregated toward specific goals (e.g., going for a picnic) that do not share any consistent set of features. Experiment 1 revealed considerable levels of false recognitions of critical words from ad hoc categories. False recognitions occurred even when the lists were presented without an organizing theme (i.e., the category's label). Experiments 1 and 2 tested whether (a) the ease of identifying the categories' themes, and (b) the lists' backward associative strength could be driving the effect. List identifiability did not correlate with false recognition, and the effect remained even when backward associative strength was controlled for. Experiment 3 manipulated the distractor items in the recognition task to address the hypothesis that the salience of unrelated items could be facilitating the occurrence of the phenomenon. The effect remained when controlling for this source of facilitation. These results have implications for assumptions made by theories of false memories, namely the preexistence of associations in the activation-monitoring framework and the central role of gist extraction in fuzzy-trace theory, while providing evidence of the occurrence of false memories for more dynamic and context-dependent knowledge structures. (PsycINFO Database Record

  16. Real Time Semantic Interoperability in AD HOC Networks of Geospatial Data Sources: Challenges, Achievements and Perspectives

    NASA Astrophysics Data System (ADS)

    Mostafavi, M. A.; Bakillah, M.

    2012-07-01

    Recent advances in geospatial technologies have made available large amount of geospatial data. Meanwhile, new developments in Internet and communication technologies created a shift from isolated geospatial databases to ad hoc networks of geospatial data sources, where data sources can join or leave the network, and form groups to share data and services. However, effective integration and sharing of geospatial data among these data sources and their users are hampered by semantic heterogeneities. These heterogeneities affect the spatial, temporal and thematic aspects of geospatial concepts. There have been many efforts to address semantic interoperability issues in the geospatial domain. These efforts were mainly focused on resolving heterogeneities caused by different and implicit representations of the concepts. However, many approaches have focused on the thematic aspects, leaving aside the explicit representation of spatial and temporal aspects. Also, most semantic interoperability approaches for networks have focused on automating the semantic mapping process. However, the ad hoc network structure is continuously modified by source addition or removal, formation of groups, etc. This dynamic aspect is often neglected in those approaches. This paper proposes a conceptual framework for real time semantic interoperability in ad hoc networks of geospatial data sources. The conceptual framework presents the fundamental elements of real time semantic interoperability through a hierarchy of interrelated semantic states and processes. Then, we use the conceptual framework to set the discussion on the achievements that have already been made, the challenges that remain to be addressed and perspectives with respect to these challenges.

  17. A Dirichlet reputation system in reliable routing of wireless ad hoc network

    SciTech Connect

    Yang, Dr. Li; Cui, Xiaohui; Cemerlic, Alma

    2010-01-01

    Ad hoc networks are very helpful in situations when no fixed network infrastructure is available, such as natural disasters and military conflicts. In such a network, all wireless nodes are equal peers simultaneously serving as both senders and routers for other nodes. Therefore, how to route packets through reliable paths becomes a fundamental problems when behaviors of certain nodes deviate from wireless ad hoc routing protocols. We proposed a novel Dirichlet reputation model based on Bayesian inference theory which evaluates reliability of each node in terms of packet delivery. Our system offers a way to predict and select a reliable path through combination of first-hand observation and second-hand reputation reports. We also proposed moving window mechanism which helps to adjust ours responsiveness of our system to changes of node behaviors. We integrated the Dirichlet reputation into routing protocol of wireless ad hoc networks. Our extensive simulation indicates that our proposed reputation system can improve good throughput of the network and reduce negative impacts caused by misbehaving nodes.

  18. Efficacy and tolerability of adjunctive brivaracetam in patients with prior antiepileptic drug exposure: A post-hoc study.

    PubMed

    Asadi-Pooya, Ali A; Sperling, Michael R; Chung, Steve; Klein, Pavel; Diaz, Anyzeila; Elmoufti, Sami; Schiemann, Jimmy; Whitesides, John

    2017-02-27

    Brivaracetam (BRV), a selective, high-affinity ligand for synaptic vesicle protein 2A, is a new antiepileptic drug (AED) for adjunctive treatment of focal (partial-onset) seizures in adults with epilepsy. This post-hoc analysis was conducted to explore the efficacy of adjunctive BRV in patients with prior levetiracetam (LEV) exposure and whether changes in efficacy were related to the similar mechanism of action of these two drugs. Data were pooled from three Phase III studies (NCT00490035; NCT00464269; NCT01261325) of adults with focal seizures taking 1-2 AEDs who received placebo or BRV 50-200mg/day without titration over a 12-week treatment period. Patients taking concomitant LEV at enrollment were excluded from this analysis. Patients were categorized by their status of prior exposure to LEV, carbamazepine (CBZ), topiramate (TPM), or lamotrigine (LTG), to investigate any consistent trend towards reduced response in AED-exposed subgroups compared to AED-naïve subgroups, regardless of the mechanism of action. Study completion rates, percent reduction from baseline in focal seizure frequency over placebo, ≥50% responder rates, and tolerability were evaluated for each subgroup. A total of 1160 patients were investigated. Study completion rates were similar in the AED-exposed subgroups and AED-naïve subgroups. In subgroups with (531 patients) or without (629 patients) prior LEV exposure, ≥50% responder rates for each dose of BRV compared with placebo were generally higher among the LEV-naïve subgroups than the previously LEV-exposed subgroups. LEV-exposed subgroups receiving BRV doses ≥50mg/day showed greater ≥50% responder rates than those receiving placebo. Similar results were observed for CBZ, TPM, and LTG. Previous treatment failure with commonly prescribed AEDs (LEV, CBZ, TPM, or LTG) is associated with a reduced response to BRV irrespective of the mechanism of action. Hence, this post-hoc analysis indicates that previous treatment failure with LEV

  19. A Prototype System for Using Multiple Radios in Directional MANET (Mobile Ad Hoc Network): A NISE Funded Applied Research Project

    DTIC Science & Technology

    2013-09-01

    Technical Document 3276 September 2013 A Prototype System for using Multiple Radios in Directional MANET (Mobile Ad Hoc Network) A...point, it is difficult to employ directional antennas in a mobile ad hoc network ( MANET ) as most current radio and wireless networking protocols were...antennas in a MANET in a radio agnostic way by building networks out of dedicated point-to-point links. This document presents a protocol that accomplishes

  20. Tri-Center Analysis: Determining Measures of Trichotomous Central Tendency for the Parametric Analysis of Tri-Squared Test Results

    ERIC Educational Resources Information Center

    Osler, James Edward

    2014-01-01

    This monograph provides an epistemological rational for the design of a novel post hoc statistical measure called "Tri-Center Analysis". This new statistic is designed to analyze the post hoc outcomes of the Tri-Squared Test. In Tri-Center Analysis trichotomous parametric inferential parametric statistical measures are calculated from…

  1. Dynamic autonomous routing technology for IP-based satellite ad hoc networks

    NASA Astrophysics Data System (ADS)

    Wang, Xiaofei; Deng, Jing; Kostas, Theresa; Rajappan, Gowri

    2014-06-01

    IP-based routing for military LEO/MEO satellite ad hoc networks is very challenging due to network and traffic heterogeneity, network topology and traffic dynamics. In this paper, we describe a traffic priority-aware routing scheme for such networks, namely Dynamic Autonomous Routing Technology (DART) for satellite ad hoc networks. DART has a cross-layer design, and conducts routing and resource reservation concurrently for optimal performance in the fluid but predictable satellite ad hoc networks. DART ensures end-to-end data delivery with QoS assurances by only choosing routing paths that have sufficient resources, supporting different packet priority levels. In order to do so, DART incorporates several resource management and innovative routing mechanisms, which dynamically adapt to best fit the prevailing conditions. In particular, DART integrates a resource reservation mechanism to reserve network bandwidth resources; a proactive routing mechanism to set up non-overlapping spanning trees to segregate high priority traffic flows from lower priority flows so that the high priority flows do not face contention from low priority flows; a reactive routing mechanism to arbitrate resources between various traffic priorities when needed; a predictive routing mechanism to set up routes for scheduled missions and for anticipated topology changes for QoS assurance. We present simulation results showing the performance of DART. We have conducted these simulations using the Iridium constellation and trajectories as well as realistic military communications scenarios. The simulation results demonstrate DART's ability to discriminate between high-priority and low-priority traffic flows and ensure disparate QoS requirements of these traffic flows.

  2. Soil Property Mapping Over Large Areas Using Sparse Ad-hoc Samples

    NASA Astrophysics Data System (ADS)

    Zhu, A.; Liu, J.

    2011-12-01

    Information on spatial variation of soil properties over large areas is a critical input for environmental modeling at large scales. Yet, quality information on soil spatial variation over large areas is difficult to obtain due to the large number of field samples required. Existing samples are often sparse and ad-hoc. The soil property maps created from these samples using existing techniques are not only at low quality but also lack the uncertainty information. This paper presents a new approach to map soil properties and quantify uncertainty in the derived soil property maps over large areas using sparse and ad-hoc samples. The underlying assumption of this new approach is the soil-landscape concept which stipulates that the more similar the environment conditions between two locations the more similar the soil property values are between the two sites. Under this assumption each sample can be considered as a representative over areas of similar environmental conditions. The level of representation of an individual sample for an unsampled location can be approximated by the similarity between their respective environment conditions. Based on this "individual representation" concept and with a Case-based Reasoning (CBR) approach soil property values at unsampled locations can be predicted and the uncertainty associated with each prediction can also be quantified based on their environmental similarity to individual samples. A case study over the Illy Region, a 50,000 km2 area in Xinjiang, Northwest China, has demonstrated that the approach can be an effective alternative for mapping soil property and quantifying uncertainty over large areas with sparse and ad-hoc samples.

  3. Design and implementation of a MIMO MAC protocol for ad hoc networking

    NASA Astrophysics Data System (ADS)

    Redi, Jason; Watson, Bill; Ramanathan, Ram; Basu, Prithwish; Tchakountio, Fabrice; Girone, Michael; Steenstrup, Martha

    2006-05-01

    Multiple Input Multiple Output (MIMO) provides the potential for significant gains in channel capacity and spectral efficiency through its use of multiple element antenna systems and space-time coding. There are numerous published accounts of experimental MIMO communications links with high numbers of transmit and receive antennas, as well as commercial products exploiting MIMO with smaller antenna configurations. However, the use of MIMO as a modulation scheme for mobile ad hoc networking has so far only been explored as part of a theoretic or simulation exercise. In this paper we describe the design and implementation of a MAC protocol for a MIMO system which is designed to exploit the capability of 8x10 MIMO for ad hoc networks. This work is unique in that from the start our design considered the specific capabilities and parameters of an existing 8x10 MIMO physical layer, including nonnegligible decoding delays, variable array size and coding schemes, as well as fixed frame sizes. Furthermore, given the bandwidths and antenna array sizes available, the physical layer design could achieve hundreds of megabits in link capacity, and our MAC protocol therefore needed to be designed and implemented in such a way as to maximize this capacity, particularly in a network multi-hop environment. Our MIMO-MAC protocol provides this capability while supporting multi-hop ad hoc networks through novel schemes for channel access, segmentation/reassembly, ARQ and link adaptation. This paper discusses the challenges and tradeoffs involved in developing a MAC for real MIMO hardware, and briefly describes a subset of our solutions to them.

  4. Concept Detection and Using Concept in Ad-hoc of Microblog Search

    DTIC Science & Technology

    2012-11-01

    10,887,718 tweets with 200 tags and 2992055 tweets with 301 tags . We use character ASCII code to detect non-English tweets . In specifically, if a tweet ...hfang@ece.udel.edu Abstract: We report our system and experiments in TREC 2012 microblog Ad-hoc task. Our goal is to return most relevant tweets to...about 16 millions tweets over the period from Jan. 24th, 2011 to Feb. 8th, 2011. Each query is presented by short keywords and post time. Systems

  5. Panel Discussion : Report of the APS Ad-Hoc Committee on LGBT Issues

    NASA Astrophysics Data System (ADS)

    Atherton, Tim; Barthelemy, Ramon; Garmon, Savannah; Reeves, Kyle; APS Ad-Hoc Committee on LGBT Issues Team

    Following the presentation of the findings and recommendations of the APS Ad-Hoc Committee on LGBT Issues (C-LGBT) by Committee Chair Michael Falk, a panel discussion will be held featuring several members of the committee. The discussion will focus on how APS can best ensure the recommendations of the committee are carried out in a timely fashion and other ideas on future APS efforts toward LGBT inclusion in physics. Discussion topics will also include the research and other input that shaped the committee's findings and recommendations.

  6. Smart border: ad-hoc wireless sensor networks for border surveillance

    NASA Astrophysics Data System (ADS)

    He, Jun; Fallahi, Mahmoud; Norwood, Robert A.; Peyghambarian, Nasser

    2011-06-01

    Wireless sensor networks have been proposed as promising candidates to provide automated monitoring, target tracking, and intrusion detection for border surveillance. In this paper, we demonstrate an ad-hoc wireless sensor network system for border surveillance. The network consists of heterogeneously autonomous sensor nodes that distributively cooperate with each other to enable a smart border in remote areas. This paper also presents energy-aware and sleeping algorithms designed to maximize the operating lifetime of the deployed sensor network. Lessons learned in building the network and important findings from field experiments are shared in the paper.

  7. Joint Random Access and Power Control Game in Ad Hoc Networks with Noncooperative Users

    NASA Astrophysics Data System (ADS)

    Long, Chengnian; Guan, Xinping

    We consider a distributed joint random access and power control scheme for interference management in wireless ad hoc networks. To derive decentralized solutions that do not require any cooperation among the users, we formulate this problem as non-cooperative joint random access and power control game, in which each user minimizes its average transmission cost with a given rate constraint. Using supermodular game theory, the existence and uniqueness of Nash equilibrium are established. Furthermore, we present an asynchronous distributed algorithm to compute the solution of the game based on myopic best response updates, which converges to Nash equilibrium globally.

  8. A cooperative MAC protocol with error-aware relay selection for wireless ad hoc networks

    NASA Astrophysics Data System (ADS)

    Liu, Shanzhi; Liu, Kai; Wang, Rui; Fang, Ruochen; Liu, Feng

    2017-01-01

    To solve performance degradation caused by channel fading, we propose a cooperative MAC protocol with error-aware relay selection for wireless ad hoc networks in this paper. In the protocol, the transmission error of data packet caused by channel fading are considered in order to achieve the best cooperative gain in the poor quality channel. In the relay selection process, potential relay nodes satisfying corresponding requirement can compete to sever as final relay node by means of priority selection and collision resolution process. Finally, simulation results show that the proposed protocol outperforms other protocol in terms of packet error rate and the saturation throughput.

  9. An accurate predictor-corrector HOC solver for the two dimensional Riemann problem of gas dynamics

    NASA Astrophysics Data System (ADS)

    Gogoi, Bidyut B.

    2016-10-01

    The work in the present manuscript is concerned with the simulation of twodimensional (2D) Riemann problem of gas dynamics. We extend our recently developed higher order compact (HOC) method from one-dimensional (1D) to 2D solver and simulate the problem on a square geometry with different initial conditions. The method is fourth order accurate in space and second order accurate in time. We then compare our results with the available benchmark results. The comparison shows an excellent agreement of our results with the existing ones in the literature. Being a finite difference solver, it is quite straight-forward and simple.

  10. Termolecular rate coefficients and the standard enthalpy of the reaction OH + CS sub 2 + M yields HOCS sub 2 + M

    SciTech Connect

    Diau, E.W.; Lee, Yuanpern )

    1991-01-10

    The reaction between OH and CS{sub 2} has been studied in He in the pressure range 9-270 Torr and the temperature range 249-298 K by means of the laser-photolysis/laser-induced-fluorescence technique. Analysis of the temporal profile of (OH) yielded the rate coefficients for the forward and reverse reactions for the equilibrium OH + CS{sub 2} + M {r equilibrium} HOCS{sub 2} + M and hence the equilibrium constant. Study of the temperature dependence of the equilibrium constant leads to the standard enthalpy of reaction {Delta}H{degree} = {minus}43.9 {plus minus} 5.3 kJ mol{sup {minus}1} and the standard entropy of reaction {Delta}S{degree} = {minus}102.9 {plus minus} 15.4 J K{sup {minus}1} mol{sup {minus}1}. The termolecular rate coefficients for the forward reaction at 298 K have also been determined to be k{sub He}{sup III} = (5.04 {plus minus} 1.01) {times} 10{sup {minus}32} cm{sup 6} molecule{sup {minus}2} s{sup {minus}1} and k{sub CS{sub 2}}{sup III} = (4.28 {plus minus} 1.07) {times} 10{sup {minus}31} cm{sup 6} molecule{sup {minus}2} s{sup {minus}1}.

  11. Nerve endoneurial microstructure facilitates uniform distribution of regenerative fibers: a post hoc comparison of midgraft nerve fiber densities.

    PubMed

    Johnson, Philip J; Newton, Piyaraj; Hunter, Daniel A; Mackinnon, Susan E

    2011-02-01

    Despite their inferiority to nerve autograft, clinical alternatives are commonly used for reconstruction of peripheral nerve injuries because of their convenient off-the-shelf availability. Previously, our group compared isografts with NeuraGen(®) (Integra, Plainsboro, NJ) nerve guides, which are a commercially available type I collagen conduit and processed rat allografts comparable to Avance(®) (AxoGen, Alachua, FL) human decellularized allograft product. From this study, qualitative observations were made of distinct differences in the pattern of regenerating fibers within conduits, acellular allografts, and isografts. In the current post hoc analysis, these observations were quantified. Using nerve density, we statistically compared the differential pattern of regenerating axon fibers within grafts and conduit. The conduits exhibited a consistent decrease in midgraft density when compared with the isograft and acellularized allografts at two gap lengths (14 mm and 28 mm) and time points (12 and 22 weeks). The decrease in density was accompanied by clustered distribution of nerve fibers in conduits, which contrasted the evenly distributed regeneration seen in processed allografts and isografts. We hypothesize that the lack of endoneurial microstructure of conduits results in the clustering regenerating fibers, and that the presence of microstructure in the acellularized allograft and isografts facilitates even distribution of regenerating fibers. © Thieme Medical Publishers.

  12. Characterization of a New Organic-Cation Cyclotetraphosphate: (1,4-HOC 6H 4NH 3) 4P 4O 12· 6H 2O

    NASA Astrophysics Data System (ADS)

    Soumhi, E. H.; Saadoune, I.; Driss, A.; Jouini, T.

    1999-05-01

    The tetra(para-phenolammonium)cyclotetraphosphate hexahydrate, (1,4-HOC6H4NH3)4P4O12· 6H2O (M=864.51 g mol-1), is monoclinicP21/cwith the unit cell parametersa=9.836(2) Å,b=8.591(1) Å,c:22.769(5) Å,β=95.41(2)°. The structure of this compound can be described as a succession of inorganic and organic sheets parallel to the (001) plane. The existence of the OH and NH3groups in positionparato the organic cation leads to the cohesion of the inorganic sheets, forming a three-dimensional network.The IR spectrum of (1,4-HOC6H4NH3)4P4O12· 6H2O is reported and discussed according to the theoretical group analysis. The IR data confirm the atomic arrangement within the structure. The coupled TG-DTA thermal study shows the successive departure of four and two water molecules, confirming the hydrated character of this cyclophosphate.

  13. Early (≤ 1-h) vs. late (>1-h) administration of frovatriptan plus dexketoprofen combination vs. frovatriptan monotherapy in the acute treatment of migraine attacks with or without aura: a post hoc analysis of a double-blind, randomized, parallel group study.

    PubMed

    Allais, Gianni; Bussone, Gennaro; Tullo, Vincenzo; Cortelli, Pietro; Valguarnera, Fabio; Barbanti, Piero; Sette, Giuliano; Frediani, Fabio; D'Arrigo, Giacomo; d'Onofrio, Florindo; Comi, Giancarlo; Curone, Marcella; Colombo, Bruno; Omboni, Stefano; Benedetto, Chiara

    2015-05-01

    The early use of triptan in combination with a nonsteroidal anti-inflammatory drug after headache onset may improve the efficacy of acute migraine treatment. In this retrospective analysis of a randomized, double-blind, parallel group study, we assessed the efficacy of early or late intake of frovatriptan 2.5 mg + dexketoprofen 25 or 37.5 mg (FroDex 25 and FroDex 37.5) vs. frovatriptan 2.5 mg alone (Frova) in the acute treatment of migraine attacks. In this double-blind, randomized parallel group study 314 subjects with acute migraine with or without aura were randomly assigned to Frova, FroDex 25, or FroDex 37.5. Pain free (PF) at 2-h (primary endpoint), PF at 4-h and pain relief (PR) at 2 and 4-h, speed of onset at 60, 90, 120 and 240-min, and sustained pain free (SPF) at 24-h were compared across study groups according to early (≤1-h; n = 220) or late (>1-h; n = 59) intake. PF rates at 2 and 4-h were significantly larger with FroDex 37.5 vs. Frova (early intake, n = 71 FroDex 37.5 and n = 75 Frova: 49 vs. 32 % and 68 vs. 52 %, p < 0.05; late intake, n = 20 Frodex 37.5, and n = 18 Frova: 55 vs. 17 %, p < 0.05 and 85 vs. 28 %, p < 0.01). Also with FroDex 25, in the early intake group (n = 74) PF episodes were significantly higher than Frova. PR at 2 and 4-h was significantly better under FroDex 37.5 than Frova (95 % vs. 50 %, p < 0.001, 100 % vs. 72 %, p < 0.05) in the late intake group (n = 21). SPF episodes at 24-h after early dosing were 25 % (Frova), 45 % (FroDex 25) and 41 % (FroDex 37.5, p < 0.05 combinations vs. monotherapy), whereas they were not significantly different with late intake. All treatments were equally well tolerated. FroDex was similarly effective regardless of intake timing from headache onset.

  14. The HOCS paradigm shift from disciplinary knowledge (LOCS)--to interdisciplinary evaluative, system thinking (HOCS): what should it take in science-technology-environment-society oriented courses, curricula and assessment?

    PubMed

    Zoller, U; Scholz, R W

    2004-01-01

    Given the current world state of affairs, striving for sustainability and the consequent paradigm shift: growth-to-sustainable development, correction-to-prevention and options selection-to-options generation: the corresponding paradigm shift in science-technology-environment-society (STES) education is unavoidable. Accordingly, the essence of the current reform in STES education, worldwide, is a purposed effort to develop students' higher-order cognitive skills (HOCS) capability; i.e., question-asking, critical system thinking, decision making and problem solving, at the expense of the "delivery" of lower-order cognitive skills (LOCS)-oriented knowledge. This means a paradigm shift from the contemporary prevalent LOCS algorithmic teaching to HOCS evaluative learning and HOCS-promoting courses, curricula, teaching strategies and assessment methodologies, leading, hopefully to evaluative thinking and transfer. Following the formulation of selected relevant axioms, major paradigm shift in STES research and education for sustainability have been identified. The consequent shift, in the STES context, from disciplinary to inter- and transdisciplinary learning, in science technology and environmental engineering education is discussed, followed by selected examples of successfully implemented HOCS-promoting courses, and assessment methodologies. It is argued, that transferable "HOCS learning" for sustainability can and should be done.

  15. Texture Analysis and Cartographic Feature Extraction.

    DTIC Science & Technology

    1985-01-01

    Investigations into using various image descriptors as well as developing interactive feature extraction software on the Digital Image Analysis Laboratory...system. Originator-supplied keywords: Ad-Hoc image descriptor; Bayes classifier; Bhattachryya distance; Clustering; Digital Image Analysis Laboratory

  16. Energy-Aware Multipath Routing Scheme Based on Particle Swarm Optimization in Mobile Ad Hoc Networks

    PubMed Central

    Robinson, Y. Harold; Rajaram, M.

    2015-01-01

    Mobile ad hoc network (MANET) is a collection of autonomous mobile nodes forming an ad hoc network without fixed infrastructure. Dynamic topology property of MANET may degrade the performance of the network. However, multipath selection is a great challenging task to improve the network lifetime. We proposed an energy-aware multipath routing scheme based on particle swarm optimization (EMPSO) that uses continuous time recurrent neural network (CTRNN) to solve optimization problems. CTRNN finds the optimal loop-free paths to solve link disjoint paths in a MANET. The CTRNN is used as an optimum path selection technique that produces a set of optimal paths between source and destination. In CTRNN, particle swarm optimization (PSO) method is primly used for training the RNN. The proposed scheme uses the reliability measures such as transmission cost, energy factor, and the optimal traffic ratio between source and destination to increase routing performance. In this scheme, optimal loop-free paths can be found using PSO to seek better link quality nodes in route discovery phase. PSO optimizes a problem by iteratively trying to get a better solution with regard to a measure of quality. The proposed scheme discovers multiple loop-free paths by using PSO technique. PMID:26819966

  17. A Family of ACO Routing Protocols for Mobile Ad Hoc Networks

    PubMed Central

    Rupérez Cañas, Delfín; Sandoval Orozco, Ana Lucila; García Villalba, Luis Javier; Kim, Tai-hoon

    2017-01-01

    In this work, an ACO routing protocol for mobile ad hoc networks based on AntHocNet is specified. As its predecessor, this new protocol, called AntOR, is hybrid in the sense that it contains elements from both reactive and proactive routing. Specifically, it combines a reactive route setup process with a proactive route maintenance and improvement process. Key aspects of the AntOR protocol are the disjoint-link and disjoint-node routes, separation between the regular pheromone and the virtual pheromone in the diffusion process and the exploration of routes, taking into consideration the number of hops in the best routes. In this work, a family of ACO routing protocols based on AntOR is also specified. These protocols are based on protocol successive refinements. In this work, we also present a parallelized version of AntOR that we call PAntOR. Using programming multiprocessor architectures based on the shared memory protocol, PAntOR allows running tasks in parallel using threads. This parallelization is applicable in the route setup phase, route local repair process and link failure notification. In addition, a variant of PAntOR that consists of having more than one interface, which we call PAntOR-MI (PAntOR-Multiple Interface), is specified. This approach parallelizes the sending of broadcast messages by interface through threads. PMID:28531159

  18. Intelligent QoS routing algorithm based on improved AODV protocol for Ad Hoc networks

    NASA Astrophysics Data System (ADS)

    Huibin, Liu; Jun, Zhang

    2016-04-01

    Mobile Ad Hoc Networks were playing an increasingly important part in disaster reliefs, military battlefields and scientific explorations. However, networks routing difficulties are more and more outstanding due to inherent structures. This paper proposed an improved cuckoo searching-based Ad hoc On-Demand Distance Vector Routing protocol (CSAODV). It elaborately designs the calculation methods of optimal routing algorithm used by protocol and transmission mechanism of communication-package. In calculation of optimal routing algorithm by CS Algorithm, by increasing QoS constraint, the found optimal routing algorithm can conform to the requirements of specified bandwidth and time delay, and a certain balance can be obtained among computation spending, bandwidth and time delay. Take advantage of NS2 simulation software to take performance test on protocol in three circumstances and validate the feasibility and validity of CSAODV protocol. In results, CSAODV routing protocol is more adapt to the change of network topological structure than AODV protocol, which improves package delivery fraction of protocol effectively, reduce the transmission time delay of network, reduce the extra burden to network brought by controlling information, and improve the routing efficiency of network.

  19. A Secure 3-Way Routing Protocols for Intermittently Connected Mobile Ad Hoc Networks

    PubMed Central

    Parasuraman, Ganesh Kumar

    2014-01-01

    The mobile ad hoc network may be partially connected or it may be disconnected in nature and these forms of networks are termed intermittently connected mobile ad hoc network (ICMANET). The routing in such disconnected network is commonly an arduous task. Many routing protocols have been proposed for routing in ICMANET since decades. The routing techniques in existence for ICMANET are, namely, flooding, epidemic, probabilistic, copy case, spray and wait, and so forth. These techniques achieve an effective routing with minimum latency, higher delivery ratio, lesser overhead, and so forth. Though these techniques generate effective results, in this paper, we propose novel routing algorithms grounded on agent and cryptographic techniques, namely, location dissemination service (LoDiS) routing with agent AES, A-LoDiS with agent AES routing, and B-LoDiS with agent AES routing, ensuring optimal results with respect to various network routing parameters. The algorithm along with efficient routing ensures higher degree of security. The security level is cited testing with respect to possibility of malicious nodes into the network. This paper also aids, with the comparative results of proposed algorithms, for secure routing in ICMANET. PMID:25136697

  20. Adaptation of mobile ad-hoc network protocols for sensor networks to vehicle control applications

    NASA Astrophysics Data System (ADS)

    Sato, Kenya; Matsui, Yosuke; Koita, Takahiro

    2005-12-01

    As sensor network applications to monitor and control the physical environment from remote locations, a mobile ad-hoc network (MANET) has been the focus of many recent research and development efforts. A MANET, autonomous system of mobile hosts, is characterized by multi-hop wireless links, absence of any cellular infrastructure, and frequent host mobility. Many kinds of routing protocols for ad-hoc network have been proposed and still actively updated, because each application has different characteristics and requirements. Since the current studies show it is almost impossible to design an efficient routing protocol to be adapted for all kinds of applications. We, therefore, have focused a certain application, inter-vehicle communication for ITS (Intelligent Transport Systems), to evaluate the routing protocols. In our experiment, we defined several traffic flow models for inter-vehicle communication applications. By using simulation, we evaluated end-to-end delay and throughput performance of data transmission for inter-vehicle communications with the existing routing protocols. The result confirms the feasibility of using some routing protocols for inter-vehicle communication services.

  1. Opportunistic Hybrid Transport Protocol (OHTP) for Cognitive Radio Ad Hoc Sensor Networks.

    PubMed

    Bin Zikria, Yousaf; Nosheen, Summera; Ishmanov, Farruh; Kim, Sung Won

    2015-12-15

    The inefficient assignment of spectrum for different communications purposes, plus technology enhancements and ever-increasing usage of wireless technology is causing spectrum scarcity. To address this issue, one of the proposed solutions in the literature is to access the spectrum dynamically or opportunistically. Therefore, the concept of cognitive radio appeared, which opens up a new research paradigm. There is extensive research on the physical, medium access control and network layers. The impact of the transport layer on the performance of cognitive radio ad hoc sensor networks is still unknown/unexplored. The Internet's de facto transport protocol is not well suited to wireless networks because of its congestion control mechanism. We propose an opportunistic hybrid transport protocol for cognitive radio ad hoc sensor networks. We developed a new congestion control mechanism to differentiate true congestion from interruption loss. After such detection and differentiation, we propose methods to handle them opportunistically. There are several benefits to window- and rate-based protocols. To exploit the benefits of both in order to enhance overall system performance, we propose a hybrid transport protocol. We empirically calculate the optimal threshold value to switch between window- and rate-based mechanisms. We then compare our proposed transport protocol to Transmission Control Protocol (TCP)-friendly rate control, TCP-friendly rate control for cognitive radio, and TCP-friendly window-based control. We ran an extensive set of simulations in Network Simulator 2. The results indicate that the proposed transport protocol performs better than all the others.

  2. Greedy data transportation scheme with hard packet deadlines for wireless ad hoc networks.

    PubMed

    Lee, HyungJune

    2014-01-01

    We present a greedy data transportation scheme with hard packet deadlines in ad hoc sensor networks of stationary nodes and multiple mobile nodes with scheduled trajectory path and arrival time. In the proposed routing strategy, each stationary ad hoc node en route decides whether to relay a shortest-path stationary node toward destination or a passing-by mobile node that will carry closer to destination. We aim to utilize mobile nodes to minimize the total routing cost as far as the selected route can satisfy the end-to-end packet deadline. We evaluate our proposed routing algorithm in terms of routing cost, packet delivery ratio, packet delivery time, and usability of mobile nodes based on network level simulations. Simulation results show that our proposed algorithm fully exploits the remaining time till packet deadline to turn into networking benefits of reducing the overall routing cost and improving packet delivery performance. Also, we demonstrate that the routing scheme guarantees packet delivery with hard deadlines, contributing to QoS improvement in various network services.

  3. A Family of ACO Routing Protocols for Mobile Ad Hoc Networks.

    PubMed

    Rupérez Cañas, Delfín; Sandoval Orozco, Ana Lucila; García Villalba, Luis Javier; Kim, Tai-Hoon

    2017-05-22

    In this work, an ACO routing protocol for mobile ad hoc networks based on AntHocNet is specified. As its predecessor, this new protocol, called AntOR, is hybrid in the sense that it contains elements from both reactive and proactive routing. Specifically, it combines a reactive route setup process with a proactive route maintenance and improvement process. Key aspects of the AntOR protocol are the disjoint-link and disjoint-node routes, separation between the regular pheromone and the virtual pheromone in the diffusion process and the exploration of routes, taking into consideration the number of hops in the best routes. In this work, a family of ACO routing protocols based on AntOR is also specified. These protocols are based on protocol successive refinements. In this work, we also present a parallelized version of AntOR that we call PAntOR. Using programming multiprocessor architectures based on the shared memory protocol, PAntOR allows running tasks in parallel using threads. This parallelization is applicable in the route setup phase, route local repair process and link failure notification. In addition, a variant of PAntOR that consists of having more than one interface, which we call PAntOR-MI (PAntOR-Multiple Interface), is specified. This approach parallelizes the sending of broadcast messages by interface through threads.

  4. Linking Satellites Via Earth "Hot Spots" and the Internet to Form Ad Hoc Constellations

    NASA Technical Reports Server (NTRS)

    Mandl, Dan; Frye, Stu; Grosvenor, Sandra; Ingram, Mary Ann; Langley, John; Miranda, Felix; Lee, Richard Q.; Romanofsky, Robert; Zaman, Afoz; Popovic, Zoya

    2004-01-01

    As more assets are placed in orbit, opportunities emerge to combine various sets of satellites in temporary constellations to perform collaborative image collections. Often, new operations concepts for a satellite or set of satellites emerge after launch. To the degree with which new space assets can be inexpensively and rapidly integrated into temporary or "ad hoc" constellations, will determine whether these new ideas will be implemented or not. On the Earth Observing 1 (EO-1) satellite, a New Millennium Program mission, a number of experiments were conducted and are being conducted to demonstrate various aspects of an architecture that, when taken as a whole, will enable progressive mission autonomy. In particular, the target architecture will use adaptive ground antenna arrays to form, as close as possible, the equivalent of wireless access points for low earth orbiting satellites. Coupled with various ground and flight software and the Internet. the architecture enables progressive mission autonomy. Thus, new collaborative sensing techniques can be implemented post-launch. This paper will outline the overall operations concept and highlight details of both the research effort being conducted in hoc constellations, mission autonomy and

  5. Greedy Data Transportation Scheme with Hard Packet Deadlines for Wireless Ad Hoc Networks

    PubMed Central

    Lee, HyungJune

    2014-01-01

    We present a greedy data transportation scheme with hard packet deadlines in ad hoc sensor networks of stationary nodes and multiple mobile nodes with scheduled trajectory path and arrival time. In the proposed routing strategy, each stationary ad hoc node en route decides whether to relay a shortest-path stationary node toward destination or a passing-by mobile node that will carry closer to destination. We aim to utilize mobile nodes to minimize the total routing cost as far as the selected route can satisfy the end-to-end packet deadline. We evaluate our proposed routing algorithm in terms of routing cost, packet delivery ratio, packet delivery time, and usability of mobile nodes based on network level simulations. Simulation results show that our proposed algorithm fully exploits the remaining time till packet deadline to turn into networking benefits of reducing the overall routing cost and improving packet delivery performance. Also, we demonstrate that the routing scheme guarantees packet delivery with hard deadlines, contributing to QoS improvement in various network services. PMID:25258736

  6. Hoc protein regulates the biological effects of T4 phage in mammals.

    PubMed

    Dabrowska, Krystyna; Zembala, Maria; Boratynski, Janusz; Switala-Jelen, Kinga; Wietrzyk, Joanna; Opolski, Adam; Szczaurska, Katarzyna; Kujawa, Marek; Godlewska, Joanna; Gorski, Andrzej

    2007-06-01

    We previously investigated the biological, non-antibacterial effects of bacteriophage T4 in mammals (binding to cancer cells in vitro and attenuating tumour growth and metastases in vivo); we selected the phage mutant HAP1 that was significantly more effective than T4. In this study we describe a non-sense mutation in the hoc gene that differentiates bacteriophage HAP1 and its parental strain T4. We found no substantial effects of the mutation on the mutant morphology, and its effects on electrophoretic mobility and hydrodynamic size were moderate. Only the high ionic strength of the environment resulted in a size difference of about 10 nm between T4 and HAP1. We compared the antimetastatic activity of the T2 phage, which does not express protein Hoc, with those of T4 and HAP1 (B16 melanoma lung colonies). We found that HAP1 and T2 decreased metastases with equal effect, more strongly than did T4. We also investigated concentrations of T4 and HAP1 in the murine blood, tumour (B16), spleen, liver, or muscle. We found that HAP1 was rapidly cleared from the organism, most probably by the liver. Although HAP1 was previously defined to bind cancer cells more effectively (than T4), its rapid elimination precluded its higher concentration in tumours.

  7. Linking Satellites Via Earth "Hot Spots" and the Internet to Form Ad Hoc Constellations

    NASA Technical Reports Server (NTRS)

    Mandl, Dan; Frye, Stu; Grosvenor, Sandra; Ingram, Mary Ann; Langley, John; Miranda, Felix; Lee, Richard Q.; Romanofsky, Robert; Zaman, Afoz; Popovic, Zoya

    2004-01-01

    As more assets are placed in orbit, opportunities emerge to combine various sets of satellites in temporary constellations to perform collaborative image collections. Often, new operations concepts for a satellite or set of satellites emerge after launch. To the degree with which new space assets can be inexpensively and rapidly integrated into temporary or "ad hoc" constellations, will determine whether these new ideas will be implemented or not. On the Earth Observing 1 (EO-1) satellite, a New Millennium Program mission, a number of experiments were conducted and are being conducted to demonstrate various aspects of an architecture that, when taken as a whole, will enable progressive mission autonomy. In particular, the target architecture will use adaptive ground antenna arrays to form, as close as possible, the equivalent of wireless access points for low earth orbiting satellites. Coupled with various ground and flight software and the Internet. the architecture enables progressive mission autonomy. Thus, new collaborative sensing techniques can be implemented post-launch. This paper will outline the overall operations concept and highlight details of both the research effort being conducted in hoc constellations, mission autonomy and

  8. P-method post hoc test for adaptive trimmed mean, HQ

    NASA Astrophysics Data System (ADS)

    Low, Joon Khim; Yahaya, Sharipah Soaad Syed; Abdullah, Suhaida; Yusof, Zahayu Md; Othman, Abdul Rahman

    2014-12-01

    Adaptive trimmed mean, HQ, which is one of the latest additions in robust estimators, had been proven to be good in controlling Type I error in omnibus test. However, post hoc (pairwise multiple comparison) procedure for HQ was yet to be developed then. Thus, we have taken the initiative to develop post hoc procedure for HQ. Percentile bootstrap method or P-Method was proposed as it was proven to be effective in controlling Type I error rate even when the sample size was small. This paper deliberates on the effectiveness of P-Method on HQ, denoted as P-HQ. The strength and weakness of the proposed method were put to test on various conditions created by manipulating several variables such as shape of distributions, number of groups, sample sizes, degree of variance heterogeneity and pairing of sample sizes and group variances. For such, a simulation study on 2000 datasets was conducted using SAS/IML Version 9.2. The performance of the method on various conditions was based on its ability in controlling Type I error which was benchmarked using Bradley's criterion of robustness. The finding revealed that P-HQ could effectively control Type I error for almost all the conditions investigated.

  9. Stable nitrogen isotope ratios and accumulation of various HOCs in northern Baltic aquatic food chains

    SciTech Connect

    Broman, D.; Axelman, J.; Bergqvist, P.A.; Naef, C.; Rolff, C.; Zebuehr, Y.

    1995-12-31

    Ratios of naturally occurring stable isotopes of nitrogen ({delta}{sup 15}N) can be used to numerically classify trophic levels of organisms in food chains. By combining analyses results of various HOCs (e.g. PCDD/Fs, PCBs, DDTs, HCHs and some other pesticides) the biomagnification of these substances can be quantitatively estimated. In this paper different pelagic and benthic northern Baltic food chains were studied. The {delta}{sup 15}N-data gave food chain descriptions qualitatively consistent with previous conceptions of trophic arrangements in the food chains. The different HOCs concentrations were plotted versus the {delta}{sup 15}N-values for the different trophic levels and an exponential model of the form e{sup (A+B*{delta}N)} was fitted to the data. The estimates of the constant B in the model allows for an estimation of a biomagnification power (B) of different singular, or groups of, contaminants. A B-value around zero indicates that a substance is flowing through the food chain without being magnified, whereas a value > 0 indicates that a substance is biomagnified. Negative B-values indicate that a substance is not taken up or is metabolized. The A-term of the expression is only a scaling factor depending on the background level of the contaminant.

  10. Who Should Be the Winner: A "Post Hoc" Analysis of the 2000 US Election

    ERIC Educational Resources Information Center

    Wu, D. W.

    2006-01-01

    The 2000 US presidential election between Al Gore and George W. Bush has been the most intriguing and controversial in American history. Using the Florida ballot data, Wu showed that the 2000 election result could have been reversed had the "butterfly ballot effect" been eliminated. Through a combinatorial approach, Harger concluded that…

  11. Modeling and Analysis of Trust Management with Trust Chain Optimization in Mobile Ad Hoc Networks

    DTIC Science & Technology

    2011-03-16

    outside attackers ) nodes when participating nodes are assumed to have no prior interactions. Trust availability is measured by the probability that a...metric, and describes the attack model. Section 5 develops the SPN performance model and describes how the SPN model can be used to evaluate system...over time. This may prevent a newcomer attack attempting to flush out its notorious past trust or reputation.4. System model 4.1. Protocol design and

  12. Daily Fluid Intake and Outcomes in Kidney Recipients: Post hoc analysis from the randomized ABCAN trial

    PubMed Central

    Weber, M; Berglund, D; Reule, S; Jackson, S; Matas, AJ; Ibrahim, HN

    2015-01-01

    Generous and even excessive fluid intake is routinely recommended to kidney transplant recipients despite minimal evidence to support this practice. We hypothesized that increased fluid intake, ascertained by 24-hour urine volume output, may adversely affect graft outcomes as it would impose an extra workload on a limited number of nephrons. Kidney transplant recipients who were randomized to losartan vs. placebo in the ABCAN trial (n=153) underwent baseline, five-year biopsies and annual iothalamate GFR assessment. Recipients with higher urine volume at randomization had higher urinary sodium and also higher urinary protein. The proportion using diuretics or CNI based regimens were similar across urinary volume tertiles. The highest urinary volume tertile (>2.56 L/day) did not predict the development of interstitial volume doubling or ESRD from IF/TA (OR=3.52, 95% CI 0.4, 38.15, p=0.26), interstitial volume doubling or all-cause ESRD (OR=7.04, 95% CI 0.66, 74.87, p=0.10), and was not associated with the conventional endpoint of doubling serum creatinine, all cause ESRD, or death (OR=0.89, 95% CI 0.21, 3.71, p=0.87). These results suggest that the current practice of liberal fluid intake may not be beneficial in low risk and mostly Caucasian transplant recipients. PMID:25619874

  13. Telephone audit for monitoring stroke unit facilities: a post hoc analysis from PROSIT study.

    PubMed

    Candelise, Livia; Gattinoni, Monica; Bersano, Anna

    2015-01-01

    Although several valid approaches exist to measure the number and the quality of acute stroke units, only few studies tested their reliability. This study is aimed at establishing whether the telephone administration of the PROject of Stroke unIt ITaly (PROSIT) audit questionnaire is reliable compared with direct face-to-face interview. Forty-three medical leaders in charge of in-hospital stroke services were interviewed twice using the same PROSIT questionnaire with 2 different modalities. First, the interviewers approached the medical leaders by telephone. Thereafter, they went to the hospital site and performed a direct face-to-face interview. Six independent couples of trained researchers conducted the audit interviews. The degree of intermodality agreement was measured with kappa statistic. We found a perfect agreement for stroke units identification between the 2 different audit modalities (K = 1.00; standard error [SE], 1.525). The agreement was also very good for stroke dedicated beds (K = 1.00; SE, 1.525) and dedicated personnel (K = 1.00; SE, 1.525), which are the 2 components of stroke unit definition. The agreement was lower for declared in use process of care and availability of diagnostic investigations. The telephone audit can be used for monitoring stroke unit structures. It is more rapid, less expensive, and can repeatedly be used at appropriate intervals. However, a reliable description of the process of care and diagnostic investigations indicators should be obtained by either local site audit visit or prospective stroke register based on individual patient data. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  14. A Performance Analysis of an Ad-hoc Ocean Sensor Network

    DTIC Science & Technology

    2006-12-01

    and reconnections . Also, the broadcasting of radio channels can be highly unstable and the network layer has to interact with the MAC layer for...will return the PATH variable that contains a list of previously included pathnames that is colon -delimited. 5. Finally, to verify that ns2 has been

  15. Wireless Ad-Hoc Networks with Receiver Multipacket Reception: Performance Analysis and Signal Processing

    DTIC Science & Technology

    2007-11-02

    estimation and symbol detection algorithms are developed for long code wide-band CDMA systems , including systems with multirate and multicode...CDMA systems . If the spreading codes have good cross- and auto-correlation properties, the matched filter front- end suppresses multiaccess...selective fading, however, code orthogonality can not be guaranteed, and the conventional RAKE receiver that uses a bank of matched filters may perform

  16. Towards Optimization of Macrocognitive Processes: Automating Analysis of the Emergence of Leadership in Ad Hoc Teams

    DTIC Science & Technology

    2014-04-21

    Recognizing Rare Social Phenomena in Conversation: Empowerment Detection in Support Group Chatrooms, Proceedings of the Association for...State University as part of the Learning Sciences Group Speakers Series, April 2nd, 2012. • Carroll, J.M. 2012. Humanity, technology and HCI

  17. Who Should Be the Winner: A "Post Hoc" Analysis of the 2000 US Election

    ERIC Educational Resources Information Center

    Wu, D. W.

    2006-01-01

    The 2000 US presidential election between Al Gore and George W. Bush has been the most intriguing and controversial in American history. Using the Florida ballot data, Wu showed that the 2000 election result could have been reversed had the "butterfly ballot effect" been eliminated. Through a combinatorial approach, Harger concluded that…

  18. F-18 fluorodeoxyglucose PET/CT and post hoc PET/MRI in a case of primary meningeal melanomatosis.

    PubMed

    Lee, Hong Je; Ahn, Byeong-Cheol; Hwang, Seong Wook; Cho, Suk Kyong; Kim, Hae Won; Lee, Sang-Woo; Hwang, Jeong-Hyun; Lee, Jaetae

    2013-01-01

    Primary meningeal melanomatosis is a rare, aggressive variant of primary malignant melanoma of the central nervous system, which arises from melanocytes within the leptomeninges and carries a poor prognosis. We report a case of primary meningeal melanomatosis in a 17-year-old man, which was diagnosed with (18)F-fluorodeoxyglucose (F-18 FDG) PET/CT, and post hoc F-18 FDG PET/MRI fusion images. Whole-body F-18 FDG PET/CT was helpful in ruling out the extracranial origin of melanoma lesions, and in assessing the therapeutic response. Post hoc PET/MRI fusion images facilitated the correlation between PET and MRI images and demonstrated the hypermetabolic lesions more accurately than the unenhanced PET/CT images. Whole body F-18 FDG PET/CT and post hoc PET/MRI images might help clinicians determine the best therapeutic strategy for patients with primary meningeal melanomatosis.

  19. Bioavailability of HOC depending on the colloidal state of humic substances: a case study with PCB-77 and Daphnia magna.

    PubMed

    Gallé, T; Grégoire, Ch; Wagner, M; Bierl, R

    2005-10-01

    Condensed organic matter with higher affinity for hydrophobic organic compounds (HOC) is currently held responsible for slow desorption and concomitant lower bioavailabilities of HOC in sediments and soils. In an experiment with Daphnia magna and IHSS Peat Humic Acid (PHA), we showed that the bioconcentration factor (BCF) of 3,3',4,4'-tetrachlorobiphenyl (PCB-77) was directly related to the charge of the humic colloid, as predicted by the metal-humic binding model WHAM. Consistent with the type of binding to the humic acid (counter-ion accumulation vs. specific binding), increasing the concentration of Na+ and Ca2+ ions generated opposite effects on colloid charge and HOC binding by the humic acid. Condensation as a colloidal phenomenon in solution as well as on surfaces needs to be addressed as a contributor to lower bioavailabilities and, possibly, to slower desorption kinetics.

  20. Energy-efficient distributed constructions of miniumum spanning tree for wireless ad-hoc networks

    SciTech Connect

    Kumar, V. S. A.; Pandurangan, G.; Khan, M.

    2004-01-01

    The Minimum Spanning Tree (MST) problem is one of the most important and commonly occurring primitive in the design and operation of data and communication networks. While there a redistributed algorithms for the MST problem these require relatively large number of messages and time, and are fairly involved, require synchronization and a lot of book keeping; this makes these algorithms impractical for emerging technologies such as ad hoc and sensor networks. In such networks, a sensor has very limited power, and any algorithm needs to be simple, local and energy efficient for being practical. Motivated by these considerations, we study the performance of a class of simple and local algorithms called Nearest Neighbor Tree (NNT) algorithms for energy-efficient construction of MSTs in a wireless ad hoc setting. These employ a very simple idea to eliminate the work involved in cycle detection in other MST algorithms: each node chooses a distinct rank, and connects to the closest node of higher rank. We consider two variants of the NNT algorithms, obtained by two ways of choosing the ranks: (i) Random NNT, in which each node chooses a rank randomly, and (ii) Directional NNT, in which each node uses directional information for choosing the rank. We show provable bounds on the performance of these algorithms in instances obtained by uniformly distributed points in the unit square. Finally, we perform extensive simulations of our algorithms. We tested our algorithms on both uniformly random distributions of points, and on realistic distributions of points in an urban setting. The cost of the tree found by the NNT algorithms is within a factor of 2 of the MST, but there is more than a ten-fold saving on the energy and about a five fold saving on the number of messages sent. Also, our algorithms are significantly simpler to implement compared to, for instance, the GHS algorithm, which is essentially optimal with regards to the message complexity. Thus, our results

  1. An Energy-Efficient and Robust Multipath Routing Protocol for Cognitive Radio Ad Hoc Networks.

    PubMed

    Singh, Kishor; Moh, Sangman

    2017-09-04

    Routing in cognitive radio ad hoc networks (CRAHNs) is a daunting task owing to dynamic topology, intermittent connectivity, spectrum heterogeneity, and energy constraints. Other prominent aspects such as channel stability, path reliability, and route discovery frequency should also be exploited. Several routing protocols have been proposed for CRAHNs in the literature. By stressing on one of the aspects more than any other, however, they do not satisfy all requirements of throughput, energy efficiency, and robustness. In this paper, we propose an energy-efficient and robust multipath routing (ERMR) protocol for CRAHNs by considering all prominent aspects including residual energy and channel stability in design. Even when the current routing path fails, the alternative routing path is immediately utilized. In establishing primary and alternative routing paths, both residual energy and channel stability are exploited simultaneously. Our simulation study shows that the proposed ERMR outperforms the conventional protocol in terms of network throughput, packet delivery ratio, energy consumption, and end-to-end delay.