Extracorporeal shock wave therapy vs cryoultrasound therapy in the treatment of chronic lateral epicondylitis. One year follow up study

PubMed Central

Vulpiani, Maria Chiara; Nusca, Sveva Maria; Vetrano, Mario; Ovidi, Serena; Baldini, Rossella; Piermattei, Cristina; Ferretti, Andrea; Saraceni, Vincenzo Maria

2015-01-01

Summary Background the purpose of this study is to compare the therapeutic effects of extracorporeal shock wave therapy (ESWT) to those of cryoultrasound (Cryo-US) therapy in chronic lateral epicondylitis during a 12-month period. Methods single-blinded, randomized, controlled study of 80 participants treated for chronic LE with 3 ESWT sessions at 48/72-hours intervals (n=40) or 12 Cryo-US therapy sessions (4 sessions per week) (n=40). VAS and satisfactory results, considered as the sum of excellent and good scores in the Roles and Maudsley score, were used as outcome measures at baseline and 3, 6 and 12 months post-treatment. Results the results show statistically significant differences in VAS between the two groups at 6 (p<0.001) and 12 months (p<0.001) in favour of the ESWT Group. At 12 months, a difference of more than 2 points in the VAS between the two groups is demonstrated in favour of the ESWT Group. Considering satisfactory results, significant differences between the two groups are observed at 6 (p=0.003) and 12 months (p <0.001) in favour of the ESWT Group where patients achieve a satisfactory rate over 50%. Conclusions ESWT has better clinical therapeutic results at 6- and 12-month follow-up as compared to Cryo-US therapy. Level of Evidence 1B. PMID:26605190

Implementation of augmented reality in operative dentistry learning.

PubMed

Llena, C; Folguera, S; Forner, L; Rodríguez-Lozano, F J

2018-02-01

To evaluate the efficacy of augmented reality (AR) in the gaining of knowledge and skills amongst dental students in the design of cavity preparations and analyse their degree of satisfaction. AR cavity models were prepared for use with computers and mobile devices. Forty-one students were divided into two groups (traditional teaching methods vs AR). Questionnaires were designed to evaluate knowledge and skills, with the administration of a satisfaction questionnaire for those using AR. The degree of compliance with the standards in cavity design was assessed. The Mann-Whitney U-test was used to compare knowledge and skills between the two groups, and the Wilcoxon test was applied to compare intragroup differences. The chi-square test in turn was used to compare the qualitative parameters of the cavity designs between the groups. Statistical significance was considered for P<.05 in all cases. No significant differences were observed in level of knowledge before, immediately after or 6 months after teaching between the two groups (P>.05). Although the results corresponding to most of the studied skills parameters were better in the experimental group, significant differences (P<.05) were only founded for cavity depth and extent for Class I and divergence of the buccal and lingual walls for the Class II. The experience was rated as favourable or very favourable by 100% of the participants. The students showed preference for computers (60%) vs mobile devices (10%). The AR techniques favoured the gaining of knowledge and skills and were regarded as a useful tool by the students. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

After the RCT: who comes to a family-based intervention for childhood overweight or obesity when it is implemented at scale in the community?

PubMed Central

Fagg, James; Cole, Tim J; Cummins, Steven; Goldstein, Harvey; Morris, Stephen; Radley, Duncan; Sacher, Paul; Law, Catherine

2015-01-01

Background When implemented at scale, the impact on health and health inequalities of public health interventions depends on who receives them in addition to intervention effectiveness. Methods The MEND 7–13 (Mind, Exercise, Nutrition…Do it!) programme is a family-based weight management intervention for childhood overweight and obesity implemented at scale in the community. We compare the characteristics of children referred to the MEND programme (N=18 289 referred to 1940 programmes) with those of the population eligible for the intervention, and assess what predicts completion of the intervention. Results Compared to the MEND-eligible population, proportionally more children who started MEND were: obese rather than overweight excluding obese; girls; Asian; from families with a lone parent; living in less favourable socioeconomic circumstances; and living in urban rather than rural or suburban areas. Having started the programme, children were relatively less likely to complete it if they: reported ‘abnormal’ compared to ‘normal’ levels of psychological distress; were boys; were from lone parent families; lived in less favourable socioeconomic circumstances; and had participated in a relatively large MEND programme group; or where managers had run more programmes. Conclusions The provision and/or uptake of MEND did not appear to compromise and, if anything, promoted participation of those from disadvantaged circumstances and ethnic minority groups. However, this tendency was diminished because programme completion was less likely for those living in less favourable socioeconomic circumstances. Further research should explore how completion rates of this intervention could be improved for particular groups. PMID:25294895

Upweighting rare favourable alleles increases long-term genetic gain in genomic selection programs.

PubMed

Liu, Huiming; Meuwissen, Theo H E; Sørensen, Anders C; Berg, Peer

2015-03-21

The short-term impact of using different genomic prediction (GP) models in genomic selection has been intensively studied, but their long-term impact is poorly understood. Furthermore, long-term genetic gain of genomic selection is expected to improve by using Jannink's weighting (JW) method, in which rare favourable marker alleles are upweighted in the selection criterion. In this paper, we extend the JW method by including an additional parameter to decrease the emphasis on rare favourable alleles over the time horizon, with the purpose of further improving the long-term genetic gain. We call this new method dynamic weighting (DW). The paper explores the long-term impact of different GP models with or without weighting methods. Different selection criteria were tested by simulating a population of 500 animals with truncation selection of five males and 50 females. Selection criteria included unweighted and weighted genomic estimated breeding values using the JW or DW methods, for which ridge regression (RR) and Bayesian lasso (BL) were used to estimate marker effects. The impacts of these selection criteria were compared under three genetic architectures, i.e. varying numbers of QTL for the trait and for two time horizons of 15 (TH15) or 40 (TH40) generations. For unweighted GP, BL resulted in up to 21.4% higher long-term genetic gain and 23.5% lower rate of inbreeding under TH40 than RR. For weighted GP, DW resulted in 1.3 to 5.5% higher long-term gain compared to unweighted GP. JW, however, showed a 6.8% lower long-term genetic gain relative to unweighted GP when BL was used to estimate the marker effects. Under TH40, both DW and JW obtained significantly higher genetic gain than unweighted GP. With DW, the long-term genetic gain was increased by up to 30.8% relative to unweighted GP, and also increased by 8% relative to JW, although at the expense of a lower short-term gain. Irrespective of the number of QTL simulated, BL is superior to RR in maintaining genetic variance and therefore results in higher long-term genetic gain. Moreover, DW is a promising method with which high long-term genetic gain can be expected within a fixed time frame.

Cost per response for abatacept versus adalimumab in rheumatoid arthritis by ACPA subgroups in Germany, Italy, Spain, US and Canada.

PubMed

Weijers, Laure; Baerwald, Christoph; Mennini, Francesco S; Rodríguez-Heredia, José M; Bergman, Martin J; Choquette, Denis; Herrmann, Kirsten H; Attinà, Giulia; Nappi, Carmela; Merino, Silvia Jimenez; Patel, Chad; Mtibaa, Mondher; Foo, Jason

2017-07-01

Rheumatoid arthritis (RA) is a chronic inflammatory disorder leading to disability and reduced quality of life. Effective treatment with biologic DMARDs poses a significant economic burden. The Abatacept versus Adalimumab Comparison in Biologic-Naïve RA Subjects with Background Methotrexate (AMPLE) trial was a head-to-head, randomized study comparing abatacept in serum anti-citrullinated protein antibody (ACPA)-positive patients, with increasing efficacy across ACPA quartile levels. The aim of this study was to evaluate the cost per response accrued using abatacept versus adalimumab in ACPA-positive and ACPA-negative patients with RA from the health care perspective in Germany, Italy, Spain, the US and Canada. A cost-consequence analysis (CCA) was designed to compare the monthly costs per responding patient/patient in remission. Efficacy, safety and resource use inputs were based on the AMPLE trial. A one-way deterministic sensitivity analysis (OWSA) was also performed to assess the impact of model inputs on the results for total incremental costs. Cost per response in ACPA-positive patients favoured abatacept compared with adalimumab (ACR20, ACR90 and HAQ-DI). Subgroup analysis favoured abatacept with increasing stringency of response criteria and serum ACPA levels. Cost per remission (DAS28-CRP) favoured abatacept in ACPA-negative patients, while cost per CDAI and SDAI favoured abatacept in ACPA-positive patients. Abatacept was consistently favoured in ACPA-Q4 patients across all outcomes and countries. Cost savings were greater with abatacept when more stringent response criteria were applied and also with increasing ACPA levels, which could lead to a lower overall health care budget impact with abatacept compared with adalimumab.

Fluorimetric determination of some thiol compounds in their dosage forms.

PubMed

Al-Ghannam, Sh M; El-Brashy, A M; Al-Farhan, B S

2002-08-01

A simple fluorimetric procedure was adopted for determination of three pharmaceutical compounds containing thiol groups namely, captopril, D-penicillamine and N-acetylcysteine. In this method, the drugs are treated with 1,2-naphthoquinone-4-sulfonic acid. The latter is reduced to 1,2-dihydroxynaphthalene-4-sulfonic acid which has a maximum fluorescence intensity at 480/318 nm (lambdaEm/Ex). The method is sensitive to 0.5-4.5 pg ml(- 1) with minimum detectability 0.05 microg ml(-1) (S/N = 2), and has been applied to determine these three thiols in their dosage forms. The results obtained are compared favourably with those obtained by their pharmacopeial methods.

Did the English strategy reduce inequalities in health? A difference-in-difference analysis comparing England with three other European countries.

PubMed

Hu, Yannan; van Lenthe, Frank J; Judge, Ken; Lahelma, Eero; Costa, Giuseppe; de Gelder, Rianne; Mackenbach, Johan P

2016-08-24

Between 1997 and 2010, the English government pursued an ambitious programme to reduce health inequalities, the explicit and sustained commitment of which was historically and internationally unique. Previous evaluations have produced mixed results. None of these evaluations have, however, compared the trends in health inequalities within England with those in other European countries. We carried out an innovative analysis to assess whether changes in trends in health inequalities observed in England after the implementation of its programme, have been more favourable than those in other countries without such a programme. Data were obtained from nationally representative surveys carried out in England, Finland, the Netherlands and Italy for years around 1990, 2000 and 2010. A modified difference-in-difference approach was used to assess whether trends in health inequalities in 2000-2010 were more favourable as compared to the period 1990-2000 in England, and the changes in trends in inequalities after 2000 in England were then compared to those in the three comparison countries. Health outcomes were self-assessed health, long-standing health problems, smoking status and obesity. Education was used as indicator of socioeconomic position. After the implementation of the English strategy, more favourable trends in some health indicators were observed among low-educated people, but trends in health inequalities in 2000-2010 in England were not more favourable than those observed in the period 1990-2000. For most health indicators, changes in trends of health inequalities after 2000 in England were also not significantly different from those seen in the other countries. In this rigorous analysis comparing trends in health inequalities in England both over time and between countries, we could not detect a favourable effect of the English strategy. Our analysis illustrates the usefulness of a modified difference-in-difference approach for assessing the impact of policies on population-level health inequalities.

Temporal comparison of ultrasound vs. auscultation and capnography in verification of endotracheal tube placement.

PubMed

Pfeiffer, P; Rudolph, S S; Børglum, J; Isbye, D L

2011-11-01

This study compared the time consumption of bilateral lung ultrasound with auscultation and capnography for verifying endotracheal intubation. A prospective, paired, and investigator-blinded study carried out in the operating theatre. Twenty-five adult patients requiring endotracheal intubation were included. During intubation, transtracheal ultrasound was performed to visualize passage of the endotracheal tube. During bag ventilation, bilateral lung ultrasound was performed for the detection of lung sliding as a sign of ventilation simultaneous with capnography and auscultation of the epigastrium and chest. Primary outcome measure was time difference to confirmed endotracheal intubation between ultrasound and auscultation alone. Secondary outcome measure was time difference between ultrasound and auscultation combined with capnography. Both methods verified endotracheal tube placement in all patients. In 68% of patients, endotracheal tube placement was visualized by real-time transtracheal ultrasound. Comparing ultrasound with the combination of auscultation and capnography, there was a significant difference between the two methods. Median time for ultrasound was 40 s [interquartile range (IQR) 35-48 s] vs. 48 s (IQR 45-53 s), P < 0.0001. Mean difference was -7.1 s in favour of ultrasound [95% confidence interval (CI) -9.4--4.8 s]. No significant difference was found between ultrasound compared with auscultation alone. Median time for auscultation alone was 42 s (IQR 37-47 s), P = 0.6, with a mean difference of -0.88 s in favour of ultrasound (95% CI -4.2-2.5 s). Verification of endotracheal tube placement with ultrasound is as fast as auscultation alone and faster than the standard method of auscultation and capnography. © 2011 The Authors. Acta Anaesthesiologica Scandinavica © 2011 The Acta Anaesthesiologica Scandinavica Foundation.

Effects of male literacy on family size: A cross sectional study conducted in Chakwal city.

PubMed

Mahmood, Humaira; Khan, Ziaullah; Masood, Sumaira

2016-04-01

To determine the effects of male education on family size, the desired family size, knowledge and use of contraception and opinion about female education. The cross-sectional study was carried out in Chakwal city, Punjab, Pakistan, from June to October 2009. A pre-tested questionnaire was used for data collection. The respondents were males and data on their demographics, age at marriage, actual and desired family size, knowledge about methods of contraception, and opinion about female education was collected. SPSS 15 was used for statistical analysis. Out of the 178 respondents, 52(29.2%) were illiterate and 126(70.8%) were educated. Among the educated, 97(77%) were in favour of small families compared to only 10(19.2%) of the uneducated males (p< 0.001). Besides, 118 (93.6%) educated males were aware of any method of contraception. The most important source of awareness was television 45(37.8%) followed by lady health visitors 40(33.9%). Among the respondents, 38(21.3%) were not using any contraceptive method because they considered it unIslamic, 16(9.1%) had fear of side effects, 57(32.0%) were desirous of large families, while 67(37.6%) had other reasons, like trying to conceive. Among the uneducated males, 17(32.7%) didn't discuss any family planning issue with their wives compared to 14(11.3%) of educated males (p< 0.001). Educational status of the males had an effect on the desired family size, contraceptive use and views in favour of female education.

Darwin's Arguments in Favour of Natural Selection and against Special Creationism

ERIC Educational Resources Information Center

Nola, Robert

2013-01-01

In many places in "The Origin of Species", Darwin compares his own theory of Natural Selection favourably with Special Creationism which comes off as a bad second best. He does this using some version of the argument form known as "Inference to the Best Explanation". The first part of this paper is methodological. It considers Whewell's notion of…

[Analysis of efficacy of radiofrequency obliteration with due regard for the target vein's diameter].

PubMed

Shaĭdakov, E V; Grigorian, A G; Iliukhin, E A; Bulatov, V L; Gal'chenko, M I

2014-01-01

Data concerning the effect of the target vein's diameter on efficacy of radiofrequency obliteration (RFO) in the current literature are limited. To assess efficacy of RFO and stripping, peculiarities of the postoperative period course with due regard for the diameter of the target veins, to compare the outcomes of RFO and classical phlebectomy in treatment of varicose disease during 1-year follow up by a composite end point. A multicenter prospective non-randomized study based on analysing therapeutic outcomes in a total of 218 patients presenting with varicose disease (C2-C3 according to the CEAP). RFO was performed in 108 patients and phlebectomy in 110 subjects. The results were assessed by means of a composite end point including four components: technical outcome at 1-year follow-up, pain, subcutaneous haemorrhage, and paresthesias. The groups of patients who endured RFO and phlebectomy were subdivided into two subgroups according to the target vein's diameter with a border of 14 mm. Statistical analysis. We used the methods of non-parametric statistics (contingency tables, chi squared test), calculating the odds ratio (OR) for a favourable outcome with a 95% confidential interval. Pain dynamics was assessed by means of intellectual data analysis (cluster analysis). «Phelbectomy ≥ 14 mm» and «RFO ≥ 14 mm». The incidence rate of a good outcome in the subgroups amounted to 20 (30.8%) and 61 (95.3%), respectively. The odds ratio for favourable outcome between the subgroups of RFA and phlebectomy amounted to 45.8; 95% CI (44.5-47.0). "RFA ≥ 14 mm" and "RFA < 14 mm". Favourable outcome rate in the subgroups amounted to 25 (39.1%) and 17 (38.6%), respectively. The differences were not statistically significant, p=0.24. The odds ratio for a good outcome between the RFO subgroups amounted to: OR=0.98; 95% CI (0.18-1.77). Comparative analysis of RFO outcomes between the clinics. Favourable outcome rate in the first clinic was 50 (92.6%), in the second 34 (87.2%), and in the third 13 (86.6%), with the difference being statistically insignificant, p=0.7. The cluster analysis of the pain dynamics after the intervention. The clusters with moderate pain were composed of the patients after phlebectomy. These clusters showed association of pain intensity with increased BMI and greater vein diameter. 1) RFA of great-diameter veins by a favourable outcome by the composite end point (CED) turned out to be superior to the classic phlebectomy. 2) For RFA the incidence rate of a favourable outcome by the CED does not depend on the target vein's diameter. 3) A pronounced pain syndrome after phlebectomy was associated with excessive body weight or obesity and greater diameter of the vein.

Ischemic stroke lesion segmentation in multi-spectral MR images with support vector machine classifiers

NASA Astrophysics Data System (ADS)

Maier, Oskar; Wilms, Matthias; von der Gablentz, Janina; Krämer, Ulrike; Handels, Heinz

2014-03-01

Automatic segmentation of ischemic stroke lesions in magnetic resonance (MR) images is important in clinical practice and for neuroscientific trials. The key problem is to detect largely inhomogeneous regions of varying sizes, shapes and locations. We present a stroke lesion segmentation method based on local features extracted from multi-spectral MR data that are selected to model a human observer's discrimination criteria. A support vector machine classifier is trained on expert-segmented examples and then used to classify formerly unseen images. Leave-one-out cross validation on eight datasets with lesions of varying appearances is performed, showing our method to compare favourably with other published approaches in terms of accuracy and robustness. Furthermore, we compare a number of feature selectors and closely examine each feature's and MR sequence's contribution.

Medical practitioners' reactions towards family medicine as a speciality in South Africa

PubMed Central

Esterhuizen, Tonya; Gathiram, Prem

2009-01-01

ABSTRACT Background Family physicians are trained to treat a wide range of diseases, treatment being centred on the patient, family and community irrespective of age, gender, or ethnic or racial background. To deal with inequalities in health care, the South African government introduced the concept of a district health system in 1997. It was only in August 2007, however, that family medicine was legislated as a speciality. This study was undertaken prior to the enactment of this legislation. Method A descriptive quantitative study using a self-administered questionnaire was undertaken. A convenience sampling technique was used (N = 60) to assess the reactions of medical practitioners towards the impending legislation. Results Overall, 60% of the sample was in favour of the legislation. There were no significant differences between those working in the private and public sectors or between generalists and specialists. With regard to those not in favour of the legislation compared to those in favour of the legislation, a significantly increased number answered the following statements in the affirmative: (i) ‘I already carry out the functions of a family physician’ (p = 0.001), (ii) ‘They [specialist family physicians] will not be as qualified as specialists in other categories’ (p = 0.005), (iii) ‘It will have a negative impact on general practice’ (p < 0.001), (iv) ‘It will increase competitiveness’ (p = 0.021), (v) ‘It will not have any effect on patient care’ (p = 0.010) and (vi) ‘There is no need for such a speciality’ (p = 0.001). Conclusion We concluded that the majority were in favour of the legislation being implemented.

Theoretical Investigations on the Influence of Artificially Altered Rock Mass Properties on Mechanical Excavation

NASA Astrophysics Data System (ADS)

Hartlieb, Philipp; Bock, Stefan

2018-03-01

This study presents a theoretical analysis of the influence of the rock mass rating on the cutting performance of roadheaders. Existing performance prediction models are assessed for their suitability for forecasting the influence of pre-damaging the rock mass with alternative methods like lasers or microwaves, prior to the mechanical excavation process. Finally, the RMCR model was chosen because it is the only reported model incorporating a range of rock mass properties into its calculations. The results show that even very tough rocks could be mechanically excavated if the occurrence, orientation and condition of joints are favourable for the cutting process. The calculated improvements in the cutting rate (m3/h) are up to 350% for the most favourable cases. In case of microwave irradiation of hard rocks with an UCS of 200 MPa, a reasonable improvement in the performance by 120% can be achieved with as little as an extra 0.7 kWh/m3 (= 1% more energy) compared to cutting only.

Exercise effects on adipokines and the IGF axis in men with prostate cancer treated with androgen deprivation: A randomized study

PubMed Central

Mina, Daniel Santa; Connor, Michael K.; Alibhai, Shabbir M.H.; Toren, Paul; Guglietti, Crissa; Matthew, Andrew G.; Trachtenberg, John; Ritvo, Paul

2013-01-01

Background Androgen deprivation therapy (ADT) has significant deleterious effects on body composition that may be accompanied by unfavourable changes in adipokine levels. While exercise has been shown to improve a number of side effects associated with ADT for prostate cancer, no studies have assessed the effect of exercise on adiponectin and leptin levels, which have been shown to alter the mitogenic environment. Methods: Twenty-six men with prostate cancer treated with ADT were randomized to home-based aerobic exercise training or resistance exercise training for 24 weeks. Adiponectin, leptin, insulin-like growth factor 1 (IGF-1), insulin-like growth factor binding protein 3 (IGFBP-3) were analyzed by ELISA (enzyme-linked immunosorbent assay), in addition to physical activity volume, peak aerobic capacity, and anthropometric measurements, at baseline, 3 months and 6 months. Results: Resistance exercise significantly reduced IGF-1 after 3 months (p = 0.019); however, this change was not maintained at 6 months. At 6 months, IGFBP-3 was significantly increased compared to baseline for the resistance training group (p = 0.044). In an exploratory analysis of all exercisers, favourable changes in body composition and aerobic fitness were correlated with favourable levels of leptin, and favourable leptin:adiponectin and IGF-1:IGFBP-3 ratios at 3 and 6 months. Conclusions: Home-based exercise is correlated with positive changes in adipokine levels and the IGF-axis that may be related to healthy changes in physical fitness and body composition. While the improvements of adipokine markers appear to be more apparent with resistance training compared to aerobic exercise, these findings must be considered cautiously and require replication from larger randomized controlled trials to clarify the role of exercise on adipokines and IGF-axis proteins for men with prostate cancer. PMID:24282459

Agomelatine versus Sertraline: An Observational, Open-labeled and 12 Weeks Follow-up Study on Efficacy and Tolerability

PubMed Central

Akpınar, Esma; Cerit, Cem; Talas, Anıl; Tural, Ümit

2016-01-01

Objective In this open-labeled, 12 weeks follow-up study, we aimed to compare the efficacy and tolerability of agomelatine with sertraline Methods The outpatients of adult psychiatry clinic who have a new onset of depression and diagnosed as ‘major depressive episode’ by clinician according to the Diagnostic and Statistical Manual of Mental Disorders 4th edition and prescribed agomelatine (25 mg/day) or sertraline (50 mg/day) were included in the study. Results The decline of mean Montgomery-Asberg Depression Rating Scale (MADRS) scores of agomelatine group was significantly higher than the sertraline group at the end of 2nd week; however, the difference was not significant at the end of 3 months. Mean Clinical Global Impression-Improvement scale (CGI-I) scores of agomelatine group was lower than sertraline group at first week. Mean CGI-Severity scale and CGI-I scores were favour to sertraline group at the end of the study. Remission rates were 46.7% for sertraline group and 33.3% for agomelatine group while response rates were 76.7% for both groups. Any patient from agomelatine group dropped-out due to adverse effects. The amount of side effects was also less with agomelatine. Conclusion Agomelatine has a rapid onset efficacy on depressive symptoms and this can be beneficial for some critical cases. Considering MADRS scores, agomelatine seems to have similar efficacy with sertraline but we also point the need for long term studies since CGI scores were favour to sertraline group at the end of the study. Agomelatine has a favourable tolerability profile both in terms of discontinuation and the amount of side effects compared to sertraline. PMID:27776387

Cost-effectiveness of prenatal food and micronutrient interventions on under-five mortality and stunting: Analysis of data from the MINIMat randomized trial, Bangladesh

PubMed Central

Selling, Katarina Ekholm; Shaheen, Rubina; Khan, Ashraful Islam; Persson, Lars-Åke; Lindholm, Lars

2018-01-01

Introduction Nutrition interventions may have favourable as well as unfavourable effects. The Maternal and Infant Nutrition Interventions in Matlab (MINIMat), with early prenatal food and micronutrient supplementation, reduced infant mortality and were reported to be very cost-effective. However, the multiple micronutrients (MMS) supplement was associated with an increased risk of stunted growth in infancy and early childhood. This unfavourable outcome was not included in the previous cost-effectiveness analysis. The aim of this study is to evaluate whether the MINIMat interventions remain cost-effective in view of both favourable (decreased under-five-years mortality) and unfavourable (increased stunting) outcomes. Method Pregnant women in rural Bangladesh, where food insecurity still is prevalent, were randomized to early (E) or usual (U) invitation to be given food supplementation and daily doses of 30 mg, or 60 mg iron with 400 μg of folic acid, or MMS with 15 micronutrients including 30 mg iron and 400 μg of folic acid. E reduced stunting at 4.5 years compared with U, MMS increased stunting at 4.5 years compared with Fe60, while the combination EMMS reduced infant mortality compared with UFe60. The outcome measure used was disability adjusted life years (DALYs), a measure of overall disease burden that combines years of life lost due to premature mortality (under five-year mortality) and years lived with disability (stunting). Incremental cost effectiveness ratios were calculated using cost data from already published studies. Results By incrementing UFe60 (standard practice) to EMMS, one DALY could be averted at a cost of US$24. Conclusion When both favourable and unfavourable outcomes were included in the analysis, early prenatal food and multiple micronutrient interventions remained highly cost effective and seem to be meaningful from a public health perspective. PMID:29447176

Response Adjusted for Days of Antibiotic Risk (RADAR): evaluation of a novel method to compare strategies to optimize antibiotic use.

PubMed

Schweitzer, V A; van Smeden, M; Postma, D F; Oosterheert, J J; Bonten, M J M; van Werkhoven, C H

2017-12-01

The Response Adjusted for Days of Antibiotic Risk (RADAR) statistic was proposed to improve the efficiency of trials comparing antibiotic stewardship strategies to optimize antibiotic use. We studied the behaviour of RADAR in a non-inferiority trial in which a β-lactam monotherapy strategy (n = 656) was non-inferior to fluoroquinolone monotherapy (n = 888) for patients with moderately severe community-acquired pneumonia. Patients were ranked according to clinical outcome, using five or eight categories, and antibiotic use. RADAR was calculated as the probability that the β-lactam group had a more favourable ranking than the fluoroquinolone group. To investigate the sensitivity of RADAR to detrimental clinical outcome we simulated increasing rates of 90-day mortality in the β-lactam group and performed the RADAR and non-inferiority analysis. The RADAR of the β-lactam group compared with the fluoroquinolone group was 60.3% (95% CI 57.9%-62.7%) using five and 58.4% (95% CI 56.0%-60.9%) using eight clinical outcome categories, all in favour of β-lactam. Sample sizes for RADAR were 38% (250/653) and 89% (580/653) of the non-inferiority sample size calculation, using five or eight clinical outcome categories, respectively. With simulated mortality rates, loss of non-inferiority of the β-lactam group occurred at a relative risk of 1.125 in the conventional analysis, whereas using RADAR the β-lactam group lost superiority at a relative risk of mortality of 1.25 and 1.5, with eight and five clinical outcome categories, respectively. RADAR favoured β-lactam over fluoroquinolone therapy for community-acquired pneumonia. Although RADAR required fewer patients than conventional non-inferiority analysis, the statistic was less sensitive to detrimental outcomes. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Machine vs. human translation of SNOMED CT terms.

PubMed

Schulz, Stefan; Bernhardt-Melischnig, Johannes; Kreuzthaler, Markus; Daumke, Philipp; Boeker, Martin

2013-01-01

In the context of past and current SNOMED CT translation projects we compare three kinds of SNOMED CT translations from English to German by: (t1) professional medical translators; (t2) a free Web-based machine translation service; (t3) medical students. 500 SNOMED CT fully specified names from the (English) International release were randomly selected. Based on this, German translations t1, t2, and t3 were generated. A German and an Austrian physician rated the translations for linguistic correctness and content fidelity. Kappa for inter-rater reliability was 0.4 for linguistic correctness and 0.23 for content fidelity. Average ratings of linguistic correctness did not differ significantly between human translation scenarios. Content fidelity was rated slightly better for student translators compared to professional translators. Comparing machine to human translation, the linguistic correctness differed about 0.5 scale units in favour of the human translation and about 0.25 regarding content fidelity, equally in favour of the human translation. The results demonstrate that low-cost translation solutions of medical terms may produce surprisingly good results. Although we would not recommend low-cost translation for producing standardized preferred terms, this approach can be useful for creating additional language-specific entry terms. This may serve several important use cases. We also recommend testing this method to bootstrap a crowdsourcing process, by which term translations are gathered, improved, maintained, and rated by the user community.

Teaching musculoskeletal clinical skills to medical trainees and physicians: a Best Evidence in Medical Education systematic review of strategies and their effectiveness: BEME Guide No. 18.

PubMed

O'Dunn-Orto, Alexandra; Hartling, Lisa; Campbell, Sandra; Oswald, Anna E

2012-01-01

Musculoskeletal (MSK) complaints make up 12-20% of primary health visits and are a source of significant expenditures and morbidity. Despite this, MSK examination is an area of weakness among practising physicians. Several studies have highlighted the need for increased MSK physical exam teaching. However, increased teaching time alone does not guarantee improvement in these skills. Thus, we aimed to identify interventions that are effective in promoting transfer of MSK clinical skills. The review protocol was approved by the Best Evidence in Medical Education (BEME) organization. A comprehensive search was conducted and systematic review methods were applied. Data were not pooled statistically due to heterogeneity. About 5089 titles were screened; 24 studies were included. Eighteen of 24 studies focused on undergraduate medical education. Five of nine studies favoured patient educator. Five of six studies favoured interactive small groups, two of four studies favoured computer-assisted learning, and two of two studies favoured peer learning. Individual studies demonstrated effectiveness of reminder sheets and Gait Arms Legs Spine teaching, respectively. This study supports the use of different instructional methods that engage learners and provide meaningful learning contexts. The majority of the studies support patient educators and interactive small group teaching.

An instrumental electrode model for solving EIT forward problems.

PubMed

Zhang, Weida; Li, David

2014-10-01

An instrumental electrode model (IEM) capable of describing the performance of electrical impedance tomography (EIT) systems in the MHz frequency range has been proposed. Compared with the commonly used Complete Electrode Model (CEM), which assumes ideal front-end interfaces, the proposed model considers the effects of non-ideal components in the front-end circuits. This introduces an extra boundary condition in the forward model and offers a more accurate modelling for EIT systems. We have demonstrated its performance using simple geometry structures and compared the results with the CEM and full Maxwell methods. The IEM can provide a significantly more accurate approximation than the CEM in the MHz frequency range, where the full Maxwell methods are favoured over the quasi-static approximation. The improved electrode model will facilitate the future characterization and front-end design of real-world EIT systems.

Review of methods used by chiropractors to determine the site for applying manipulation

PubMed Central

2013-01-01

Background With the development of increasing evidence for the use of manipulation in the management of musculoskeletal conditions, there is growing interest in identifying the appropriate indications for care. Recently, attempts have been made to develop clinical prediction rules, however the validity of these clinical prediction rules remains unclear and their impact on care delivery has yet to be established. The current study was designed to evaluate the literature on the validity and reliability of the more common methods used by doctors of chiropractic to inform the choice of the site at which to apply spinal manipulation. Methods Structured searches were conducted in Medline, PubMed, CINAHL and ICL, supported by hand searches of archives, to identify studies of the diagnostic reliability and validity of common methods used to identify the site of treatment application. To be included, studies were to present original data from studies of human subjects and be designed to address the region or location of care delivery. Only English language manuscripts from peer-reviewed journals were included. The quality of evidence was ranked using QUADAS for validity and QAREL for reliability, as appropriate. Data were extracted and synthesized, and were evaluated in terms of strength of evidence and the degree to which the evidence was favourable for clinical use of the method under investigation. Results A total of 2594 titles were screened from which 201 articles met all inclusion criteria. The spectrum of manuscript quality was quite broad, as was the degree to which the evidence favoured clinical application of the diagnostic methods reviewed. The most convincing favourable evidence was for methods which confirmed or provoked pain at a specific spinal segmental level or region. There was also high quality evidence supporting the use, with limitations, of static and motion palpation, and measures of leg length inequality. Evidence of mixed quality supported the use, with limitations, of postural evaluation. The evidence was unclear on the applicability of measures of stiffness and the use of spinal x-rays. The evidence was of mixed quality, but unfavourable for the use of manual muscle testing, skin conductance, surface electromyography and skin temperature measurement. Conclusions A considerable range of methods is in use for determining where in the spine to administer spinal manipulation. The currently published evidence falls across a spectrum ranging from strongly favourable to strongly unfavourable in regard to using these methods. In general, the stronger and more favourable evidence is for those procedures which take a direct measure of the presumptive site of care– methods involving pain provocation upon palpation or localized tissue examination. Procedures which involve some indirect assessment for identifying the manipulable lesion of the spine–such as skin conductance or thermography–tend not to be supported by the available evidence. PMID:24499598

Effects of Strength Training Using Unstable Surfaces on Strength, Power and Balance Performance Across the Lifespan: A Systematic Review and Meta-analysis.

PubMed

Behm, David G; Muehlbauer, Thomas; Kibele, Armin; Granacher, Urs

2015-12-01

The effectiveness of strength training on unstable surfaces (STU) versus stable surfaces (STS) or a control condition (CON; i.e., no training or regular training only) for strength, power and balance performance across the lifespan has not yet been investigated in a systematic review and meta-analysis. The aims of this systematic review and meta-analysis were to determine the general effects of STU versus STS or CON on muscle strength, power and balance in healthy individuals across the lifespan and to investigate whether performance changes following STU are age specific. A computerized systematic literature search was performed in the electronic databases PubMed and Web of Science from January 1984 up to February 2015. Initially, 209 articles were identified for review. Only controlled trials were included if they investigated STU in healthy individuals and tested at least one measure of maximal strength, strength endurance, muscle power, or static/dynamic balance. In total, 22 studies met the inclusion criteria. The included studies were coded for the following criteria: age, sex, training status, training modality, exercise and test modality. Effect size measures included within-subject standardized mean differences (SMDw) and weighted between-subject standardized mean differences (SMDb). Heterogeneity between studies was assessed using I2 and χ2 statistics. The methodological quality of each study was assessed using the Physiotherapy Evidence Database (PEDro) Scale. Our search failed to identify studies that examined the effects of STU versus STS or CON in children and middle-aged adults. However, four studies were identified that investigated the effects of STU versus CON or STS in adolescents, 15 studies were identified in young adults and three studies were identified in old adults. Compared with CON, STU produced medium effects on maximal strength in young adults and no effects to medium effects in old adults. In addition, large effects were detected on strength endurance in adolescents and in young adults; in old adults, a small effect was found. With regard to muscle power, medium effects were observed in young adults and small effects were observed in old adults. Further, large effects were found for static and dynamic balance in old adults, but only a small effect was found for dynamic balance in young adults. The comparison of STU and STS revealed inconsistent results as indicated by training-induced changes in favour of STU, as well as STS. Small to medium effects were found for maximal strength in adolescents in favour of STS, and small effects were found in young adults in favour of STU. With regard to strength endurance, large effects were found in adolescents in favour of STS and small effects were found in favour of STU. Additionally, we detected small effects in young adults in favour of STU. In terms of muscle power, no effects were observed in adolescents but medium effects were found in favour of STS in young adults. With regard to balance, small effects were detected in adolescents for static and dynamic balance in favour of STU. In young adults, small effects were found for static balance in favour of STS. With regard to dynamic balance, the analysis revealed small effects in young adults in favour of STU. The quality of the included studies was rather low, with mean PEDro scores of 5.8, 4.0 and 5.0 for studies including adolescents, young adults and old adults, respectively. Further, trivial to considerable heterogeneity between studies (i.e., 0% ≤ I2 ≤ 96%) was detected. Compared with CON, STU is effective in improving muscle strength, power and balance in adolescents, young adults and old adults. However, inconsistent results were particularly found in adolescents and young adults when the specific effects of STU were compared with those of STS. We conclude that the performance of STU compared with STS has limited extra effects on muscle strength, power and balance performance in healthy adolescents and young adults. Given that our systematic search did not identify studies that examined the effects of STU versus STS in children, middle-aged adults and old adults, further research of high methodological quality is needed to determine whether there are additive effects of STU as compared with STS in those age groups.

The association between exposure to psychosocial work factors and mental health in older employees, a 3-year follow-up study.

PubMed

Havermans, Bo M; Boot, Cécile R L; Hoekstra, Trynke; Houtman, Irene L D; Brouwers, Evelien P M; Anema, Johannes R; van der Beek, Allard J

2018-01-01

Unfavourable exposure to psychosocial work factors threatens older employees' mental health, and their sustained employment. This study assesses whether an improved compared to stable unfavourable and stable favourable exposure to psychosocial work factors is associated with a change in mental health in older employees at 3-year follow-up. The current study used data from the Study on Transitions in Employment, Ability and Motivation (STREAM), in workers aged 45-65 years (n = 5249). Two-year (2010-2012) exposure was assessed for psychological demands, autonomy, support, mental load, and distributive justice. Linear regression analyses were performed to compare improved exposure to unfavourable psychosocial work factors with stable unfavourable and stable favourable exposure and mental health at follow-up (2013), corrected for confounders. Analyses were stratified for age groups (45-54 and 55-65 years) and gender. In certain subgroups, stable unfavourable exposure to psychological demands, autonomy, support, and distributive justice was associated with a significantly lower mental health score than improved exposure. Stable favourable exposure to support was associated with a higher mental health score than improved support, whereas stable favourable exposure to autonomy was associated with a lower mental health score compared to improved exposure. There is a longitudinal association between changes in exposure to psychosocial work factors and mental health. Improvement in unfavourable exposure to psychosocial work factors was associated with improved mental health. This is important information for organisations that consider deploying measures to improve the psychosocial work environment of older workers.

Targeting the impact of agri-environmental policy - Future scenarios in two less favoured areas in Portugal.

PubMed

Jones, Nadia; Fleskens, Luuk; Stroosnijder, Leo

2016-10-01

Targeting agri-environmental measures (AEM) improves their effectiveness in the delivery of public goods, provided the necessary coordination with other incentives. In less favoured areas (LFA) measures focusing on the conservation of extensive farming contribute to sustainable land management in these areas. In this paper we investigate the implementation of a possible AEM supporting the improvement of permanent pastures coordinated with the extensive livestock and single farm payments actually in place. Through applying a spatially-explicit mixed integer optimisation model we simulate future land use scenarios for two less favoured areas in Portugal (Centro and Alentejo) considering two policy scenarios: a 'targeted AEM', and a 'non-targeted AEM'. We then compare the results with a 'basic policy' option (reflecting a situation without AEM). This is done with regard to landscape-scale effects on the reduction of fire hazard and erosion risk, as well as effects on farm income. The results show that an AEM for permanent pastures would be more cost-effective for erosion and fire hazard mitigation if implemented within a spatially targeted framework. However when cost-effectiveness is assessed with other indicators (e.g. net farm income and share of grazing livestock) 'non-targeted AEM' implementation delivers the best outcome in Alentejo. In Centro the implementation of an AEM involves important losses of income compared to the 'basic policy'. 'Targeted AEM' tends to favour farms in very marginal conditions, i.e. targeting is demonstrated to perform best in landscapes where spatial heterogeneity is higher. The results also show the risk of farm abandonment in the two studied less favoured areas: in all three scenarios more than 30% of arable land is deemed to be abandoned. Copyright © 2016 Elsevier Ltd. All rights reserved.

Hospital characteristics and favourable neurological outcome among patients with out-of-hospital cardiac arrest in Osaka, Japan.

PubMed

Matsuyama, Tasuku; Kiyohara, Kosuke; Kitamura, Tetsuhisa; Nishiyama, Chika; Nishiuchi, Tatsuya; Hayashi, Yasuyuki; Kawamura, Takashi; Ohta, Bon; Iwami, Taku

2017-01-01

To assess the association between favourable neurological outcome and hospital characteristics such as hospital volume and number of critical care centres (CCMCs) after out-of-hospital cardiac arrest (OHCA). This retrospective, population-based observational study conducted in Osaka Prefecture, Japan included adult patients with OHCA, aged ≥18 years who were transported to acute care hospitals between January 2005 and December 2012. We divided acute care hospitals into CCMCs or non-CCMCs, the latter of which were divided into the following three groups according to the annual average number of transported OHCA cases: low-volume (≤10 cases), middle-volume (11-39 cases), and high-volume (≥40 cases) groups. Random effects logistic regression models, with hospital treated as a random effect, were used to assess factors potentially associated with a favourable neurological outcome. A total of 44,474 patients were eligible. The proportions of favourable neurological outcome from OHCA were 0.9% (31/3559) in the low-volume group, 1.2% (106/9171) in the middle-volume group, 1.6% (222/14,007) in the high-volume group, and 4.3% (766/17,737) in the CCMC group (P<0.001). In the multivariable analysis, transport to CCMCs was significantly associated with favourable neurological outcome, compared with transport to non-CCMCs (adjusted odds ratio 1.63; 95% confidence interval, 1.60-1.66). Among the non-CCMC group, there was no significant relationship between hospital volume and favourable neurological outcome. In this population, transport of OHCA patients to CCMCs led to significantly higher one-month survival rates with favourable neurological outcome from OHCA, whereas no significant association was noted among the hospitals with different volumes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Pollinator shifts as triggers of speciation in painted petal irises (Lapeirousia: Iridaceae)

PubMed Central

Forest, Félix; Goldblatt, Peter; Manning, John C.; Baker, David; Colville, Jonathan F.; Devey, Dion S.; Jose, Sarah; Kaye, Maria; Buerki, Sven

2014-01-01

Background and Aims Adaptation to different pollinators has been hypothesized as one of the main factors promoting the formation of new species in the Cape region of South Africa. Other researchers favour alternative causes such as shifts in edaphic preferences. Using a phylogenetic framework and taking into consideration the biogeographical scenario explaining the distribution of the group as well as the distribution of pollinators, this study compares pollination strategies with substrate adaptations to develop hypotheses of the primary factors leading to speciation in Lapeirousia (Iridaceae), a genus of corm-bearing geophytes well represented in the Cape and presenting an important diversity of pollination syndromes and edaphic preferences. Methods Phylogenetic relationships are reconstructed within Lapeirousia using nuclear and plastid DNA sequence data. State-of-the-art methods in biogeography, divergence time estimation, character optimization and diversification rate assessments are used to examine the evolution of pollination syndromes and substrate shifts in the history of the group. Based on the phylogenetic results, ecological factors are compared for nine sister species pairs in Lapeirousia. Key Results Seventeen pollinator shifts and ten changes in substrate types were inferred during the evolution of the genus Lapeirousia. Of the nine species pairs examined, all show divergence in pollination syndromes, while only four pairs present different substrate types. Conclusions The available evidence points to a predominant influence of pollinator shifts over substrate types on the speciation process within Lapeirousia, contrary to previous studies that favoured a more important role for edaphic factors in these processes. This work also highlights the importance of biogeographical patterns in the study of pollination syndromes. PMID:24323246

Down’s syndrome screening is unethical: views of today’s research ethics committees

PubMed Central

Reynolds, T M

2003-01-01

Background: Screening for Down’s syndrome forms part of routine obstetric practice. Ethical considerations relating to genetic screening form a major part of the workload of research ethics committees. This study investigated the attitudes of research ethics committee members to several conditions varying in clinical severity and prognosis, including Down’s syndrome. Methods: The members of 40 randomly chosen research ethics committees were surveyed. A simple questionnaire comprising 19 clinical scenarios based around four “clinical” conditions was designed to review conditions that were potentially embarrassing, affecting life span but not mental ability, premature death, and intellectual impairment with a risk of neonatal cardiac defects (Down’s syndrome). Screening tests with different degrees of effectiveness were described and the diagnostic test descriptions ranged from having no risk to an unaffected fetus to causing spontaneous abortion of two normal fetuses for each affected fetus identified. Replies were graded on a scale of 1 to 5. Results: Seventy seven replies were received from 28 different research ethics committees. Screening was supported for treatment of a life threatening condition (95% in favour) but screening for conditions of a slight increase in premature death (14% in favour) or cosmetic features (10% in favour) were considered unethical. Views were ambiguous (49% in favour) about conditions involving significant shortening of lifespan. Down’s syndrome screening was considered more ethical when described as a serious condition (56% in favour) than when the clinical features were described (44% in favour). Once increased rates of spontaneous abortion on confirmatory testing were added, 79% (21% in favour) and 86% (14% in favour) stated that screening was unethical (for “serious” and “clinical features” descriptions, respectively). Conclusions: Down’s syndrome screening raises ethical concerns about genetic testing in general that need to be dealt with before the introduction of any prenatal screening test. PMID:12663637

Measuring striving for understanding and learning value of geometry: a validity study

NASA Astrophysics Data System (ADS)

Ubuz, Behiye; Aydınyer, Yurdagül

2017-11-01

The current study aimed to construct a questionnaire that measures students' personality traits related to striving for understanding and learning value of geometry and then examine its psychometric properties. Through the use of multiple methods on two independent samples of 402 and 521 middle school students, two studies were performed to address this issue to provide support for its validity. In Study 1, exploratory factor analysis indicated the two-factor model. In Study 2, confirmatory factor analysis indicated the better fit of two-factor model compared to one or three-factor model. Convergent and discriminant validity evidence provided insight into the distinctiveness of the two factors. Subgroup validity evidence revealed gender differences for striving for understanding geometry trait favouring girls and grade level differences for learning value of geometry trait favouring the sixth- and seventh-grade students. Predictive validity evidence demonstrated that the striving for understanding geometry trait but not learning value of geometry trait was significantly correlated with prior mathematics achievement. In both studies, each factor and the entire questionnaire showed satisfactory reliability. In conclusion, the questionnaire was psychometrically sound.

Importance of an intact dura in management of compound elevated fractures; a short series and literature review.

PubMed

Mohindra, Sandeep; Singh, Harnarayan; Savardekar, Amey

2012-01-01

To describe compound elevated fractures (CEFs) of the skull vault, with radiological pictures, management problems and prognosticative factors. The authors describe three cases of CEFs of the cranium, their mode of injury, clinical findings, radiological images and management problems. The authors have reviewed the existing literature regarding epidemiological data, neurological status, dural breech, methods of management and final outcome, in respect of CEFs. The first case had no dural breech, the second case had completely shattered dura, with extruding brain matter from the wound, while the third case had an elevated bone flap in consequence to large extradural haematoma. The patients with intact dura had relatively favourable outcome, when compared to patients with shattered dura. Three cases are added to the existing 10 such cases described in English literature. The major cause of unfavourable outcome remains sepsis and the presence of intact dura places these cases in the relatively safe category, regarding infective complications. The authors attempt at highlighting the importance of intact dura with such an injury. The review of literature supports favourable outcomes in patients having no dural breech.

Public access defibrillation improved the outcome after out-of-hospital cardiac arrest in school-age children: a nationwide, population-based, Utstein registry study in Japan

PubMed Central

Mitani, Yoshihide; Ohta, Kunio; Yodoya, Noriko; Otsuki, Shoichiro; Ohashi, Hiroyuki; Sawada, Hirofumi; Nagashima, Masami; Sumitomo, Naokata; Komada, Yoshihiro

2013-01-01

Aims The purpose of this study was to determine whether implementation of public access defibrillation (PAD) improves the outcome after out-of-hospital cardiac arrest (OHCA) in school-age children at national level. Methods and results We conducted a prospective, nationwide, population-based Japanese Utstein registry study of consecutive OHCA cases in elementary and middle school children (7–15 years of age) who had a bystander-witnessed arrest of presumed cardiac origin during 2005–09 and received pre-hospital resuscitation by emergency responders. The primary endpoint was a favourable neurological outcome 1 month after an arrest. Among 230 eligible patients enrolled, 128 had ventricular fibrillation (VF) as an initial rhythm. Among these 128 patients, 29 (23%) children received a first shock by a bystander. Among these 29 patients, the proportion of the favourable neurological outcome after OHCA was 55%. During the study period, the proportion of patients initially shocked by a bystander among eligible patients increased from 2 to 21% (P = 0.002 for trend). The proportion of patients with a favourable neurological outcome after OHCA increased from 12 to 36% overall (P = 0.006). The collapse to defibrillation time was shorter in bystander-initiated defibrillation when compared with defibrillation by emergency responders (3.3 ± 3.7 vs. 12.9 ± 5.8 min, P < 0.001), and was independently associated with a favourable neurological outcome after OHCA [P = 0.03, odds ratio (OR) per 1 min increase, 0.90 (95% confidence interval 0.82–0.99)]. A non-family member's witness was independently associated with VF as the initial rhythm [P < 0.001, OR 4.03 (2.08–7.80)]. Conclusion Implementation of PAD improved the outcome after OHCA in school-age children at national level in Japan. PMID:23603306

CT-angiography source images indicate less fatal outcome despite coma of patients in the Basilar Artery International Cooperation Study.

PubMed

Pallesen, Lars P; Khomenko, Andrei; Dzialowski, Imanuel; Barlinn, Jessica; Barlinn, Kristian; Zerna, Charlotte; van der Hoeven, Erik Jrj; Algra, Ale; Kapelle, L Jaap; Michel, Patrik; Bodechtel, Ulf; Demchuk, Andrew M; Schonewille, Wouter; Puetz, Volker

2017-02-01

Background Coma is associated with poor outcome in patients with basilar artery occlusion. Aims We sought to assess whether the posterior circulation Acute Stroke Prognosis Early CT Score and the Pons-Midbrain Index applied to CT angiography source images predict the outcome of comatose patients in the Basilar Artery International Cooperation Study. Methods Basilar Artery International Cooperation Study was a prospective, observational registry of patients with acute basilar artery occlusion with 48 recruiting centers worldwide. We applied posterior circulation Acute Stroke Prognosis Early CT Score and Pons-Midbrain Index to CT angiography source images of Basilar Artery International Cooperation Study patients who presented with coma. We calculated adjusted risk ratios to assess the association of dichotomized posterior circulation Acute Stroke Prognosis Early CT Score (≥8 vs. <8) and Pons-Midbrain Index (<3 vs. ≥3) with mortality and favourable outcome (modified Rankin Scale score 0-3) at one month. Results Of 619 patients in the Basilar Artery International Cooperation Study registry, CT angiography source images were available for review in 158 patients. Among these, 78 patients (49%) presented with coma. Compared to non-comatose patients, comatose patients were more likely to die (risk ratios 2.34; CI 95% 1.56-3.52) and less likely to have a favourable outcome (risk ratios 0.44; CI 95% 0.24-0.80). Among comatose patients, a Pons-Midbrain Index < 3 was related to reduced mortality (adjusted RR 0.66; 95% CI 0.46-0.96), but not to favourable outcome (adjusted RR 1.19; 95% CI 0.39-3.62). Posterior circulation Acute Stroke Prognosis Early CT Score dichotomized at ≥ 8 vs. <8 was not significantly associated with death (adjusted RR 0.70; 95% CI 0.46-1.05). Conclusion In comatose patients with basilar artery occlusion, the extent of brainstem ischemia appears to be related to mortality but not to favourable outcome.

Exponentially fitted symplectic Runge-Kutta-Nyström methods derived by partitioned Runge-Kutta methods

NASA Astrophysics Data System (ADS)

Monovasilis, Th.; Kalogiratou, Z.; Simos, T. E.

2013-10-01

In this work we derive symplectic EF/TF RKN methods by symplectic EF/TF PRK methods. Also EF/TF symplectic RKN methods are constructed directly from classical symplectic RKN methods. Several numerical examples will be given in order to decide which is the most favourable implementation.

Young Adults' Implicit and Explicit Attitudes towards the Sexuality of Older Adults.

PubMed

Thompson, Ashley E; O'Sullivan, Lucia F; Byers, E Sandra; Shaughnessy, Krystelle

2014-09-01

Sexual interest and capacity can extend far into later life and result in many positive health outcomes. Yet there is little support for sexual expression in later life, particularly among young adults. This study assessed and compared young adults' explicit and implicit attitudes towards older adult sexuality. A sample of 120 participants (18-24 years; 58% female) completed a self-report (explicit) measure and a series of Implicit Association Tests capturing attitudes towards sexuality among older adults. Despite reporting positive explicit attitudes, young people revealed an implicit bias against the sexual lives of older adults. In particular, young adults demonstrated implicit biases favouring general, as compared to sexual, activities and young adults as compared to older adults. Moreover, the bias favouring general activities was amplified with regard to older adults as compared to younger adults. Our findings challenge the validity of research relying on self-reports of attitudes about older adult sexuality.

Attitudes toward Master's and Clinical Doctorate Degrees in Physical Therapy

PubMed Central

Mistry, Yamini; Francis, Christian; Haldane, Jessica; Symonds, Scott; Uguccioni, Erika; Berg, Katherine

2014-01-01

ABSTRACT Purpose: To examine the attitudes of a self-selected sample of Canadian physical therapists toward the transition from bachelor's to master's degrees and the implementation of clinical doctorate degrees in physical therapy (PT). Methods: A cross-sectional survey was conducted using a modified Dillman tailored approach. All eligible members of the Canadian Physiotherapy Association (CPA) were invited to participate. Results: Of 1,397 Canadian physical therapists who responded to the survey, 45% favoured the transition from bachelor's to master's degrees, 21% did not, and 34% were neutral; 27% favoured a transition from a master's to a doctoral degree for entry into practice in PT, 53% did not favour this transition, and 20% were neutral. Finally, 56% favoured the implementation of a post-professional clinical doctorate (PPCD) in PT, 23% did not, and 21% were neutral. Conclusions: Overall, a self-selected sample of Canadian physical therapists supported the future implementation of a post-professional clinical doctorate degree in PT but did not support an entry-to-practice doctoral degree. However, these results must be interpreted with caution because of the study's small sample size. PMID:25922561

An exploration of men's experiences of undergoing active surveillance for favourable-risk prostate cancer: A mixed methods study protocol.

PubMed

Ruane-McAteer, Eimear; O'Sullivan, Joe; Porter, Sam; Venderbos, Lionne; Prue, Gillian

2016-08-02

Prostate cancer is one of the most common male cancers worldwide. Active Surveillance (AS) has been developed to allow men with lower risk disease to postpone or avoid the adverse side effects associated with curative treatments until the disease progresses. Despite the medical benefits of AS, it is reported that living with untreated cancer can create a significant emotional burden for patients. The aim of this study is to gain insight into the experiences of men eligible to undergo AS for favourable-risk PCa. This study has a mixed-methods sequential explanatory design consisting of two phases: quantitative followed by qualitative. Phase 1 has a multiple point, prospective, longitudinal exploratory design. Ninety men diagnosed with favourable-risk prostate cancer will be assessed immediately post-diagnosis (baseline) and followed over a period of 12 months, in intervals of 3 month. Ninety age-matched men with no cancer diagnosis will also be recruited using peer nomination and followed up in the same 3 month intervals. Following completion of Phase 1, 10-15 AS participants who have reported both the best and worst psychological functioning will be invited to participate in semi-structured qualitative interviews. Phase 2 will facilitate further exploration of the quantitative results and obtain a richer understanding of participants' personal interpretations of their illness and psychological wellbeing. To our knowledge, this is the first study to utilise early baseline measures; include a healthy comparison group; calculate sample size through power calculations; and use a mixed methods approach to gain a deeper more holistic insight into the experiences of men diagnosed with favourable-risk prostate cancer.

The effectiveness of a squash eyewear promotion strategy

PubMed Central

Eime, R; Finch, C; Wolfe, R; Owen, N; McCarty, C

2005-01-01

Objective: To evaluate the protective eyewear promotion (PEP) project, which was a comprehensive educational strategy to increase the use of appropriate protective eyewear by squash players. Methods: An ecological study design was used. Four squash venues in one playing association were randomly chosen to receive PEP and four in another association maintained usual practice and hence formed a control group. The primary evaluation measurements were surveys of cross sectional samples of players carried out before and after the intervention. The surveys investigated players' knowledge, behaviours, and attitudes associated with the use of protective eyewear. The survey carried out after the intervention also determined players' exposure to PEP. Univariate and multivariate analyses were undertaken to describe differences at PEP venues from pre- to post-intervention and to compare these with the control venues. Results: The PEP players had 2.4 times the odds (95% confidence interval, 1.3 to 4.2) of wearing appropriate eyewear compared with control group players post-intervention, relative to the groups' pre-intervention baselines. Components of PEP, such as stickers and posters and the availability and prominent positioning of the project eyewear, were found to contribute to players adopting favourable eyewear behaviours. Conclusions: Components of the PEP intervention were shown to be effective. The true success will be the sustainability and dissemination of the project, favourable eyewear behaviours, and evidence of the prevention of eye injuries long into the future. PMID:16118310

Specific net present value: an improved method for assessing modularisation costs in water services with growing demand.

PubMed

Maurer, M

2009-05-01

A specific net present value (SNPV) approach is introduced as a criterion in economic engineering decisions. The SNPV expresses average costs, including the growth rate and plant utilisation over the planning horizon, factors that are excluded from a standard net present value approach. The use of SNPV favours alternatives that are cheaper per service unit and are therefore closer to the costs that a user has to cover. It also shows that demand growth has a similar influence on average costs as an economy of scale. In a high growth scenario, solutions providing less idle capacity can have higher present value costs and still be economically favourable. The SNPV approach is applied in two examples to calculate acceptable additional costs for modularisation and comparable costs for on-site treatment (OST) as an extreme form of modularisation. The calculations show that: (i) the SNPV approach is suitable for quantifying the comparable costs of an OST system in a different scenario; (ii) small systems with projected high demand growth rates and high real interest rates are the most probable entry market for OST water treatment systems; (iii) operating expenses are currently the main economic weakness of membrane-based wastewater OST systems; and (iv) when high growth in demand is expected, up to 100% can be additionally invested in modularisation and staging the expansion of a treatment plant.

The medical profession and changing attitudes towards advertising and competition.

PubMed

Bell, J D; Fay, M T

1991-02-27

This paper examines the attitudes of general medical practitioners towards competition and advertising and the changes that have occurred between 1985 and 1988. The data was derived from a self completion questionnaire, 1500 of which were evenly distributed among the members of five professions; doctors, dentists, lawyers, accountants and veterinarians. General practitioners are now favourably disposed towards advertising by the profession as a whole in an effort to increase awareness of medical services (70% in favour in 1988 compared to only 53% in 1985), but the perceived need for increased business efficiency has lessened (70% in 1988 compared to 78% in 1985). Collegiality continues to be the dominant ideology but this position has weakened slightly. In 1988 only 65% of general practitioners regarded other members of the profession as colleagues rather than competitors, compared to 73% in 1985.

Comparing concentration methods: parasitrap® versus Kato-Katz for studying the prevalence of Helminths in Bengo province, Angola.

PubMed

Mirante, Clara; Clemente, Isabel; Zambu, Graciette; Alexandre, Catarina; Ganga, Teresa; Mayer, Carlos; Brito, Miguel

2016-09-01

Helminth intestinal parasitoses are responsible for high levels of child mortality and morbidity. Hence, the capacity to diagnose these parasitoses and consequently ensure due treatment represents a factor of great importance. The main objective of this study involves comparing two methods of concentration, parasitrap and Kato-Katz, for the diagnosis of intestinal parasitoses in faecal samples. Sample processing made recourse to two different concentration methods: the commercial parasitrap® method and the Kato-Katz method. We correspondingly collected a total of 610 stool samples from pre-school and school age children. The results demonstrate the incidence of helminth parasites in 32.8% or 32.3% of the sample collected depending on whether the concentration method applied was either the parasitrap method or the Kato-Katz method. We detected a relatively high percentage of samples testing positive for two or more species of helminth parasites. We would highlight that in searching for larvae the Kato-Katz method does not prove as appropriate as the parasitrap method. Both techniques prove easily applicable even in field working conditions and returning mutually agreeing results. This study concludes in favour of the need for deworming programs and greater public awareness among the rural populations of Angola.

Nursing work environment, patient safety and quality of care in pediatric hospital.

PubMed

Alves, Daniela Fernanda Dos Santos; Guirardello, Edinêis de Brito

2016-06-01

Objectives To describe the characteristics of the nursing work environment, safety attitudes, quality of care, measured by the nursing staff of the pediatric units, as well as to analyze the evolution of quality of care and hospital indicators. Methods Descriptive study with 136 nursing professionals at a paediatric hospital, conducted through personal and professional characterization form, Nursing Work Index - Revised, Safety Attitudes Questionnaire - Short Form 2006 and quality indicators. Results The professionals perceive the environment as favourable to professional practice, and consider good quality care that is also observed by reducing the incidence of adverse events and decreased length of stay. The domain job satisfaction was considered favourable to patient safety. Conclusions The work environment is favourable to nursing practice, the professionals nursing approve the quality of care and the indicators tended reducing adverse events and length of stay.

Single site multiport umbilical laparoscopic appendicectomy versus conventional multiport laparoscopic appendicectomy in acute settings

PubMed Central

Yadav, SP

2014-01-01

Introduction Although conventional multiport laparoscopic appendicectomy (CMLA) is preferred for managing acute appendicitis, the recently developed transumbilical laparoscopic approach is rapidly gaining popularity. However, its wide dissemination seems restricted by technical/technological issues. In this regard, a newly developed method of single site multiport umbilical laparoscopic appendicectomy (SMULA) was compared prospectively with CMLA to assess the former’s efficacy and the technical advantages in acute scenarios. Methods Overall, 430 patients were studied: 212 in the SMULA group and 218 in the CMLA group. The same surgeon performed all the procedures using routine laparoscopic instruments. The SMULA technique entailed three ports inserted directly at the umbilical mound through three distinct strategically placed mini-incisions without raising the umbilical flap. The CMLA involved the traditional three-port technique. Results Both groups were comparable in terms of demographic criteria, indications for surgery, intraoperative blood loss, time to ambulation, length of hospital stay and umbilical morbidity. Although the mean operative time was marginally longer in the SMULA group (43.35 minutes, standard deviation [SD]: 21.16 minutes) than in the CMLA group (42.28 minutes, SD: 21.41 minutes), this did not reach statistical significance. Conversely, the mean pain scores on day 0 and the cosmetic outcomes differed significantly and favoured the SMULA technique. None of the patients developed port site hernias over the follow-up period (mean 2.9 years). Conclusions The favourable outcomes for the SMULA technique are likely to be due to the three small segregated incisions at one place and better trocar ergonomics. The SMULA technique is safe in an acute setting and may be considered of value among the options for transumbilical appendicectomy. PMID:25198978

Comparative analysis of short - term functional outcomes and quality of life in a prospective series of brachytherapy and Da Vinci robotic prostatectomy

PubMed Central

García-Sánchez, Cristina; Román Martín, Ana A.; Conde-Sánchez, J. Manuel; Congregado-Ruíz, C. Belén; Osman-García, Ignacio; Medina-López, Rafael A.

2017-01-01

ABSTRACT Introduction There is a growing interest in achieving higher survival rates with the lowest morbidity in localized prostate cancer (PC) treatment. Consequently, minimally invasive techniques such as low-dose rate brachytherapy (BT) and robotic-assisted prostatectomy (RALP) have been developed and improved. Comparative analysis of functional outcomes and quality of life in a prospective series of 51BT and 42Da Vinci prostatectomies DV Materials and Methods Comparative analysis of functional outcomes and quality of life in a prospective series of 93 patients with low-risk localized PC diagnosed in 2011. 51patients underwent low-dose rate BT and the other 42 patients RALP. IIEF to assess erectile function, ICIQ to evaluate continence and SF36 test to quality of life wee employed. Results ICIQ at the first revision shows significant differences which favour the BT group, 79% present with continence or mild incontinence, whereas in the DV group 45% show these positive results. Differences disappear after 6 months, with 45 patients (89%) presenting with continence or mild incontinence in the BT group vs. 30 (71%) in the DV group. 65% of patients are potent in the first revision following BT and 39% following DV. Such differences are not significant and cannot be observed after 6 months. No significant differences were found in the comparative analysis of quality of life. Conclusions ICIQ after surgery shows significant differences in favour of BT, which disappear after 6 months. Both procedures have a serious impact on erectile function, being even greater in the DV group. Differences between groups disappear after 6 months. PMID:28128908

Methods of suicide used by children and adolescents.

PubMed

Hepp, Urs; Stulz, Niklaus; Unger-Köppel, Jürg; Ajdacic-Gross, Vladeta

2012-02-01

Although relatively rare, suicide is a leading cause of death in children and adolescents in the Western world. This study examined whether children and adolescents are drawn to other methods of suicide than adults. Swiss suicides from 1998 to 2007 were examined. The main methods of suicide were analysed with respect to age and gender. Of the 12,226 suicides which took place in this 10-year period, 333 were committed by children and adolescents (226 males, 107 females). The most prevalent methods of suicide in children and adolescents 0-19 years were hanging, jumping from heights and railway-suicides (both genders), intoxication (females) and firearms (males). Compared to adults, railway-suicides were over-represented in young males and females (both P < .001). Jumping from heights was over-represented in young males (P < .001). Thus, availability has an important effect on methods of suicide chosen by children and adolescents. Restricting access to most favoured methods of suicide might be an important strategy in suicide prevention.

Target volume definition for 18F-FDG PET-positive lymph nodes in radiotherapy of patients with non-small cell lung cancer.

PubMed

Nestle, Ursula; Schaefer-Schuler, Andrea; Kremp, Stephanie; Groeschel, Andreas; Hellwig, Dirk; Rübe, Christian; Kirsch, Carl-Martin

2007-04-01

FDG PET is increasingly used in radiotherapy planning. Recently, we demonstrated substantial differences in target volumes when applying different methods of FDG-based contouring in primary lung tumours (Nestle et al., J Nucl Med 2005;46:1342-8). This paper focusses on FDG-positive mediastinal lymph nodes (LN(PET)). In our institution, 51 NSCLC patients who were candidates for radiotherapy prospectively underwent staging FDG PET followed by a thoracic PET scan in the treatment position and a planning CT. Eleven of them had 32 distinguishable non-confluent mediastinal or hilar nodal FDG accumulations (LN(PET)). For these, sets of gross tumour volumes (GTVs) were generated at both acquisition times by four different PET-based contouring methods (visual: GTV(vis); 40% SUVmax: GTV40; SUV=2.5: GTV2.5; target/background (T/B) algorithm: GTV(bg)). All differences concerning GTV sizes were within the range of the resolution of the PET system. The detectability and technical delineability of the GTVs were significantly better in the late scans (e.g. p = 0.02 for diagnostic application of SUVmax = 2.5; p = 0.0001 for technical delineability by GTV2.5; p = 0.003 by GTV40), favouring the GTV(bg) method owing to satisfactory overall applicability and independence of GTVs from acquisition time. Compared with CT, the majority of PET-based GTVs were larger, probably owing to resolution effects, with a possible influence of lesion movements. For nodal GTVs, different methods of contouring did not lead to clinically relevant differences in volumes. However, there were significant differences in technical delineability, especially after early acquisition. Overall, our data favour a late acquisition of FDG PET scans for radiotherapy planning, and the use of a T/B algorithm for GTV contouring.

Evaluating methods to establish habitat suitability criteria: A case study in the upper Delaware River Basin, USA

USGS Publications Warehouse

Galbraith, Heather S.; Blakeslee, Carrie J.; Cole, Jeffrey C.; Talbert, Colin; Maloney, Kelly O.

2016-01-01

Defining habitat suitability criteria (HSC) of aquatic biota can be a key component to environmental flow science. HSC can be developed through numerous methods; however, few studies have evaluated the consistency of HSC developed by different methodologies. We directly compared HSC for depth and velocity developed by the Delphi method (expert opinion) and by two primary literature meta-analyses (literature-derived range and interquartile range) to assess whether these independent methods produce analogous criteria for multiple species (rainbow trout, brown trout, American shad, and shallow fast guild) and life stages. We further evaluated how these two independently developed HSC affect calculations of habitat availability under three alternative reservoir management scenarios in the upper Delaware River at a mesohabitat (main channel, stream margins, and flood plain), reach, and basin scale. In general, literature-derived HSC fell within the range of the Delphi HSC, with highest congruence for velocity habitat. Habitat area predicted using the Delphi HSC fell between the habitat area predicted using two literature-derived HSC, both at the basin and the site scale. Predicted habitat increased in shallow regions (stream margins and flood plain) using literature-derived HSC while Delphi-derived HSC predicted increased channel habitat. HSC generally favoured the same reservoir management scenario; however, no favoured reservoir management scenario was the most common outcome when applying the literature range HSC. The differences found in this study lend insight into how different methodologies can shape HSC and their consequences for predicted habitat and water management decisions. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

The effect of occupational therapy in patients with chronic obstructive pulmonary disease: A randomized controlled trial.

PubMed

Martinsen, Unni; Bentzen, Hege; Holter, Morag Kelly; Nilsen, Tove; Skullerud, Hallvard; Mowinckel, Petter; Kjeken, Ingvild

2017-03-01

Aim The main aim of this study was to evaluate the effect of individualized occupational therapy in patients with chronic obstructive pulmonary disease (COPD). Additionally, the authors wanted to explore the occupational problems experienced in daily life by individuals with COPD. Methods A total of 52 patients were randomly assigned to the intervention group (occupational therapy) or control group (treatment as usual). The primary outcome was assessed using the Canadian Occupational Performance Measure (COPM), and participants were assessed at baseline and after four and 12 months. Results There were no treatment effects on occupational performance or satisfaction with performance, as measured by the COPM. However, we found a significant effect in favour of the intervention group at exertion when performing an individually chosen activity, and in the activity dimension of St George's Respiratory Questionnaire. A total of 595 occupational problems were reported, most frequently within mobility, active recreation, and household management. Conclusions The results show that, compared with the usual care, individualized occupational therapy did not improve occupational performance or satisfaction with performance. Small but significant changes in activity performance in favour of the intervention group were found in some of the secondary outcomes.

A review of randomized controlled trials comparing the effectiveness of hand held computers with paper methods for data collection

PubMed Central

Lane, Shannon J; Heddle, Nancy M; Arnold, Emmy; Walker, Irwin

2006-01-01

Background Handheld computers are increasingly favoured over paper and pencil methods to capture data in clinical research. Methods This study systematically identified and reviewed randomized controlled trials (RCTs) that compared the two methods for self-recording and reporting data, and where at least one of the following outcomes was assessed: data accuracy; timeliness of data capture; and adherence to protocols for data collection. Results A comprehensive key word search of NLM Gateway's database yielded 9 studies fitting the criteria for inclusion. Data extraction was performed and checked by two of the authors. None of the studies included all outcomes. The results overall, favor handheld computers over paper and pencil for data collection among study participants but the data are not uniform for the different outcomes. Handheld computers appear superior in timeliness of receipt and data handling (four of four studies) and are preferred by most subjects (three of four studies). On the other hand, only one of the trials adequately compared adherence to instructions for recording and submission of data (handheld computers were superior), and comparisons of accuracy were inconsistent between five studies. Conclusion Handhelds are an effective alternative to paper and pencil modes of data collection; they are faster and were preferred by most users. PMID:16737535

Ab initio calculations of the photoionization of diatomic molecules

NASA Astrophysics Data System (ADS)

Lefebvre-Brion, Helene; Raşeev, Georges

2003-01-01

A review is presented of the calculation of photoionization spectra, particularly in the spectral range where electron autoionization of diatomic molecules takes place. In addition to some interesting results obtained over years that compare favourably with experiment, the emphasis here is put on the relation between the methods developed for the calculation of observables associated with the continuum energy spectrum of the electrons and the Alchemy system of programs. This system of programs serves as a basis for initial and intermediate calculations. The examples presented show that diatomic molecules not only in gas phase but also oriented in space or physisorbed at surfaces may be studied readily.

[Magnetic closure for ileostomy (author's transl)].

PubMed

Loygue, J; Salmon, R; Bloch, P

1980-09-20

The Maclet magnetic stoma seal already used by the authors for colostomies was applied to the closure of permanent terminal ileostomies. A reservoir is constructed upstreams of the closure with the last loop of ileum, so that the faeces accumulate and can be evacuated by intermittence. Patients empty the reservoir by removing the cap which blocks the intestinal lumen and introducing a probe into it. The technique was used on 2 patients who had undergone total proctocolectomy for familial polyposis of the colon. One patient has now been followed up for 3 years and the other for 6 months. The perfect continence obtained by this method favourably compares with Kock's continent ileostomy.

Comparing extraction rates of fossil fuel producers against global climate goals

NASA Astrophysics Data System (ADS)

Rekker, Saphira A. C.; O'Brien, Katherine R.; Humphrey, Jacquelyn E.; Pascale, Andrew C.

2018-06-01

Meeting global and national climate goals requires action and cooperation from a multitude of actors1,2. Current methods to define greenhouse gas emission targets for companies fail to acknowledge the unique influence of fossil fuel producers: combustion of reported fossil fuel reserves has the potential to push global warming above 2 °C by 2050, regardless of other efforts to mitigate climate change3. Here, we introduce a method to compare the extraction rates of individual fossil fuel producers against global climate targets, using two different approaches to quantify a burnable fossil fuel allowance (BFFA). BFFAs are calculated and compared with cumulative extraction since 2010 for the world's ten largest investor-owned companies and ten largest state-owned entities (SOEs), for oil and for gas, which together account for the majority of global oil and gas reserves and production. The results are strongly influenced by how BFFAs are quantified; allocating based on reserves favours SOEs over investor-owned companies, while allocating based on production would require most reduction to come from SOEs. Future research could refine the BFFA to account for equity, cost-effectiveness and emissions intensity.

Gamma-hydroxybutyrate (GHB) for treatment of alcohol withdrawal and prevention of relapses.

PubMed

Leone, Maurizio A; Vigna-Taglianti, Federica; Avanzi, Giancarlo; Brambilla, Romeo; Faggiano, Fabrizio

2010-02-17

Chronic excessive alcohol consumption may lead to dependence, and to alcohol withdrawal syndrome (AWS) in case of abrupt drinking cessation. Gamma-hydroxybutyric acid (GHB) can prevent and suppress withdrawal symptoms, and improve the medium-term abstinence rate. A clear balance between effectiveness and harmfulness has not been yet established. To evaluate the efficacy and safety of GHB for treatment of AWS and prevention of relapse We searched Cochrane Drugs and Alcohol Group' Register of Trials (October 2008), PubMed, EMBASE, CINAHL (January 2005 - October 2008), EconLIT (1969 to February 2008), reference list of retrieved articles Randomized controlled trials (RCTs) and Controlled Prospective Studies (CPS) evaluating the efficacy and the safety of GHB vs placebo or other pharmacological treatments. Three authors independently extracted data and assessed the methodological quality of studies. Thirteen RCTs were included. Eleven studies were conducted in Italy.For withdrawal syndrome, comparing GHB 50mg with placebo, results from 1 study, 23 participants favour GHB for withdrawal symptoms: WMD -12.1 (95% CI, -15.9 to -8.29) and side effects were more frequent in the placebo group: RR 16.2 (95% CI, 1.04 to 254.9).In the comparison with Chlormetiazole, for GHB 50mg, results from 1 study, 21 participants favour GHB for withdrawal symptoms: MD -3.40 (95% CI -5.09 to -1.71), for GHB 100mg, results from 1 study, 98 participants favour anticonvulsants for side effects: RR 1.84 (95% CI 1.19 to 2.85).At mid-term, comparing GHB with placebo, results favour GHB for abstinence rate (RR 5.35; 1.28-22.4), controlled drinking (RR 2.13; 1.07-5.54), relapses (RR 0.36; 0.21-0.63), and number of daily drinks (WMD -4.60; -6.18 to -3.02). GHB performed better than NTX and Disulfiram on abstinence (RR 2.59; 1.35-4.98, RR 1.66; 0.99-2.80 respectively). The association of GHB and NTX was better than NTX on abstinence (RR 12.2; 1.79-83.9), as well was the association of NTX, GHB and Escitalopram versus Escitalopram alone (RR 4.58; 1.28-16.5). For Alcohol Craving Scale results favour GHB versus placebo (WMD -1.90; -2.45 to 1.35) and Disulfiram (WMD -1.40; -1.86 to-0.94). GHB 50mg is effective compared to placebo in the treatment of AWS, and in preventing relapses in previously detoxified alcoholics at 3 months follow-up, but the results of this review do not provide sufficient evidence in favour of GHB compared to benzodiazepines and Chlormethiazole for AWS prevention. GHB is better than NTX and Disulfiram in maintaining abstinence and it has a better effect on craving than placebo and Disulfiram. Side effects of GHB are not statistically different from those with BZD, NTX or Disulfiram. However, concern has been raised regarding the risk of developing addiction, misuse or abuse, especially in polydrug abusers.

A new non-degradative method to purify glycogen.

PubMed

Tan, Xinle; Sullivan, Mitchell A; Gao, Fei; Li, Shihan; Schulz, Benjamin L; Gilbert, Robert G

2016-08-20

Liver glycogen, a complex branched glucose polymer containing a small amount of protein, is important for maintaining glucose homeostasis (blood-sugar control) in humans. It has recently been found that glycogen molecular structure is impaired in diabetes. Isolating the carbohydrate polymer and any intrinsically-attached protein(s) is an essential prerequisite for studying this structural impairment. This requires an effective, non-degradative and efficient purification method to exclude the many other proteins present in liver. Proteins and glycogen have different ranges of molecular sizes. Despite the plethora of proteins that might still be present in significant abundance after other isolation techniques, SEC (size exclusion chromatography, also known as GPC), which separates by molecular size, should separate those extraneous to glycogen from glycogen with any intrinsically associated protein(s). A novel purification method is developed for this, based on preparative SEC following sucrose gradient centrifugation. Proteomics is used to show that the new method compares favourably with current methods in the literature. Copyright © 2016 Elsevier Ltd. All rights reserved.

Linear regression analysis for comparing two measurers or methods of measurement: but which regression?

PubMed

Ludbrook, John

2010-07-01

1. There are two reasons for wanting to compare measurers or methods of measurement. One is to calibrate one method or measurer against another; the other is to detect bias. Fixed bias is present when one method gives higher (or lower) values across the whole range of measurement. Proportional bias is present when one method gives values that diverge progressively from those of the other. 2. Linear regression analysis is a popular method for comparing methods of measurement, but the familiar ordinary least squares (OLS) method is rarely acceptable. The OLS method requires that the x values are fixed by the design of the study, whereas it is usual that both y and x values are free to vary and are subject to error. In this case, special regression techniques must be used. 3. Clinical chemists favour techniques such as major axis regression ('Deming's method'), the Passing-Bablok method or the bivariate least median squares method. Other disciplines, such as allometry, astronomy, biology, econometrics, fisheries research, genetics, geology, physics and sports science, have their own preferences. 4. Many Monte Carlo simulations have been performed to try to decide which technique is best, but the results are almost uninterpretable. 5. I suggest that pharmacologists and physiologists should use ordinary least products regression analysis (geometric mean regression, reduced major axis regression): it is versatile, can be used for calibration or to detect bias and can be executed by hand-held calculator or by using the loss function in popular, general-purpose, statistical software.

Polymorphisms of alpha-actinin-3 and ciliary neurotrophic factor in national-level Italian athletes.

PubMed

Persi, A; Maltese, P E; Bertelli, M; Cecchin, S; Ciaghi, M; Guarnieri, M C; Agnello, L; Maggioni, M A; Merati, G; Veicsteinas, A

2013-06-01

The R577X polymorphism of the alpha-actinin-3 (ACTN3) gene and the IVS1-6G>A polymorphism of the ciliary neurotrophic factor (CNTF) gene have been associated with a favourable muscle phenotype (more muscle fibres with high glycolytic activity), reduced predisposition for congenital dystrophy and resistance to sarcopenia in old age. The aim of this study was to look for evidence of selective pressure towards genotypes favourable for strong muscle activity in a sample of national-level Italian athletes. We analysed two stop codon polymorphisms in the DNA of 50 Italian athletes, specialised in power or endurance sports, and compared their genotypic distribution with those of a population of 50 controls. In a representative sub-group of athletes (N.=42) we then compared the genetic data with anaerobic threshold, assessed by an incremental exercise test up to exhaustion. The athlete group showed an allelic distribution of ACTN3 (R/R:64%, R/X:16%, X/X:20%) and CNTF (G/G:72%, G/A:26%, A/A:2%), significantly imbalanced towards alleles R/R and G/G, respectively, compared to controls (ACTN3=R/R:40% R/X:22% X/X:38% and CNTF=G/G:52%, G/A:24%, A/A:24%) (p=0.0024 and p=0.0001, respectively). Only the ACTN3 577X/X polymorphism showed a significant association with the anaerobic threshold of athletes (F-ratio= 4.037; p=0.025). Factorial ANOVA demonstrated a non significant interaction between favourable allelic patterns of ACTN3 and CNTF genes on aerobic performance in the athlete group. The relationship found between favourable muscle phenotype and this genetic profile may have interesting implications in sport performance and training, athlete selection and different clinical activities, such as physical rehabilitation and modifying phenotypes associated with neuromuscular diseases.

Influence of attitudes on pharmacists' intention to report serious adverse drug events to the Food and Drug Administration

PubMed Central

Gavaza, Paul; Brown, Carolyn M; Lawson, Kenneth A; Rascati, Karen L; Wilson, James P; Steinhardt, Mary

2011-01-01

AIM To investigate the influence of pharmacists' attitudes on intention to report serious adverse drug events (ADEs) to the Food and Drug Administration (FDA). METHODS This cross-sectional study used a mail survey to collect data from hospital and community pharmacists practicing in Texas, United States. Three and 16 items were used to measure intention and attitudes, respectively, using a seven-point bipolar scale. Pharmacists' demographic and practice characteristics, and past reporting were also measured. RESULTS The response rate was 26.4% (n = 377/1500 pharmacists). Most pharmacists intended (n = 297, 78.8%) to report serious ADEs that they will encounter to the FDA through MedWatch. Overall, pharmacists held favourable attitudes towards reporting serious ADEs (mean = 24.5, SD = 6.7, possible range 1–49, neutral = 16). Pharmacists intending to report serious ADEs had more favourable attitudes than those who did not (P < 0.001). About 90% of the pharmacists believed that reporting serious ADEs would improve patient safety. However, 72.6% indicated that reporting serious ADEs was time consuming and over half (55.5%) of the respondents believed that reporting serious ADEs disrupted the normal workflow. Non-intenders held stronger beliefs that ADE reporting would disrupt the normal workflow and was time consuming compared with intenders. Years of experience, number of hours worked and practice setting were associated with pharmacists' attitudes towards reporting (P < 0.05). CONCLUSIONS Most pharmacists held moderately favourable attitudes and high intentions toward reporting serious ADEs to the FDA. This study's findings contribute to an increased understanding of individual factors that influence pharmacists' attitude and intention towards reporting serious ADEs to the FDA. PMID:21332572

Multicomponent Lifestyle Interventions for Treating Overweight and Obesity in Children and Adolescents: A Systematic Review and Meta-Analyses

PubMed Central

Giske, L.; Fure, B.; Juvet, L. K.

2017-01-01

Background Treatment of childhood obesity is important in preventing development of obesity-related diseases later in life. This systematic review evaluates the effect of multicomponent lifestyle interventions for children and adolescents from 2 to 18 years. Methods and Results We performed systematic searches in nine databases. Thirty-nine studies met the criteria for meta-analyses. We found a significant difference in body mass index (BMI) after 6 months (MD −0.99 (95% CI −1.36 to −0.61)), 12 months (MD −0.67 (95% CI −1.01 to −0.32)), and 24 months (MD −0.96 (95% CI −1.63 to −0.29)) in favour of multicomponent lifestyle interventions compared to standard, minimal, and no treatment. We also found a significant difference in BMI Z scores after 6 months (MD −0.12 (95% CI −0.17 to −0.06)), 12 months (MD −0.16 (95% CI −0.21 to −0.11)), and 24 months (MD −0.16 (95% CI −0.21 to −0.10)) in favour of multicomponent lifestyle interventions. Subgroup analyses suggested an increased effect in specialist health care with a group treatment component included in the intervention. Conclusion Multicomponent lifestyle interventions have a moderate effect on change in BMI and BMI Z score after 6, 12, and 24 months compared with standard, minimal, and no treatment. PMID:29391949

Nurse Plants vs. Nurse Objects: Effects of Woody Plants and Rocky Cavities on the Recruitment of the Pilosocereus leucocephalus Columnar Cactus

PubMed Central

Munguía-Rosas, Miguel Angel; Sosa, Vinicio J.

2008-01-01

Background and Aims Most studies on cactus recruitment have focused on the role of woody plants as seedling facilitators. Although the spatial association of cacti with objects had been described, the mechanisms underlying this association remain unknown. The aims of this study were to identify which mechanisms facilitate the establishment of a columnar cactus under the shade and protection of objects and to compare these mechanisms with those involved in plant–plant facilitation. Methods Three split-split-plot field experiments were conducted to compare the effects of two microhabitats (inside rocky cavities and beneath plant canopies) on seed removal, germination, seedling survivorship and dry weight. Flat, open spaces were used as the control. For each microhabitat, the effect of seed or seedling protection and substrate limitation were explored; aboveground microclimate and some soil properties were also characterized. Key Results The permanence of superficial seeds was greater inside rocky cavities than beneath woody plant canopies or on flat, open areas. Germination was similar in cavities and beneath plant canopies, but significantly higher than on flat, open areas. Seedling survivorship was greater beneath plant canopies than inside cavities or on flat, open spaces. Conclusions The mechanisms of plant facilitation are different from those of object facilitation. There are seed–seedling conflicts involved in the recruitment of P. leucocephalus: nurse plants favour mainly seedling survivorship by providing a suitable microenvironment, while nurse objects mainly favour seed permanence, by protecting them from predators. PMID:18056054

Evaluation of different conditions and culture media for the recovery of Aeromonas spp. from water and shellfish samples.

PubMed

Latif-Eugenín, F; Beaz-Hidalgo, R; Figueras, M J

2016-09-01

To perform a comparative study for determining the optimum culture method (direct plating or enrichment) and medium (ampicillin dextrin agar (ADA), starch ampicillin agar (SAA), bile salts irgasan brilliant green modified (BIBG-m)) for recovering Aeromonas species from water and shellfish samples. By direct culture, Aeromonas was detected in 65% (13/20) of the water samples and in 54·5% (6/11) of the shellfish samples. However, when a pre-enrichment step was included, the number of positive water samples increased to 75% (15/20) and the ones of shellfish to 90·1% (10/11). The enriched culture significantly favoured (P < 0·05) the isolation of Aeromonas allosaccharophila from water, Aeromonas salmonicida from shellfish and Aeromonas caviae from both types of samples. The most specific (P < 0·05) culture medium for detecting Aeromonas from water was ADA. However, no differences were observed in the case of shellfish samples (P > 0·05). Isolation of Aeromonas media from water was favoured (P < 0·05) in the ADA medium, while SAA enhanced (P < 0·05) the isolation of Aer. salmonicida from shellfish. The culture method and medium used influenced the recovery of some Aeromonas species from water and shellfish samples. This fact should be considered in future prevalence studies to avoid overestimating the above mentioned Aeromonas species. © 2016 The Society for Applied Microbiology.

Radiofrequency vs laser in the management of mild to moderate obstructive sleep apnoea: does the number of treatment sessions matter?

PubMed

Atef, Ahmed; Mosleh, Mohammed; Hesham, Mohammed; Fathi, Ahmed; Hassan, Mohammed; Fawzy, Mahmoud

2005-11-01

Obstructive sleep apnea (OSA) is a relatively common and serious problem with many medical and social consequences. Laser and radiofrequency are two recent techniques used to treat OSA and they can be carried out under local anaesthesia, but they need multiple sessions to achieve satisfactory outcome and are associated with better short-term than long-term outcomes. In this work we compare the two modalities as regards the optimal number of treatment sessions needed to achieve a favourable outcome in the short and long term. A total of 150 patients with apnoea hypopnoea index (AHI) between 5 and 30 events per hour, no morbid obesity and retropalatal site of obstruction were included in this prospective study. Patients were randomly and equally divided into two groups, each comprising 75 patients. The first group was treated with bipolar radiofrequency volumetric tissue reduction of the palate (BRVTR) and the second group was treated with laser-assisted uvulopalatoplasty (LAUP). Each group was further subdivided into five subgroups each consisting of 15 patients. The first group received one treatment session, the second received two sessions, the third received three sessions, the fourth received four sessions and the fifth group received five treatment sessions. Evaluation of efficiency of both techniques in treating OSA was assessed objectively by polysomnography. In those treated with BRVTR; at least three sessions were needed to achieve a favourable outcome in OSA in the short and long term. In those treated with LAUP, a single treatment session was enough to achieve a favourable outcome on OSA in the short term, while two sessions were needed to achieve the same long-term outcome. In OSA, fewer treatment sessions are needed with LAUP (one session) than with BRVTR (three sessions) to achieve a favourable outcome. In LAUP more treatment sessions (two) are needed to maintain a longer-term favourable outcome than those needed to achieve short-term favourable outcome (one session), which is not the case with BRVTR (three sessions are needed to achieve both short- and long-term favourable results).

Impact of oligodendroglial component in glioblastoma (GBM-O): Is the outcome favourable than glioblastoma?

PubMed

Goda, Jayant S; Lewis, Shirley; Agarwal, Aditi; Epari, Sridhar; Churi, Shraddha; Padmavati, A; Gupta, Tejpal; Shetty, Prakash; Moiyadi, Aliasgar; Jalali, Rakesh

2015-08-01

Prognosis of patients with glioblastoma with oligodendroglial component (GBM-O) is not well defined. We report our experience of patients of GBM-O treated at our center. Between January 2007 and August 2013, out of 817 consecutive patients with glioblastoma (GBM), 74 patients with GBM-O were identified in our prospectively maintained database. An experienced neuropathologist revaluated the histopathology of all these 74 patients and the diagnosis of GBM-O was eventually confirmed in 57 patients. Patients were uniformly treated with maximal safe resection followed by focal radiotherapy with concurrent and adjuvant temozolamide (TMZ). At a median follow up of 16 months, median overall survival (OS) and progression free survival (PFS) of the entire cohort was 23 months and 13 months respectively. Near total excision was performed in 30/57 (52.6%). On univariate analysis, age < 50 years was a significant favourable prognostic factor for OS (p = 0.009) and PFS (p = 0.017), while patients with near total resection had a significantly better PFS (p = 0.017), patients who completed a minimum of 6 cycles of adjuvant TMZ had significantly better OS (p = 0.000) and PFS (p = 0.003). On multivariate analysis, none of the above factors were significant except for patient who had completed a minimum of 6 cycles of TMZ (OS; p = 0.000 & PFS; p = 0.015). A comparative analysis of GBM-O patients with a similarly treated cohort of 105 GBM patients during the same period revealed significantly better median OS in favour of GBM-O (p = 0.01). Our experience suggests patients with GBM-O have a more favourable clinical outcome as compared to GBM. Copyright © 2015 Elsevier B.V. All rights reserved.

Integrated pest management of "Golden Delicious" apples.

PubMed

Simončič, A; Stopar, M; Velikonja Bolta, Š; Bavčar, D; Leskovšek, R; Baša Česnik, H

2015-01-01

Monitoring of plant protection product (PPP) residues in "Golden Delicious" apples was performed in 2011-2013, where 216 active substances were analysed with three analytical methods. Integrated pest management (IPM) production and improved IPM production were compared. Results were in favour of improved IPM production. Some active compounds determined in IPM production (boscalid, pyraclostrobin, thiacloprid and thiametoxam) were not found in improved IPM production. Besides that, in 2011 and 2012, captan residues were lower in improved IPM production. Risk assessment was also performed. Chronic exposure of consumers was low in general, but showed no major differences for IPM and improved IPM production for active substances determined in both types of production. Analytical results were compared with the European Union report of 2010 where 1.3% of apple samples exceeded maximum residue levels (MRLs), while MRL exceedances were not observed in this survey.

Development of a simple and low cost microbioreactor for high-throughput bioprocessing.

PubMed

Rahman, Pattanathu K S M; Pasirayi, Godfrey; Auger, Vincent; Ali, Zulfiqur

2009-02-01

A simple microbioreactor for high-throughput bioprocessing made from low cost polymer polytetrafluoroethylene (PTFE) tubes with a working volume of 1.5 ml is described. We have developed a microfluidic system that handles a small population of cells of a model microorganism, Pseudomonas aeruginosa DS10-129. Under the conditions of the microbioreactor, the organism produced extracellular secondary metabolites by using nutrient broth modified with glycerol. Pyocyanins were isolated from the fermented medium as a metabolite of interest. Antibiotic properties of pyocyanin were effective against a number of microorganisms such as Staphylococcus aureus, S. epidermis, Bacillus subtilis, Micrococcus luteus and Saccharomyces cerevisiae. Batch fermentation of the model organism in the microbioreactor was compared to shake-flask and conventional bench fermenter methods. Results obtained from the microbioreactor compared favourably with the conventional processes.

Induction of hairy roots by various strains of Agrobacterium rhizogenes in different types of Capsicum species explants.

PubMed

Md Setamam, Nursuria; Jaafar Sidik, Norrizah; Abdul Rahman, Zainon; Che Mohd Zain, Che Radziah

2014-06-30

Capsicum annuum and Capsicum frutescens, also known as "chilies", belong to the Solanaceae family and have tremendous beneficial properties. The application of hairy root culture may become an alternative method for future development of these species by adding value, such as by increasing secondary metabolites and improving genetic and biochemical stability compared with normal Capsicum plants. Therefore, in this research, different types of explants of both species were infected with various Agrobacterium rhizogenes strains to provide more information about the morphology and induction efficiency of hairy roots. After 2 weeks of in vitro seed germination, young seedling explants were cut into three segments; the cotyledon, hypocotyl, and radical. Then, the explants were co-cultured with four isolated A. rhizogenes strains in Murashige & Skoog culture media (MS) containing decreasing carbenicillin disodium concentrations for one month. In this experiment, thick and short hairy roots were induced at all induction sites of C. annuum while thin, elongated hairy roots appeared mostly at wound sites of C. frutescens. Overall, the hairy root induction percentages of C. frutescens were higher compared with C. annuum. Hairy root initiation was observed earliest using radicles (1st week), followed by cotyledons (2nd week), and hypocotyls (3rd week). Cotyledon explants of both species had the highest induction frequency with all strains compared with the other explants types. Strains ATCC 13333 and ATCC 15834 were the most favourable for C. frutescens while ATCC 43056 and ATCC 43057 were the most favourable for C. annuum. The interactions between the different explants and strains showed significant differences with p-values < 0.0001 in both Capsicum species. Both Capsicum species were amenable to A. rhizogenes infection and hairy root induction is recommended for use as an alternative explants in future plant-based studies.

Research ethics committee decision-making in relation to an efficient neonatal trial.

PubMed

Gale, C; Hyde, M J; Modi, N

2017-07-01

Randomised controlled trials, a gold-standard approach to reduce uncertainties in clinical practice, are growing in cost and are often slow to recruit. We determined whether methodological approaches to facilitate large, efficient clinical trials were acceptable to UK research ethics committees (RECs). We developed a protocol in collaboration with parents, for a comparative-effectiveness, randomised controlled trial comparing two widely used blood transfusion practices in preterm infants. We incorporated four approaches to improve recruitment and efficiency: (i) point-of-care design using electronic patient records for patient identification, randomisation and data acquisition, (ii) short two-page information sheet; (iii) explicit mention of possible inclusion benefit; (iv) opt-out consent with enrolment as the default. With the support of the UK Health Research Authority, we submitted an identical protocol to 12 UK REC. RECs in the UK. Number of REC granting favourable opinions. The use of electronic patient records was acceptable to all RECs; one REC raised concerns about the short parent information sheet, 10 about inclusion benefit and 9 about opt-out consent. Following responses to queries, nine RECs granted a favourable final opinion and three rejected the application because they considered the opt-out consent process invalid. A majority of RECs in this study consider the use of electronic patient record data, short information sheets, opt-out consent and mention of possible inclusion benefit to be acceptable in neonatal comparative-effectiveness research. We identified a need for guidance for RECs in relation to opt-out consent processes. These methods provide opportunity to facilitate large randomised controlled trials. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Impact of cardiopulmonary resuscitation duration on neurologically favourable outcome after out-of-hospital cardiac arrest: A population-based study in Japan.

PubMed

Matsuyama, Tasuku; Kitamura, Tetsuhisa; Kiyohara, Kosuke; Nishiyama, Chika; Nishiuchi, Tatsuya; Hayashi, Yasuyuki; Kawamura, Takashi; Ohta, Bon; Iwami, Taku

2017-04-01

The optimal cardiopulmonary resuscitation (CPR) duration for patients with out-of-hospital cardiac arrest (OHCA) remains unclear. We aimed to assess the association between CPR duration and outcome after OHCA. This prospective, population-based observational study conducted in Osaka, Japan enrolled 6981 adult patients with non-traumatic witnessed OHCA who achieved return of spontaneous circulation (ROSC) from January 2005 through December 2012. CPR duration was defined as the time of CPR initiation by emergency medical service personnel to the ROSC in pre-hospital settings or after hospital admission. The primary outcome was one-month survival with neurologically favourable outcome (cerebral performance category scale 1 or 2). Overall, median CPR duration was 25min (interquartile range: 15-34) and the proportion of neurologically favourable outcome was 12.5% (875/6,981). The proportion of neurologically favourable outcome among the CPR duration ≥31min group was significantly lower compared with that among the 0-5min group (55.1% [320/581] versus 2.2% [54/2424], adjusted odds ratio [AOR] 0.04; 95% confidence interval [CI] 0.03-0.05 in all patients, 78.4% [240/306] versus 11.4% [30/264], AOR 0.04; 95% CI 0.02-0.06 in the shockable group, 29.1% [80/275] versus 1.1% [24/2160], and AOR 0.03; 95% CI 0.02-0.05 in the non-shockable group). The cumulative proportion for neurologically favourable outcome reached 99% after 44, 41, and 43min of CPR in all patients, the shockable group, and the non-shockable group, respectively. The proportion of patients with neurologically favourable outcome declined with increasing CPR duration, but some OHCA patients could benefit from prolonged CPR duration >30min. Copyright © 2017 Elsevier B.V. All rights reserved.

Detrended fluctuation analysis of non-stationary cardiac beat-to-beat interval of sick infants

NASA Astrophysics Data System (ADS)

Govindan, Rathinaswamy B.; Massaro, An N.; Al-Shargabi, Tareq; Niforatos Andescavage, Nickie; Chang, Taeun; Glass, Penny; du Plessis, Adre J.

2014-11-01

We performed detrended fluctuation analysis (DFA) of cardiac beat-to-beat intervals (RRis) collected from sick newborn infants over 1-4 day periods. We calculated four different metrics from the DFA fluctuation function: the DFA exponents αL (>40 beats up to one-fourth of the record length), αs (15-30 beats), root-mean-square (RMS) fluctuation on a short-time scale (20-50 beats), and RMS fluctuation on a long-time scale (110-150 beats). Except αL , all metrics clearly distinguished two groups of newborn infants (favourable vs. adverse) with well-characterized outcomes. However, the RMS fluctuations distinguished the two groups more consistently over time compared to αS . Furthermore, RMS distinguished the RRi of the two groups earlier compared to the DFA exponent. In all the three measures, the favourable outcome group displayed higher values, indicating a higher magnitude of (auto-)correlation and variability, thus normal physiology, compared to the adverse outcome group.

Exercise in children with joint hypermobility syndrome and knee pain: a randomised controlled trial comparing exercise into hypermobile versus neutral knee extension

PubMed Central

2013-01-01

Background Knee pain in children with Joint Hypermobility Syndrome (JHS) is traditionally managed with exercise, however the supporting evidence for this is scarce. No trial has previously examined whether exercising to neutral or into the hypermobile range affects outcomes. This study aimed to (i) determine if a physiotherapist-prescribed exercise programme focused on knee joint strength and control is effective in reducing knee pain in children with JHS compared to no treatment, and (ii) whether the range in which these exercises are performed affects outcomes. Methods A prospective, parallel-group, randomised controlled trial conducted in a tertiary hospital in Sydney, Australia compared an 8 week exercise programme performed into either the full hypermobile range or only to neutral knee extension, following a minimum 2 week baseline period without treatment. Randomisation was computer-generated, with allocation concealed by sequentially numbered opaque sealed envelopes. Knee pain was the primary outcome. Quality of life, thigh muscle strength, and function were also measured at (i) initial assessment, (ii) following the baseline period and (iii) post treatment. Assessors were blinded to the participants’ treatment allocation and participants blinded to the difference in the treatments. Results Children with JHS and knee pain (n=26) aged 7-16 years were randomly assigned to the hypermobile (n=12) or neutral (n=14) treatment group. Significant improvements in child-reported maximal knee pain were found following treatment, regardless of group allocation with a mean 14.5 mm reduction on the visual analogue scale (95% CI 5.2 – 23.8 mm, p=0.003). Significant differences between treatment groups were noted for parent-reported overall psychosocial health (p=0.009), specifically self-esteem (p=0.034), mental health (p=0.001) and behaviour (p=0.019), in favour of exercising into the hypermobile range (n=11) compared to neutral only (n=14). Conversely, parent-reported overall physical health significantly favoured exercising only to neutral (p=0.037). No other differences were found between groups and no adverse events occurred. Conclusions Parents perceive improved child psychosocial health when children exercise into the hypermobile range, while exercising to neutral only is perceived to favour the child’s physical health. A physiotherapist prescribed, supervised, individualised and progressed exercise programme effectively reduces knee pain in children with JHS. Trial registration Australia & New Zealand Clinical Trials Registry; ACTRN12606000109505. PMID:23941143

AMT measurements compared with gravimetry and magnetometry for structural study of a sedimentary basin: Letlhakeng-Botlhapatlou groundwater project, Botswana

NASA Astrophysics Data System (ADS)

Bourgeois, B.; Mathieu, F.; Vachette, C.; Vaubourg, P.

1994-02-01

Within the framework of hydrogeological studies for additional water supply to the main towns of Botswana, the BRGM company has carried out a multimethod geophysical survey of a large sedimentary basin in the Kalahari desert, for the purpose of assessing its water resources. On a regional scale, gravimetry, magnetometry and audio-magnetotellurics (AMT) were used to determine the structure of the basin, which is intensely faulted into horsts and grabens. Next, a number of favourable areas were selected for detailed profiling with horizontal portable loop EM (HLEM) and DC electrical arrays to locate accurately the fractured zones at the edges of grabens, the targets for exploratory drillholes. The AMT method proved to be the most effective for mapping the basement of the basin, thanks to the good resistivity contrast between the resistive basement and its conductive cover, and to the regional constancy of sedimentary organisation of the cover. The presence of the uniformly resistive Kalahari Sands at the top of the cover was also very favourable, protecting AMT data from troublesome "static" effects. These good conditions enabled a fast and innovative quantitative interpretation of AMT soundings, determined by borehole calibration and based on the reading of the apparent resistivity at a single frequency (10 Hz).

Evolution in Practice: How has British Neurosurgery Changed in the Last 10 Years?

PubMed Central

Tarnaris, A; Arvin, B; Ashkan, K

2008-01-01

INTRODUCTION Neurosurgery is a fast-evolving surgical subspecialty driven by technological advances, socio-economic factors and patient expectations. In this study, we have compared the work-load volume in a single institution in the years of 1994 and 2004 and commented on the possible reasons for the changes and the impacts they may have for the future. PATIENTS AND METHODS A retrospective, log-book review of all operations performed in the years 1994 and 2004 in a single, tertiary, neurosurgical centre was performed. RESULTS Neurosurgical practice has evolved over this period. Current practice has moved away from clipping of aneurysms and towards coil embolisation performed by interventional radiologists. Electrode stimulation of deep brain regions for movement disorders is the current practice, whereas 10 years ago the same disorders were dealt with by lesioning of the relevant regions. In spinal neurosurgery, instrumentation is increasingly favoured currently. In the field of neuro-oncology, current practice favours minimal access to the target area by the use of stereotactic localisation. CONCLUSIONS Changes were most pronounced in the subspecialties of vascular, functional and spinal neurosurgery within this 10-year period. Knowledge of such dynamics is valuable in health resource management as well as planning for neurosurgical training programmes. PMID:18765031

Innovative Mixed-Methods Research: Moving beyond Design Technicalities to Epistemological and Methodological Realizations

ERIC Educational Resources Information Center

Riazi, A. Mehdi

2016-01-01

Mixed-methods research (MMR), as an inter-discourse (quantitative and qualitative) methodology, can provide applied linguistics researchers the opportunity to draw on and integrate the strengths of the two research methodological approaches in favour of making more rigorous inferences about research problems. In this article, the argument is made…

The effect of mud therapy on pain relief in patients with knee osteoarthritis: a meta-analysis of randomized controlled trials.

PubMed

Liu, Hua; Zeng, Chao; Gao, Shu-guang; Yang, Tuo; Luo, Wei; Li, Yu-sheng; Xiong, Yi-lin; Sun, Jin-peng; Lei, Guang-hua

2013-10-01

A meta-analysis was conducted to examine the effect of mud therapy on pain relief in patients with knee osteoarthritis (OA). A detailed search of PubMed®/MEDLINE® was undertaken to identify randomized controlled trials and prospective comparative studies published before 9 March 2013 that compared mud therapy with control group treatments in patients with knee OA. A quantitative meta-analysis of seven studies (410 patients) was performed. There was a significant difference between the groups in the visual analogue scale pain score (standardized mean difference [SMD] -0.73) and Western Ontario and McMaster Universities Osteoarthritis Index pain score (SMD -0.30), with differences in favour of mud therapy. Mud therapy is a favourable option for pain relief in patients with knee OA. Additional high-quality randomized controlled trials need to be conducted to explore this issue further and to confirm this conclusion.

Asymptotic confidence intervals for the Pearson correlation via skewness and kurtosis.

PubMed

Bishara, Anthony J; Li, Jiexiang; Nash, Thomas

2018-02-01

When bivariate normality is violated, the default confidence interval of the Pearson correlation can be inaccurate. Two new methods were developed based on the asymptotic sampling distribution of Fisher's z' under the general case where bivariate normality need not be assumed. In Monte Carlo simulations, the most successful of these methods relied on the (Vale & Maurelli, 1983, Psychometrika, 48, 465) family to approximate a distribution via the marginal skewness and kurtosis of the sample data. In Simulation 1, this method provided more accurate confidence intervals of the correlation in non-normal data, at least as compared to no adjustment of the Fisher z' interval, or to adjustment via the sample joint moments. In Simulation 2, this approximate distribution method performed favourably relative to common non-parametric bootstrap methods, but its performance was mixed relative to an observed imposed bootstrap and two other robust methods (PM1 and HC4). No method was completely satisfactory. An advantage of the approximate distribution method, though, is that it can be implemented even without access to raw data if sample skewness and kurtosis are reported, making the method particularly useful for meta-analysis. Supporting information includes R code. © 2017 The British Psychological Society.

When we test, do we stress? Impact of the testing environment on cortisol secretion and memory performance in older adults.

PubMed

Sindi, Shireen; Fiocco, Alexandra J; Juster, Robert-Paul; Pruessner, Jens; Lupien, Sonia J

2013-08-01

The majority of studies find that older adults have worse memory performance than young adults. However, contextual features in the testing environment may be perceived as stressful by older adults, increasing their stress hormone levels. Given the evidence that older adults are highly sensitive to the effects of stress hormones (cortisol) on memory performance, it is postulated that a stressful testing environment in older adults can lead to an acute stress response and to memory impairments. The current study compared salivary cortisol levels and memory performance in young and older adults tested in environments manipulated to be stressful (unfavourable condition) or not stressful (favourable condition) for each age group. 28 young adults and 32 older adults were tested in two testing conditions: (1) a condition favouring young adults (constructed to be less stressful for young adults), and (2) a condition favouring older adults (constructed to be less stressful for older adults). The main outcome measure was salivary cortisol levels. Additionally, immediate and delayed memory performances were assessed during each condition. In older adults only, we found significantly high cortisol levels and low memory performance in the condition favouring young adults. In contrast, cortisol levels were lower and memory performance was better when older adults were tested in conditions favouring them. There was no effect of testing condition in young adults. The results demonstrate that older adults' memory performance is highly sensitive to the testing environment. These findings have important implications for both research and clinical settings in which older adults are tested for memory performance. Copyright © 2012 Elsevier Ltd. All rights reserved.

Vulnerability of dynamic genetic conservation units of forest trees in Europe to climate change.

PubMed

Schueler, Silvio; Falk, Wolfgang; Koskela, Jarkko; Lefèvre, François; Bozzano, Michele; Hubert, Jason; Kraigher, Hojka; Longauer, Roman; Olrik, Ditte C

2014-05-01

A transnational network of genetic conservation units for forest trees was recently documented in Europe aiming at the conservation of evolutionary processes and the adaptive potential of natural or man-made tree populations. In this study, we quantified the vulnerability of individual conservation units and the whole network to climate change using climate favourability models and the estimated velocity of climate change. Compared to the overall climate niche of the analysed target species populations at the warm and dry end of the species niche are underrepresented in the network. However, by 2100, target species in 33-65 % of conservation units, mostly located in southern Europe, will be at the limit or outside the species' current climatic niche as demonstrated by favourabilities below required model sensitivities of 95%. The highest average decrease in favourabilities throughout the network can be expected for coniferous trees although they are mainly occurring within units in mountainous landscapes for which we estimated lower velocities of change. Generally, the species-specific estimates of favourabilities showed only low correlations to the velocity of climate change in individual units, indicating that both vulnerability measures should be considered for climate risk analysis. The variation in favourabilities among target species within the same conservation units is expected to increase with climate change and will likely require a prioritization among co-occurring species. The present results suggest that there is a strong need to intensify monitoring efforts and to develop additional conservation measures for populations in the most vulnerable units. Also, our results call for continued transnational actions for genetic conservation of European forest trees, including the establishment of dynamic conservation populations outside the current species distribution ranges within European assisted migration schemes. © 2013 John Wiley & Sons Ltd.

Dacron® vs. PTFE as bypass materials in peripheral vascular surgery – systematic review and meta-analysis

PubMed Central

Roll, Stephanie; Müller-Nordhorn, Jacqueline; Keil, Thomas; Scholz, Hans; Eidt, Daniela; Greiner, Wolfgang; Willich, Stefan N

2008-01-01

Background In peripheral vascular bypass surgery different synthetic materials are available for bypass grafting. It is unclear which of the two commonly used materials, polytetrafluoroethylene (PTFE) or polyester (Dacron®) grafts, is to be preferred. Thus, the aim of this meta-analysis and systematic review was to compare the effectiveness of these two prosthetic bypass materials (Dacron® and PTFE). Methods We performed a systematic literature search in MEDLINE, Cochrane-Library – CENTRAL, EMBASE and other databases for relevant publications in English and German published between 1999 and 2008. Only randomized controlled trials were considered for inclusion. We assessed the methodological quality by means of standardized checklists. Primary patency was used as the main endpoint. Random-effect meta-analysis as well as pooling data in life table format was performed to combine study results. Results Nine randomized controlled trials (RCT) were included. Two trials showed statistically significant differences in primary patency, one favouring Dacron® and one favouring PTFE grafts, while 7 trials did not show statistically significant differences between the two materials. Meta-analysis on the comparison of PTFE vs. Dacron® grafts yielded no differences with regard to primary patency rates (hazard ratio 1.04 (95% confidence interval [0.85;1.28]), no significant heterogeneity (p = 0.32, I2 = 14%)). Similarly, there were no significant differences with regard to secondary patency rates. Conclusion Systematic evaluation and meta-analysis of randomized controlled trials comparing Dacron® and PTFE as bypass materials for peripheral vascular surgery showed no evidence of an advantage of one synthetic material over the other. PMID:19099583

Can the biomass-ratio hypothesis predict mixed-species litter decomposition along a climatic gradient?

PubMed Central

Tardif, Antoine; Shipley, Bill; Bloor, Juliette M. G.; Soussana, Jean-François

2014-01-01

Background and Aims The biomass-ratio hypothesis states that ecosystem properties are driven by the characteristics of dominant species in the community. In this study, the hypothesis was operationalized as community-weighted means (CWMs) of monoculture values and tested for predicting the decomposition of multispecies litter mixtures along an abiotic gradient in the field. Methods Decomposition rates (mg g−1 d−1) of litter from four herb species were measured using litter-bed experiments with the same soil at three sites in central France along a correlated climatic gradient of temperature and precipitation. All possible combinations from one to four species mixtures were tested over 28 weeks of incubation. Observed mixture decomposition rates were compared with those predicted by the biomass-ratio hypothesis. Variability of the prediction errors was compared with the species richness of the mixtures, across sites, and within sites over time. Key Results Both positive and negative prediction errors occurred. Despite this, the biomass-ratio hypothesis was true as an average claim for all sites (r = 0·91) and for each site separately, except for the climatically intermediate site, which showed mainly synergistic deviations. Variability decreased with increasing species richness and in less favourable climatic conditions for decomposition. Conclusions Community-weighted mean values provided good predictions of mixed-species litter decomposition, converging to the predicted values with increasing species richness and in climates less favourable to decomposition. Under a context of climate change, abiotic variability would be important to take into account when predicting ecosystem processes. PMID:24482152

Solution-focused intervention for sick listed employees with psychological problems or muscle skeletal pain: a randomised controlled trial [ISRCTN39140363

PubMed Central

Nystuen, Pal; Hagen, Kare B

2006-01-01

Background Long-term sick leave has been of concern to politicians and decision-makers in Norway for several years. In the current study we assess the efficacy of a solution-focused follow-up for sick-listed employees. Methods Employees on long-term sick leave due to psychological problems or muscle skeletal pain (n = 703) were invited to participate in the project. Following self-recruitment, 103 were randomly allocated to receive solution-focused follow-up (n = 53) or "treatment as usual" (n = 50). The intervention was integrated within the regular follow up of six social security offices and organised as eight weekly solution focused work sessions. Effectiveness was measured by rate of return to work and health related quality of life (SF-36). Results Intention to treat analysis showed no significant differences between the two groups for any of the outcome measures. Secondary analysis, comparing those who attended at least 50% of the sessions with the control group revealed a significant difference in favour of the active intervention group in the SF-36 subscale of mental health (Effect Size 0.56, p = 0.05). When comparing the subgroup of participants with psychological problems there was a significant difference in mental health in favour of the intervention group (Effect Size 0.71, p = 0.041). Conclusion A voluntary solution-focused intervention offered by social-security offices is no more effective than regular follow up for employees on long-term sick leave due to psychological problems or muscle skeletal pain. PMID:16542443

In silico and experimental evaluation of DNA-based detection methods for the ability to discriminate almond from other Prunus spp.

PubMed

Brežná, Barbara; Šmíd, Jiří; Costa, Joana; Radvanszky, Jan; Mafra, Isabel; Kuchta, Tomáš

2015-04-01

Ten published DNA-based analytical methods aiming at detecting material of almond (Prunus dulcis) were in silico evaluated for potential cross-reactivity with other stone fruits (Prunus spp.), including peach, apricot, plum, cherry, sour cherry and Sargent cherry. For most assays, the analysis of nucleotide databases suggested none or insufficient discrimination of at least some stone fruits. On the other hand, the assay targeting non-specific lipid transfer protein (Röder et al., 2011, Anal Chim Acta 685:74-83) was sufficiently discriminative, judging from nucleotide alignments. Empirical evaluation was performed for three of the published methods, one modification of a commercial kit (SureFood allergen almond) and one attempted novel method targeting thaumatin-like protein gene. Samples of leaves and kernels were used in the experiments. The empirical results were favourable for the method from Röder et al. (2011) and a modification of SureFood allergen almond kit, both showing cross-reactivity <10(-3) compared to the model almond. Copyright © 2014 Elsevier Ltd. All rights reserved.

Attitudes and perceptions of the general Malaysian public regarding family presence during resuscitation.

PubMed

Chew, Keng Sheng; Ghani, Zuhailah Abdul

2014-08-01

Family presence (FP) during resuscitation is an increasingly favoured trend, as it affords many benefits to the critically ill patient's family members. However, a previously conducted study showed that only 15.8% of surveyed Malaysian healthcare staff supported FP during resuscitation. This cross-sectional study used a bilingual self-administered questionnaire to examine the attitudes and perceptions of the general Malaysian public toward the presence of family members during resuscitation of their loved ones. The questionnaires were randomly distributed to Malaysians in three different states and in the federal territory of Kuala Lumpur. Out of a total of 190 survey forms distributed, 184 responses were included for analysis. Of the 184 respondents, 140 (76.1%) indicated that they favoured FP during resuscitation. The most common reason cited was that FP during resuscitation provides family members with the assurance that everything possible had been done for their loved ones (n = 157, 85.3%). Respondents who had terminal illnesses were more likely to favour FP during resuscitation than those who did not, and this was statistically significant (95.0% vs. 73.8%; p = 0.04). FP during resuscitation was favoured by a higher percentage of the general Malaysian public as compared to Malaysian healthcare staff. This could be due to differences in concerns regarding the resuscitation process between members of the public and healthcare staff.

Canadian Guidelines on Pharmacotherapy for Disruptive and Aggressive Behaviour in Children and Adolescents With Attention-Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, or Conduct Disorder

PubMed Central

Gorman, Daniel A; Gardner, David M; Murphy, Andrea L; Feldman, Mark; Bélanger, Stacey A; Steele, Margaret M; Boylan, Khrista; Cochrane-Brink, Kate; Goldade, Roxanne; Soper, Paul R; Ustina, Judy; Pringsheim, Tamara

2015-01-01

Objective: To develop evidence-based guidelines on pharmacotherapy for severe disruptive and aggressive behaviour in children and adolescents with attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), or conduct disorder (CD). The guidelines assume that psychosocial interventions have been pursued but did not achieve sufficient improvement. Method: A multidisciplinary consensus group used the Grading of Recommendations Assessment, Development and Evaluation approach for rating evidence quality and for grading recommendations. We conducted a systematic review of medications studied in placebo-controlled trials for treating disruptive and aggressive behaviour in children and adolescents with ADHD, ODD, or CD. We followed consensus procedures to make 1 of 4 recommendations for each medication: strong, in favour (↑↑); conditional, in favour (↑?); conditional, against (↓?); and strong, against (↓↓). Results: For children and adolescents with disruptive or aggressive behaviour associated with ADHD, psychostimulants received a strong recommendation in favour of use, while atomoxetine and alpha-2 agonists received a conditional recommendation in favour of use. If these patients do poorly with ADHD medications, the medication with the most evidence is risperidone. Risperidone also has the most evidence for treating disruptive or aggressive behaviour in the absence of ADHD. However, given risperidone’s major adverse effects, it received only a conditional recommendation in favour of use. We recommended against using quetiapine, haloperidol, lithium, or carbamazepine because of the poor quality of evidence and their major adverse effects. Conclusion: When severe disruptive or aggressive behaviour occurs with ADHD, medications for ADHD should be used first. Other medications have major adverse effects and, with the exception of risperidone, very limited evidence to support their use. PMID:25886657

The potential role of taxes and subsidies on food in the prevention of obesity in Europe.

PubMed

González-Zapata, Laura Inés; Alvarez-Dardet, Carlos; Millstone, Erik; Clemente-Gómez, Vicente; Holdsworth, Michelle; Ortiz-Moncada, Rocio; Lobstein, Tim; Sarri, Katerina; De Marchi, Bruna; Horvath, Katalin Z

2010-08-01

Obesity implies costs not only for the individual but also for society. The authors explore the opinions of stakeholders on the potential of taxes or subsidies, as measures for tackling obesity in Europe. Structured interviews were conducted using Multicriteria Mapping, a computer-based, decision-support tool, with 189 interviewees drawn from 21 different stakeholder categories across nine members of the EU interviews, to appraise 20 predefined policy options aimed at reducing obesity, including 'taxing obesity-promoting foods' and 'subsidising healthy foods.' A four-step approach involved selecting options, defining criteria, scoring options quantitatively and weighting criteria to provide overall rankings of options. Interviews were recorded and transcribed to yield qualitative data. Compared with other policy options appraised, taxation and subsidies were not favourably received, mainly because they were considered difficult to implement. Overall, trade unions rated both options more favourably than all other stakeholder groups. As anticipated, both options received their lowest scores from representatives of the farming, food processing and advertising industries. Nutritional/obesity advisory experts and public sector caterers gave the most positive ratings to subsidies overall. Along with public health professionals, large commercial retailers were most in favour of taxation. Taxation and subsidies were poorly appraised compared with other policy measures, with stakeholders expressing reservations mainly focussed on the practicalities and cost of introducing such measures. Although applying taxes/subsidies could be useful to combat obesity, the study suggests that most stakeholders still need to be convinced of their viability and acceptability when compared with other measures.

Comparing South African Female and Male Pre-Service Teachers' Beliefs about the Nature of Mathematics

ERIC Educational Resources Information Center

Spangenberg, Erica Dorethea; Myburgh, Chris

2017-01-01

Girls performing well in mathematics at school do not necessarily enrol for mathematics courses at South African universities. Teachers could be transferring beliefs about the nature of mathematics favouring boys. This paper compared male and female pre-service teachers' beliefs about the nature of mathematics. A quantitative, descriptive research…

Patellar denervation with electrocautery in total knee arthroplasty without patellar resurfacing: a meta-analysis.

PubMed

Cheng, Tao; Zhu, Chen; Guo, Yongyuan; Shi, Sifeng; Chen, Desheng; Zhang, Xianlong

2014-11-01

The impact of patellar denervation with electrocautery in total knee arthroplasty (TKA) on post-operative outcomes has been under debate. This study aims to conduct a meta-analysis and systematic review to compare the benefits and risks of circumpatellar electrocautery with those of non-electrocautery in primary TKAs. Comparative and randomized clinical studies were identified by conducting an electronic search of articles dated up to September 2012 in PubMed, EMBASE, Scopus, and the Cochrane databases. Six studies that focus on a total of 849 knees were analysed. A random-effects model was conducted using the inverse-variance method for continuous variables and the Mantel-Haenszel method for dichotomous variables. There was no significant difference in the incidence of anterior knee pain between the electrocautery and non-electrocautery groups. In term of patellar score and Knee Society Score, circumpatellar electrocautery improved clinical outcomes compared with non-electrocautery in TKAs. The statistical differences were in favour of the electrocautery group but have minimal clinical significance. In addition, the overall complications indicate no statistical significance between the two groups. This study shows no strong evidence either for or against electrocautery compared with non-electrocautery in TKAs. Therapeutic study (systematic review and meta-analysis), Level III.

A novel method for beef potentiator preparation and identification of its characteristic aroma compounds.

PubMed

Gao, Xianli; Yan, Shuang; Yang, Bao; Lu, Jian; Jin, Zhao

2014-06-01

Beef potentiator (BP) is the most popular savoury flavour and regarded as the soul of the modern food industry. In this work, BP was prepared by a novel method with Aspergillus oryzae and Aspergillus niger (BPSF). Three other BPs prepared using commercial enzymes (Protamex, Flavourzyme and papain; BPCEs) were used as controls to investigate its aroma characteristics and related compounds. Sensory evaluation showed that BPSF possessed more favourable and distinctive sauce-like, meat-like, roast and alcoholic attributes when compared with BPCEs. Significantly higher contents (peak areas) and proportions of pyrazines, pyrroles, sulfurous compounds and alcohols in BPSF were responsible for its sensory characteristics, and most of these aroma compounds were derived from microbial metabolism during beef koji preparation and the Maillard reaction. BP prepared by synergistic fermentation with A. oryzae and A. niger is a potential alternative for BP preparation. © 2013 Society of Chemical Industry.

Comparison between KPVT/SPM and SoHO/MDI magnetograms with an application to solar irradiance reconstructions

NASA Astrophysics Data System (ADS)

Wenzler, T.; Solanki, S. K.; Krivova, N. A.; Fluri, D. M.

2004-12-01

To be able to use both space- and ground-based solar magnetograms and construct long time series of derived parameters it is important to cross-calibrate them so that we can estimate their reliability and combine them. Using two different techniques, we compare magnetograms as well as continuum images recorded by the Spectropolarimeter (SPM) on Kitt Peak and the Michelson Doppler Interferometer (MDI) on board SoHO. We find that the result obtained depends on the method used. The method we favour gives almost identical umbral and penumbral areas and very similar total magnetic fluxes in faculae. The magnetic fluxes in umbrae and penumbrae returned by the two instruments, however, differ considerably. We also demonstrate that SPM data can be employed to reconstruct total solar irradiance variations with almost the same accuracy as recently shown for MDI data.

Economic evaluation of an experience sampling method intervention in depression compared with treatment as usual using data from a randomized controlled trial.

PubMed

Simons, Claudia J P; Drukker, Marjan; Evers, Silvia; van Mastrigt, Ghislaine A P G; Höhn, Petra; Kramer, Ingrid; Peeters, Frenk; Delespaul, Philippe; Menne-Lothmann, Claudia; Hartmann, Jessica A; van Os, Jim; Wichers, Marieke

2017-12-29

Experience sampling, a method for real-time self-monitoring of affective experiences, holds opportunities for person-tailored treatment. By focussing on dynamic patterns of positive affect, experience sampling method interventions (ESM-I) accommodate strategies to enhance personalized treatment of depression-at potentially low-costs. This study aimed to investigate the cost-effectiveness of an experience sampling method intervention in patients with depression, from a societal perspective. Participants were recruited between January 2010 and February 2012 from out-patient mental health care facilities in or near the Dutch cities of Eindhoven and Maastricht, and through local advertisements. Out-patients diagnosed with major depression (n = 101) receiving pharmacotherapy were randomized into: (i) ESM-I consisting of six weeks of ESM combined with weekly feedback regarding the individual's positive affective experiences, (ii) six weeks of ESM without feedback, or (iii) treatment as usual only. Alongside this randomised controlled trial, an economic evaluation was conducted consisting of a cost-effectiveness and a cost-utility analysis, using Hamilton Depression Rating Scale (HDRS) and quality adjusted life years (QALYs) as outcome, with willingness-to-pay threshold for a QALY set at €50,000 (based on Dutch guidelines for moderate severe to severe illnesses). The economic evaluation showed that ESM-I is an optimal strategy only when willingness to pay is around €3000 per unit HDRS and around €40,500 per QALY. ESM-I was the least favourable treatment when willingness to pay was lower than €30,000 per QALY. However, at the €50,000 willingness-to-pay threshold, ESM-I was, with a 46% probability, the most favourable treatment (base-case analysis). Sensitivity analyses confirmed the robustness of these results. We may tentatively conclude that ESM-I is a cost-effective add-on intervention to pharmacotherapy in outpatients with major depression. Netherlands Trial register, NTR1974 .

Repetitive Transcranial Magnetic Stimulation for Treatment-Resistant Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

PubMed Central

Sehatzadeh, Shayan; Tu, Hong Anh; Palimaka, Stefan; Yap, Belinda; O'Reilly, Daria; Bowen, Jim; Higgins, Caroline; Holubowich, Corinne

2016-01-01

Background To date, several randomized controlled trials (RCTs) have shown the efficacy of repetitive transcranial magnetic stimulation (rTMS) in the treatment of major depression. Objective This analysis examined the antidepressant efficacy of rTMS in patients with treatment-resistant unipolar depression. Methods A literature search was performed for RCTs published from January 1, 1994, to November 20, 2014. The search was updated on March 1, 2015. Two independent reviewers evaluated the abstracts for inclusion, reviewed full texts of eligible studies, and abstracted data. Meta-analyses were conducted to obtain summary estimates. The primary outcome was changes in depression scores measured by the Hamilton Rating Scale for Depression (HRSD), and we considered, a priori, the mean difference of 3.5 points to be a clinically important treatment effect. Remission and response to the treatment were secondary outcomes, and we calculated number needed to treat on the basis of these outcomes. We examined the possibility of publication bias by constructing funnel plots and by Begg's and Egger's tests. A meta-regression was undertaken to examine the effect of specific rTMS technical parameters on the treatment effects. Results Twenty-three RCTs compared rTMS with sham, and six RCTs compared rTMS with electroconvulsive therapy (ECT). Trials of rTMS versus sham showed a statistically significant improvement in depression scores with rTMS (weighted mean difference [WMD] 2.31, 95% CI 1.19–3.43; P < .001). This improvement was smaller than the pre-specified clinically important treatment effect. There was a 10% absolute difference between rTMS and sham in the rates of remission or response. This translates to a number needed to treat of 10. Risk ratios for remission and response were 2.20 (95% CI 1.44–3.38, P = .001 and 1.72 [95% CI], 1.13–2.62, P = .01), respectively, favouring rTMS. No publication bias was detected. Trials of rTMS versus ECT showed a statistically and clinically significant difference between rTMS and ECT in favour of ECT (WMD 5.97, 95% CI 0.94–11.0, P = .02). Risk ratios for remission and response were 1.44 (95% CI 0.64–3.23, P = .38) and 1.72 (95% CI 0.95–3.11, P = .07), respectively, favouring ECT. Conclusions Overall, the body of evidence favoured ECT for treatment of patients who are treatment-resistant. Repetitive transcranial magnetic stimulation had a small short-term effect for improving depression in comparison with sham, but follow-up studies did not show that the small effect will continue for longer periods. PMID:27099642

Applying a Mixed Method Design to Evaluate Training Seminars within an Early Childhood Education Project

ERIC Educational Resources Information Center

Grammatikopoulos, Vasilis; Zachopoulou, Evridiki; Tsangaridou, Niki; Liukkonen, Jarmo; Pickup, Ian

2008-01-01

The body of research relating to assessment in education suggests that professional developers and seminar administrators have generally paid little attention to evaluation procedures. Scholars have also been critical of evaluations which use a single data source and have favoured the use of a multiple method design to generate a complete picture…

Clinical outcomes of arthroscopic single and double row repair in full thickness rotator cuff tears

PubMed Central

Ji, Jong-Hun; Shafi, Mohamed; Kim, Weon-Yoo; Kim, Young-Yul

2010-01-01

Background: There has been a recent interest in the double row repair method for arthroscopic rotator cuff repair following favourable biomechanical results reported by some studies. The purpose of this study was to compare the clinical results of arthroscopic single row and double row repair methods in the full-thickness rotator cuff tears. Materials and Methods: 22 patients of arthroscopic single row repair (group I) and 25 patients who underwent double row repair (group II) from March 2003 to March 2005 were retrospectively evaluated and compared for the clinical outcomes. The mean age was 58 years and 56 years respectively for group I and II. The average follow-up in the two groups was 24 months. The evaluation was done by using the University of California Los Angeles (UCLA) rating scale and the shoulder index of the American Shoulder and Elbow Surgeons (ASES). Results: In Group I, the mean ASES score increased from 30.48 to 87.40 and the mean ASES score increased from 32.00 to 91.45 in the Group II. The mean UCLA score increased from the preoperative 12.23 to 30.82 in Group I and from 12.20 to 32.40 in Group II. Each method has shown no statistical clinical differences between two methods, but based on the sub scores of UCLA score, the double row repair method yields better results for the strength, and it gives more satisfaction to the patients than the single row repair method. Conclusions: Comparing the two methods, double row repair group showed better clinical results in recovering strength and gave more satisfaction to the patients but no statistical clinical difference was found between 2 methods. PMID:20697485

Worldwide studies on aircraft disinsection at "blocks away".

PubMed

Sullivan, W N; Pal, R; Wright, J W; Azurin, J C; Okamoto, R; McGuire, J U; Waters, R M

1972-01-01

During 1971 worldwide experiments on the disinsection of passenger cabins at "blocks away" (as the aircraft starts taxiing for take-off) were conducted in several types of jet aircraft. A procedure was developed whereby the high capacity Boeing 747 could be disinsected by four stewardesses in less than 1 minute. The favourable results of these and previous trials indicate that this method is suitable as a standard procedure for aircraft disinsection for international quarantine purposes.The biological effectiveness against resistant and non-resistant mosquitos of a 2% concentration of a pyrethroid, resmethrin, in Freon 11+Freon 12 (1:1) (without kerosine) and a favourable passenger response make it suitable as a standard formulation for aircraft disinsection.

Skin-to-skin care for procedural pain in neonates.

PubMed

Johnston, Celeste; Campbell-Yeo, Marsha; Disher, Timothy; Benoit, Britney; Fernandes, Ananda; Streiner, David; Inglis, Darlene; Zee, Rebekah

2017-02-16

Skin-to-skin care (SSC), often referred to as 'kangaroo care' (KC) due to its similarity with marsupial behaviour of ventral maternal-infant contact, is one non-pharmacological intervention for pain control in infants. The primary objectives were to determine the effect of SSC alone on pain from medical or nursing procedures in neonates compared to no intervention, sucrose or other analgesics, or additions to simple SSC such as rocking; and to determine the effects of the amount of SSC (duration in minutes), method of administration (e.g. who provided the SSC) of SSC in reducing pain from medical or nursing procedures in neonatesThe secondary objectives were to determine the safety of SSC care for relieving procedural pain in infants; and to compare the SSC effect in different postmenstrual age subgroups of infants. For this update, we used the standard search strategy of the Cochrane Neonatal Review group to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1); MEDLINE via PubMed (1966 to 25 February 2016); Embase (1980 to 25 February 2016); and CINAHL (1982 to 25 February 2016). We also searched clinical trials' databases, conference proceedings, and the reference lists of retrieved articles for randomized controlled trials and quasi-randomized trials. Studies with randomisation or quasi-randomisation, double- or single-blinded, involving term infants (≥ 37 completed weeks' postmenstrual age (PMA) to a maximum of 44 weeks' PMA and preterm infants (< 37 completed weeks PMA) receiving SSC for painful procedures conducted by healthcare professionals. The main outcome measures were physiological or behavioural pain indicators and composite pain scores. A mean difference (MD) with 95% confidence interval (CI) using a fixed-effect model was reported for continuous outcome measures. We included variations on type of tissue-damaging procedure, provider of care, and duration of SSC. Twenty-five studies (n = 2001 infants) were included. Nineteen studies (n = 1065) used heel lance as the painful procedure, one study combined venepuncture and heel stick (n = 50), three used intramuscular injection (n = 776), one used 'vaccination' (n = 60), and one used tape removal (n = 50). The studies were generally strong and had low or uncertain risk of bias. Blinding of the intervention was not possible, making them subject to high risk, depending on the method of scoring outcomes.Seventeen studies (n = 810) compared SSC to a no-treatment control. Although 15 studies measured heart rate during painful procedures, data from only five studies (n = 161) could be combined for a mean difference (MD) of -10.78 beats per minute (95% CI -13.63 to -7.93) favouring SSC. Meta-analysis of four studies (n = 120) showed no difference in heart rate following the painful procedure (MD 0.08, 95% CI -4.39 to 4.55). Two studies (n = 38) reported heart rate variability with no significant differences. Two studies (n = 101) in a meta-analysis on oxygen saturation at 30 and 60 seconds following the painful procedure did not show a difference. Duration of crying meta-analysis was performed on four studies (n = 133): two (n = 33) investigated response to heel lance (MD = -34.16, 95% CI -42.86 to -25.45), and two (n = 100) following IM injection (MD = -8.83, 95% CI -14.63 to -3.02), favouring SSC. Five studies, one consisting of two substudies (n = 267), used the Premature Infant Pain Profile (PIPP) as a primary outcome, which favoured SCC at 30 seconds (MD -3.21, 95% CI -3.94 to -2.47), at 60 seconds (3 studies; n = 156) (MD -1.64, 95% CI -2.86 to -0.43), and at 90 seconds (n = 156) (MD -1.28, 95% CI -2.53 to -0.04); but at 120 seconds there was no difference (n = 156) (MD 0.07, 95% CI -1.11 to 1.25). No studies on return of heart rate to baseline level, cortisol levels, and facial actions could be combined for meta-analysis findings.Eight studies compared SSC to another intervention with or without a no-treatment control. Two cross-over studies (n = 80) compared mother versus other provider (father, another female) on PIPP scores at 30, 60, 90, and 120 seconds with no significant difference. When SSC was compared to other interventions, there were not enough similar studies to pool results in an analysis. One study compared SSC (n = 640) with and without dextrose and found that the combination was most effective and that SSC alone was more effective than dextrose alone. Similarly, in another study SSC was more effective than oral glucose for heart rate (n = 95). SSC either in combination with breastfeeding or alone was favoured over a no-treatment control, but not different to breastfeeding. One study compared SSC alone and in combination with both sucrose and breastfeeding on heart rate (HR), NIPS scores, and crying time (n = 127). The combinations were more effective than SSC alone for NIPS and crying. Expressed breast milk was compared to SSC in one study (n = 50) and found both equally effective on PIPP scores. There were not enough participants with similar outcomes and painful procedures to compare age groups or duration of SSC. No adverse events were reported in any of the studies. SSC appears to be effective as measured by composite pain indicators with both physiological and behavioural indicators and, independently, using heart rate and crying time; and safe for a single painful procedure. Purely behavioural indicators tended to favour SSC but with facial actions there is greater possibility of observers not being blinded. Physiological indicators were mixed although the common measure of heart rate favoured SSC. Two studies compared mother-providers to others, with non-significant results. There was more heterogeneity in the studies with behavioural or composite outcomes. There is a need for replication studies that use similar, clearly defined outcomes. Studies examining optimal duration of SSC, gestational age groups, repeated use, and long-term effects of SSC are needed. Of interest would be to study synergistic effects of SSC with other interventions.

Favoured Free-Time: Comparing Children's Activity Preferences in the UK and the USA

ERIC Educational Resources Information Center

Griffiths, Merris

2011-01-01

This study presents a comparative study of the free-time activity preferences of 9- to 11-year-old children in the UK and USA, as drawn by them in art workshops. Six themes emerged relating to sport, outdoor play, family/peers, media, special occasions and other (indefinable) activities. The children's talk about their drawings revealed additional…

Clinical outcomes of arthroscopic single and double row repair in full thickness rotator cuff tears.

PubMed

Ji, Jong-Hun; Shafi, Mohamed; Kim, Weon-Yoo; Kim, Young-Yul

2010-07-01

There has been a recent interest in the double row repair method for arthroscopic rotator cuff repair following favourable biomechanical results reported by some studies. The purpose of this study was to compare the clinical results of arthroscopic single row and double row repair methods in the full-thickness rotator cuff tears. 22 patients of arthroscopic single row repair (group I) and 25 patients who underwent double row repair (group II) from March 2003 to March 2005 were retrospectively evaluated and compared for the clinical outcomes. The mean age was 58 years and 56 years respectively for group I and II. The average follow-up in the two groups was 24 months. The evaluation was done by using the University of California Los Angeles (UCLA) rating scale and the shoulder index of the American Shoulder and Elbow Surgeons (ASES). In Group I, the mean ASES score increased from 30.48 to 87.40 and the mean ASES score increased from 32.00 to 91.45 in the Group II. The mean UCLA score increased from the preoperative 12.23 to 30.82 in Group I and from 12.20 to 32.40 in Group II. Each method has shown no statistical clinical differences between two methods, but based on the sub scores of UCLA score, the double row repair method yields better results for the strength, and it gives more satisfaction to the patients than the single row repair method. Comparing the two methods, double row repair group showed better clinical results in recovering strength and gave more satisfaction to the patients but no statistical clinical difference was found between 2 methods.

Cost-effectiveness analysis of treatment strategies for initial Clostridium difficile infection.

PubMed

Varier, R U; Biltaji, E; Smith, K J; Roberts, M S; Jensen, M K; LaFleur, J; Nelson, R E

2014-12-01

Clostridium difficile infection (CDI) is costly. Current guidelines recommend metronidazole as first-line therapy and vancomycin as an alternative. Recurrence is common. Faecal microbiota transplantation (FMT) is an effective therapy for recurrent CDI (RCDI). This study explores the cost-effectiveness of FMT, vancomycin and metronidazole for initial CDI. We constructed a decision-analytic computer simulation using inputs from published literature to compare FMT with a 10-14-day course of oral metronidazole or vancomycin for initial CDI. Parameters included cure rates (baseline value (range)) for metronidazole (80% (65-85%)), vancomycin (90% (88-92%)) and FMT(91% (83-100%)). Direct costs of metronidazole, vancomycin and FMT, adjusted to 2011 dollars, were $57 ($43-72), $1347 ($1195-1499) and $1086 ($815-1358), respectively. Our effectiveness measure was quality-adjusted life years (QALYs). One-way and probabilistic sensitivity analyses were conducted from the third-party payer perspective. Analysis using baseline values showed that FMT($1669, 0.242 QALYs) dominated (i.e. was less costly and more effective) vancomycin ($1890, 0.241 QALYs). FMT was more costly and more effective than metronidazole ($1167, 0.238 QALYs), yielding an incremental cost-effectiveness ratio (ICER) of $124 964/QALY. One-way sensitivity analyses showed that metronidazole dominated both strategies if its probability of cure were >90%; FMT dominated if it cost <$584. In a probabilistic sensitivity analysis at a willingness-to-pay threshold of $100 000/QALY, metronidazole was favoured in 55% of model iterations; FMT was favoured in 38%. Metronidazole, as the first-line treatment for CDIs, is less costly. FMT and vancomycin are more effective. However, FMT is less likely to be economically favourable, and vancomycin is unlikely to be favourable as first-line therapy when compared with FMT. © 2014 The Authors Clinical Microbiology and Infection © 2014 European Society of Clinical Microbiology and Infectious Diseases.

[Job as a risk factor for obesity... and the contrary].

PubMed

Perbellini, L

2004-01-01

Obesity constitutes a risk for several vascular, metabolic and neoplastic diseases. In industrialised countries, but more and more in developing countries too, the prevalence of obesity is increasing. Body Mass Index and circumference of the abdomen are the two simplest and most utilized methods of measuring the degree of obesity in an individual and of comparing selected groups with different ethnic, social, cultural and occupational features. The main aim of this article is to initiate a discussion on the possible contribution that the Occupational Health Physician can make to solving the problem of obesity, which is becoming more and more alarming in social terms. The working conditions favouring an increase in body weight and the negative effects that obesity has on various types of work are reported. A critical review of the literature on obesity and overweight stresses that a low educational level, a low socio-economic status, lack of physical activity in leisure time and certain working conditions, together with the ready availability of food, are the main factors favouring increased prevalence of obesity. Certain jobs also contribute significantly to this problem. Automation and the use of machines/robots for very heavy work in industrialised countries have the "collateral effect" of favouring body weight increase due to low energy consumption. Jobs that are a source of stress, such as work on three rotating shifts, can cause metabolic disorders leading to an increased prevalence of obesity. Contrariwise, obesity renders the individual unfit for some jobs, in fact, an increased incidence of industrial accidents has been related to obesity. The occupational health physicians engaged in surveillance of workers' health conditions can make a positive contribution to alleviating this problem by focusing their activity on the primary prevention of obesity and advising workers on how to maintain the right weight; otherwise, obese workers should be referred to appropriate medical centres.

Ecological restoration of farmland: progress and prospects.

PubMed

Wade, Mark R; Gurr, Geoff M; Wratten, Steve D

2008-02-27

Sustainable agricultural practices in conjunction with ecological restoration methods can reduce the detrimental effects of agriculture. The Society for Ecological Restoration International has produced generic guidelines for conceiving, organizing, conducting and assessing ecological restoration projects. Additionally, there are now good conceptual frameworks, guidelines and practical methods for developing ecological restoration programmes that are based on sound ecological principles and supported by empirical evidence and modelling approaches. Restoration methods must also be technically achievable and socially acceptable and spread over a range of locations. It is important to reconcile differences between methods that favour conservation and those that favour economic returns, to ensure that conservation efforts are beneficial for both landowners and biodiversity. One option for this type of mutual benefit is the use of agri-environmental schemes to provide financial incentives to landholders in exchange for providing conservation services and other benefits. However, further work is required to define and measure the effectiveness of agri-environmental schemes. The broader potential for ecological restoration to improve the sustainability of agricultural production while conserving biodiversity in farmscapes and reducing external costs is high, but there is still much to learn, particularly for the most efficient use of agri-environmental schemes to change land use practice.

[Preventive activities in primary health care: identifying the agreement among evidence-based guidelines].

PubMed

Gosalbes Soler, V; Márquez Calderón, S; Maiques Galán, A; Latour Pérez, J; Bernal Delgado, E; Puig Barberá, J; Arranz Lázaro, M

2000-01-01

The purpose of this article is to identify the agreement among evidence-based guidelines about recommendations on preventive activities in low risk adults. For which we identified, from the 1996 US Task Force on Preventive Services Guide those preventives activities classified like A or B (recommendation in favour of provision) and like D or E (recommendation against provision), excepting those D and E recommendations based on descriptives studies or expert opinions. Both preventive activities aimed at pregnant women and children and those which are not applicable to our context were excluded. Selected preventive services were compared with the range of age, sex and periodicity in which agreement with the recommendations of American College of Physicians and Canadian Task Force on Preventive Services existed. We found the following agreements. Screening activities. In favour: screening for hypercholesterolemia, hypertension, breast cancer, colorectal cancer, uterine cervix cancer, rubella, visual and hearing impairment and problem drinking. Against: cancer of prostate, lung, bladder and thyroid, and asymptomatic bacteriuria. Counseling activities. In favour: smoking, motor-vehicles injuries, alcohol consumption, unintended pregnancy. Immunizations and quimioprophylaxis. In favour: Vaccines for influenza, tetanus-diphtheria, hepatitis B and measles-mumps-rubella. Postexposure prophylaxis to hepatitis A, hepatitis B, meningococcal, rabies and tetanus. We see then, that a high degree in agreement among the main guidelines exists; about the preventive activities to perform in Primary Health Services, nevertheless we observed low fulfillment of certain preventive activities in Primary Health Services, different barriers for the accomplishment from these activities were described.

Cost-minimization analysis favours intravenous ferric carboxymaltose over ferric sucrose or oral iron as preoperative treatment in patients with colon cancer and iron deficiency anaemia.

PubMed

Calvet, Xavier; Gené, Emili; ÀngelRuíz, Miquel; Figuerola, Ariadna; Villoria, Albert; Cucala, Mercedes; Mearin, Fermín; Delgado, Salvadora; Calleja, Jose Luis

2016-01-01

Ferric Carboxymaltose (FCM), Iron Sucrose (IS) and Oral Iron (OI) are alternative treatments for preoperative anaemia. To compare the cost implications, using a cost-minimization analysis, of three alternatives: FCM vs. IS vs. OI for treating iron-deficient anaemia before surgery in patients with colon cancer. Data from 282 patients with colorectal cancer and anaemia were obtained from a previous study. One hundred and eleven received FCS, 16 IS and 155 OI. Costs of intravenous iron drugs were obtained from the Spanish Regulatory Agency. Direct and indirect costs were obtained from the analytical accounting unit of the Hospital. In the base case mean costs per patient were calculated. Sensitivity analysis and probabilistic Monte Carlo simulation were performed. Total costs per patient were 1827® in the FCM group, 2312® in the IS group and 2101® in the OI group. Cost savings per patient for FCM treatment were 485® compared to IS and 274® compared to OI. A Monte Carlo simulation favoured the use of FCM in 84.7% and 84.4% of simulations when compared to IS and OI, respectively. FCM infusion before surgery reduced costs in patients with colon cancer and iron-deficiency anaemia when compared with OI and IS.

Mode of detection: an independent prognostic factor for women with breast cancer.

PubMed

Hofvind, Solveig; Holen, Åsne; Román, Marta; Sebuødegård, Sofie; Puig-Vives, Montse; Akslen, Lars

2016-06-01

To investigate breast cancer survival and risk of breast cancer death by detection mode (screen-detected, interval, and detected outside the screening programme), adjusting for prognostic and predictive tumour characteristics. Information about detection mode, prognostic (age, tumour size, histologic grade, lymph node status) and predictive factors (molecular subtypes based on immunohistochemical analyses of hormone receptor status (estrogen and progesterone) and Her2 status) were available for 8344 women in Norway aged 50-69 at diagnosis of breast cancer, 2005-2011. A total of 255 breast cancer deaths were registered by the end of 2011. Kaplan-Meier method was used to estimate six years breast cancer specific survival and Cox proportional hazard model to estimate hazard ratio (HR) for breast cancer death by detection mode, adjusting for prognostic and predictive factors. Women with screen-detected cancer had favourable prognostic and predictive tumour characteristics compared with interval cancers and those detected outside the screening programme. The favourable characteristics were present for screen-detected cancers, also within the subtypes. Adjusted HR of dying from breast cancer was two times higher for women with symptomatic breast cancer (interval or outside the screening), using screen-detected tumours as the reference. Detection mode is an independent prognostic factor for women diagnosed with breast cancer. Information on detection mode might be relevant for patient management to avoid overtreatment. © The Author(s) 2015.

Bilingual Lexical Interillumination in the Foreign Language Classroom

ERIC Educational Resources Information Center

St. John, Oliver

2010-01-01

Foreign language (FL) education has been marked by a monolingual principle that has favoured "intralingual" methodologies. Bakhtin's view of language interillumination--that languages throw light on each other--challenges such language teaching practices radically. Using conversation analysis methods, this article examines transcripts of…

[Theatre as communication method in psychogeriatric care: effects on behaviour, mood and quality of life of people with dementia ].

PubMed

van Dijk, A M; van Weert, J C M; Dröes, R M

2012-12-01

Recently, a new communication method was introduced in nursing homes for people with dementia. This so-called Veder Method, developed by professional actors with former educational background in care,combines proven effective emotion-oriented care methods, like reminiscence,with theatrical stimuli like songs and poetry. The method is applied during theatre shows and living room theatre activities. In this exploratory study the surplus value of a living room theatre activity according to the Veder method compared to a reminiscence group activity was evaluated. Within a quasi experimental design, three groups of nursing home residents with dementia were compared: Experimental group 1 (E1; N=64)joined a 'living room theatre activity' offered by trained caregivers. Experimental group 2 (E2; N=31) joined a 'living room theatre activity' offered by professional actors. The control group (N=52) received a reminiscence group activity. Behaviour, mood and quality of life were measured using standardized observation scales at three points in time: (T1) pretest; (T2)during the intervention and; (T3) posttest, two hours after the intervention. During and after the intervention, positive effects were found in favour of E2 on behaviour (i.e. laughing, recalled memories), mood (i.e. happy/content) and quality of life (i.e. social involvement, feeling at home). A living room theatre activity according to the Veder Method has more positive effect on nursing home residents compared to a normal reminiscence group activity, if offered by professional actors.This article is a slightly edited translation of Does theatre improve the quality of life of people with dementia? International Psychogeriatrics2012;24: 36r381 by the same authors.

WITHDRAWN: Immobilisation and functional treatment for acute lateral ankle ligament injuries in adults.

PubMed

Kerkhoffs, Gino M M J; Rowe, Brian H; Assendelft, Willem J J; Kelly, Karen D; Struijs, Peter A A; van Dijk, C N

2013-03-28

Acute lateral ankle ligament injuries (ankle sprains) are common problems in acute medical care. The treatment variation observed for the acutely injured lateral ankle ligament complex suggests a lack of evidence-based management strategies for this problem. The objective of this review was to assess the effectiveness of methods of immobilisation for acute lateral ankle ligament injuries and to compare immobilisation with functional treatment methods. We searched the Cochrane Bone, Joint and Muscle Trauma Group specialised register (December 2001); the Cochrane Controlled Trials Register (The Cochrane Library, Issue 4, 2001), MEDLINE (1966-May 2000), EMBASE (1988-May 2000), reference lists of articles, and contacted organisations and researchers in the field. Randomised and quasi-randomised controlled trials comparing either different types of immobilisation or immobilisation versus functional treatments for injuries to the lateral ligament complex of the ankle in adults were included. Trials which investigated the treatment of chronic instability or post-surgical treatment were excluded. Data were independently extracted by two authors. Where appropriate, results of comparable studies were pooled using fixed effects models. Individual and pooled statistics were reported as relative risks with 95% confidence intervals for dichotomous outcomes and weighted (WMD) or standardised (SMD) mean differences and 95% confidence intervals for continuous outcome measures. Heterogeneity between trials was tested using a standard chi-squared test. Twenty-one trials involving 2184 participants were included. The mean validity score of the included trials increased from 9.1 (SD 3.0) to 10 (SD 2.9) after retrieving further information (maximum 18 points). Statistically significant differences in favour of functional treatment when compared with immobilisation were found for seven outcome measures: more patients returned to sport in the long term (relative risk (RR) 1.86, 95% confidence interval (CI) 1.22 to 2.86); the time taken to return to sport was shorter (WMD 4.88 (days), 95% CI 1.50 to 8.25); more patients had returned to work at short term follow-up (RR 5.75, 95% CI 1.01 to 32.71); the time taken to return to work was shorter (WMD 8.23 days, 95% CI 6.31 to 10.16); fewer patients suffered from persistent swelling at short term follow-up (RR 1.74, 95% CI 1.17 to 2.59); fewer patients suffered from objective instability as tested by stress X-ray (WMD 2.60, 95% CI 1.24 to 3.96); and patients treated functionally were more satisfied with their treatment (RR 1.83, 95% CI 1.09 to 3.07). A separate analysis of trials that scored 50 per cent or more in quality assessment found a similar result for time to return to work only (WMD (days) 12.89, 95% CI 7.10 to 18.67). No significant differences between varying types of immobilisation, immobilisation and physiotherapy or no treatment were found, apart from one trial where patients returned to work sooner after treatment with a soft cast. In all analyses performed, no results were significantly in favour of immobilisation. Functional treatment appears to be the favourable strategy for treating acute ankle sprains when compared with immobilisation. However, these results should be interpreted with caution, as most of the differences are not significant after exclusion of the low quality trials. Many trials were poorly reported and there was variety amongst the functional treatments evaluated.

Systematic Review of the Economic Burden of Overt Hepatic Encephalopathy and Pharmacoeconomic Impact of Rifaximin.

PubMed

Neff, Guy; Iii, Woodie Zachry

2018-04-12

Hepatic encephalopathy (HE), a common neurologic complication in cirrhosis, is associated with substantial disease and economic burden. Rifaximin is a non-systemic antibiotic that reduces the risk of overt HE recurrence and overt HE-related hospitalizations. Our objective was to provide an overview of the direct HE-related costs and cost benefits of rifaximin, lactulose, and rifaximin plus lactulose. A systematic review of PubMed and relevant meeting abstracts was conducted to identify publications since 1 January 2007 reporting economic data related to HE and rifaximin and/or lactulose. Further, a public database and published literature were used to estimate current costs of hospitalization for overt HE, and potential cost savings of HE-related hospitalizations with rifaximin. The methodological quality of included studies was evaluated using the Drummond checklist. A total of 16 reports were identified for inclusion in the systematic review. Globally, HE-related direct costs ranged from $US5370 to $US50,120 annually per patient. Rifaximin was associated with shorter hospital stays and reduced healthcare costs. Rifaximin also has the potential to reduce overt HE-related hospitalization risk by 50% compared with lactulose. Rifaximin was shown to have a favourable pharmacoeconomic profile compared with lactulose (based on the incremental cost-effectiveness ratio). In addition to its clinical benefits (e.g. reduction in the risk of recurrence of overt HE, overt HE-related hospitalizations, favourable adverse event profile), economic data are favourable for the use of rifaximin in patients with a history of overt HE.

Discursive junctions in flood risk governance - A comparative understanding in six European countries.

PubMed

Kaufmann, Maria; Wiering, Mark

2017-07-01

Flood risks are managed differently across Europe. While a number of research studies aim to understand these differences, they tend to pay little attention to the social constructionist aspects of flood risk governance, i.e. the meaning that societies give to flood risk and governance. This paper aims to address this gap by understanding differences in flood risk management approaches (FRMA) from a discursive-institutional perspective. Based on this perspective, an analytical framework was developed to systematically analyse and compare discourses pertaining to flood risk and its governance in six European member states (England (the United Kingdom), Flanders (Belgium), France, the Netherlands, Poland and Sweden). Correspondingly, this paper demonstrates how the hegemonic discursive-institutional patterns of flood risk governance differ between the six European countries. These differences may influence the capability of countries to learn from each other, adopt new FRMAs or cooperate with each other. Moreover, the paper argues that differences in discourses partially account for the differences in FRMAs between countries, combined with other factors. Additionally, broader implications are discussed. For example, the research findings imply that some discourses tend to favour or disfavour other discourses, and that they additionally also tend to favour particular FRMAs; e.g. the flood risk discourse pertaining to high manageability of risks seems to favour a governance discourse of collectivity and central governance. The different insights imply that further research is necessary to understand the complex interaction of discourses and institutional arrangements. Copyright © 2017 Elsevier Ltd. All rights reserved.

Relationship between Ontario chiropractors' attitudes toward drug prescription rights and Canadian versus non-Canadian college of graduation: results from an online survey.

PubMed

Emary, Peter Charles; Stuber, Kent Jason

2016-03-01

To investigate differences between chiropractors' attitudes toward drug prescription rights based on chiropractic college of graduation. A secondary data analysis of a 2015 survey of chiropractors from Ontario, Canada was performed. The questionnaire included 14 items concerning chiropractors' knowledge and attitudes toward drug prescription including demographics. 960 of 2,677 deliverable questionnaires were completed (36% response rate). The majority of respondents favoured limited prescribing rights for chiropractors regardless of college of graduation. Respondents who graduated from Canadian institutions were significantly more in favour of these privileges compared to graduates from non-Canadian schools. Over three-quarters of all respondents opposed the idea of chiropractors having full prescribing rights. No significant association was found between respondents' philosophical orientation and school attended. Ontario chiropractors who graduated from Canadian chiropractic institutions were most interested in obtaining limited drug prescription rights for the profession compared to non-Canadian chiropractic institution graduates.

Role of particle size and composition in metal adsorption by solids deposited on urban road surfaces.

PubMed

Gunawardana, Chandima; Egodawatta, Prasanna; Goonetilleke, Ashantha

2014-01-01

Despite common knowledge that the metal content adsorbed by fine particles is relatively higher compared to coarser particles, the reasons for this phenomenon have gained little research attention. The research study discussed in the paper investigated the variations in metal content for different particle sizes of solids associated with pollutant build-up on urban road surfaces. Data analysis confirmed that parameters favourable for metal adsorption to solids such as specific surface area, organic carbon content, effective cation exchange capacity and clay forming minerals content decrease with the increase in particle size. Furthermore, the mineralogical composition of solids was found to be the governing factor influencing the specific surface area and effective cation exchange capacity. There is high quartz content in particles >150 μm compared to particles <150 μm. As particle size reduces below 150 μm, the clay forming minerals content increases, providing favourable physical and chemical properties that influence adsorption. Copyright © 2013 Elsevier Ltd. All rights reserved.

Use of the learning conversation improves instructor confidence in life support training: An open randomised controlled cross-over trial comparing teaching feedback mechanisms.

PubMed

Baldwin, Lydia J L; Jones, Christopher M; Hulme, Jonathan; Owen, Andrew

2015-11-01

Feedback is vital for the effective delivery of skills-based education. We sought to compare the sandwich technique and learning conversation structured methods of feedback delivery in competency-based basic life support (BLS) training. Open randomised crossover study undertaken between October 2014 and March 2015 at the University of Birmingham, United Kingdom. Six-hundred and forty healthcare students undertaking a European Resuscitation Council (ERC) BLS course were enrolled, each of whom was randomised to receive teaching using either the sandwich technique or the learning conversation. Fifty-eight instructors were randomised to initially teach using either the learning conversation or sandwich technique, prior to crossing-over and teaching with the alternative technique after a pre-defined time period. Outcome measures included skill acquisition as measured by an end-of-course competency assessment, instructors' perception of teaching with each feedback technique and candidates' perception of the feedback they were provided with. Scores assigned to use of the learning conversation by instructors were significantly more favourable than for the sandwich technique across all but two assessed domains relating to instructor perception of the feedback technique, including all skills-based domains. No difference was seen in either assessment pass rates (80.9% sandwich technique vs. 77.2% learning conversation; OR 1.2, 95% CI 0.85-1.84; p=0.29) or any domain relating to candidates' perception of their teaching technique. This is the first direct comparison of two feedback techniques in clinical medical education using both quantitative and qualitative methodology. The learning conversation is preferred by instructors providing competency-based life support training and is perceived to favour skills acquisition. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Impaction grafted bone chip size effect on initial stability in an acetabular model: Mechanical evaluation.

PubMed

Holton, Colin; Bobak, Peter; Wilcox, Ruth; Jin, Zhongmin

2013-01-01

Acetabular bone defect reconstruction is an increasing problem for surgeons with patients undergoing complex primary or revision total hip replacement surgery. Impaction bone grafting is one technique that has favourable long-term clinical outcome results for patients who undergo this reconstruction method for acetabular bone defects. Creating initial mechanical stability of the impaction bone graft in this technique is known to be the key factor in achieving a favourable implant survival rate. Different sizes of bone chips were used in this technique to investigate if the size of bone chips used affected initial mechanical stability of a reconstructed acetabulum. Twenty acetabular models were created in total. Five control models were created with a cemented cup in a normal acetabulum. Then five models in three different groups of bone chip size were constructed. The three groups had an acetabular protrusion defect reconstructed using either; 2-4 mm(3), 10 mm(3) or 20 mm(3) bone chip size for impaction grafting reconstruction. The models underwent compression loading up to 9500 N and displacement within the acetabular model was measured indicating the initial mechanical stability. This study reveals that, although not statistically significant, the largest (20 mm(3)) bone chip size grafted models have an inferior maximum stiffness compared to the medium (10 mm(3)) bone chip size. Our study suggests that 10 mm(3) size of bone chips provide better initial mechanical stability compared to smaller or larger bone chips. We dismissed the previously held opinion that the biggest practically possible graft is best for acetabular bone graft impaction.

Planned hospital birth versus planned home birth

PubMed Central

Olsen, Ole; Clausen, Jette A

2014-01-01

Background Observational studies of increasingly better quality and in different settings suggest that planned home birth in many places can be as safe as planned hospital birth and with less intervention and fewer complications. This is an update of a Cochrane review first published in 1998. Objectives To assess the effects of planned hospital birth compared with planned home birth in selected low-risk women, assisted by an experienced midwife with collaborative medical back up in case transfer should be necessary. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (30 March 2012) and contacted editors and authors involved with possible trials. Selection criteria Randomised controlled trials comparing planned hospital birth with planned home birth in low-risk women as described in the objectives. Data collection and analysis The two review authors as independently as possible assessed trial quality and extracted data. We contacted study authors for additional information. Main results Two trials met the inclusion criteria but only one trial involving 11 women provided some outcome data and was included. The evidence from this trial was of moderate quality and too small to allow conclusions to be drawn. Authors’ conclusions There is no strong evidence from randomised trials to favour either planned hospital birth or planned home birth for low-risk pregnant women. However, the trials show that women living in areas where they are not well informed about home birth may welcome ethically well-designed trials that would ensure an informed choice. As the quality of evidence in favour of home birth from observational studies seems to be steadily increasing, it might be as important to prepare a regularly updated systematic review including observational studies as described in the Cochrane Handbook for Systematic Reviews of Interventions as to attempt to set up new randomised controlled trials. PMID:22972043

Dysphagia in Acute Stroke: Incidence, Burden and Impact on Clinical Outcome

PubMed Central

Broeg-Morvay, Anne; Meisterernst, Julia; Schlager, Markus; Mono, Marie-Luise; El-Koussy, Marwan; Kägi, Georg; Jung, Simon; Sarikaya, Hakan

2016-01-01

Background Reported frequency of post-stroke dysphagia in the literature is highly variable. In view of progress in stroke management, we aimed to assess the current burden of dysphagia in acute ischemic stroke. Methods We studied 570 consecutive patients treated in a tertiary stroke center. Dysphagia was evaluated by using the Gugging Swallowing Screen (GUSS). We investigated the relationship of dysphagia with pneumonia, length of hospital stay and discharge destination and compared rates of favourable clinical outcome and mortality at 3 months between dysphagic patients and those without dysphagia. Results Dysphagia was diagnosed in 118 of 570 (20.7%) patients and persisted in 60 (50.9%) at hospital discharge. Thirty-six (30.5%) patients needed nasogastric tube because of severe dysphagia. Stroke severity rather than infarct location was associated with dysphagia. Dysphagic patients suffered more frequently from pneumonia (23.1% vs. 1.1%, p<0.001), stayed longer at monitored stroke unit beds (4.4±2.8 vs. 2.7±2.4 days; p<0.001) and were less often discharged to home (19.5% vs. 63.7%, p = 0.001) as compared to those without dysphagia. At 3 months, dysphagic patients less often had a favourable outcome (35.7% vs. 69.7%; p<0.001), less often lived at home (38.8% vs. 76.5%; p<0.001), and more often had died (13.6% vs. 1.6%; p<0.001). Multivariate analyses identified dysphagia to be an independent predictor of discharge destination and institutionalization at 3 months, while severe dysphagia requiring tube placement was strongly associated with mortality. Conclusion Dysphagia still affects a substantial portion of stroke patients and may have a large impact on clinical outcome, mortality and institutionalization. PMID:26863627

Effectiveness of long-acting antipsychotics in clinical practice : 1. A retrospective, 18-month follow up and comparison between paliperidone palmitate, risperidone long-acting injection and zuclopenthixol decanoate

PubMed Central

Cordiner, Matthew; Shajahan, Polash; McAvoy, Sarah; Bashir, Muhammad; Taylor, Mark

2016-01-01

Objectives: In the UK, nine different compounds are available as long-acting antipsychotic injections (LAIs). There are few clinical guidelines for determining which LAIs are most effective in specific patient groups. To measure the clinical effectiveness of LAIs we aimed to determine the now-established concept of antipsychotic discontinuation rates and measure Clinical Global Impression (CGI) outcomes. Method: The population (n was approximately 560,000) was a secondary care NHS adult mental health service in Lanarkshire, Scotland, UK. This was a retrospective, electronic case note search of LAI-naïve patients commenced on paliperidone palmitate (n = 31), risperidone long-acting injection (RLAI) (n = 102) or zuclopenthixol decanoate (n = 105), with an 18-month follow up. Kaplan–Meier survival statistics for discontinuation rates and hospital admission were calculated. CGI severity and improvement scores were retrospectively assigned by the investigating team. Results: Paliperidone palmitate performed less favourably than risperidone long-acting injection (RLAI) or zuclopenthixol decanoate. Paliperidone palmitate had higher discontinuation rates due to any cause, inefficacy and increased hospitalization risk. Paliperidone palmitate had the smallest proportion of patients assigned a clinically desirable CGI-I score of 1 (very much improved) or 2 (much improved). Conclusions: Paliperidone palmitate had less favourable discontinuation and CGI outcomes compared with RLAI and zuclopenthixol decanoate. This could not be adequately explained by patients in the paliperidone group being more chronically or severely unwell, nor by the presence of comorbidities such as alcohol or substance misuse, or by the use of lower mean dosages compared with RLAI or zuclopenthixol decanoate. We considered that prescribers are familiarizing themselves with paliperidone and outcomes may improve over time. PMID:26913175

Evaluation of polymorphic variants in apoptotic genes and their role in susceptibility and clinical progression to systemic lupus erythematosus.

PubMed

Glesse, N; Vianna, P; Paim, L M G; Matte, M C C; Aguiar, A K K; Palhano, P L; Monticielo, O A; Brenol, C V; Xavier, R M; Chies, J A B

2017-06-01

Background Systemic lupus erythematosus (SLE) is an autoimmune disease marked by the disruption of the immune homeostasis. Patients exhibit a wide range of clinical manifestations, and environmental and genetic factors are involved in SLE pathogenesis. Evidence suggests that abnormalities in the cellular and molecular events that coordinate apoptosis may favour the generation of autoantigens involved in autoimmunity. In this way, the apoptotic deregulation may be affected by polymorphic variants in apoptotic-related genes. Methods We analyzed FAS, FASL, BCL-2 and BAX polymorphisms in order to correlate to SLE susceptibility and clinical features. A total of 427 SLE patients from the Hospital de Clínicas de Porto Alegre and 543 controls from southern Brazil were evaluated. Results We observed higher frequencies of the FASL -844CC genotype and -844C allele, as well as of the FASL-844C/IVS2nt-124A haplotype in African-derived SLE patients when compared to controls ( P < 0.001). FASL -844C, which is related to high FasL expression, could contribute to increased apoptosis and to the breakdown of immunological tolerance, favouring autoantibody production and inflammation. On the other hand, the BAX -248GA genotype and the -248A allele , related to low protein expression, were observed as a protective factor against SLE in this same population. The rate of apoptosis and cell death was evaluated in peripheral lymphocytes, and SLE patients presented a higher percentage of dead lymphocytes (CD3 + Annexin V + 7-AAD + ) compared to the control group. Conclusion Our data support a role for apoptosis in SLE susceptibility.

Value Creating Education and the Capability Approach: A Comparative Analysis of Soka Education's Facility to Promote Well-Being and Social Justice

ERIC Educational Resources Information Center

Sherman, Paul David

2016-01-01

The relatively unfamiliar pedagogy of Soka (value creating) education is analysed for its capacity to promote well-being and social justice, using the well-known Capability Approach (CA) as a comparator. Various aspects of Soka education correspond favourably with the CA, indicating its potential as a credible and constructive approach for…

Worldwide studies on aircraft disinsection at “blocks away”

PubMed Central

Sullivan, W. N.; Pal, R.; Wright, J. W.; Azurin, J. C.; Okamoto, R.; McGuire, J. U.; Waters, R. M.

1972-01-01

During 1971 worldwide experiments on the disinsection of passenger cabins at “blocks away” (as the aircraft starts taxiing for take-off) were conducted in several types of jet aircraft. A procedure was developed whereby the high capacity Boeing 747 could be disinsected by four stewardesses in less than 1 minute. The favourable results of these and previous trials indicate that this method is suitable as a standard procedure for aircraft disinsection for international quarantine purposes. The biological effectiveness against resistant and non-resistant mosquitos of a 2% concentration of a pyrethroid, resmethrin, in Freon 11+Freon 12 (1:1) (without kerosine) and a favourable passenger response make it suitable as a standard formulation for aircraft disinsection. PMID:4538193

Post-hoc analysis of randomised, placebo-controlled, double-blind study (MCI186-19) of edaravone (MCI-186) in amyotrophic lateral sclerosis.

PubMed

Takei, Koji; Takahashi, Fumihiro; Liu, Shawn; Tsuda, Kikumi; Palumbo, Joseph

2017-10-01

Post-hoc analyses of the ALS Functional Rating Scale-Revised (ALSFRS-R) score data, the primary endpoint in the 24-week double-blind placebo-controlled study of edaravone (MCI186-19, NCT01492686), were performed to confirm statistical robustness of the result. The previously reported original analysis had used a last observation carried forward (LOCF) method and also excluded patients with fewer than three completed treatment cycles. The post-hoc sensitivity analyses used different statistical methods as follows: 1) including all patients regardless of treatment cycles received (ALL LOCF); 2) a mixed model for repeated measurements (MMRM) analysis; and 3) the Combined Assessment of Function and Survival (CAFS) endpoint. Findings were consistent with the original primary analysis in showing superiority of edaravone over placebo. We also investigated the distribution of change in ALSFRS-R total score across all patients in the study as well as which ALSFRS-R items and domains may have contributed to the overall efficacy findings. The distribution of changes in ALSFRS-R total score from baseline to the end of cycle 6 (ALL LOCF) shifted in favour of edaravone compared to placebo. Edaravone was descriptively favoured for each ALSFRS-R item and each of the four ALSFRS-R domains at the end of cycle 6 (ALL LOCF), suggesting a generalised effect of edaravone in slowing functional decline across all anatomical regions. The effect of edaravone appeared to be similar in patients with bulbar onset and limb onset. Together, these observations would be consistent with its putative neuroprotective effects against the development of oxidative damage unspecific to anatomical regions.

Stromal mast cells in invasive breast cancer are a marker of favourable prognosis: a study of 4,444 cases.

PubMed

Rajput, Ashish B; Turbin, Dmitry A; Cheang, Maggie Cu; Voduc, David K; Leung, Sam; Gelmon, Karen A; Gilks, C Blake; Huntsman, David G

2008-01-01

We have previously demonstrated in a pilot study of 348 invasive breast cancers that mast cell (MC) infiltrates within primary breast cancers are associated with a good prognosis. Our aim was to verify this finding in a larger cohort of invasive breast cancer patients and examine the relationship between the presence of MCs and other clinical and pathological features. Clinically annotated tissue microarrays (TMAs) containing 4,444 cases were constructed and stained with c-Kit (CD-117) using standard immunoperoxidase techniques to identify and quantify MCs. For statistical analysis, we applied a split-sample validation technique. Breast cancer specific survival was analyzed by Kaplan-Meier [KM] method and log rank test was used to compare survival curves. Survival analysis by KM method showed that the presence of stromal MCs was a favourable prognostic factor in the training set (P = 0.001), and the validation set group (P = 0.006). X-tile plot generated to define the optimal number of MCs showed that the presence of any number of stromal MCs predicted good prognosis. Multivariate analysis showed that the MC effect in the training set (Hazard ratio [HR] = 0.804, 95% Confidence interval [CI], 0.653-0.991, P = 0.041) and validation set analysis (HR = 0.846, 95% CI, 0.683-1.049, P = 0.128) was independent of age, tumor grade, tumor size, lymph node, ER and Her2 status. This study concludes that stromal MC infiltration in invasive breast cancer is an independent good prognostic marker and reiterates the critical role of local inflammatory responses in breast cancer progression.

Stromal mast cells in invasive breast cancer are a marker of favourable prognosis: a study of 4,444 cases

PubMed Central

Rajput, Ashish B.; Turbin, Dmitry A.; Cheang, Maggie CU; Voduc, David K.; Leung, Sam; Gelmon, Karen A.; Gilks, C. Blake

2007-01-01

Purpose We have previously demonstrated in a pilot study of 348 invasive breast cancers that mast cell (MC) infiltrates within primary breast cancers are associated with a good prognosis. Our aim was to verify this finding in a larger cohort of invasive breast cancer patients and examine the relationship between the presence of MCs and other clinical and pathological features. Experimental design Clinically annotated tissue microarrays (TMAs) containing 4,444 cases were constructed and stained with c-Kit (CD-117) using standard immunoperoxidase techniques to identify and quantify MCs. For statistical analysis, we applied a split-sample validation technique. Breast cancer specific survival was analyzed by Kaplan–Meier [KM] method and log rank test was used to compare survival curves. Results Survival analysis by KM method showed that the presence of stromal MCs was a favourable prognostic factor in the training set (P = 0.001), and the validation set group (P = 0.006). X-tile plot generated to define the optimal number of MCs showed that the presence of any number of stromal MCs predicted good prognosis. Multivariate analysis showed that the MC effect in the training set (Hazard ratio [HR] = 0.804, 95% Confidence interval [CI], 0.653–0.991, P = 0.041) and validation set analysis (HR = 0.846, 95% CI, 0.683–1.049, P = 0.128) was independent of age, tumor grade, tumor size, lymph node, ER and Her2 status. Conclusions This study concludes that stromal MC infiltration in invasive breast cancer is an independent good prognostic marker and reiterates the critical role of local inflammatory responses in breast cancer progression. PMID:17431762

Multiplexed microsatellite recovery using massively parallel sequencing

USGS Publications Warehouse

Jennings, T.N.; Knaus, B.J.; Mullins, T.D.; Haig, S.M.; Cronn, R.C.

2011-01-01

Conservation and management of natural populations requires accurate and inexpensive genotyping methods. Traditional microsatellite, or simple sequence repeat (SSR), marker analysis remains a popular genotyping method because of the comparatively low cost of marker development, ease of analysis and high power of genotype discrimination. With the availability of massively parallel sequencing (MPS), it is now possible to sequence microsatellite-enriched genomic libraries in multiplex pools. To test this approach, we prepared seven microsatellite-enriched, barcoded genomic libraries from diverse taxa (two conifer trees, five birds) and sequenced these on one lane of the Illumina Genome Analyzer using paired-end 80-bp reads. In this experiment, we screened 6.1 million sequences and identified 356958 unique microreads that contained di- or trinucleotide microsatellites. Examination of four species shows that our conversion rate from raw sequences to polymorphic markers compares favourably to Sanger- and 454-based methods. The advantage of multiplexed MPS is that the staggering capacity of modern microread sequencing is spread across many libraries; this reduces sample preparation and sequencing costs to less than $400 (USD) per species. This price is sufficiently low that microsatellite libraries could be prepared and sequenced for all 1373 organisms listed as 'threatened' and 'endangered' in the United States for under $0.5M (USD).

Teach a Confidence Interval for the Median in the First Statistics Course

ERIC Educational Resources Information Center

Howington, Eric B.

2017-01-01

Few introductory statistics courses consider statistical inference for the median. This article argues in favour of adding a confidence interval for the median to the first statistics course. Several methods suitable for introductory statistics students are identified and briefly reviewed.

Efficacy of sildenafil on ischaemic digital ulcer healing in systemic sclerosis: the placebo-controlled SEDUCE study

PubMed Central

Hachulla, Eric; Hatron, Pierre-Yves; Carpentier, Patrick; Agard, Christian; Chatelus, Emmanuel; Jego, Patrick; Mouthon, Luc; Queyrel, Viviane; Fauchais, Anne-Laure; Michon-Pasturel, Ulrique; Jaussaud, Roland; Mathian, Alexis; Granel, Brigitte; Diot, Elisabeth; Farge-Bancel, Dominique; Mekinian, Arsène; Avouac, Jérôme; Desmurs-Clavel, Hélène; Clerson, Pierre

2016-01-01

Objective To assess the effect of sildenafil, a phosphodiesterase type 5 inhibitor, on digital ulcer (DU) healing in systemic sclerosis (SSc). Methods Randomised, placebo-controlled study in patients with SSc to assess the effect of sildenafil 20 mg or placebo, three times daily for 12 weeks, on ischaemic DU healing. The primary end point was the time to healing for each DU. Time to healing was compared between groups using Cox models for clustered data (two-sided tests, p=0.05). Results Intention-to-treat analysis involved 83 patients with a total of 192 DUs (89 in the sildenafil group and 103 in the placebo group). The HR for DU healing was 1.33 (0.88 to 2.00) (p=0.18) and 1.27 (0.85 to 1.89) (p=0.25) when adjusted for the number of DUs at entry, in favour of sildenafil. In the per protocol population, the HRs were 1.49 (0.98 to 2.28) (p=0.06) and 1.43 (0.93 to 2.19) p=0.10. The mean number of DUs per patient was lower in the sildenafil group compared with the placebo group at week (W) 8 (1.23±1.61 vs 1.79±2.40 p=0.04) and W12 (0.86±1.62 vs 1.51±2.68, p=0.01) resulting from a greater healing rate (p=0.01 at W8 and p=0.03 at W12). Conclusions The primary end point was not reached in intention-to-treat, partly because of an unexpectedly high healing rate in the placebo group. We found a significant decrease in the number of DUs in favour of sildenafil compared with placebo at W8 and W12, confirming a sildenafil benefit. Trial registration number NCT01295736. PMID:25995322

Induction of hairy roots by various strains of Agrobacterium rhizogenes in different types of Capsicum species explants

PubMed Central

2014-01-01

Background Capsicum annuum and Capsicum frutescens, also known as “chilies”, belong to the Solanaceae family and have tremendous beneficial properties. The application of hairy root culture may become an alternative method for future development of these species by adding value, such as by increasing secondary metabolites and improving genetic and biochemical stability compared with normal Capsicum plants. Therefore, in this research, different types of explants of both species were infected with various Agrobacterium rhizogenes strains to provide more information about the morphology and induction efficiency of hairy roots. After 2 weeks of in vitro seed germination, young seedling explants were cut into three segments; the cotyledon, hypocotyl, and radical. Then, the explants were co-cultured with four isolated A. rhizogenes strains in Murashige & Skoog culture media (MS) containing decreasing carbenicillin disodium concentrations for one month. Results In this experiment, thick and short hairy roots were induced at all induction sites of C. annuum while thin, elongated hairy roots appeared mostly at wound sites of C. frutescens. Overall, the hairy root induction percentages of C. frutescens were higher compared with C. annuum. Hairy root initiation was observed earliest using radicles (1st week), followed by cotyledons (2nd week), and hypocotyls (3rd week). Cotyledon explants of both species had the highest induction frequency with all strains compared with the other explants types. Strains ATCC 13333 and ATCC 15834 were the most favourable for C. frutescens while ATCC 43056 and ATCC 43057 were the most favourable for C. annuum. The interactions between the different explants and strains showed significant differences with p-values < 0.0001 in both Capsicum species. Conclusions Both Capsicum species were amenable to A. rhizogenes infection and hairy root induction is recommended for use as an alternative explants in future plant-based studies. PMID:24981787

Extrapolation-Based References Improve Motion and Eddy-Current Correction of High B-Value DWI Data: Application in Parkinson's Disease Dementia.

PubMed

Nilsson, Markus; Szczepankiewicz, Filip; van Westen, Danielle; Hansson, Oskar

2015-01-01

Conventional motion and eddy-current correction, where each diffusion-weighted volume is registered to a non diffusion-weighted reference, suffers from poor accuracy for high b-value data. An alternative approach is to extrapolate reference volumes from low b-value data. We aim to compare the performance of conventional and extrapolation-based correction of diffusional kurtosis imaging (DKI) data, and to demonstrate the impact of the correction approach on group comparison studies. DKI was performed in patients with Parkinson's disease dementia (PDD), and healthy age-matched controls, using b-values of up to 2750 s/mm2. The accuracy of conventional and extrapolation-based correction methods was investigated. Parameters from DTI and DKI were compared between patients and controls in the cingulum and the anterior thalamic projection tract. Conventional correction resulted in systematic registration errors for high b-value data. The extrapolation-based methods did not exhibit such errors, yielding more accurate tractography and up to 50% lower standard deviation in DKI metrics. Statistically significant differences were found between patients and controls when using the extrapolation-based motion correction that were not detected when using the conventional method. We recommend that conventional motion and eddy-current correction should be abandoned for high b-value data in favour of more accurate methods using extrapolation-based references.

Flammability of gas mixtures. Part 1: fire potential.

PubMed

Schröder, Volkmar; Molnarne, Maria

2005-05-20

International and European dangerous substances and dangerous goods regulations refer to the standard ISO 10156 (1996). This standard includes a test method and a calculation procedure for the determination of the flammability of gases and gas mixtures in air. The substance indices for the calculation, the so called "Tci values", which characterise the fire potential, are provided as well. These ISO Tci values are derived from explosion diagrams of older literature sources which do not take into account the test method and the test apparatus. However, since the explosion limits are influenced by apparatus parameters, the Tci values and lower explosion limits, given by the ISO tables, are inconsistent with those measured according to the test method of the same standard. In consequence, applying the ISO Tci values can result in wrong classifications. In this paper internationally accepted explosion limit test methods were evaluated and Tci values were derived from explosion diagrams. Therefore, an "open vessel" method with flame propagation criterion was favoured. These values were compared with the Tci values listed in ISO 10156. In most cases, significant deviations were found. A detailed study about the influence of inert gases on flammability is the objective of Part 2.

A hydrostatic weighing method using total lung capacity and a small tank.

PubMed Central

Warner, J G; Yeater, R; Sherwood, L; Weber, K

1986-01-01

The purpose of this study was to establish the validity and reliability of a hydrostatic weighing method using total lung capacity (measuring vital capacity with a respirometer at the time of weighing) the prone position, and a small oblong tank. The validity of the method was established by comparing the TLC prone (tank) method against three hydrostatic weighing methods administered in a pool. The three methods included residual volume seated, TLC seated and TLC prone. Eighty male and female subjects were underwater weighed using each of the four methods. Validity coefficients for per cent body fat between the TLC prone (tank) method and the RV seated (pool), TLC seated (pool) and TLC prone (pool) methods were .98, .99 and .99, respectively. A randomised complete block ANOVA found significant differences between the RV seated (pool) method and each of the three TLC methods with respect to both body density and per cent body fat. The differences were negligible with respect to HW error. Reliability of the TLC prone (tank) method was established by weighing twenty subjects three different times with ten-minute time intervals between testing. Multiple correlations yielded reliability coefficients for body density and per cent body fat values of .99 and .99, respectively. It was concluded that the TLC prone (tank) method is valid, reliable and a favourable method of hydrostatic weighing. PMID:3697596

A hydrostatic weighing method using total lung capacity and a small tank.

PubMed

Warner, J G; Yeater, R; Sherwood, L; Weber, K

1986-03-01

The purpose of this study was to establish the validity and reliability of a hydrostatic weighing method using total lung capacity (measuring vital capacity with a respirometer at the time of weighing) the prone position, and a small oblong tank. The validity of the method was established by comparing the TLC prone (tank) method against three hydrostatic weighing methods administered in a pool. The three methods included residual volume seated, TLC seated and TLC prone. Eighty male and female subjects were underwater weighed using each of the four methods. Validity coefficients for per cent body fat between the TLC prone (tank) method and the RV seated (pool), TLC seated (pool) and TLC prone (pool) methods were .98, .99 and .99, respectively. A randomised complete block ANOVA found significant differences between the RV seated (pool) method and each of the three TLC methods with respect to both body density and per cent body fat. The differences were negligible with respect to HW error. Reliability of the TLC prone (tank) method was established by weighing twenty subjects three different times with ten-minute time intervals between testing. Multiple correlations yielded reliability coefficients for body density and per cent body fat values of .99 and .99, respectively. It was concluded that the TLC prone (tank) method is valid, reliable and a favourable method of hydrostatic weighing.

A Comparison of Traditional, Step-Path, and Geostatistical Techniques in the Stability Analysis of a Large Open Pit

NASA Astrophysics Data System (ADS)

Mayer, J. M.; Stead, D.

2017-04-01

With the increased drive towards deeper and more complex mine designs, geotechnical engineers are often forced to reconsider traditional deterministic design techniques in favour of probabilistic methods. These alternative techniques allow for the direct quantification of uncertainties within a risk and/or decision analysis framework. However, conventional probabilistic practices typically discretize geological materials into discrete, homogeneous domains, with attributes defined by spatially constant random variables, despite the fact that geological media display inherent heterogeneous spatial characteristics. This research directly simulates this phenomenon using a geostatistical approach, known as sequential Gaussian simulation. The method utilizes the variogram which imposes a degree of controlled spatial heterogeneity on the system. Simulations are constrained using data from the Ok Tedi mine site in Papua New Guinea and designed to randomly vary the geological strength index and uniaxial compressive strength using Monte Carlo techniques. Results suggest that conventional probabilistic techniques have a fundamental limitation compared to geostatistical approaches, as they fail to account for the spatial dependencies inherent to geotechnical datasets. This can result in erroneous model predictions, which are overly conservative when compared to the geostatistical results.

Approximation of optimal filter for Ornstein-Uhlenbeck process with quantised discrete-time observation

NASA Astrophysics Data System (ADS)

Bania, Piotr; Baranowski, Jerzy

2018-02-01

Quantisation of signals is a ubiquitous property of digital processing. In many cases, it introduces significant difficulties in state estimation and in consequence control. Popular approaches either do not address properly the problem of system disturbances or lead to biased estimates. Our intention was to find a method for state estimation for stochastic systems with quantised and discrete observation, that is free of the mentioned drawbacks. We have formulated a general form of the optimal filter derived by a solution of Fokker-Planck equation. We then propose the approximation method based on Galerkin projections. We illustrate the approach for the Ornstein-Uhlenbeck process, and derive analytic formulae for the approximated optimal filter, also extending the results for the variant with control. Operation is illustrated with numerical experiments and compared with classical discrete-continuous Kalman filter. Results of comparison are substantially in favour of our approach, with over 20 times lower mean squared error. The proposed filter is especially effective for signal amplitudes comparable to the quantisation thresholds. Additionally, it was observed that for high order of approximation, state estimate is very close to the true process value. The results open the possibilities of further analysis, especially for more complex processes.

Perception of front-of-pack labels according to social characteristics, nutritional knowledge and food purchasing habits.

PubMed

Méjean, Caroline; Macouillard, Pauline; Péneau, Sandrine; Hercberg, Serge; Castetbon, Katia

2013-03-01

To identify patterns of perception of front-of-pack (FOP) nutrition labels and to determine social factors, nutritional knowledge and attention to packaging features related to such patterns. Cross-sectional. Perception was measured using indicators of understanding and acceptability of three simple FOP labels (the 'Green Tick', the logo of the French Nutrition and Health Programme (PNNS logo) and 'simple traffic lights' (STL)) and two detailed formats ('multiple traffic lights' (MTL) and the 'colour range' logo (CR)). Associations of perception patterns with individual characteristics were examined using χ2 tests. Data from the French NutriNet-Santé cohort study. A total of 38,763 adults. Four perception patterns emerged. Poorly educated individuals were most often found in groups favouring simple formats. The 'favourable to CR' group had a high rate of men and older persons. Poor nutritional knowledge was more frequent in the 'favourable to STL' group, while individuals with substantial knowledge were proportionally more numerous in the 'favourable to MTL' group. The 'favourable to STL' group more frequently self-reported noting price and marketing characteristics during purchasing, while the 'favourable to MTL' and 'favourable to CR' groups declared more interest in nutritional information. The 'favourable to Green Tick and PNNS logo' group self-reported paying closer attention to claims and quality guarantee labels. The 'favourable to MTL' cluster was most frequently represented in our survey. However, simple FOP formats may be most appropriate for increasing awareness of healthy eating among targeted groups with poor nutritional knowledge and little interest in the nutritional quality of packaged foods.

Costing transurethral resection of the prostate and diagnosis related group in Australia compared with United States costs.

PubMed

Gordon, N S

1994-02-01

The cost of a transurethral resection of the prostate is of considerable concern to the community. More of these procedures are being performed as the number of patients in the aged population increases. The costs of wages and salaries, purchase of equipment and depreciation, stationery, linen, investigations (pathology) and pharmaceuticals are compared with the bed charges (as charged to a private patient), the cost per inpatient day and the cost per inpatient treated, which is calculated from the operating fund budget expenditure of The Bendigo Hospital. The cost per diagnosis related group (DRG) 336 (defined as: transurethral prostatectomy, age greater than 69 and/or complication/co-morbidity; mean length of stay 7.0; relative weight = 0.9869) and DRG 337 (defined as: transurethral prostatectomy, age less than 70 without complication/co-morbidity; mean length of stay 5.8; relative weight = 0.7788) are compared with the figures for a similar procedure in 1987 in a United States hospital and extrapolated, by the use of the Consumer Price Index, to 1992 levels. The findings demonstrate that transurethral resection of the prostate as costed in this hospital compares very favourably with that in a US hospital, and favourably from the point of view of health care costs.

Exercise in prevention and treatment of anxiety and depression among children and young people.

PubMed

Larun, L; Nordheim, L V; Ekeland, E; Hagen, K B; Heian, F

2006-07-19

Depression and anxiety are common psychological disorders for children and adolescents. Psychological (e.g. psychotherapy), psychosocial (e.g. cognitive behavioral therapy) and biological (e.g. SSRIs or tricyclic drugs) treatments are the most common treatments being offered. The large variety of therapeutic interventions give rise to questions of clinical effectiveness and side effects. Physical exercise is inexpensive with few, if any, side effects. To assess the effects of exercise interventions in reducing or preventing anxiety or depression in children and young people up to 20 years of age. We searched the Cochrane Controlled Trials Register (latest issue available), MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC and Sportdiscus up to August 2005. Randomised trials of vigorous exercise interventions for children and young people up to the age of 20, with outcome measures for depression and anxiety. Two authors independently selected trials for inclusion, assessed methodological quality and extracted data. The trials were combined using meta-analysis methods. A narrative synthesis was performed when the reported data did not allow statistical pooling. Sixteen studies with a total of 1191 participants between 11 and 19 years of age were included.Eleven trials compared vigourous exercise versus no intervention in a general population of children. Six studies reporting anxiety scores showed a non-significant trend in favour of the exercise group (standard mean difference (SMD) (random effects model) -0.48, 95% confidence interval (CI) -0.97 to 0.01). Five studies reporting depression scores showed a statistically significant difference in favour of the exercise group (SMD (random effects model) -0.66, 95% CI -1.25 to -0.08). However, all trials were generally of low methodological quality and they were highly heterogeneous with regard to the population, intervention and measurement instruments used. One small trial investigated children in treatment showed no statistically significant difference in depression scores in favour of the control group (SMD (fixed effects model) 0.78, 95% CI -0.47 to 2.04). No studies reported anxiety scores for children in treatment. Five trials comparing vigorous exercise to low intensity exercise show no statistically significant difference in depression and anxiety scores in the general population of children. Three trials reported anxiety scores (SMD (fixed effects model) -0.14, 95% CI -0.41 to 0.13). Two trials reported depression scores (SMD (fixed effects model) -0.15, 95% CI -0.44 to 0.14). Two small trials found no difference in depression scores for children in treatment (SMD (fixed effects model) -0.31, 95% CI -0.78 to 0.16). No studies reported anxiety scores for children in treatment. Four trials comparing exercise with psychosocial interventions showed no statistically significant difference in depression and anxiety scores in the general population of children. Two trials reported anxiety scores (SMD (fixed effects model) -0.13, 95% CI -0.43 to 0.17). Two trials reported depression scores (SMD (fixed effects model) 0.10, 95% CI-0.21 to 0.41). One trial found no difference in depression scores for children in treatment (SMD (fixed effects model) -0.31, 95% CI -0.97 to 0.35). No studies reported anxiety scores for children in treatment. Whilst there appears to be a small effect in favour of exercise in reducing depression and anxiety scores in the general population of children and adolescents, the small number of studies included and the clinical diversity of participants, interventions and methods of measurement limit the ability to draw conclusions. It makes little difference whether the exercise is of high or low intensity. The effect of exercise for children in treatment for anxiety and depression is unknown as the evidence base is scarce.

Association of brain metabolites with blood lactate and glucose levels with respect to neurological outcomes after out-of-hospital cardiac arrest: A preliminary microdialysis study.

PubMed

Hifumi, Toru; Kawakita, Kenya; Yoda, Takeshi; Okazaki, Tomoya; Kuroda, Yasuhiro

2017-01-01

Out-of-hospital cardiac arrest (OHCA) is associated with poor prognosis. Cerebral microdialysis (CMD) is an efficient sampling technique to detect neurochemical changes in brain interstitial tissue. In this retrospective study, we hypothesised that there are different CMD levels between patients with favourable and unfavourable neurological outcomes. Data of patients with OHCA admitted to Kagawa University Hospital and administered therapeutic hypothermia (TH) were collected. Using a CMD probe, extracellular glucose, lactate and pyruvate levels were measured hourly along with intracranial perfusion pressure (ICP) and cerebral perfusion pressure (CPP) for the initial 72h during TH. The lactate/pyruvate (LP) ratio was calculated. Patients were divided into favourable [Glasgow-Pittsburgh cerebral performance category 1-2 at 30days after cardiac arrest] or unfavourable neurological outcome groups. CMD biochemical markers and blood lactate and glucose levels were compared between two groups. Ten patients were included. ICP was significantly higher in the unfavourable than in the favourable neurological outcome group; there were no significant differences with respect to CPP. The CMD LP ratio in the unfavourable outcome group progressively increased; significant differences were observed on days 2, 3 and 4 (p<0.01). Significant differences in blood lactate levels were observed between the groups only on day 3.5. CMD and blood glucose levels were higher in the unfavourable than in the favourable outcome group during TH. The association of CMD levels with long-term outcomes would be better defined in a large randomised prospective study. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Parental presence during cardiopulmonary resuscitation of children: the experience, opinions and moral positions of emergency teams in France.

PubMed

Tripon, Cédric; Defossez, Gautier; Ragot, Stéphanie; Ghazali, Aïham; Boureau-Voultoury, Amélie; Scépi, Michel; Oriot, Denis

2014-04-01

To evaluate the experience, opinions and moral positions of French emergency physicians (EP) who had taken a paediatric university course on parental presence during child cardiopulmonary resuscitation (CPR), and to compare it with the responses of nurses on their teams. A questionnaire was sent to 550 EPs who had taken the course during the previous 6 years; the EPs were also asked to give a copy of the questionnaire to nurses on their staff. Data were collected on experience of parental presence during child CPR, opinions on the practice, arguments for and against parental presence, and the moral positions of respondents regarding their perception of life and the sharing of medical/parental power in the decision-making process. 343 responses were analysed, 47% from EPs (29% response rate) and 53% from nurses. 52% of respondents had experienced parental presence during child CPR, but it had been the physician's wish on only 6% of these occasions. Only 17% of respondents favoured parental presence, with EPs (27%) being favourable more often than nurses (12%). The reasons against parental presence were psychological trauma for the parents, risk of interference with medical management, and care team stress. Respondents not in favour of parental presence expressed this view more for medical reasons than for parent-related reasons. The physicians not in favour of parental presence espoused a moral position predicated on medical power. A majority of EPs and nurses were reluctant to have parents present during child CPR. Their attitude involved medical paternalism.

Effects of environment and education on knowledge and attitude of nursing students towards leprosy.

PubMed

Rajkumar, E; Julious, S; Salome, A; Jennifer, G; John, A S; Kannan, L; Richard, J

2011-01-01

The objective of this cross-sectional comparative study was to find the effects of environment and education on knowledge and attitude of nursing students towards leprosy. Data were collected, using a pretested questionnaire, from the first year and third year students of a School of Nursing attached to a leprosy specialty hospital and also from a comparable School of Nursing attached to a general hospital. The results showed that trainees acquired more knowledge on leprosy during training in both schools of nursing. However, those trained in leprosy hospital environment had higher knowledge and attitude scores than those trained in general hospital environment. The attitude of the trainees attached to leprosy hospital was favourable even before they had formal training in leprosy. Those trained in the general hospital showed more favourable attitude after training compared to before training. School of Nursing attached to leprosy hospital provided an atmosphere conducive to learning and understanding more about leprosy. The trainees retained what was learnt because of regular association with patients affected by leprosy. For employment in hospital or community based services or research related to leprosy, nurses trained in a leprosy hospital would have added value of knowledge and attitude.

Density perturbation in the models reconstructed from jerk parameter

NASA Astrophysics Data System (ADS)

Sinha, Srijita; Banerjee, Narayan

2018-06-01

The present work deals with the late time evolution of the linear density contrast in the dark energy models reconstructed from the jerk parameter. It is found that the non-interacting models are favoured compared to the models where an interaction is allowed in the dark sector.

Polymerase chain reaction for screening clinical isolates of corynebacteria for the production of diphtheria toxin.

PubMed Central

Pallen, M J; Hay, A J; Puckey, L H; Efstratiou, A

1994-01-01

AIMS--To assess the performance of the polymerase chain reaction (PCR) when used to screen rapidly large numbers of corynebacteria for toxin production; and to determine the incidence of false positive PCR results with non-toxigenic Corynebacterium diphtheriae isolates. METHODS--Eighty seven recent British isolates of corynebacteria were assayed by PCR. All isolates were assayed from both blood and tellurite agar within a five day period. Thirty three non-toxigenic isolates of C diphtheriae from six countries were also tested by PCR and by the Elek immunodiffusion assay. RESULTS--There was complete concordance between the results of PCR and traditional methods on the recent British isolates, with one exception: an Elek positive "C ulcerans" isolate, which was PCR positive from tellurite but not from blood agar. One of the thirty three (3%) non-toxigenic isolates of C diphtheriae was PCR positive. CONCLUSIONS--These results suggest that PCR compares favourably with traditional methods for the detection of toxigenic corynebacteria and that it represents a powerful new tool in the diagnosis of an old disease. Images PMID:8027375

Effects of different cooking methods on fatty acid profiles in four freshwater fishes from the Laurentian Great Lakes region.

PubMed

Neff, Margaret R; Bhavsar, Satyendra P; Braekevelt, Eric; Arts, Michael T

2014-12-01

Fish is often promoted as a healthy part of the human diet due its high content of long chain n-3 polyunsaturated fatty acids (LC-PUFA). Previous studies have shown that cooked fish can have different fatty acid profiles than raw fillets, depending on the cooking method and fish species. In this study, the fatty acid content of broiled, baked or fried skinless, boneless fillets of four fish species from the tributaries of the Great Lakes, or connecting rivers, was compared to fatty acid profiles in raw sections from the same fillet. Cooking treatments had little effect on n-3 fatty acid content; however, fried treatments generally had higher n-6 and MUFA content, which is likely a result of the cooking oil used (canola). Broiling or baking is generally the most healthy option presented in this study, as these methods result in lower levels of less-favourable fatty acids; however, the choice of cooking oil may also influence the overall fatty acid content in cooked fish. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Monitoring of Dermanyssus gallinae in free-range poultry farms.

PubMed

Zenner, L; Bon, G; Chauve, C; Nemoz, C; Lubac, S

2009-06-01

Various methods for monitoring Dermanyssus gallinae infestations within free-range egg production units were compared. The study was carried out in five egg-producing free-range poultry buildings infested with D. gallinae. Each farm was divided into six zones (each zone including nest boxes, perches and duckboard) for placing two types of traps (corrugated cardboard and thick card traps) or examining dried droppings for presence of mites. Traps were removed 24 h later, placed into bags and mites were counted at the laboratory using binocular magnification. Droppings were also inspected by eye and mite numbers were estimated. All the methods used allowed us to detect mites although their efficacy differed. The number of mites collected was independent of the type of trap used. Examination of the droppings did not differentiate between buildings with differing mite populations. Placing traps in the nest boxes is a less reliable indicator than placing them on the perches. It appears that the most coherent method for evaluating the D. gallinae population within a free-range flock is to place thick card traps throughout the building, on perches favoured by birds.

Acute myeloid leukaemia: expression of MYC protein and its association with cytogenetic risk profile and overall survival.

PubMed

Mughal, Muhammad Kashif; Akhter, Ariz; Street, Lesley; Pournazari, Payam; Shabani-Rad, Meer-Taher; Mansoor, Adnan

2017-09-01

Acute myeloid leukaemia (AML) is a clinically aggressive disease with marked genetic heterogeneity. Cytogenetic abnormalities provide the basis for risk stratification into clinically favourable, intermediate, and unfavourable groups. There are additional genetic mutations, which further influence the prognosis of patients with AML. Most of these result in molecular aberrations whose downstream target is MYC. It is therefore logical to study the relationship between MYC protein expression and cytogenetic risk groups. We studied MYC expression by immunohistochemistry in a large cohort (n = 199) of AML patients and correlated these results with cytogenetic risk profile and overall survival (OS). We illustrated differential expression of MYC protein across various cytogenetic risk groups (p = 0.03). Highest expression of MYC was noted in AML patients with favourable cytogenetic risk group. In univariate analysis, MYC expression showed significant negative influence of OS in favourable and intermediate cytogenetic risk group (p = 0.001). Interestingly, MYC expression had a protective effect in the unfavourable cytogenetic risk group. In multivariate analysis, while age and cytogenetic risk group were significant factors influencing survival, MYC expression by immunohistochemistry methods also showed some marginal impact (p = 0.069). In conclusion, we have identified differential expression of MYC protein in relation to cytogenetic risk groups in AML patients and documented its possible impact on OS in favourable and intermediate cytogenetic risk groups. These preliminary observations mandate additional studies to further investigate the routine clinical use of MYC protein expression in AML risk stratification. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Comparison of cardiogoniometry and electrocardiography with perfusion cardiac magnetic resonance imaging and late gadolinium enhancement.

PubMed

Birkemeyer, Ralf; Toelg, Ralph; Zeymer, Uwe; Wessely, Rainer; Jäckle, Sebastian; Hairedini, Bajram; Lübke, Mike; Aßfalg, Manfred; Jung, Werner

2012-12-01

Cardiogoniometry (CGM) is a spatio-temporal five-lead resting electrocardiographic method utilizing automated analysis. The purpose of this study was to determine CGM's and electrocardiography (ECG)'s accuracy for detecting myocardial ischaemia and/or lesions in comparison with perfusion cardiac magnetic resonance imaging (CMRI) and late gadolinium enhancement (LGE). Forty (n= 40) patients with suspected or known stable coronary artery disease were examined by CGM and resting ECG directly prior to CMRI including adenosine stress perfusion (ASP) and LGE. The investigators visually reading the CMRI were blinded to the CGM and ECG results. Half of the patients (n= 20) had a normal CMRI while the other half presented with either abnormal ASP and/or detectable LGE. Cardiogoniometry yielded an accuracy of 83% (sensitivity 70%) and ECG of 63% (sensitivity 35%) compared with CMRI. In this pilot study CGM compares more favourably than ECG with the detection of ischaemia and/or structural myocardial lesions on CMRI.

Trained nurses can obtain satisfactory bone marrow aspirates and trephine biopsies.

PubMed Central

Lawson, S; Aston, S; Baker, L; Fegan, C D; Milligan, D W

1999-01-01

AIMS: To assess the feasibility of training nurse practitioners to perform bone marrow aspiration and trephine biopsy, and to compare the quality of these samples with those obtained by medical staff. METHODS: A retrospective audit was undertaken of nurse practitioner and medical staff performance in bone marrow procedures in a busy haematology day unit. RESULTS: Nurse practitioners fared favourably in comparison with medical staff in performing bone marrow trephine biopsies, with mean biopsy lengths of 11 mm and 10.7 mm respectively. However, only 78% of the smears obtained by the nurses were judged technically satisfactory, compared with 91% prepared by doctors. This discrepancy was thought to be due largely to the quality of slide spreading. CONCLUSIONS: With motivated staff and a structured educational and training programme it is possible for nurse practitioners to perform the techniques of bone marrow aspiration and biopsy, and obtain specimens of satisfactory quality, thus improving efficiency of the haematology day unit and increasing quality of patient care. Images PMID:10396248

Anticonvulsants for alcohol withdrawal.

PubMed

Minozzi, Silvia; Amato, Laura; Vecchi, Simona; Davoli, Marina

2010-03-17

Alcohol abuse and dependence represents a most serious health problem worldwide with major social, interpersonal and legal interpolations. Besides benzodiazepines, anticonvulsants are often used for the treatment of alcohol withdrawal symptoms. Anticonvulsants drugs are indicated for the treatment of alcohol withdrawal syndrome, alone or in combination with benzodiazepine treatments. In spite of the wide use, the exact role of the anticonvulsants for the treatment of alcohol withdrawal has not yet bee adequately assessed. To evaluate the effectiveness and safety of anticonvulsants in the treatment of alcohol withdrawal. We searched Cochrane Drugs and Alcohol Group' Register of Trials (December 2009), PubMed, EMBASE, CINAHL (1966 to December 2009), EconLIT (1969 to December 2009). Parallel searches on web sites of health technology assessment and related agencies, and their databases. Randomized controlled trials (RCTs) examining the effectiveness, safety and overall risk-benefit of anticonvulsants in comparison with a placebo or other pharmacological treatment. All patients were included regardless of age, gender, nationality, and outpatient or inpatient therapy. Two authors independently screened and extracted data from studies. Fifty-six studies, with a total of 4076 participants, met the inclusion criteria. Comparing anticonvulsants with placebo, no statistically significant differences for the six outcomes considered.Comparing anticonvulsant versus other drug, 19 outcomes considered, results favour anticonvulsants only in the comparison carbamazepine versus benzodiazepine (oxazepam and lorazepam) for alcohol withdrawal symptoms (CIWA-Ar score): 3 studies, 262 participants, MD -1.04 (-1.89 to -0.20), none of the other comparisons reached statistical significance.Comparing different anticonvulsants no statistically significant differences in the two outcomes considered.Comparing anticonvulsants plus other drugs versus other drugs (3 outcomes considered), results from one study, 72 participants, favour paraldehyde plus chloral hydrate versus chlordiazepoxide, for the severe-life threatening side effects, RR 0.12 (0.03 to 0.44). Results of this review do not provide sufficient evidence in favour of anticonvulsants for the treatment of AWS. There are some suggestions that carbamazepine may actually be more effective in treating some aspects of alcohol withdrawal when compared to benzodiazepines, the current first-line regimen for alcohol withdrawal syndrome. Anticonvulsants seem to have limited side effects, although adverse effects are not rigorously reported in the analysed trials.

Effect of ferrate on green algae removal.

PubMed

Kubiňáková, Emília; Híveš, Ján; Gál, Miroslav; Fašková, Andrea

2017-09-01

Green algae Cladophora aegagropila, present in cooling water of thermal power plants, causes many problems and complications, especially during summer. However, algae and its metabolites are rarely eliminated by common removal methods. In this work, the elimination efficiency of electrochemically prepared potassium ferrate(VI) on algae from cooling water was investigated. The influence of experimental parameters, such as Fe(VI) dosage, application time, pH of the system, temperature and hydrodynamics of the solution on removal efficiency, was optimized. This study demonstrates that algae C. aegagropila can be effectively removed from cooling water by ferrate. Application of ferrate(VI) at the optimized dosage and under the suitable conditions (temperature, pH) leads to 100% removal of green algae Cladophora from the system. Environmentally friendly reduction products (Fe(III)) and coagulation properties favour the application of ferrate for the treatment of water contaminated with studied microorganisms compared to other methods such as chlorination and use of permanganate, where harmful products are produced.

Electron- and positron-impact atomic scattering calculations using propagating exterior complex scaling

NASA Astrophysics Data System (ADS)

Bartlett, P. L.; Stelbovics, A. T.; Rescigno, T. N.; McCurdy, C. W.

2007-11-01

Calculations are reported for four-body electron-helium collisions and positron-hydrogen collisions, in the S-wave model, using the time-independent propagating exterior complex scaling (PECS) method. The PECS S-wave calculations for three-body processes in electron-helium collisions compare favourably with previous convergent close-coupling (CCC) and time-dependent exterior complex scaling (ECS) calculations, and exhibit smooth cross section profiles. The PECS four-body double-excitation cross sections are significantly different from CCC calculations and highlight the need for an accurate representation of the resonant helium final-state wave functions when undertaking these calculations. Results are also presented for positron-hydrogen collisions in an S-wave model using an electron-positron potential of V12 = - (8 + (r1 - r2)2)-1/2. This model is representative of the full problem, and the results demonstrate that ECS-based methods can accurately calculate scattering, ionization and positronium formation cross sections in this three-body rearrangement collision.

Nanoliter reactors improve multiple displacement amplification of genomes from single cells.

PubMed

Marcy, Yann; Ishoey, Thomas; Lasken, Roger S; Stockwell, Timothy B; Walenz, Brian P; Halpern, Aaron L; Beeson, Karen Y; Goldberg, Susanne M D; Quake, Stephen R

2007-09-01

Since only a small fraction of environmental bacteria are amenable to laboratory culture, there is great interest in genomic sequencing directly from single cells. Sufficient DNA for sequencing can be obtained from one cell by the Multiple Displacement Amplification (MDA) method, thereby eliminating the need to develop culture methods. Here we used a microfluidic device to isolate individual Escherichia coli and amplify genomic DNA by MDA in 60-nl reactions. Our results confirm a report that reduced MDA reaction volume lowers nonspecific synthesis that can result from contaminant DNA templates and unfavourable interaction between primers. The quality of the genome amplification was assessed by qPCR and compared favourably to single-cell amplifications performed in standard 50-microl volumes. Amplification bias was greatly reduced in nanoliter volumes, thereby providing a more even representation of all sequences. Single-cell amplicons from both microliter and nanoliter volumes provided high-quality sequence data by high-throughput pyrosequencing, thereby demonstrating a straightforward route to sequencing genomes from single cells.

Atom-optics knife-edge: Measuring sub-nanokelvin momentum distributions

NASA Astrophysics Data System (ADS)

Ramos, Ramon; Spierings, David; Steinberg, Aephraim

2017-04-01

Temperatures below 1 nanokelvin have been achieved in the recent years, enabling new classes of experiments which benefit from the resulting long coherence times. This achievement comes hand in hand with the challenge of measuring such low temperatures. By employing the equivalent of a knife-edge measurement for matter-waves, we have been able to characterize ultra-low momentum widths. We measured a momentum width corresponding to an effective temperature of 900 +/- 200 pK, only limited by our cooling performance. We show that this technique compares favourably with more traditional methods, which would require expansion times of 100's of ms or frequency stability of 10's of Hz. Finally, we show that the effective knife-edge, created by a potential barrier, begins to become ''blunt'' due to tunneling for thin barriers, and we obtain quantitative agreement with a theoretical model. This method is a useful tool for atomic interferometry and other areas in ultracold atoms where a robust and precise technique for characterizing the momentum distribution is required.

Simple control laws for low-thrust orbit transfers

NASA Technical Reports Server (NTRS)

Petropoulos, Anastassios E.

2003-01-01

Two methods are presented by which to determine both a thrust direction and when to apply thrust to effect specified changes in any of the orbit elements except for true anomaly, which is assumed free. The central body is assumed to be a point mass, and the initial and final orbits are assumed closed. Thrust, when on, is of a constant value, and specific impulse is constant. The thrust profiles derived from the two methods are not propellant-optimal, but are based firstly on the optimal thrust directions and location on the osculating orbit for changing each of the orbit elements and secondly on the desired changes in the orbit elements. Two examples of transfers are presented, one in semimajor axis and inclination, and one in semimajor axis and eccentricity. The latter compares favourably with a propellant-optimized transfer between the same orbits. The control laws have few input parameters, but can still capture the complexity of a wide variety of orbit transfers.

Teachers' Views of Their Assessment Practice

ERIC Educational Resources Information Center

Atjonen, Päivi

2014-01-01

The main aim of this research was to analyse teachers' views of pupil assessment. The theoretical framework was based on existing literature on advances and challenges of pupil assessment in regard to support for learning, fairness, educational partnership, feedback, and favourable methods. The data were gathered by means of a questionnaire…

The promise of complementarity: Using the methods of foresight for health workforce planning.

PubMed

Rees, Gareth H; Crampton, Peter; Gauld, Robin; MacDonell, Stephen

2018-05-01

Health workforce planning aims to meet a health system's needs with a sustainable and fit-for-purpose workforce, although its efficacy is reduced in conditions of uncertainty. This PhD breakthrough article offers foresight as a means of addressing this uncertainty and models its complementarity in the context of the health workforce planning problem. The article summarises the findings of a two-case multi-phase mixed method study that incorporates actor analysis, scenario development and policy Delphi. This reveals a few dominant actors of considerable influence who are in conflict over a few critical workforce issues. Using these to augment normative scenarios, developed from existing clinically developed model of care visions, a number of exploratory alternative descriptions of future workforce situations are produced for each case. Their analysis reveals that these scenarios are a reasonable facsimile of plausible futures, though some are favoured over others. Policy directions to support these favoured aspects can also be identified. This novel approach offers workforce planners and policy makers some guidance on the use of complimentary data, methods to overcome the limitations of conventional workforce forecasting and a framework for exploring the complexities and ambiguities of a health workforce's evolution.

Simultaneous removal of 2,4,6-tribromophenol from water and bromate ion minimization by ozonation.

PubMed

Gounden, Asogan N; Singh, Sooboo; Jonnalagadda, Sreekantha B

2018-06-02

The study investigates the degradation of 2,4,6-tribromophenol (2,4,6-TBP) and the influence of solution pH, alkalinity, H 2 O 2 and O 3 dosage. Debromination efficiency of 2,4,6-TBP was the highest in basic water (pH = 10.61). The extent of TOC removal compared favourably with the amount of substrate converted, suggesting favourable mineralization of oxygenated by-products (OBPs). Ozonation in basic water favoured the formation of toxicBrO 3 - , while in acidic water (pH = 2.27) BrO 3 - yield was lowest. In acidic water the presence of CO 3 2- showed negligible effect on conversion, TOC and  BrO 3 - yield compared to ozonation alone. In basic water both 2,4,6-TBP conversion and TOC removal decreased with an increase in CO 3 2- , hence minimizing BrO 3 - formation. The O 3 /H 2 O 2 process showed an improvement in the debromination efficiency and TOC data revealed that total mineralization of OBP's was achieved. However, only 10% H 2 O 2 was able to effectively decrease BrO 3 - formation. Increasing the ozone concentration from 20 to 100 ppm enhanced the conversion of 2,4,6-TBP and TOC removal. At low ozone concentrations poor mineralization of OBP's occurred, while complete mineralization was achieved at higher ozone dose. The reaction pathways for ozone degradation of 2,4,6-TBP in acidic and basic waters is proposed. Copyright © 2018 Elsevier B.V. All rights reserved.

Comparing simple root phenotyping methods on a core set of rice genotypes.

PubMed

Shrestha, R; Al-Shugeairy, Z; Al-Ogaidi, F; Munasinghe, M; Radermacher, M; Vandenhirtz, J; Price, A H

2014-05-01

Interest in belowground plant growth is increasing, especially in relation to arguments that shallow-rooted cultivars are efficient at exploiting soil phosphorus while deep-rooted ones will access water at depth. However, methods for assessing roots in large numbers of plants are diverse and direct comparisons of methods are rare. Three methods for measuring root growth traits were evaluated for utility in discriminating rice cultivars: soil-filled rhizotrons, hydroponics and soil-filled pots whose bottom was sealed with a non-woven fabric (a potential method for assessing root penetration ability). A set of 38 rice genotypes including the OryzaSNP set of 20 cultivars, additional parents of mapping populations and products of marker-assisted selection for root QTLs were assessed. A novel method of image analysis for assessing rooting angles from rhizotron photographs was employed. The non-woven fabric was the easiest yet least discriminatory method, while the rhizotron was highly discriminatory and allowed the most traits to be measured but required more than three times the labour of the other methods. The hydroponics was both easy and discriminatory, allowed temporal measurements, but is most likely to suffer from artefacts. Image analysis of rhizotrons compared favourably to manual methods for discriminating between cultivars. Previous observations that cultivars from the indica subpopulation have shallower rooting angles than aus or japonica cultivars were confirmed in the rhizotrons, and indica and temperate japonicas had lower maximum root lengths in rhizotrons and hydroponics. It is concluded that rhizotrons are the preferred method for root screening, particularly since root angles can be assessed. © 2013 German Botanical Society and The Royal Botanical Society of the Netherlands.

A magnet built on bronchoscopic suction for extraction of tracheobronchial headscarf pins: a novel technique and review of a tertiary centre experience†

PubMed Central

Elsayed, Hany H.; Mostafa, Ahmed M.; Soliman, Saleh; El-Bawab, Hatem Y.; Moharram, Adel A.; El-Nori, Ahmed A.

2016-01-01

OBJECTIVES Airway metal pins are one of the most commonly inhaled foreign bodies in Eastern societies in young females wearing headscarves. We innovated a modified bronchoscopic technique to extract tracheobronchial headscarf pins by the insertion of a magnet to allow an easy and non-traumatic extraction of the pins. The aim of this study was to assess the feasibility and safety of our new technique and compare it with our large previous experience with the classic bronchoscopic method of extraction of tracheobronchial headscarf pins. METHODS We performed a study comparing our retrospective experience of classic bronchoscopic extraction from February 2004 to January 2014 and prospective experience with our modified technique using the magnet from January 2014 to June 2015. An institutional review board and new device approval were obtained. RESULTS Three hundred and twenty-six procedures on 315 patients were performed during our initial 10-year experience. Of them, 304 patients were females. The median age of our group was 13 (0–62). The median time from inhalation to procedure was 1 day (0–1022). After introducing our modified new technique using the magnet, 20 procedures were performed. Nineteen were females. The median time of the procedure and the need to forcefully bend the pin for extraction were in favour of the new technique in comparison with our classic approach (2 vs 6 min; P < 0.001) (2 patients = 20% vs 192 = 58%; P < 0.001). The conversion rate to surgery was also in favour of the modified technique but did not reach statistical significance (0 = 0% vs 15 = 4.8%; P = 0.32). All patients who underwent the modified technique were discharged home on the same day of the procedure. No procedural complications were recorded. All remain well on a follow-up period of up to 14 months. CONCLUSIONS Bronchoscopic extraction of tracheobronchial inhaled headscarf pins using a novel technique using homemade magnets was safer and simpler in comparison with our large experience with the classic approach. We advise the use of this device (or concept) in selected patients in centres dealing with this problem. PMID:26850113

Comparison of sampling methods for the detection of human rhinovirus RNA.

PubMed

Waris, Matti; Österback, Riikka; Lahti, Elina; Vuorinen, Tytti; Ruuskanen, Olli; Peltola, Ville

2013-09-01

Obtaining a nasal swab (NS) from a child for human rhinovirus (HRV) RNA detection is simple and well tolerated even for repeated sampling, but only few studies have compared them qualitatively and quantitatively with other sampling methods. Real-time PCR was used to study the stability of HRV genomes in swabs, and to compare different swabs and induced sputum specimens with nasopharyngeal aspirates (NPAs). Replicate swabs in a dry test tube were stored at room temperature or mailed to the laboratory before freezing, and compared to freshly frozen specimens. To compare sampling methods, paediatric patients had NPA, NS and throat swab collected. In paired sputum and NPA specimens, viral load was correlated to the amount of β-actin mRNA. Specimens were stable at room temperature for at least 4 days and survived mailing without loss of HRV detectability. As compared to NPA, NS had an equal diagnostic sensitivity, with no significant quantitative difference using flocked nylon swabs and a 2.2-fold drop in the average copy number using cotton swabs. The diagnostic sensitivity of cotton swab-collected throat specimens was 97%, with a 26-fold lower mean copy number. Sputum specimens had higher HRV RNA (2.3-fold) and β-actin mRNA (1.6-fold) copy numbers than NPAs, but there was a poor correlation between HRV RNA and β-actin mRNA. HRV remains well detectable by PCR in specimens mailed to the laboratory. The diagnostic efficacy of NPA can be obtained with NS, quantitative comparison and patient comfort favouring flocked nylon-tipped over cotton-tipped swabs. Copyright © 2013 Elsevier B.V. All rights reserved.

The prediction of blood-tissue partitions, water-skin partitions and skin permeation for agrochemicals.

PubMed

Abraham, Michael H; Gola, Joelle M R; Ibrahim, Adam; Acree, William E; Liu, Xiangli

2014-07-01

There is considerable interest in the blood-tissue distribution of agrochemicals, and a number of researchers have developed experimental methods for in vitro distribution. These methods involve the determination of saline-blood and saline-tissue partitions; not only are they indirect, but they do not yield the required in vivo distribution. The authors set out equations for gas-tissue and blood-tissue distribution, for partition from water into skin and for permeation from water through human skin. Together with Abraham descriptors for the agrochemicals, these equations can be used to predict values for all of these processes. The present predictions compare favourably with experimental in vivo blood-tissue distribution where available. The predictions require no more than simple arithmetic. The present method represents a much easier and much more economic way of estimating blood-tissue partitions than the method that uses saline-blood and saline-tissue partitions. It has the added advantages of yielding the required in vivo partitions and being easily extended to the prediction of partition of agrochemicals from water into skin and permeation from water through skin. © 2013 Society of Chemical Industry.

Active transportation environments surrounding Canadian schools.

PubMed

O'Loghlen, Sean; Pickett, J William; Janssen, Ian

2011-01-01

Walking or cycling to school represents an opportunity for children to engage in physical activity. The study objectives were to: 1) describe active transportation policies, programs, and built environments of Canadian schools and their surrounding neighbourhoods, and 2) document variations based on urban-rural location and school type (primary vs. secondary vs. mixed primary/secondary schools). 397 schools from across Canada were studied. A school administrator completed a questionnaire and responses were used to assess schools' policies and programs related to active transportation and the safety and aesthetics of their respective neighbourhoods. Built environment features in a 1 km-radius circular buffer around each school were measured using geographic information systems. Greater than 70% of schools had passive policies (e.g., skateboards permitted on school grounds) and facilities (e.g., bicycle racks in secure area to avoid theft) to encourage bicycle and small-wheeled vehicle use. Less than 40% of schools had active programs designed to encourage active transportation, such as organized 'walk to school' days. Garbage in the streets, crime and substance abuse were barriers in most school neighbourhoods. Approximately 42% of schools were located on high-speed roads not amenable to active transportation and 14% did not have a sidewalk leading to the school. Secondary schools had less favourable active transportation policies/programs and neighbourhood safety/aesthetics compared to primary schools. Rural schools had less favourable built environments than urban schools. Canadian children, particularly those from rural areas, face a number of impediments to active transportation as a method of travelling to school.

Systematic review and meta-analysis: Sodium picosulphate with magnesium citrate as bowel preparation for colonoscopy

PubMed Central

Munsterman, Isabelle D; Eskes, Anne M; Maaskant, Jolanda M; van der Hulst, René

2016-01-01

Background An effective and tolerable bowel preparation is important to secure quality of colonoscopies. It remains unclear if sodium picosulphate with magnesium citrate (SPMC), which is considered a tolerable bowel preparation agent, is also an effective alternative for polyethylene glycol (PEG) and sodium phosphate (NaP). Aim The aim of this article is to compare effectiveness of SPMC to PEG and NaP through assessment of quality of bowel cleansing measured by validated tools. Methods We searched electronic databases up to January 2015. Only randomised controlled trials (RCTs) were included. Two authors independently performed selection of studies, risk of bias assessment and data extraction. Results Thirteen RCTs were included, with overall good quality, but large heterogeneity. SPMC had slightly better quality of bowel cleansing than PEG (pooled RR 1.06; 95% CI 1.02 to 1.11). In most trials SPMC was significantly better tolerated than PEG. There were no significant differences in effectiveness or tolerability between SPMC and NaP. Side effects were similar between agents, except for dizziness (pooled RR 1.71; 95% CI 1.32 to 2.21 in favour of PEG vs. SPMC) and vomiting (pooled RR 0.35; 95% CI 0.13 to 0.95 in favour of single-dose SPMC vs. split-dose). Conclusions SPMC is equally effective to NaP and little superior to PEG in terms of bowel cleansing. SPMC preparations were better tolerated than PEG preparations. SPMC may be considered as standard bowel preparation for colonoscopy. PMID:29163958

Critical assessment of three high performance liquid chromatography analytical methods for food carotenoid quantification.

PubMed

Dias, M Graça; Oliveira, Luísa; Camões, M Filomena G F C; Nunes, Baltazar; Versloot, Pieter; Hulshof, Paul J M

2010-05-21

Three sets of extraction/saponification/HPLC conditions for food carotenoid quantification were technically and economically compared. Samples were analysed for carotenoids alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein, lycopene, and zeaxanthin. All methods demonstrated good performance in the analysis of a composite food standard reference material for the analytes they are applicable to. Methods using two serial connected C(18) columns and a mobile phase based on acetonitrile, achieved a better carotenoid separation than the method using a mobile phase based on methanol and one C(18)-column. Carotenoids from leafy green vegetable matrices appeared to be better extracted with a mixture of methanol and tetrahydrofuran than with tetrahydrofuran alone. Costs of carotenoid determination in foods were lower for the method with mobile phase based on methanol. However for some food matrices and in the case of E-Z isomer separations, this was not technically satisfactory. Food extraction with methanol and tetrahydrofuran with direct evaporation of these solvents, and saponification (when needed) using pyrogallol as antioxidant, combined with a HPLC system using a slight gradient mobile phase based on acetonitrile and a stationary phase composed by two serial connected C(18) columns was the most technically and economically favourable method. 2010. Published by Elsevier B.V.

The Reliability of Setting Grade Boundaries Using Comparative Judgement

ERIC Educational Resources Information Center

Benton, Tom; Elliott, Gill

2016-01-01

In recent years the use of expert judgement to set and maintain examination standards has been increasingly criticised in favour of approaches based on statistical modelling. This paper reviews existing research on this controversy and attempts to unify the evidence within a framework where expertise is utilised in the form of comparative…

Current Problems in Developing the Natural Resource Potential of the Russian Exclave in the Baltic

ERIC Educational Resources Information Center

Fedorov, Gennady M.; Gritsenko, Vladimir A.; Dedkov, Viktor P.; Zotov, Sergey I.; Chernyshkov, Pavel P.

2016-01-01

The compact Kaliningrad region boasts relatively favourable environmental conditions and a remarkable diversity of natural resources. This article seeks to compare the natural resources of the exclave and other Russian regions. The authors examine recent statistical data to estimate the region's natural and resource potential, analyse its…

Feet and Syllables in "Elephants" and "Missiles": A Reappraisal

ERIC Educational Resources Information Center

Zonneveld, Wim; van der Pas, Brigit; de Bree, Elise

2007-01-01

Using data from a case study presented in Chiat (1989), Marshall and Chiat (2003) compare two different approaches to account for the realization of intervocalic consonants in child phonology: "coda capture theory" and the "foot domain account". They argue in favour of the latter account. In this note, we present a reappraisal…

Biogenic unmodified gold nanoparticles for selective and quantitative detection of cerium using UV-vis spectroscopy and photon correlation spectroscopy (DLS).

PubMed

Priyadarshini, E; Pradhan, N; Panda, P K; Mishra, B K

2015-06-15

The ability of self-functionalized biogenic GNPs towards highly selective colorimetric detection of rare earth element cerium is being reported for the first time. GNPs underwent rapid aggregation on addition of cerium indicated by red shift of SPR peak followed by complete precipitation. Hereby, this concept of co-ordination of cerium ions onto the GNP surface has been utilized for detection of cerium. The remarkable capacity of GNPs to sensitively detect Ce without proves beneficial compared to previous reports of colorimetric sensing. MDL was 15 and 35 ppm by DLS and UV-vis spectroscopy respectively, suggesting DLS to be highly sensitive and a practical alternative in ultrasensitive detection studies. The sensing system showed a good linear fit favouring feasible detection of cerium in range of 2-50 ppm. Similar studies further showed the superior selectivity of biogenic GNPs compared to chemically synthesized counterparts. The sensing system favours on-site analysis as it overcomes need of complex instrumentation, lengthy protocols and surface modification of GNP. Copyright © 2015 Elsevier B.V. All rights reserved.

Comparison of green method for chitin deacetylation

NASA Astrophysics Data System (ADS)

Anwar, Muslih; Anggraeni, Ayu Septi; Amin, M. Harisuddin Al

2017-03-01

Developing highly environmentally friendly and cost-effective approaches for the chitosan production has paramount important in the future technology. Deacetylation process is one of the most importing steps to classify the quality of chitosan. This research aimed to study the best method for deacetylation of chitin considered by several factors like the concentration of base, temperature, time and reaction method. From the green chemistry point of view, conventional refluxing method relatively wasted energy compared to another method such as maceration, grinding and sonication. The degree of deacetylation (DD) of chitosan was studied by sonication, resulted in slightly increasing of DD from 73.14 to 73.28% during the time from 0.5 h to 1 h. Deacetylation of chitin with various sodium hydroxide concentration 60, 70 and 80% gave 73.14, 76.36 and 77.88% of DD, respectively. Variation of temperature at 40, 60, and 80 °C was slightly affected on increasing DD from 67.53, 72.84 and 73.14%, respectively. The DD of chitosan significantly increased from 60.19, 74.27 and 81.20% respectively correspondent to varying NaOH concentration 60, 70 and 80% using the maceration method. Solid phase grinding method for half hour resulted in 79.49% of DD. The application of ultrasound grinding method not only was enhanced toward the deacetylation but also favoured the depolymerization process. Moreover, maceration for 7 days with 80% NaOH can be as an alternative method.

The efficacy of manual therapy and exercise for treating non-specific neck pain: A systematic review

PubMed Central

Hidalgo, Benjamin; Hall, Toby; Bossert, Jean; Dugeny, Axel; Cagnie, Barbara; Pitance, Laurent

2017-01-01

OBJECTIVE: To review and update the evidence for different forms of manual therapy (MT) and exercise for patients with different stages of non-specific neck pain (NP). Data sources: MEDLINE, Cochrane-Register-of-Controlled-Trials, PEDro, EMBASE. METHOD: A qualitative systematic review covering a period from January 2000 to December 2015 was conducted according to updated-guidelines. Specific inclusion criteria only on RCTs were used; including differentiation according to stages of NP (acute – subacute [ASNP] or chronic [CNP]), as well as sub-classification based on type of MT interventions: MT1 (HVLA manipulation); MT2 (mobilization and/or soft-tissue-techniques); MT3 (MT1 + MT2); and MT4 (Mobilization-with-Movement). In each sub-category, MT could be combined or not with exercise and/or usual medical care. RESULTS: Initially 121 studies were identified for potential inclusion. Based on qualitative and quantitative evaluation criteria, 23 RCTs were identified for review. Evidence for ASNP: MODERATE-evidence: In favour of (i) MT1 to the cervical spine (Cx) combined with exercises when compared to MT1 to the thoracic spine (Tx) combined with exercises; (ii) MT3 to the Cx and Tx combined with exercise compared to MT2 to the Cx with exercise or compared to usual medical care for pain and satisfaction with care from short to long-term. Evidence for CNP: STRONG-evidence: Of no difference of efficacy between MT2 at the symptomatic Cx level(s) in comparison to MT2 on asymptomatic Cx level(s) for pain and function. MODERATE to STRONG-evidence: In favour of MT1 and MT3 on Cx and Tx with exercise in comparison to exercise or MT alone for pain, function, satisfaction with care and general-health from short to moderate-terms. MODERATE-evidence: In favour (i) of MT1 as compared to MT2 and MT4, all applied to the Cx, for neck mobility, and pain in the very short term; (ii) of MT2 using sof-tissue-techniques to the Cx and Tx or MT3 to the Cx and Tx in comparison to no-treatment in the short-term for pain and disability. CONCLUSION: This systematic review updates the evidence for MT combined or not with exercise and/or usual medical care for different stages of NP and provides recommendations for future studies. Two majors points could be highlighted, the first one is that combining different forms of MT with exercise is better than MT or exercise alone, and the second one is that mobilization need not be applied at the symptomatic level(s) for improvements of NP patients. These both points may have clinical implications for reducing the risk involved with some MT techniques applied to the cervical spine. PMID:28826164

Matching-adjusted indirect comparison of efficacy in patients with moderate-to-severe plaque psoriasis treated with ixekizumab vs. secukinumab.

PubMed

Warren, R B; Brnabic, A; Saure, D; Langley, R G; See, K; Wu, J J; Schacht, A; Mallbris, L; Nast, A

2018-05-01

Head-to-head randomized studies comparing ixekizumab and secukinumab in the treatment of psoriasis are not available. To assess efficacy and quality of life using matching-adjusted indirect comparisons for treatment with ixekizumab vs. secukinumab. Psoriasis Area and Severity Index (PASI) improvement of at least 75%, 90% and 100% and Dermatology Life Quality Index (DLQI) 0/1 response rates for approved dosages of ixekizumab (160 mg at Week 0, then 80 mg every two weeks for the first 12 weeks) and secukinumab (300 mg at Weeks 0, 1, 2, 3 and 4, then 300 mg every 4 weeks) treatment were compared using data from active (etanercept and ustekinumab) and placebo-controlled studies. Comparisons were made using the Bucher (BU) method and two modified versions of the Signorovitch (SG) method (SG total and SG separate). Subsequently, results based on active treatment common comparators were combined using generic inverse-variance meta-analysis. In the meta-analysis of studies with active comparators, PASI 90 response rates were 12·7% [95% confidence interval (CI) 5·5-19·8, P = 0·0005], 10·0% (95% CI 2·1-18·0, P = 0·01) and 11·2% (95% CI 3·2-19·1, P = 0·006) higher and PASI 100 response rates were 11·7% (95% CI 5·9-17·5, P < 0·001), 12·7% (95% CI 6·0-19·4, P < 0·001) and 13·1% (95% CI 6·3-19·9, P < 0·001) higher for ixekizumab compared with secukinumab using BU, SG total and SG separate methods. PASI 75 results were comparable when SG methods were used and favoured ixekizumab when the BU method was used. Week 12 DLQI 0/1 response rates did not differ significantly. Ixekizumab had higher PASI 90 and PASI 100 responses at week 12 compared with secukinumab using adjusted indirect comparisons. © 2017 The Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.

[Analysis of body mass index in different sector workers for over ten years].

PubMed

Perbellini, L; Zonzin, C; Baldo, M

2010-01-01

A critical review of the literature on obesity and overweight underlines that a low educational level, a low social-economic status, certain working conditions, the lack of physical activity in leisure time, together with the availability of food, are the main factors favouring increased prevalence of obesity. Certain jobs also contribute significantly to this problem. Automation, the use of machines for heavy works and sedentary activities favour body weight increase. Jobs that are a source of stress, such as work with night shift can cause metabolic disorders leading to an increased prevalence of obesity. The main aim of this article is to study the trend of body weight in different working area during ten years, comparing this parameter to different factors such as job, blood pressure, smoke, alcool and health diseases.

Use of the PIXEL method to investigate gas adsorption in metal–organic frameworks† †Electronic supplementary information (ESI) available. See DOI: 10.1039/c6ce00555a Click here for additional data file. Click here for additional data file. Click here for additional data file.

PubMed Central

Maloney, Andrew G. P.; Wood, Peter A.

2016-01-01

PIXEL has been used to perform calculations of adsorbate-adsorbent interaction energies between a range of metal–organic frameworks (MOFs) and simple guest molecules. Interactions have been calculated for adsorption between MOF-5 and Ar, H2, and N2; Zn2(BDC)2(TED) (BDC = 1,4-benzenedicarboxylic acid, TED = triethylenediamine) and H2; and HKUST-1 and CO2. The locations of the adsorption sites and the calculated energies, which show differences in the Coulombic or dispersion characteristic of the interaction, compare favourably to experimental data and literature energy values calculated using density functional theory. PMID:28496380

Analysis of improved government geological map information for mineral exploration: Incorporating efficiency, productivity, effectiveness, and risk considerations

USGS Publications Warehouse

Bernknopf, R.L.; Wein, A.M.; St-Onge, M. R.; Lucas, S.B.

2007-01-01

This bulletin/professional paper focuses on the value of geoscientific information and knowledge, as provided in published government bedrock geological maps, to the mineral exploration sector. An economic model is developed that uses an attribute- ranking approach to convert geological maps into domains of mineral favourability. Information about known deposits in these (or analogous) favourability domains allow the calculation of exploration search statistics that provide input into measures of exploration efficiency, productivity, effectiveness, risk, and cost stemming from the use of the published geological maps. Two case studies, the Flin Flon Belt (Manitoba and Saskatchewan) and the south Baffin Island area (Nunavut), demonstrate that updated, finer resolution maps can be used to identify more exploration campaign options, and campaigns thats are more efficient, more effective, and less risky than old, coarser resolution maps when used as a guide for mineral exploration. The Flin Flon Belt study illustrates that an updated, coarser resolution bedrock map enables improved mineral exploration efficiency, productivity, and effectiveness by locating 60% more targets and supporting an exploration campaign that is 44% more efficient. Refining the map resolution provides an additional 17% reduction in search effort across all favourable domains and a 55% reduction in search effort in the most favourable domain. The south Baffin Island case study projects a 40% increase in expected targets and a 27% reduction in search effort when the updated, finer resolution map is used in lieu of the old, coarser resolution map. On southern Baffin Island, the economic value of the up dated map ranges from CAN$2.28 million to CAN$15.21 million, which can be compared to the CAN$1.86 million that it cost to produce the map (a multiplier effect of up to eight).

Immunohistochemical expression of p53 proteins in Wilms' tumour: a possible association with the histological prognostic parameter of anaplasia.

PubMed

Cheah, P L; Looi, L M; Chan, L L

1996-01-01

Wilms' tumour (nephroblastoma) has been associated with chromosomal abnormalities at the 11p13, 11p15 and 16q regions. A study into the possibility of mutations occurring within p53, the ubiquitous adult tumour suppressor gene, in Wilms' tumour was carried out. Thirty-eight cases were studied. Of these 36 were categorised into the favourable histology group and two into the unfavourable histology group based on the National Wilms' Tumour Study criteria. Archival formalin-fixed, paraffin-embedded tissue sections from each case were stained with a polyclonal (AB565:Chemicon) and a monoclonal (DO7:Dako) antibody raised against p53 protein using a peroxidase-labelled streptavidin biotin kit (Dako). 'Cure' (disease-free survival of 60 months or longer) was documented in 39% of cases with favourable histology tumours. Eleven percent in this group succumbed to the disease. Both cases with unfavourable histology died. Four out of 36 (11%) tumours with favourable histology demonstrated weak to moderate staining with both AB565 and DO7 in more than 75% of tumour cells. In contrast, p53 protein expression in unfavourable histology tumours was significantly increased compared with the favourable histology group (P = 0.021) with both cases demonstrating immunopositivity in > 75% of tumour cells when stained with AB565 and DO7. The intensity of staining ranged from moderate to strong in both cases. It appears from this preliminary study that the immunohistochemical expression of p53 protein in Wilms' tumour, presumably a result of mutation in the p53 tumour suppressor gene, correlates with histological classification, histological categorisation being one of the useful features in the prognostic assessment of Wilms' tumours.

Physiotherapy interventions for ankylosing spondylitis.

PubMed

Dagfinrud, H; Kvien, T K; Hagen, K B

2008-01-23

Ankylosing spondylitis (AS) is a chronic, inflammatory rheumatic disease. Physiotherapy is considered an important part of the overall management of AS. To summarise the available scientific evidence on the effectiveness of physiotherapy interventions in the management of AS. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, AMED, CINAHL and PEDro up to January 2007 for all relevant publications, without any language restrictions. We checked the reference lists of relevant articles and contacted the authors of included articles. We included randomised and quasi-randomised studies with AS patients and where at least one of the comparison groups received physiotherapy. The main outcomes of interest were pain, stiffness, spinal mobility, physical function and patient global assessment. Two reviewers independently selected trials for inclusion, extracted data and assessed trial quality. Investigators were contacted to obtain missing information. Eleven trials with a total of 763 participants were included in this updated review. Four trials compared individualised home exercise programs or a supervised exercise program with no intervention and reported low quality evidence for effects in spinal mobility (Relative percentage differences (RPDs) from 5-50%) and physical function (four points on a 33-point scale). Three trials compared supervised group physiotherapy with an individualised home-exercise program and reported moderate quality evidence for small differences in spinal mobility (RPDs 7.5-18%) and patient global assessment (1.46 cm) in favour of supervised group exercises. In one study, a three-week inpatient spa-exercise therapy followed by 37 weeks of weekly outpatient group physiotherapy (without spa) was compared with weekly outpatient group physiotherapy alone; there was moderate quality evidence for effects in pain (18%), physical function (24%) and patient global assessment (27%) in favour of the combined spa-exercise therapy. One study compared daily outpatient balneotherapy and an exercise program with only exercise program, and another study compared balneotherapy with fresh water therapy. None of these studies showed significant between-group differences. One study compared an experimental exercise program with a conventional program; statistically significant change scores were reported on nearly all spinal mobility measures and physical function in favour of the experimental program. The results of this review suggest that an individual home-based or supervised exercise program is better than no intervention; that supervised group physiotherapy is better than home exercises; and that combined inpatient spa-exercise therapy followed by group physiotherapy is better than group physiotherapy alone.

The Professional Learning of Teachers in Higher Education

ERIC Educational Resources Information Center

Knight, Peter; Tait, Jo; Yorke, Mantz

2006-01-01

Educational professional development is a global concern. It is often characterised by event-delivery methods, though there are signs that other approaches are gaining favour. The authors stress the significance of non-formal learning, and the ways in which it can be promoted and enhanced within the activity systems within which teachers in higher…

Has Bedside Teaching Had Its Day?

ERIC Educational Resources Information Center

Qureshi, Zeshan; Maxwell, Simon

2012-01-01

Though a diverse array of teaching methods is now available, bedside teaching is arguably the most favoured. Students like it because it is patient-centred, and it includes a high proportion of relevant skills. It is on the decline, coinciding with declining clinical skills of junior doctors. Several factors might account for this: busier…

Farmers' Attitude towards a Participatory Research Method Used to Evaluate Weed Management Strategies in Bananas

ERIC Educational Resources Information Center

Ganpat, Wayne G.; Isaac, Wendy-Ann P.; Brathwaite, Richard A. I.; Bekele, Isaac

2009-01-01

In this study, farmers were engaged in a participatory research project and their attitudes evaluated. The purpose was to identify the characteristics of farmers who are favourably predisposed towards meaningful participation in the process. Several cover crops were tested for possible use in the management of watergrass ("Commelina…

Protonation states of intermediates in the reaction mechanism of [NiFe] hydrogenase studied by computational methods.

PubMed

Dong, Geng; Ryde, Ulf

2016-06-01

The [NiFe] hydrogenases catalyse the reversible conversion of H2 to protons and electrons. The active site consists of a Fe ion with one carbon monoxide, two cyanide, and two cysteine (Cys) ligands. The latter two bridge to a Ni ion, which has two additional terminal Cys ligands. It has been suggested that one of the Cys residues is protonated during the reaction mechanism. We have used combined quantum mechanical and molecular mechanics (QM/MM) geometry optimisations, large QM calculations with 817 atoms, and QM/MM free energy simulations, using the TPSS and B3LYP methods with basis sets extrapolated to the quadruple zeta level to determine which of the four Cys residues is more favourable to protonate for four putative states in the reaction mechanism, Ni-SIa, Ni-R, Ni-C, and Ni-L. The calculations show that for all states, the terminal Cys-546 residue is most easily protonated by 14-51 kJ/mol, owing to a more favourable hydrogen-bond pattern around this residue in the protein.

[Today's meaning of classical authors of political thinking].

PubMed

Weinacht, Paul-Ludwig

2005-01-01

How can classical political authors be actualised? The question is asked in a discipline which is founded in old traditions: the political science. One of its great matters is the history of political ideas. Classic authors are treated in many books, but they are viewed in different perspectives; colleagues do not agree with shining and bad examples. For actualising classic we have to go a methodically reflected way: historic not historicistic, with sensibility for classic and christian norms without dogmatism or scepticism. Searching the permanent problems we try to translate the original concepts of the classic authors carefully in our time. For demonstrating our method of actualising, we choose the French classical author Montesquieu. His famous concept of division of powers is misunderstood as a "liberal" mechanism which works in itself in favour of freedom (such as Kant made work a "natural mechanism" in a people of devils in favour of their legality); in reality Montesquieu acknoledges that constitutional und organisational work cannot stabilise themselves but must be found in social character and in human virtues.

Coevolution between positive reciprocity, punishment, and partner switching in repeated interactions.

PubMed

Wubs, Matthias; Bshary, Redouan; Lehmann, Laurent

2016-06-15

Cooperation based on mutual investments can occur between unrelated individuals when they are engaged in repeated interactions. Individuals then need to use a conditional strategy to deter their interaction partners from defecting. Responding to defection such that the future payoff of a defector is reduced relative to cooperating with it is called a partner control mechanism. Three main partner control mechanisms are (i) to switch from cooperation to defection when being defected ('positive reciprocity'), (ii) to actively reduce the payoff of a defecting partner ('punishment'), or (iii) to stop interacting and switch partner ('partner switching'). However, such mechanisms to stabilize cooperation are often studied in isolation from each other. In order to better understand the conditions under which each partner control mechanism tends to be favoured by selection, we here analyse by way of individual-based simulations the coevolution between positive reciprocity, punishment, and partner switching. We show that random interactions in an unstructured population and a high number of rounds increase the likelihood that selection favours partner switching. In contrast, interactions localized in small groups (without genetic structure) increase the likelihood that selection favours punishment and/or positive reciprocity. This study thus highlights the importance of comparing different control mechanisms for cooperation under different conditions. © 2016 The Author(s).

Cost-effectiveness of prenatal food and micronutrient interventions on under-five mortality and stunting: Analysis of data from the MINIMat randomized trial, Bangladesh.

PubMed

Svefors, Pernilla; Selling, Katarina Ekholm; Shaheen, Rubina; Khan, Ashraful Islam; Persson, Lars-Åke; Lindholm, Lars

2018-01-01

Nutrition interventions may have favourable as well as unfavourable effects. The Maternal and Infant Nutrition Interventions in Matlab (MINIMat), with early prenatal food and micronutrient supplementation, reduced infant mortality and were reported to be very cost-effective. However, the multiple micronutrients (MMS) supplement was associated with an increased risk of stunted growth in infancy and early childhood. This unfavourable outcome was not included in the previous cost-effectiveness analysis. The aim of this study is to evaluate whether the MINIMat interventions remain cost-effective in view of both favourable (decreased under-five-years mortality) and unfavourable (increased stunting) outcomes. Pregnant women in rural Bangladesh, where food insecurity still is prevalent, were randomized to early (E) or usual (U) invitation to be given food supplementation and daily doses of 30 mg, or 60 mg iron with 400 μg of folic acid, or MMS with 15 micronutrients including 30 mg iron and 400 μg of folic acid. E reduced stunting at 4.5 years compared with U, MMS increased stunting at 4.5 years compared with Fe60, while the combination EMMS reduced infant mortality compared with UFe60. The outcome measure used was disability adjusted life years (DALYs), a measure of overall disease burden that combines years of life lost due to premature mortality (under five-year mortality) and years lived with disability (stunting). Incremental cost effectiveness ratios were calculated using cost data from already published studies. By incrementing UFe60 (standard practice) to EMMS, one DALY could be averted at a cost of US$24. When both favourable and unfavourable outcomes were included in the analysis, early prenatal food and multiple micronutrient interventions remained highly cost effective and seem to be meaningful from a public health perspective.

Baseline characteristics of the omega-3 fatty acids (Fish oils) and Aspirin in Vascular access OUtcomes in REnal Disease (FAVOURED) study.

PubMed

Viecelli, Andrea K; Pascoe, Elaine M; Polkinghorne, Kevan R; Hawley, Carmel M; Paul-Brent, Peta-Anne; Badve, Sunil V; Cass, Alan; Johnson, David W; Kerr, Peter G; Mori, Trevor A; Scaria, Anish; Hooi, Seong L; Ong, Meng L; Irish, Ashley B

2016-03-01

The Fish oils and Aspirin in Vascular access OUtcomes in REnal Disease (FAVOURED) trial investigated whether 3 months of omega-3 polyunsaturated fatty acids, either alone or in combination with aspirin, will effectively reduce primary access failure of de novo arteriovenous fistulae. This report presents the baseline characteristics of all study participants, examines whether study protocol amendments successfully increased recruitment of a broader and more representative haemodialysis cohort, including patients already receiving aspirin, and contrasts Malaysian participants with those from Australia, New Zealand and the United Kingdom (UK). This international, randomized, double-blind, placebo-controlled trial included patients older than 19 years with stage 4 or 5 chronic kidney disease currently receiving, or planned within 12 months to receive haemodialysis. Participants (n = 568) were overweight (28.6 ± 7.3 kg/m(2) ), relatively young (54.8 ± 14.3 years), and predominantly male (63%) with a high prevalence of diabetes mellitus (46%) but low rate of ischaemic heart disease (8%). Sixty one percent were planned for lower arm arteriovenous fistula creation. Malaysian participants (n = 156) were younger (51.8 ± 13.6 years vs 57.1 ± 14.2 years, P < 0.001) with a higher prevalence of diabetes mellitus (65% vs 43%, P < 0.001), but less ischaemic heart disease (5% vs 14%, P < 0.01) compared with the combined Australian, New Zealand and UK cohort (n = 228). Protocol modifications allowing for inclusion of patients receiving aspirin increased the prevalence of co-morbidities compared with the original cohort. The FAVOURED study participants, while mostly similar to patients in contemporary national registry reports and comparable recent clinical trials, were on average younger and had less ischaemic heart disease. These differences were reduced as a consequence of including patients already receiving aspirin. © 2015 Asian Pacific Society of Nephrology.

Computer Vision Photogrammetry for Underwater Archaeological Site Recording in a Low-Visibility Environment

NASA Astrophysics Data System (ADS)

Van Damme, T.

2015-04-01

Computer Vision Photogrammetry allows archaeologists to accurately record underwater sites in three dimensions using simple twodimensional picture or video sequences, automatically processed in dedicated software. In this article, I share my experience in working with one such software package, namely PhotoScan, to record a Dutch shipwreck site. In order to demonstrate the method's reliability and flexibility, the site in question is reconstructed from simple GoPro footage, captured in low-visibility conditions. Based on the results of this case study, Computer Vision Photogrammetry compares very favourably to manual recording methods both in recording efficiency, and in the quality of the final results. In a final section, the significance of Computer Vision Photogrammetry is then assessed from a historical perspective, by placing the current research in the wider context of about half a century of successful use of Analytical and later Digital photogrammetry in the field of underwater archaeology. I conclude that while photogrammetry has been used in our discipline for several decades now, for various reasons the method was only ever used by a relatively small percentage of projects. This is likely to change in the near future since, compared to the `traditional' photogrammetry approaches employed in the past, today Computer Vision Photogrammetry is easier to use, more reliable and more affordable than ever before, while at the same time producing more accurate and more detailed three-dimensional results.

Predictors of favourable outcome in inflammatory Crohn's disease. A retrospective observational study.

PubMed

Zabana, Yamile; Garcia-Planella, Esther; van Domselaar, Manuel; Mañosa, Míriam; Gordillo, Jordi; López-Sanromán, Antonio; Cabré, Eduard; Domènech, Eugeni

2013-12-01

No studies have specifically searched for predictors of a favourable outcome that would allow a conservative therapeutic approach in adult Crohn's disease (CD). To identify predictors of a favourable disease course over time at CD diagnosis. We identified and included all patients diagnosed with CD between January 1994 and December 2003, who had CD with an inflammatory pattern and no perianal disease at diagnosis, and who were followed up for at least 5 years. Clinical and therapeutic features until December 2008 and losses to follow-up were identified. We defined a favourable outcome as the absence of stricturing and penetrating complications of the disease (including perianal disease), together with the absence of need for anti-TNF therapy or resectional surgery during follow up. One hundred and forty-five patients were included and followed up for a median of 96 months (IQR, 79-140). At diagnosis, location was ileal in 39%, colonic in 28%, and ileocolonic in 32%; 50% of the patients were active smokers, and 41% used immunomodulators. Eighty-two patients (57%) met the criteria for a favourable outcome at the end of follow-up. The only factor associated with a favourable outcome was isolated colonic involvement (P=0.022), with 73% of these patients meeting the criteria for a favourable outcome. A favourable outcome of initially uncomplicated CD is not easily predicted at disease diagnosis by means of clinical or epidemiologic factors. Nevertheless, patients with isolated colonic disease are less likely to have an aggressive course. Copyright © 2013 Elsevier España, S.L. and AEEH y AEG. All rights reserved.

Assessing medicare beneficiaries’ strength‐of‐preference scores for health care options: how engaging does the elicitation technique need to be?

PubMed Central

Crump, Trafford; Llewellyn‐Thomas, Hilary A.

2011-01-01

Abstract Objective  The objective was to determine if participants’ strength‐of‐preference scores for elective health care interventions at the end‐of‐life (EOL) elicited using a non‐engaging technique are affected by their prior use of an engaging elicitation technique. Design  Medicare beneficiaries were randomly selected from a larger survey sample. During a standardized interview, participants considered four scenarios involving a choice between a relatively less‐ or more‐intense EOL intervention. For each scenario, participants indicated their favoured intervention, then used a 7‐point Leaning Scale (LS1) to indicate how strongly they preferred their favoured intervention relative to the alternative. Next, participants engaged in a Threshold Technique (TT), which, depending on the participant’s initially favoured intervention, systematically altered a particular attribute of the scenario until the participant switched preferences. Finally, they repeated the LS (LS2) to indicate how strongly they preferred their initially‐favoured intervention. Results  Two hundred and two participants were interviewed (189–198 were included in this study). The concordance of individual participants’ LS1 and LS2 scores was assessed using Kendall tau‐b correlation coefficients; scores of 0.74, 0.84, 0.85 and 0.89 for scenarios 1–4, respectively, were observed. Conclusion  Kendall tau‐b statistics indicate a high concordance between LS scores, implying that the interposing engaging TT exercise had no significant effects on the LS2 strength‐of‐preference scores. Future investigators attempting to characterize the distributions of strength‐of‐preference scores for EOL care from a large, diverse community could use non‐engaging elicitation methods. The potential limitations of this study require that further investigation be conducted into this methodological issue. PMID:21323819

COX-2 overexpression in resected pancreatic head adenocarcinomas correlates with favourable prognosis

PubMed Central

2014-01-01

Background Overexpression of cyclooxygenase-2 (COX-2) has been implicated in oncogenesis and progression of adenocarcinomas of the pancreatic head. The data on the prognostic importance of COX expression in these tumours is inconsistent and conflicting. We evaluated how COX-2 overexpression affected overall postoperative survival in pancreatic head adenocarcinomas. Methods The study included 230 consecutive pancreatoduodenectomies for pancreatic cancer (PC, n = 92), ampullary cancer (AC, n = 62) and distal bile duct cancer (DBC, n = 76). COX-2 expression was assessed by immunohistochemistry. Associations between COX-2 expression and histopathologic variables including degree of differentiation, histopathologic type of differentiation (pancreatobiliary vs. intestinal) and lymph node ratio (LNR) were evaluated. Unadjusted and adjusted survival analysis was performed. Results COX-2 staining was positive in 71% of PC, 77% in AC and 72% in DBC. Irrespective of tumour origin, overall patient survival was more favourable in patients with COX-2 positive tumours than COX-2 negative (p = 0.043 in PC, p = 0.011 in AC, p = 0.06 in DBC). In tumours of pancreatobiliary type of histopathological differentiation, COX-2 expression did not significantly affect overall patient survival. In AC with intestinal differentiation COX-2 expression significantly predicted favourable survival (p = 0.003). In PC, COX-2 expression was significantly associated with high degree of differentiation (p = 0.002). COX-2 and LNR independently predicted good prognosis in a multivariate model. Conclusions COX-2 is overexpressed in pancreatic cancer, ampullary cancer and distal bile duct cancer and confers a survival benefit in all three cancer types. In pancreatic cancer, COX-2 overexpression is significantly associated with the degree of differentiation and independently predicts a favourable prognosis. PMID:24950702

Non anti-coagulant factors associated with filter life in continuous renal replacement therapy (CRRT): a systematic review and meta-analysis.

PubMed

Brain, Matthew; Winson, Elizabeth; Roodenburg, Owen; McNeil, John

2017-02-20

Optimising filter life and performance efficiency in continuous renal replacement therapy has been a focus of considerable recent research. Larger high quality studies have predominantly focussed on optimal anticoagulation however CRRT is complex and filter life is also affected by vascular access, circuit and management factors. We performed a systematic search of the literature to identify and quantify the effect of vascular access, circuit and patient factors that affect filter life and presented the results as a meta-analysis. A systematic review and meta-analysis was performed by searching Pubmed (MEDLINE) and Ovid EMBASE libraries from inception to 29 th February 2016 for all studies with a comparator or independent variable relating to CRRT circuits and reporting filter life. Included studies documented filter life in hours with a comparator other than anti-coagulation intervention. All studies comparing anticoagulation interventions were searched for regression or hazard models pertaining to other sources of variation in filter life. Eight hundred nineteen abstracts were identified of which 364 were selected for full text analysis. 24 presented data on patient modifiers of circuit life, 14 on vascular access modifiers and 34 on circuit related factors. Risk of bias was high and findings are hypothesis generating. Ranking of vascular access site by filter longevity favours: tunnelled semi-permanent catheters, femoral, internal jugular and subclavian last. There is inconsistency in the difference reported between femoral and jugular catheters. Amongst published literature, modality of CRRT consistently favoured continuous veno-venous haemodiafiltration (CVVHD-F) with an associated 44% lower failure rate compared to CVVH. There was a trend favouring higher blood flow rates. There is insufficient data to determine advantages of haemofilter membranes. Patient factors associated with a statistically significant worsening of filter life included mechanical ventilation, elevated SOFA or LOD score, elevations in ionized calcium, elevated platelet count, red cell transfusion, platelet factor 4 (PF-4) antibodies, and elevated fibrinogen. Majority of studies are observational or report circuit factors in sub-analysis. Risk of bias is high and findings require targeted investigations to confirm. The interaction of patient, pathology, anticoagulation, vascular access, circuit and staff factors contribute to CRRT filter life. There remains an ambiguity from published data as to which site and side should be the first choice for vascular access placement and what interaction this has with patient factors and timing. Early consideration of tunnelled semi-permanent access may provide optimal filter life if longer periods of CRRT are anticipated. There remains an absence of robust evidence outside of anti-coagulation strategies despite over 20 years of therapy delivery however trends favour CVVHD-F over CVVH.

Attitudes on cost-effectiveness and equity: a cross-sectional study examining the viewpoints of medical professionals

PubMed Central

Li, David G; Wong, Gordon X; Martin, David T; Tybor, David J; Kim, Jennifer; Lasker, Jeffrey; Mitty, Roger; Salem, Deeb

2017-01-01

Objective To determine the attitudes of physicians and trainees in regard to the roles of both cost-effectiveness and equity in clinical decision making. Design In this cross-sectional study, electronic surveys containing a hypothetical decision-making scenario were sent to medical professionals to select between two colon cancer screening tests for a population. Setting Three Greater Boston academic medical institutions: Tufts University School of Medicine, Tufts Medical Centre and Lahey Hospital and Medical Centre. Participants 819 medical students, 497 residents-in-training and 671 practising physicians were contacted electronically using institutional and organisational directories. Main outcome(s) and measure(s) Stratified opinions of medical providers and trainee subgroups regarding cost-effectiveness and equity. Results A total of 881 respondents comprising 512 medical students, 133 medical residents-in-training and 236 practising physicians completed the survey (total response rate 44.3%). Thirty-six per cent of medical students, 44% of residents-in-training and 53% of practising physicians favoured the less effective and more equitable screening test. Residents-in-training (OR 1.49, CI 1.01 to 2.21; p=0.044) and practising physicians (OR 2.12, CI 1.54 to 2.92; p<0.001) were more likely to favour the equitable option compared with medical students. Moreover, female responders across all three cohorts favoured the more equitable screening test to a greater degree than did male responders (OR 1.70, CI 1.29 to 2.24; p<0.001). Conclusions Cost-effectiveness analysis does not accurately reflect the importance that medical professionals place on equity. Among medical professionals, practising physicians appear to be more egalitarian than residents-in-training, while medical students appear to be most utilitarian and cost-effective. Meanwhile, female respondents in all three cohorts favoured the more equitable option to a greater degree than their male counterparts. Healthcare policies that trade off equity in favour of cost-effectiveness may be unacceptable to many medical professionals, especially practising physicians and women. PMID:28765138

[On bacterial aftergrowth in drinking and industrial water. II. Apparative and processing influence upon the growth and the possibility of disinfection of ion exchange resin filter systems (author's transl)].

PubMed

Schubert, R H

1975-12-01

The comparative examination of numerous ion exchange resin filter systems for discontinuous water softening on the market revealed that apparative and processing characteristics are of great influence upon the aftergrowth of bacteria in the water of ion exchange resin systems. Within the examination it was taken into consideration that on the end-delivery-tube of the water pipe with regard to the colony count the conditions were more unfavourable during the long standstill over a weekend (table 1) than during the week (table2). The less favourable conditions have therefore been examined separately. The work has been divided in six test series. In the first one 5 ion exchange resin systems the types A-E are simultaneously tested with regard to the colony count in the water at the inflow to the apparatus and after the passage of it; regeneration twice a week with sodium chloride. The data ascertained in the course of several weeks (without first data on mondays) and the separated mondays data are examined according to logarithmic transformation with the assistance of variance analysis and the Newman Keuls-test for differences. The results show (tab. 4 and 5) that apparative parameters and such relevant to the technical process (tab. 3) have an influence upon the bacterial after growth of the water. The most favourable ion exchange resin filter is type E because it shows more favourable values than all other systems and the tapwater. In the second test serie the systems A-E have been regenerated with 1% Chloramin T containing sodium chloride. The results show again the type E as the statistically significant most favourable system in comparison with the others and the tapwater. In the third test serie it has been examined whether the long period of standstill of the brine in the resin bed which has probably been responsible for the good results of the type E would lead to values just as favourable if transferred to another type of apparatus. ...

Attitudes on cost-effectiveness and equity: a cross-sectional study examining the viewpoints of medical professionals.

PubMed

Li, David G; Wong, Gordon X; Martin, David T; Tybor, David J; Kim, Jennifer; Lasker, Jeffrey; Mitty, Roger; Salem, Deeb

2017-08-01

To determine the attitudes of physicians and trainees in regard to the roles of both cost-effectiveness and equity in clinical decision making. In this cross-sectional study, electronic surveys containing a hypothetical decision-making scenario were sent to medical professionals to select between two colon cancer screening tests for a population. Three Greater Boston academic medical institutions: Tufts University School of Medicine, Tufts Medical Centre and Lahey Hospital and Medical Centre. 819 medical students, 497 residents-in-training and 671 practising physicians were contacted electronically using institutional and organisational directories. Stratified opinions of medical providers and trainee subgroups regarding cost-effectiveness and equity. A total of 881 respondents comprising 512 medical students, 133 medical residents-in-training and 236 practising physicians completed the survey (total response rate 44.3%). Thirty-six per cent of medical students, 44% of residents-in-training and 53% of practising physicians favoured the less effective and more equitable screening test. Residents-in-training (OR 1.49, CI 1.01 to 2.21; p=0.044) and practising physicians (OR 2.12, CI 1.54 to 2.92; p<0.001) were more likely to favour the equitable option compared with medical students. Moreover, female responders across all three cohorts favoured the more equitable screening test to a greater degree than did male responders (OR 1.70, CI 1.29 to 2.24; p<0.001). Cost-effectiveness analysis does not accurately reflect the importance that medical professionals place on equity. Among medical professionals, practising physicians appear to be more egalitarian than residents-in-training, while medical students appear to be most utilitarian and cost-effective. Meanwhile, female respondents in all three cohorts favoured the more equitable option to a greater degree than their male counterparts. Healthcare policies that trade off equity in favour of cost-effectiveness may be unacceptable to many medical professionals, especially practising physicians and women. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Individual and culture-level components of survey response styles: A multi-level analysis using cultural models of selfhood.

PubMed

Smith, Peter B; Vignoles, Vivian L; Becker, Maja; Owe, Ellinor; Easterbrook, Matthew J; Brown, Rupert; Bourguignon, David; Garðarsdóttir, Ragna B; Kreuzbauer, Robert; Cendales Ayala, Boris; Yuki, Masaki; Zhang, Jianxin; Lv, Shaobo; Chobthamkit, Phatthanakit; Jaafar, Jas Laile; Fischer, Ronald; Milfont, Taciano L; Gavreliuc, Alin; Baguma, Peter; Bond, Michael Harris; Martin, Mariana; Gausel, Nicolay; Schwartz, Seth J; Des Rosiers, Sabrina E; Tatarko, Alexander; González, Roberto; Didier, Nicolas; Carrasco, Diego; Lay, Siugmin; Nizharadze, George; Torres, Ana; Camino, Leoncio; Abuhamdeh, Sami; Macapagal, Ma Elizabeth J; Koller, Silvia H; Herman, Ginette; Courtois, Marie; Fritsche, Immo; Espinosa, Agustín; Villamar, Juan A; Regalia, Camillo; Manzi, Claudia; Brambilla, Maria; Zinkeng, Martina; Jalal, Baland; Kusdil, Ersin; Amponsah, Benjamin; Çağlar, Selinay; Mekonnen, Kassahun Habtamu; Möller, Bettina; Zhang, Xiao; Schweiger Gallo, Inge; Prieto Gil, Paula; Lorente Clemares, Raquel; Campara, Gabriella; Aldhafri, Said; Fülöp, Márta; Pyszczynski, Tom; Kesebir, Pelin; Harb, Charles

2016-12-01

Variations in acquiescence and extremity pose substantial threats to the validity of cross-cultural research that relies on survey methods. Individual and cultural correlates of response styles when using 2 contrasting types of response mode were investigated, drawing on data from 55 cultural groups across 33 nations. Using 7 dimensions of self-other relatedness that have often been confounded within the broader distinction between independence and interdependence, our analysis yields more specific understandings of both individual- and culture-level variations in response style. When using a Likert-scale response format, acquiescence is strongest among individuals seeing themselves as similar to others, and where cultural models of selfhood favour harmony, similarity with others and receptiveness to influence. However, when using Schwartz's (2007) portrait-comparison response procedure, acquiescence is strongest among individuals seeing themselves as self-reliant but also connected to others, and where cultural models of selfhood favour self-reliance and self-consistency. Extreme responding varies less between the two types of response modes, and is most prevalent among individuals seeing themselves as self-reliant, and in cultures favouring self-reliance. As both types of response mode elicit distinctive styles of response, it remains important to estimate and control for style effects to ensure valid comparisons. © 2016 International Union of Psychological Science.

[Rage against the machine -- necessity of robotic assisted prostatectomy].

PubMed

Friedrich, M; Steiner, T; Popken, G

2013-03-01

During the last decade urologists have faced a dramatic increase in robotic surgery. Despite the exceptional acceptance of this technique there is a complete lack of evidence for the equi-efficacy or superiority of this technique compared to open or laparoscopic prostatectomy. There is now an increasing body of evidence for the evaluation of robotic assisted prostatectomy. Robotic assisted prostatectomy is a safe procedure. The rate of technical failure is small. The rate of surgical complications is comparable with that of open or conventional laparoscopic prostatectomy. Similar to the conventional laparoscopic prostatectomy there is a trend for a minor blood loss and a smaller transfusion rate compared to the retropubic approach. In recent meta-analyses there is no advatage regarding the oncological or functional outcome for robotic prostatectomy. Neither the rate of positive surgical margins nor the rate of biochemical recurrence favours robotic prostatectomy. Regarding functional outcome some publications describe better results for urinary and sexual function for robotic surgery. Careful evaluation of these data reveals a low level of evidence due to a strong bias in favour of robotic surgery. In contrast, recent analysis of "Medicare" data reveal a considerable poorer urinary function after robotic prostatectomy compared to open retropubic prostatectomy. The Urological Board of the Helios Hospital Group does not recommend the use of a robotic device for radical prostatectomy. © Georg Thieme Verlag KG Stuttgart · New York.

[Access to government-funded psychotherapy: Comparing the point of view of psychologists and psychotherapists].

PubMed

Bradley, Stacy; Doucet, Rachelle; Kohler, Erich; Drapeau, Martin

Objectives Within the Quebec context, as well as the larger Canadian and International context, increasing access to mental health care treatment has become a major health care priority (see Peachey, Hicks, & Adams, 2013). Initiatives to increase access through government-funded psychotherapy have been successfully implemented in Australia and the United Kingdom. The current study sought to document how licensed psychologists and psychotherapists in Quebec differ in their attitudes about the components of these government-funded psychotherapy programs and increasing access to psychotherapy treatment.Methods The target population for the study included both psychologists and psychotherapists whom were licensed to practice psychotherapy with the Ordre of Psychologists of Quebec. Participants (N = 1 275) were recruited by email to participate in an online questionnaire focusing on components such as the services that should be offered in a new government-funded psychotherapy model (eg., individual therapy, family therapy; including employment and debt counselling), the choice and autonomy clinicians have in their treatment interventions, the role of the referring General Practitioner (GP), the fees per psychotherapy hour, the hiring structure (e.g., in the public sector versus reimbursing private psychotherapy services), among others.Results The results indicated that psychotherapists were more in favour of including family and couple therapy, and employment/vocational counselling than psychologists. Psychologists were more in favour of using evidence-based practices as well as tracking treatment outcomes using validated measures, and publishing treatment satisfaction ratings to the public. Psychotherapists were more in favour of being paid on a session-to-session basis as opposed to be being hired on a salaried basis to offer government-funded psychotherapy.Conclusions Given that psychologists and psychotherapists differ in their training background and have historically played different roles in the health care system, it is important to understand how they differ in their perspectives on accessibility to psychotherapy. The implications for implementing government-funded psychotherapy initiatives in Quebec given the different professional perspectives of the two groups are discussed.

Overexpression of SERBP1 (Plasminogen activator inhibitor 1 RNA binding protein) in human breast cancer is correlated with favourable prognosis

PubMed Central

2012-01-01

Background Plasminogen activator inhibitor 1 (PAI-1) overexpression is an important prognostic and predictive biomarker in human breast cancer. SERBP1, a protein that is supposed to regulate the stability of PAI-1 mRNA, may play a role in gynaecological cancers as well, since upregulation of SERBP1 was described in ovarian cancer recently. This is the first study to present a systematic characterisation of SERBP1 expression in human breast cancer and normal breast tissue at both the mRNA and the protein level. Methods Using semiquantitative realtime PCR we analysed SERBP1 expression in different normal human tissues (n = 25), and in matched pairs of normal (n = 7) and cancerous breast tissues (n = 7). SERBP1 protein expression was analysed in two independent cohorts on tissue microarrays (TMAs), an initial evaluation set, consisting of 193 breast carcinomas and 48 normal breast tissues, and a second large validation set, consisting of 605 breast carcinomas. In addition, a collection of benign (n = 2) and malignant (n = 6) mammary cell lines as well as breast carcinoma lysates (n = 16) were investigated for SERBP1 expression by Western blot analysis. Furthermore, applying non-radioisotopic in situ hybridisation a subset of normal (n = 10) and cancerous (n = 10) breast tissue specimens from the initial TMA were analysed for SERBP1 mRNA expression. Results SERBP1 is not differentially expressed in breast carcinoma compared to normal breast tissue, both at the RNA and protein level. However, recurrence-free survival analysis showed a significant correlation (P = 0.008) between abundant SERBP1 expression in breast carcinoma and favourable prognosis. Interestingly, overall survival analysis also displayed a tendency (P = 0.09) towards favourable prognosis when SERBP1 was overexpressed in breast cancer. Conclusions The RNA-binding protein SERBP1 is abundantly expressed in human breast cancer and may represent a novel breast tumour marker with prognostic significance. Its potential involvement in the plasminogen activator protease cascade warrants further investigation. PMID:23236990

Omission of dacarbazine or bleomycin, or both, from the ABVD regimen in treatment of early-stage favourable Hodgkin's lymphoma (GHSG HD13): an open-label, randomised, non-inferiority trial.

PubMed

Behringer, Karolin; Goergen, Helen; Hitz, Felicitas; Zijlstra, Josée M; Greil, Richard; Markova, Jana; Sasse, Stephanie; Fuchs, Michael; Topp, Max S; Soekler, Martin; Mathas, Stephan; Meissner, Julia; Wilhelm, Martin; Koch, Peter; Lindemann, Hans-Walter; Schalk, Enrico; Semrau, Robert; Kriz, Jan; Vieler, Tom; Bentz, Martin; Lange, Elisabeth; Mahlberg, Rolf; Hassler, Andre; Vogelhuber, Martin; Hahn, Dennis; Mezger, Jörg; Krause, Stefan W; Skoetz, Nicole; Böll, Boris; von Tresckow, Bastian; Diehl, Volker; Hallek, Michael; Borchmann, Peter; Stein, Harald; Eich, Hans; Engert, Andreas

2015-04-11

The role of bleomycin and dacarbazine in the ABVD regimen (ie, doxorubicin, bleomycin, vinblastine, and dacarbazine) has been questioned, especially for treatment of early-stage favourable Hodgkin's lymphoma, because of the drugs' toxicity. We aimed to investigate whether omission of either bleomycin or dacarbazine, or both, from ABVD reduced the efficacy of this regimen in treatment of Hodgkin's lymphoma. In this open-label, randomised, multicentre trial (HD13) we compared two cycles of ABVD with two cycles of the reduced-intensity regimen variants ABV (doxorubicin, bleomycin, and vinblastine), AVD (doxorubicin, vinblastine, and dacarbazine), and AV (doxorubicin and vinblastine), in patients with newly diagnosed, histologically proven, classic or nodular, lymphocyte predominant Hodgkin's lymphoma. In each treatment group, 30 Gy involved-field radiotherapy (IFRT) was given after both cycles of chemotherapy were completed. From Jan 28, 2003, patients were centrally randomly assigned (1:1:1:1) with a minimisation method to the four groups. Because of high event rates, assignment to the AV and ABV groups stopped early, on Sept 30, 2005, and Feb 10, 2006; assignment to ABVD and AVD continued (1:1) until Sept 30, 2009. Our primary objective was to show non-inferiority of the experimental variants compared with ABVD in terms of freedom from treatment failure (FFTF), by excluding a difference of 6% after 5 years corresponding to a hazard ratio (HR) of 1.72, via a 95% CI. Analyses reported here include qualified patients only, and between-group comparisons include only patients recruited during the same period. The trial was registered, number ISRCTN63474366. Of 1502 qualified patients, 566, 198, 571, and 167 were randomly assigned to receive ABVD, ABV, AVD, or AV, respectively. 5 year FFTF was 93.1%, 81.4%, 89.2%, and 77.1% with ABVD, ABV, AVD, and AV, respectively. Compared with ABVD, inferiority of the dacarbazine-deleted variants was detected with 5 year differences of -11.5% (95% CI -18.3 to -4.7; HR 2.06 [1.21 to 3.52]) for ABV and -15.2% (-23.0 to -7.4; HR 2.57 [1.51 to 4.40]) for AV. Non-inferiority of AVD compared with ABVD could also not be detected (5 year difference -3.9%, -7.7 to -0·1; HR 1.50, 1.00 to 2.26). 178 (33%) of 544 patients given ABVD had WHO grade III or IV toxicity, compared with 53 (28%) of 187 given ABV, 142 (26%) of 539 given AVD, and 40 (26%) of 151 given AV. Leucopenia was the most common event, and highest in the groups given bleomycin. Dacarbazine cannot be omitted from ABVD without a substantial loss of efficacy. With respect to our predefined non-inferiority margin, bleomycin cannot be safely omitted either, and the standard of care for patients with early-stage favourable Hodgkin's lymphoma should remain ABVD followed by IFRT. Deutsche Krebshilfe and Swiss State Secretariat for Education and Research. Copyright © 2015 Elsevier Ltd. All rights reserved.

Chemotherapy versus supportive care alone in pediatric palliative care for cancer: comparing the preferences of parents and health care professionals.

PubMed

Tomlinson, Deborah; Bartels, Ute; Gammon, Janet; Hinds, Pamela S; Volpe, Jocelyne; Bouffet, Eric; Regier, Dean A; Baruchel, Sylvain; Greenberg, Mark; Barrera, Maru; Llewellyn-Thomas, Hilary; Sung, Lillian

2011-11-22

The choice between palliative chemotherapy (defined as the use of cytotoxic medications delivered intravenously for the purpose of our study) and supportive care alone is one of the most difficult decisions in pediatric oncology, yet little is known about the preferences of parents and health care professionals. We compared the strength of these preferences by considering children's quality of life and survival time as key attributes. In addition, we identified factors associated with the reported preferences. We included parents of children whose cancer had no reasonable chance of being cured and health care professionals in pediatric oncology as participants in our study. We administered separate interviews to parents and to health care professionals. Visual analogue scales were shown to respondents to illustrate the anticipated level of the child's quality of life, the expected duration of survival and the probability of cure (shown only to health care professionals). Respondents were then asked which treatment option they would favour given these baseline attributes. In addition, respondents reported what factors might affect such a decision and ranked all factors identified in order of importance. The primary measure was the desirability score for supportive care alone relative to palliative chemotherapy, as obtained using the threshold technique. A total of 77 parents and 128 health care professionals participated in our study. Important factors influencing the decision between therapeutic options were child quality-of-life and survival time among both parents and health care professionals. Hope was particularly important to parents. Parents significantly favoured chemotherapy (42/77, 54.5%) compared with health care professionals (20/128, 15.6%; p < 0.0001). The opinions of the physician and child significantly influenced the parents' desire for supportive care; for health care professionals, the opinions of parents and children were significant factors influencing this decision. Compared with health care professionals, parents more strongly favour aggressive treatment in the palliative phase and rank hope as a more important factor for making decisions about treatment. Understanding the differences between parents and health care professionals in the relative desirability of supportive care alone may aid in communication and improve end-of-life care for children with cancer.

Computational insights into crystal plane dependence of thermal activity of anion (C and N)-substituted titania.

PubMed

V, Sai Phani Kumar; Arya, Rahul; Deshpande, Parag A

2017-11-29

Geometry optimizations of anion (C and N) doped anatase TiO 2 were carried out by using DFT+U calculations. Various anion vacancy sites were examined to study the synergistic effects of anion doping accompanied with anion vacancy formation on lattice oxygen activation. Two non-identical crystal planes (0 0 1) and (1 0 0) were chosen for C and N substitutions. Energetically favoured N-vacancy pairs were identified on TiO 2 surfaces. Substitution of N along with anion vacancies at various sites was energetically more favoured than that of C-doping in bulk TiO 2 while the energies were comparable for surface substitutions. Bond length distributions due to the formation of differential bonds were determined. Net oxygen activation and accompanying reversible oxygen exchange capacities were compared for TiO 2-2x C x and TiO 2-3x N 2x . Substitution of C in the surface exposed (1 0 0) plane of TiO 2 resulted in 47.6% and 23.8% of bond elongation and compression, respectively, resulting in 23.8% of net oxygen activation which was higher when compared to N substitution in the (1 0 0) plane of TiO 2 resulting in a net oxygen activation of 17%.

Comparing regional precipitation and temperature extremes in climate model and reanalysis products

DOE PAGES

Angélil, Oliver; Perkins-Kirkpatrick, Sarah; Alexander, Lisa V.; ...

2016-07-12

A growing field of research aims to characterise the contribution of anthropogenic emissions to the likelihood of extreme weather and climate events. These analyses can be sensitive to the shapes of the tails of simulated distributions. If tails are found to be unrealistically short or long, the anthropogenic signal emerges more or less clearly, respectively, from the noise of possible weather. Here we compare the chance of daily land-surface precipitation and near-surface temperature extremes generated by three Atmospheric Global Climate Models typically used for event attribution, with distributions from six reanalysis products. The likelihoods of extremes are compared for area-averagesmore » over grid cell and regional sized spatial domains. Results suggest a bias favouring overly strong attribution estimates for hot and cold events over many regions of Africa and Australia, and a bias favouring overly weak attribution estimates over regions of North America and Asia. For rainfall, results are more sensitive to geographic location. Although the three models show similar results over many regions, they do disagree over others. Equally, results highlight the discrepancy amongst reanalyses products. This emphasises the importance of using multiple reanalysis and/or observation products, as well as multiple models in event attribution studies.« less

A Pilot Study of Women’s Affective Responses to Common and Uncommon Forms of Aerobic Exercise

PubMed Central

Stevens, Courtney J.; Smith, Jane Ellen; Bryan, Angela D.

2015-01-01

Objective To test the extent to which participants exposed to an uncommon versus common exercise stimulus would result in more favourable affect at post task. Design Experimental design. Participants, (N = 120) American women aged 18–45 years, were randomly assigned to complete 30-minutes of either the uncommon (HOOP; n = 58) or common (WALK; n = 62) exercise stimulus. Main Outcome Measures Self-reported affect and intentions for future exercise were measured before and after the 30-minute exercise bout. Results Analyses of covariance (ANCOVA) were run to compare post-task affect across the HOOP and WALK conditions. At post-task, participants assigned to HOOP reported more positively valenced affect, higher ratings of positive activated affect, lower ratings of negative deactivated affect, and stronger intentions for future aerobic exercise compared to participants assigned to WALK. Conclusions Participants who completed an uncommon bout of aerobic exercise (HOOP) reported more favourable affect post-exercise, as well as stronger intentions for future exercise, compared to participants who completed a common bout of aerobic exercise (WALK). Future work using a longitudinal design is needed to understand the relationships between familiarity with an exercise stimulus, affective responses to exercise, motivation for future exercise behaviour, and exercise maintenance over time. PMID:26394246

Selective organ specific inflammation in offspring harbouring microchimerism from strongly alloreactive mothers.

PubMed

Leveque, Lucie; Hodgson, Samantha; Peyton, Stephen; Koyama, Motoko; MacDonald, Kelli P A; Khosrotehrani, Kiarash

2014-05-01

The origins of autoimmunity are not yet understood despite significant advances in immunology. The trafficking of maternal cells to the offspring represents the very first immunological event in foetal life and is reinforced during lactation. The persistence of maternal cells in offspring's tissues and circulation has been associated with several autoimmune disorders. However a direct causal effect has never been demonstrated. Maternal T cells specifically targeting foetal insulin producing cells have been shown to generate islet inflammation without directly participating in this process. Our objective was to evaluate if alloreactive maternal cells could directly trigger a graft-versus host like reaction or indirectly influence the development of the offspring's regulatory T cells favouring autoimmunity. We adopted a breeding strategy comparing genetically identical offspring from either strongly alloreactive transgenic mothers compared to immunodeficient mothers. We detected maternal alloreactive T cells in the offspring and early signs of inflammation in small intestine of 6 weeks old offspring. Interestingly, CD4(+) Foxp3(+) regulatory T cell frequency was diminished in mesenteric lymph nodes from eight months old offspring born of alloreactive mothers compared to offspring of immunodeficient mothers. Our study favours a hypothesis where highly alloreactive maternal cell microchimerism indirectly predisposes offspring to autoimmunity. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Epirubicin versus mitoxantrone in combination chemotherapy for metastatic breast cancer.

PubMed

Pavesi, L; Preti, P; Da Prada, G; Pedrazzoli, P; Poggi, G; Robustelli della Cuna, G

1995-01-01

As valid therapeutic alternatives to adriamycin, with a more favourable safety profile, epirubicin (E) and novantrone (N) were compared in combination with fluorouracil (F) and cyclophosphamide (C) in a prospective randomized clinical trial as first-line treatment for metastatic breast cancer (mbc). 158 women with mbc were randomly allocated to receive FEC or FNC regimen; the dosage in mg/m2 was as follows: 500 for C and F, 75 for E and 10 for N. All drugs were administered iv. on day 1 and recycled on day 21. In 141 evaluable patients the response rate (CR+PR) was better in the FEC (43.6%) than in the FNC regimen (30.3%) (95% C.I. of 32% to 55% versus 14% to 34%), without any statistically significant difference. Differences in response rate were significantly in favour of FEC group in previously untreated patients (57.6% versus 25%, p = .02), and in postmenopausal women (46.1% versus 23.6%, p = .01). No significant differences between the two treatment arms were observed in terms of either time to progression or duration of response and survival. The most important dose-limiting toxicity was hematological (leuko-and thrombocytopenia were significantly higher in FNC-treated patients). This difference in hematological toxicity sustained a significantly different incidence of delays in administering chemotherapy courses, which precluded the administration of comparable doses of all drugs in both groups. The incidence of complete alopecia was significantly higher in FEC-treated patients, while no clinical or instrumental evidence of CHF was observed with either regimen. Due to its more favourable therapeutic profile, the E-containing regimen seems a suitable first-line treatment for previously untreated patients with mbc, while the FNC combination should be offered to women refusing hair loss.

Physical restraint: perceptions of nurse managers, registered nurses and healthcare assistants.

PubMed

Leahy-Warren, P; Varghese, V; Day, M R; Curtin, M

2018-02-09

To examine the perceptions of nurse managers, registered nurses and healthcare assistants of physical restraint use on older people in a long-term care setting in the Republic of Ireland. The use of physical restraint, although controversial, persists in long-term care settings, despite recommendations for restraint-free environments. Perception and attitude of staff can influence use of physical restraint. A descriptive cross-sectional design was used. A total of 250 nursing and healthcare assistant staff were recruited. A questionnaire incorporating demographics and the Perceptions of Restraint Use Questionnaire was used. Descriptive and inferential statistical analyses were conducted. Mean age of respondents (n = 156) was 41 years, and the majority were female. Overall, a low level of importance was attached to the use of restraint. Nurse managers and registered nurses compared favourably with healthcare assistants who attached a higher importance to use of restraint. Across all three staff groups, greatest importance was attached to the use of physical restraint for reducing falls, followed by prevention of treatment interference. Restraint was least favoured as a means of impairment management. Education was not an explanatory factor in perceived importance of physical restraint use. Nurse managers and registered nurses are unlikely to use physical restraint. However, there is concern regarding perception of healthcare assistants on use of restraint. Results from this study compare favourably with those in countries that have no policy on physical restraint use. Educational programmes alone are insufficient to address use of physical restraint. Attention to skill mix with adequate support for healthcare assistants in long-term care settings is recommended. © 2018 International Council of Nurses.

Vemurafenib in BRAF-mutant metastatic melanoma patients in real-world clinical practice: prognostic factors associated with clinical outcomes.

PubMed

Schouwenburg, Maartje G; Jochems, Anouk; Leeneman, Brenda; Franken, Margreet G; van den Eertwegh, Alfons J M; Haanen, John B A G; van Zeijl, Michiel C T; Aarts, Maureen J; van Akkooi, Alexander C J; van den Berkmortel, Franchette W P J; Blokx, Willeke A M; de Groot, Jan Willem B; Hospers, Geke A P; Kapiteijn, Ellen; Koornstra, Rutger H; Kruit, Wim H; Louwman, Marieke W J; Piersma, Djura; van Rijn, Rozemarijn S; Suijkerbuijk, Karijn P M; Ten Tije, Albert J; Vreugdenhil, Gerard; Wouters, Michel W J M; van der Hoeven, Jacobus J M

2018-08-01

The aim of this population-based study was to identify the factors associated with clinical outcomes in vemurafenib-treated patients and to evaluate outcomes across subgroups of patients with different risk profiles. Data were retrieved from the Dutch Melanoma Treatment Registry. Time to next treatment (TTNT) and overall survival (OS) of all metastatic melanoma patients who received vemurafenib between 2012 and 2015 were assessed using Kaplan-Meier estimates. A risk score was developed on the basis of all prognostic factors associated with TTNT and OS derived from multivariable Cox regression analyses. Patients were stratified according to the presence of prognostic risk factors by counting the number of factors, ranging from 0 to 6. A total of 626 patients received vemurafenib with a median follow-up of 35.8 months. The median TTNT and OS were 4.7 months [95% confidence intervals (CI): 4.4-5.1] and 7.3 months (95% CI: 6.6-8.0). The strongest prognostic factors were serum lactate dehydrogenase (LDH) level, Eastern Cooperative Oncology Group performance score, number of organ sites involved and brain metastases. Patients with a favourable risk profile (no risk factors) had a median TTNT and OS of 7.1 (95% CI: 5.8-8.5) and 15.4 months (95% CI: 10.0-20.9). The median OS more than halved for patients with greater than or equal to 2 risk factors compared with patients with no risk factors. The clinical outcomes of vemurafenib in metastatic melanoma patients with a favourable risk profile are comparable with the results of the trials. Combining prognostic factors into a risk score could be valuable to stratify patients into favourable and poor-prognosis groups.

Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases.

PubMed

Tsao, May N; Xu, Wei; Wong, Rebecca Ks; Lloyd, Nancy; Laperriere, Normand; Sahgal, Arjun; Rakovitch, Eileen; Chow, Edward

2018-01-25

This is an update to the review published in the Cochrane Library (2012, Issue 4).It is estimated that 20% to 40% of people with cancer will develop brain metastases during the course of their illness. The burden of brain metastases impacts quality and length of survival. To assess the effectiveness and adverse effects of whole brain radiotherapy (WBRT) given alone or in combination with other therapies to adults with newly diagnosed multiple brain metastases. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Embase to May 2017 and the National Cancer Institute Physicians Data Query for ongoing trials. We included phase III randomised controlled trials (RCTs) comparing WBRT versus other treatments for adults with newly diagnosed multiple brain metastases. Two review authors independently assessed trial quality and abstracted information in accordance with Cochrane methods. We added 10 RCTs to this updated review. The review now includes 54 published trials (45 fully published reports, four abstracts, and five subsets of data from previously published RCTs) involving 11,898 participants.Lower biological WBRT doses versus controlThe hazard ratio (HR) for overall survival (OS) with lower biological WBRT doses as compared with control (3000 cGy in 10 daily fractions) was 1.21 (95% confidence interval (CI) 1.04 to 1.40; P = 0.01; moderate-certainty evidence) in favour of control. The HR for neurological function improvement (NFI) was 1.74 (95% CI 1.06 to 2.84; P = 0.03; moderate-certainty evidence) in favour of control fractionation.Higher biological WBRT doses versus controlThe HR for OS with higher biological WBRT doses as compared with control (3000 cGy in 10 daily fractions) was 0.97 (95% CI 0.83 to 1.12; P = 0.65; moderate-certainty evidence). The HR for NFI was 1.14 (95% CI 0.92 to 1.42; P = 0.23; moderate-certainty evidence).WBRT and radiosensitisersThe addition of radiosensitisers to WBRT did not confer additional benefit for OS (HR 1.05, 95% CI 0.99 to 1.12; P = 0.12; moderate-certainty evidence) or for brain tumour response rates (odds ratio (OR) 0.84, 95% CI 0.63 to 1.11; P = 0.22; high-certainty evidence).Radiosurgery and WBRT versus WBRT aloneThe HR for OS with use of WBRT and radiosurgery boost as compared with WBRT alone for selected participants was 0.61 (95% CI 0.27 to 1.39; P = 0.24; moderate-certainty evidence). For overall brain control at one year, the HR was 0.39 (95% CI 0.25 to 0.60; P < 0.0001; high-certainty evidence) favouring the WBRT and radiosurgery boost group.Radiosurgery alone versus radiosurgery and WBRTThe HR for local brain control was 2.73 (95% CI 1.87 to 3.99; P < 0.00001; high-certainty evidence)favouring the addition of WBRT to radiosurgery. The HR for distant brain control was 2.34 (95% CI 1.73 to 3.18; P < 0.00001; high-certainty evidence) favouring WBRT and radiosurgery. The HR for OS was 1.00 (95% CI 0.80 to 1.25; P = 0.99; moderate-certainty evidence). Two trials reported worse neurocognitive outcomes and one trial reported worse quality of life outcomes when WBRT was added to radiosurgery.We could not pool data from trials related to chemotherapy, optimal supportive care (OSC), molecular targeted agents, neurocognitive protective agents, and hippocampal sparing WBRT. However, one trial reported no differences in quality-adjusted life-years for selected participants with brain metastases from non-small-cell lung cancer randomised to OSC and WBRT versus OSC alone. None of the trials with altered higher biological WBRT dose-fractionation schemes reported benefit for OS, NFI, or symptom control compared with standard care. However, OS and NFI were worse for lower biological WBRT dose-fractionation schemes than for standard dose schedules.The addition of WBRT to radiosurgery improved local and distant brain control in selected people with brain metastases, but data show worse neurocognitive outcomes and no differences in OS.Selected people with multiple brain metastases from non-small-cell lung cancer may show no difference in OS when OSC is given and WBRT is omitted.Use of radiosensitisers, chemotherapy, or molecular targeted agents in conjunction with WBRT remains experimental.Further trials are needed to evaluate the use of neurocognitive protective agents and hippocampal sparing with WBRT. As well, future trials should examine homogeneous participants with brain metastases with focus on prognostic features and molecular markers.

An efficient probe of the cosmological CPT violation

NASA Astrophysics Data System (ADS)

Zhao, Gong-Bo; Wang, Yuting; Xia, Jun-Qing; Li, Mingzhe; Zhang, Xinmin

2015-07-01

We develop an efficient method based on the linear regression algorithm to probe the cosmological CPT violation using the CMB polarisation data. We validate this method using simulated CMB data and apply it to recent CMB observations. We find that a combined data sample of BICEP1 and BOOMERanG 2003 favours a nonzero isotropic rotation angle at 2.3σ confidence level, i.e., bar alpha=-3.3o±1.4o (68% CL) with systematics included.

Spectrophotometric Methods for Simultaneous Determination of Oxytetracycline HCl and Flunixin Meglumine in Their Veterinary Pharmaceutical Formulation.

PubMed

Merey, Hanan A; Abd-Elmonem, Mahmmoud S; Nazlawy, Hagar N; Zaazaa, Hala E

2017-01-01

Four precise, accurate, selective, and sensitive UV-spectrophotometric methods were developed and validated for the simultaneous determination of a binary mixture of Oxytetracycline HCl (OXY) and Flunixin Meglumine (FLU). The first method, dual wavelength (DW), depends on measuring the difference in absorbance (ΔA 273.4-327 nm) for the determination of OXY where FLU is zero while FLU is determined at ΔA 251.7-275.7 nm. The second method, first-derivative spectrophotometric method (1D), depends on measuring the peak amplitude of the first derivative selectively at 377 and 266.7 nm for the determination of OXY and FLU, respectively. The third method, ratio difference method, depends on the difference in amplitudes of the ratio spectra at ΔP 286.5-324.8 nm and ΔP 249.6-286.3 nm for the determination of OXY and FLU, respectively. The fourth method, first derivative of ratio spectra method (1DD), depends on measuring the amplitude peak to peak of the first derivative of ratio spectra at 296.7 to 369 nm and 259.1 to 304.7 nm for the determination of OXY and FLU, respectively. Different factors affecting the applied spectrophotometric methods were studied. The proposed methods were validated according to ICH guidelines. Satisfactory results were obtained for determination of both drugs in laboratory prepared mixture and pharmaceutical dosage form. The developed methods are compared favourably with the official ones.

Working Successfully towards Inclusion--or Excluding Pupils? A Comparative Retroductive Study of Three Similar Schools in Their Work with EBD

ERIC Educational Resources Information Center

Malmqvist, Johan

2016-01-01

Sweden uses municipally run pupil referral units (PRUs) for students displaying emotional behavioural difficulties (EBD). This study investigates one Swedish municipality where transfers of students to PRUs were related to school practices favouring either inclusion or exclusion. A purposeful sampling procedure was used to select three elementary…

Gender and Performance in Accounting Examinations: Exploring the Impact of Examination Format

ERIC Educational Resources Information Center

Arthur, Neal; Everaert, Patricia

2012-01-01

This paper addresses the question of whether the increasing use of multiple-choice questions will favour particular student groups, i.e. male or female students. Using data from Belgium, this paper empirically examines the existence of a gender effect by comparing the relative performance of male and female students in both multiple-choice and…

"Passing It On": Beyond Formal or Informal Pedagogies

ERIC Educational Resources Information Center

Cain, Tim

2013-01-01

Informal pedagogies are a subject of debate in music education, and there is some evidence of teachers abandoning formal pedagogies in favour of informal ones. This article presents a case of one teacher's formal pedagogy and theorises it by comparing it with a case of informal pedagogy. The comparison reveals affordances of formal pedagogies…

Web-Based Student Feedback: Comparing Teaching-Award and Research-Award Recipients

ERIC Educational Resources Information Center

Symbaluk, Diane G.; Howell, Andrew J.

2010-01-01

We examined web-based ratings and open-ended comments of teaching-award winners (n = 120) and research-award winners (n = 119) to determine if teaching-award winners received more favourable ratings and comments on RateMyProfessors.com. As predicted, students rated teaching-award winners higher than research-award winners on measures of teaching…

Why wait? Three mechanisms selecting for environment-dependent developmental delays.

PubMed

Scott, M F; Otto, S P

2014-10-01

Many species delay development unless particular environments or rare disturbance events occur. How can such a strategy be favoured over continued development? Typically, it is assumed that continued development (e.g. germination) is not advantageous in environments that have low juvenile/seedling survival (mechanism 1), either due to abiotic or competitive effects. However, it has not previously been shown how low early survival must be in order to favour environment-specific developmental delays for long-lived species. Using seed dormancy as an example of developmental delays, we identify a threshold level of seedling survival in 'bad' environments below which selection can favour germination that is limited to 'good' environments. This can be used to evaluate whether observed differences in seedling survival are sufficient to favour conditional germination. We also present mathematical models that demonstrate two other, often overlooked, mechanisms that can favour conditional germination in the absence of differences in seedling survival. Specifically, physiological trade-offs can make it difficult to have germination rates that are equally high in all environments (mechanism 2). We show that such trade-offs can either favour conditional germination or intermediate (mixed) strategies, depending on the trade-off shape. Finally, germination in every year increases the likelihood that some individuals are killed in population-scale disturbances before reproducing; it can thus be favourable to only germinate immediately after a disturbance (mechanism 3). We demonstrate how demographic data can be used to evaluate these selection pressures. By presenting these three mechanisms and the conditions that favour conditional germination in each case, we provide three hypotheses that can be tested as explanations for the evolution of environment-dependent developmental delays. © 2014 European Society for Evolutionary Biology. Journal of Evolutionary Biology © 2014 European Society For Evolutionary Biology.

A transition-based joint model for disease named entity recognition and normalization.

PubMed

Lou, Yinxia; Zhang, Yue; Qian, Tao; Li, Fei; Xiong, Shufeng; Ji, Donghong

2017-08-01

Disease named entities play a central role in many areas of biomedical research, and automatic recognition and normalization of such entities have received increasing attention in biomedical research communities. Existing methods typically used pipeline models with two independent phases: (i) a disease named entity recognition (DER) system is used to find the boundaries of mentions in text and (ii) a disease named entity normalization (DEN) system is used to connect the mentions recognized to concepts in a controlled vocabulary. The main problems of such models are: (i) there is error propagation from DER to DEN and (ii) DEN is useful for DER, but pipeline models cannot utilize this. We propose a transition-based model to jointly perform disease named entity recognition and normalization, casting the output construction process into an incremental state transition process, learning sequences of transition actions globally, which correspond to joint structural outputs. Beam search and online structured learning are used, with learning being designed to guide search. Compared with the only existing method for joint DEN and DER, our method allows non-local features to be used, which significantly improves the accuracies. We evaluate our model on two corpora: the BioCreative V Chemical Disease Relation (CDR) corpus and the NCBI disease corpus. Experiments show that our joint framework achieves significantly higher performances compared to competitive pipeline baselines. Our method compares favourably to other state-of-the-art approaches. Data and code are available at https://github.com/louyinxia/jointRN. dhji@whu.edu.cn. © The Author (2017). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Bleeding Efficiency and Meat Oxidative Stability and Microbiological Quality of New Zealand White Rabbits Subjected to Halal Slaughter without Stunning and Gas Stun-killing

PubMed Central

Nakyinsige, K.; Fatimah, A. B.; Aghwan, Z. A.; Zulkifli, I.; Goh, Y. M.; Sazili, A. Q.

2014-01-01

A study was conducted to compare the effect of halal slaughter without stunning and gas stun killing followed by bleeding on residual blood content and storage stability of rabbit meat. Eighty male New Zealand white rabbits were divided into two groups of 40 animals each and subjected to either halal slaughter without stunning (HS) or gas stun-kill (GK). The volume of blood lost during exsanguination was measured. Residual blood was further quantified by determination of haemoglobin content in Longissimus lumborum (LL) muscle. Storage stability of the meat was evaluated by microbiological analysis and measuring lipid oxidation in terms of thiobarbituric acid reactive substances (TBARS). HS resulted in significantly higher blood loss than GK. HS had significantly lower residual haemoglobin in LL muscle compared to GK. Slaughter method had no effect on rabbit meat lipid oxidation at 0, 1, and 3 d postmortem. However, at 5 and 8 days of storage at 4°C, significant differences (p<0.05) were found, with meat from the GK group exhibiting significantly higher levels of MDA than that from HS. At day 3, greater growth of Pseudomonas aeroginosa and E. coli were observed in the GK group (p<0.05) with B. thermosphacta and total aerobic counts remained unaffected by slaughter method. At days 5 and 7 postmortem, bacterial counts for all tested microbes were affected by slaughter method, with GK exhibiting significantly higher growth than HS. It can be concluded that slaughter method can affect keeping quality of rabbit meat, and HS may be a favourable option compared to GK due to high bleed out. PMID:25049968

Bleeding Efficiency and Meat Oxidative Stability and Microbiological Quality of New Zealand White Rabbits Subjected to Halal Slaughter without Stunning and Gas Stun-killing.

PubMed

Nakyinsige, K; Fatimah, A B; Aghwan, Z A; Zulkifli, I; Goh, Y M; Sazili, A Q

2014-03-01

A study was conducted to compare the effect of halal slaughter without stunning and gas stun killing followed by bleeding on residual blood content and storage stability of rabbit meat. Eighty male New Zealand white rabbits were divided into two groups of 40 animals each and subjected to either halal slaughter without stunning (HS) or gas stun-kill (GK). The volume of blood lost during exsanguination was measured. Residual blood was further quantified by determination of haemoglobin content in Longissimus lumborum (LL) muscle. Storage stability of the meat was evaluated by microbiological analysis and measuring lipid oxidation in terms of thiobarbituric acid reactive substances (TBARS). HS resulted in significantly higher blood loss than GK. HS had significantly lower residual haemoglobin in LL muscle compared to GK. Slaughter method had no effect on rabbit meat lipid oxidation at 0, 1, and 3 d postmortem. However, at 5 and 8 days of storage at 4°C, significant differences (p<0.05) were found, with meat from the GK group exhibiting significantly higher levels of MDA than that from HS. At day 3, greater growth of Pseudomonas aeroginosa and E. coli were observed in the GK group (p<0.05) with B. thermosphacta and total aerobic counts remained unaffected by slaughter method. At days 5 and 7 postmortem, bacterial counts for all tested microbes were affected by slaughter method, with GK exhibiting significantly higher growth than HS. It can be concluded that slaughter method can affect keeping quality of rabbit meat, and HS may be a favourable option compared to GK due to high bleed out.

Wavelet-Bayesian inference of cosmic strings embedded in the cosmic microwave background

NASA Astrophysics Data System (ADS)

McEwen, J. D.; Feeney, S. M.; Peiris, H. V.; Wiaux, Y.; Ringeval, C.; Bouchet, F. R.

2017-12-01

Cosmic strings are a well-motivated extension to the standard cosmological model and could induce a subdominant component in the anisotropies of the cosmic microwave background (CMB), in addition to the standard inflationary component. The detection of strings, while observationally challenging, would provide a direct probe of physics at very high-energy scales. We develop a framework for cosmic string inference from observations of the CMB made over the celestial sphere, performing a Bayesian analysis in wavelet space where the string-induced CMB component has distinct statistical properties to the standard inflationary component. Our wavelet-Bayesian framework provides a principled approach to compute the posterior distribution of the string tension Gμ and the Bayesian evidence ratio comparing the string model to the standard inflationary model. Furthermore, we present a technique to recover an estimate of any string-induced CMB map embedded in observational data. Using Planck-like simulations, we demonstrate the application of our framework and evaluate its performance. The method is sensitive to Gμ ∼ 5 × 10-7 for Nambu-Goto string simulations that include an integrated Sachs-Wolfe contribution only and do not include any recombination effects, before any parameters of the analysis are optimized. The sensitivity of the method compares favourably with other techniques applied to the same simulations.

Design of biodegradable nanoparticles: a novel approach to encapsulating poorly soluble phytochemical ellagic acid

NASA Astrophysics Data System (ADS)

Bala, I.; Bhardwaj, V.; Hariharan, S.; Sitterberg, J.; Bakowsky, U.; Kumar, M. N. V. Ravi

2005-12-01

Nanosizing of poorly water soluble drugs or incorporating them into nanoparticles to increase their solubility and thereby the bioavailability has become a favoured approach today. This work describes a novel method for encapsulating poorly water soluble phytochemical ellagic acid that is also sparingly soluble/insoluble in routine solvents used to prepare nanoparticles.

A Too Liberal Religious Education? A Thought Experiment for Teachers and Theorists

ERIC Educational Resources Information Center

Moulin, Dan

2009-01-01

This paper proposes that the ideas of political philosopher John Rawls could be adapted to offer a new starting point for a pedagogy of religious education (RE) in the non-denominational sector. It is argued that contemporary approaches to RE may infringe the liberal principle of freedom of belief by favouring certain methods of interpreting…

Measuring Attitude towards RE: Factoring Pupil Experience and Home Faith Background into Assessment

ERIC Educational Resources Information Center

Thanissaro, Phra Nicholas

2012-01-01

Recent studies have increasingly favoured contextualisation of religious education (RE) to pupils' home faith background in spite of current assessment methods that might hinder this. For a multi-religious, multi-ethnic sample of 369 London school pupils aged from 13 to 15 years, this study found that the participatory, transformative and…

Restrictions on smoking: changes in knowledge, attitudes and predicted behaviour in metropolitan Toronto from 1983 to 1988.

PubMed

Pederson, L L; Bull, S B; Ashley, M J; Kozma, D

1992-01-01

To describe recent changes in knowledge, attitudes and behaviour with regard to restrictions on smoking, we compared the findings of population-based surveys conducted in Metropolitan Toronto in 1983 and 1988. In both surveys identical questions and similar data collection procedures were used. There were no changes in knowledge scores regarding the health effects of active smoking or environmental tobacco smoke (ETS), nor in smoking behaviour. In contrast, there were marked changes in attitudes. The population favoured more restrictions on smoking, including prohibition in specific locations, and there was greater support for restrictions on sales and advertising, for differential insurance rates favouring nonsmokers, and for higher taxes on cigarettes. Fewer 1988 respondents reported smoking among their associates and more reported being bothered by others' smoking. The implications for public health education and policy development are discussed.

The influence of L-acetylcarnitine on reinnervation of the oculomotor nerve.

PubMed

Pettorossi, V E; Draicchio, F; Fernandez, E; Pallini, R

1993-01-01

In guinea-pigs the oral administration of L-acetylcarnitine (L-AC) markedly favours the process of reinnervation of the oculomotor nerve sectioned at intracranial level. The gains of the horizontal and vertical vestibulo-ocular reflexes (HVOR, VVOR) were taken into consideration in testing the functional recovery of the nerve. As a consequence of the drug administration, 24 weeks after the operation the gains of the treated animals were higher than those of the controls. Reduction of misalignments of the stimulus-response orientation was also observed in treated animals as compared to the controls. This suggests that L-AC potentiates motor reinnervation by enhancing the nerve-growing processes and favouring a better consolidation of the appropriate neuromuscular synapses. The increased gain, and the improvement of the alignment in ocular responses, due to L-AC would allow for an increase of visual function during head movement by optimizing gaze stability.

Effect of Grape Seed Extract and Quercetin on Cardiovascular and Endothelial Parameters in High-Risk Subjects

PubMed Central

Clifton, Peter M.

2004-01-01

Grape seed extract (GSE) has in vitro antioxidant activity but whether or not it works in vivo is not clear. In a fully randomised, crossover trial with 4-week treatment periods on 36 men and women with above-average vascular risk, we aimed to demonstrate that 2 g/day of GSE (1 g of polyphenols) alone, or with 1 g/day of added quercetin in yoghurt, favourably alters vascular function, endothelial function, and degree of oxidative damage in comparison to a control yoghurt. GSE alone improved flow-mediated dilatation determined ultrasonically by an absolute 1.1% compared with control. There was no effect of the combination of GSE with quercetin. No other blood or urine measure was altered. Thus sufficient polyphenols from GSE appear to be absorbed to influence endothelial nitric oxide production, and GSE has the potential to favourably influence vascular function. PMID:15577189

A comparison of outcomes for adults and children undergoing resection for inflammatory bowel disease: is there a difference?

PubMed

Mcmullin, Christine M; Morton, Jonathan; Vickramarajah, Saranya; Cameron, Ewen; Parkes, Miles; Torrente, Franco; Heuschkel, Robert; Carroll, Nicholas; Davies, R Justin

2014-01-01

Background. The incidence of inflammatory bowel disease (IBD) is increasing in the paediatric population. Since 2007, a single surgeon whose main practice is in the treatment of adults has performed surgery for IBD in adults and children within two dedicated multidisciplinary teams. Our aim was to assess and compare outcomes for adults and children following surgery for IBD. Methods. Analysis of a prospectively collected database was carried out to include all patients who had undergone resectional surgery for IBD between 2007 and 2012. Results. 48 adults and 30 children were included in the study. Median age for children was 14 years (range 8-16) and for adults was 33.5 years (range 17-64). Median BMI was 23 (range 18-38) and 19 (range 13-29.5) in adults and children, respectively (P < 0.001). Laparoscopic resection was performed in 27 (90%) children and 36 (75%) adults. Postoperative complication rates were comparable, 11 (23%) in adults versus 6 (20%) in children (P = 1.00). Conclusion. Resectional surgery for IBD in children has outcomes that compare favourably with the adult population, with the majority of cases being performed by a laparoscopic approach.

Protein precipitation of diluted samples in SDS-containing buffer with acetone leads to higher protein recovery and reproducibility in comparison with TCA/acetone approach.

PubMed

Santa, Cátia; Anjo, Sandra I; Manadas, Bruno

2016-07-01

Proteomic approaches are extremely valuable in many fields of research, where mass spectrometry methods have gained an increasing interest, especially because of the ability to perform quantitative analysis. Nonetheless, sample preparation prior to mass spectrometry analysis is of the utmost importance. In this work, two protein precipitation approaches, widely used for cleaning and concentrating protein samples, were tested and compared in very diluted samples solubilized in a strong buffer (containing SDS). The amount of protein recovered after acetone and TCA/acetone precipitation was assessed, as well as the protein identification and relative quantification by SWATH-MS yields were compared with the results from the same sample without precipitation. From this study, it was possible to conclude that in the case of diluted samples in denaturing buffers, the use of cold acetone as precipitation protocol is more favourable than the use of TCA/acetone in terms of reproducibility in protein recovery and number of identified and quantified proteins. Furthermore, the reproducibility in relative quantification of the proteins is even higher in samples precipitated with acetone compared with the original sample. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Life-style characteristics and cardiovascular risk factors in regular downhill skiers: an observational study

PubMed Central

2013-01-01

Background Downhill skiing is part of active life style in many residents of Alpine regions. However, only very little information is available whether downhill skiing on a regular basis is associated with a healthier life style resulting in the reduction of major risk factors for cardiovascular diseases and memory deficits when compared to the general population. Thus, the aim of the study was to compare life-style characteristics and cardiovascular risk factors between regular downhill skiers and the general population. Methods Self-reported health and life-style data were collected by questionnaire from 1259 long-term downhill skiers (971 males, aged 57.3 ± 14.6 years; 288 females, aged 47.7 ± 16.4 years) and compared with data from the general population. Results Long-term skiers showed more favourable life-style characteristics and a better health status than the general population. Prevalences of hypercholesterolemia, systemic hypertension, diabetes, the frequency of mental stress and the occurrence of memory deficits declined with increasing yearly skiing frequency. Conclusion Long-term alpine skiing on a regular basis may contribute to healthy aging by its association with a healthier life style. PMID:23987102

Cost-effectiveness of antiplatelet drugs after percutaneous coronary intervention

PubMed Central

Wisløff, Torbjørn; Atar, Dan

2016-01-01

Abstract Aims Clopidogrel has, for long time, been accepted as the standard treatment for patients who have undergone a percutaneous coronary intervention (PCI). The introduction of prasugrel—and more recently, ticagrelor—has introduced a decision-making problem for clinicians and governments worldwide: to use the cheaper clopidogrel or the more effective, and also more expensive prasugrel or ticagrelor. We aim to give helpful contributions to this debate by analysing the cost-effectiveness of clopidogrel, prasugrel, and ticagrelor compared with each other. Methods and results We modified a previously developed Markov model of cardiac disease progression. In the model, we followed up cohorts of patients who have recently had a PCI until 100 years or death. Possible events are revascularization, bleeding, acute myocardial infarction, and death. Our analysis shows that ticagrelor is cost-effective in 77% of simulations at an incremental cost-effectiveness ratio of €7700 compared with clopidogrel. Ticagrelor was also cost-effective against prasugrel at a cost-effectiveness ratio of €7800. Given a Norwegian cost-effectiveness threshold of €70 000, both comparisons appear to be clearly cost-effective in favour of ticagrelor. Conclusion Ticagrelor is cost-effective compared with both clopidogrel and prasugrel for patients who have undergone a PCI. PMID:29474586

Correction factors for self-selection when evaluating screening programmes.

PubMed

Spix, Claudia; Berthold, Frank; Hero, Barbara; Michaelis, Jörg; Schilling, Freimut H

2016-03-01

In screening programmes there is recognized bias introduced through participant self-selection (the healthy screenee bias). Methods used to evaluate screening programmes include Intention-to-screen, per-protocol, and the "post hoc" approach in which, after introducing screening for everyone, the only evaluation option is participants versus non-participants. All methods are prone to bias through self-selection. We present an overview of approaches to correct for this bias. We considered four methods to quantify and correct for self-selection bias. Simple calculations revealed that these corrections are actually all identical, and can be converted into each other. Based on this, correction factors for further situations and measures were derived. The application of these correction factors requires a number of assumptions. Using as an example the German Neuroblastoma Screening Study, no relevant reduction in mortality or stage 4 incidence due to screening was observed. The largest bias (in favour of screening) was observed when comparing participants with non-participants. Correcting for bias is particularly necessary when using the post hoc evaluation approach, however, in this situation not all required data are available. External data or further assumptions may be required for estimation. © The Author(s) 2015.

Comparison of direct and indirect methods of estimating health state utilities for resource allocation: review and empirical analysis.

PubMed

Arnold, David; Girling, Alan; Stevens, Andrew; Lilford, Richard

2009-07-22

Utilities (values representing preferences) for healthcare priority setting are typically obtained indirectly by asking patients to fill in a quality of life questionnaire and then converting the results to a utility using population values. We compared such utilities with those obtained directly from patients or the public. Review of studies providing both a direct and indirect utility estimate. Papers reporting comparisons of utilities obtained directly (standard gamble or time tradeoff) or indirectly (European quality of life 5D [EQ-5D], short form 6D [SF-6D], or health utilities index [HUI]) from the same patient. PubMed and Tufts database of utilities. Sign test for paired comparisons between direct and indirect utilities; least squares regression to describe average relations between the different methods. Mean utility scores (or median if means unavailable) for each method, and differences in mean (median) scores between direct and indirect methods. We found 32 studies yielding 83 instances where direct and indirect methods could be compared for health states experienced by adults. The direct methods used were standard gamble in 57 cases and time trade off in 60(34 used both); the indirect methods were EQ-5D (67 cases), SF-6D (13), HUI-2 (5), and HUI-3 (37). Mean utility values were 0.81 (standard gamble) and 0.77 (time tradeoff) for the direct methods; for the indirect methods: 0.59(EQ-5D), 0.63 (SF-6D), 0.75 (HUI-2) and 0.68 (HUI-3). Direct methods of estimating utilities tend to result in higher health ratings than the more widely used indirect methods, and the difference can be substantial.Use of indirect methods could have important implications for decisions about resource allocation: for example, non-lifesaving treatments are relatively more favoured in comparison with lifesaving interventions than when using direct methods.

Influence of PVP in magnetic properties of NiSn nanoparticles prepared by polyol method

NASA Astrophysics Data System (ADS)

Bobadilla, L. F.; García, C.; Delgado, J. J.; Sanz, O.; Romero-Sarria, F.; Centeno, M. A.; Odriozola, J. A.

2012-11-01

The influence of PVP on the magnetic properties of NiSn nanoparticles prepared by polyol method has been studied. NiSn nanoparticles exhibit superparamagnetic behavior although there is a ferromagnetic contribution due to particles agglomerated below the blocking temperature. The particle size is controlled by the addiction of PVP in varying amounts. The addition of PVP also favours the particles isolation, narrow the particle size distribution and decrease the interparticle interaction strength increasing the superparamagnetic contribution.

Within-Crop Air Temperature and Humidity Outcomes on Spatio-Temporal Distribution of the Key Rose Pest Frankliniella occidentalis.

PubMed

Fatnassi, Hicham; Pizzol, Jeannine; Senoussi, Rachid; Biondi, Antonio; Desneux, Nicolas; Poncet, Christine; Boulard, Thierry

2015-01-01

Frankliniella occidentalis (Pergande) is a key pest of various crops worldwide. In this study, we analyse the dependence of the infestation of this pest on spatially distributed micro climatic factors in a rose greenhouse. Despite the importance of this subject, the few existing studies have been realized in laboratory rather than in greenhouse conditions. However, recent progress on greenhouse microclimate characterisation has highlighted the strong indoor climate heterogeneity that may influence the within-crop pest distribution. In this study, both microclimate (air temperature and humidity) and thrips distribution were simultaneously mapped in a rose greenhouse. The measurements were sensed in a horizontal plane situated at mid-height of the rose crop inside the greenhouse. Simultaneously, thrips population dynamics were assessed after an artificial and homogeneous infestation of the rose crop. The spatio-temporal distribution of climate and thrips within the greenhouse were compared, and links between thrips infestation and climatic conditions were investigated. A statistical model was used to define the favourable climate conditions for thrips adults and larvae. Our results showed that (i) the air temperature and air humidity were very heterogeneously distributed within the crop, (ii) pest populations aggregated in the most favourable climatic areas and (iii) the highest population density of thrips adults and larvae were recorded at 27°C and 22°C for temperature and 63% and 86% for humidity, respectively. These findings confirm, in real rose cropping conditions, previous laboratory studies on the F. occidentalis climatic optimum and provide a solid scientific support for climatic-based control methods against this pest.

Within-Crop Air Temperature and Humidity Outcomes on Spatio-Temporal Distribution of the Key Rose Pest Frankliniella occidentalis

PubMed Central

Fatnassi, Hicham; Pizzol, Jeannine; Senoussi, Rachid; Biondi, Antonio; Desneux, Nicolas; Poncet, Christine; Boulard, Thierry

2015-01-01

Frankliniella occidentalis (Pergande) is a key pest of various crops worldwide. In this study, we analyse the dependence of the infestation of this pest on spatially distributed micro climatic factors in a rose greenhouse. Despite the importance of this subject, the few existing studies have been realized in laboratory rather than in greenhouse conditions. However, recent progress on greenhouse microclimate characterisation has highlighted the strong indoor climate heterogeneity that may influence the within-crop pest distribution. In this study, both microclimate (air temperature and humidity) and thrips distribution were simultaneously mapped in a rose greenhouse. The measurements were sensed in a horizontal plane situated at mid-height of the rose crop inside the greenhouse. Simultaneously, thrips population dynamics were assessed after an artificial and homogeneous infestation of the rose crop. The spatio-temporal distribution of climate and thrips within the greenhouse were compared, and links between thrips infestation and climatic conditions were investigated. A statistical model was used to define the favourable climate conditions for thrips adults and larvae. Our results showed that (i) the air temperature and air humidity were very heterogeneously distributed within the crop, (ii) pest populations aggregated in the most favourable climatic areas and (iii) the highest population density of thrips adults and larvae were recorded at 27°C and 22°C for temperature and 63% and 86% for humidity, respectively. These findings confirm, in real rose cropping conditions, previous laboratory studies on the F. occidentalis climatic optimum and provide a solid scientific support for climatic-based control methods against this pest. PMID:26011275

Traumatic brain injuries caused by traffic accidents in five European countries: outcome and public health consequences.

PubMed

Majdan, Marek; Mauritz, Walter; Wilbacher, Ingrid; Janciak, Ivan; Brazinova, Alexandra; Rusnak, Martin; Leitgeb, Johannes

2013-08-01

Road traffic accidents (RTAs) have been identified by public health organizations as being of major global concern. Traumatic brain injuries (TBIs) are among the most severe injuries and are in a large part caused by RTA. The objective of this article is to analyse the severity and outcome of TBI caused by RTA in different types of road users in five European countries. The demographic, severity and outcome measures of 683 individuals with RTA-related TBI from Austria, Slovakia, Bosnia, Croatia and Macedonia were analysed. Five types of road users (car drivers, car passengers, motorcyclists, bicyclists and pedestrians) were compared using univariate and multivariate statistical methods. Short-term outcome [intensive care unit (ICU) survival] and last available long-term outcome of patients were analysed. In our data set, 44% of TBI were traffic related. The median age of patients was 32.5 years, being the lowest (25 years) in car passengers. The most severe and extensive injuries were reported in pedestrians. Pedestrians had the lowest rate of ICU survival (60%) and favourable long-term outcome (46%). Drivers had the highest ICU survival (73%) and car passengers had the best long-term outcome (59% favourable). No differences in the outcome were found between countries with different economy levels. TBI are significantly associated with RTA and thus, tackling them together could be more effective. The population at highest risk of RTA-related TBI are young males (in our sample median age: 32.5 years). Pedestrians have the most severe TBI with the worst outcome. Both groups should be a priority for public health action.

Socially Constructed Hierarchies of Impairments: The Case of Australian and Irish Workers' Access to Compensation for Injuries.

PubMed

Harpur, Paul; Connolly, Ursula; Blanck, Peter

2017-12-01

Socially constructed hierarchies of impairment complicate the general disadvantage experienced by workers with disabilities. Workers with a range of abilities categorized as a "disability" are likely to experience less favourable treatment at work and have their rights to work discounted by laws and institutions, as compared to workers without disabilities. Value judgments in workplace culture and local law mean that the extent of disadvantage experienced by workers with disabilities additionally will depend upon the type of impairment they have. Rather than focusing upon the extent and severity of the impairment and how society turns an impairment into a recognized disability, this article aims to critically analyse the social hierarchy of physical versus mental impairment. Using legal doctrinal research methods, this paper analysis how Australian and Irish workers' compensation and negligence laws regard workers with mental injuries and impairments as less deserving of compensation and protection than like workers who have physical and sensory injuries or impairments. This research finds that workers who acquire and manifest mental injuries and impairments at work are less able to obtain compensation and protection than workers who have developed physical and sensory injuries of equal or lesser severity. Organizational cultures and governmental laws and policies that treat workers less favourably because they have mental injuries and impairments perpetuates unfair and artificial hierarchies of disability attributes. We conclude that these "sanist" attitudes undermine equal access to compensation for workplace injury as prohibited by the United Nations Convention on the Rights of Persons with Disabilities.

The CONSENSUS study: protocol for a mixed methods study to establish which outcomes should be included in a core outcome set for oropharyngeal cancer

PubMed Central

2014-01-01

Background The incidence of oropharyngeal cancer is increasing in the developed world. This has led to a large rise in research activity and clinical trials in this area, yet there is no consensus on which outcomes should be measured. As a result, the outcomes measured often differ between trials of comparable interventions, making the combination or comparison of results between trials impossible. Outcomes may also be ‘cherry-picked’, such that favourable results are reported, and less favourable results withheld. The development of a minimum outcome reporting standard, known as a core outcome set, goes some way to addressing these problems. Core outcome sets are ideally developed using a patient-centred approach so that the outcomes measured are relevant to patients and clinical practice. Core outcome sets drive up the quality and relevance of research by ensuring that the right outcomes are consistently measured and reported in trials in specific areas of health or healthcare. Methods/Design This is a mixed methods study involving three phases to develop a core outcome set for oropharyngeal cancer clinical trials. Firstly, a systematic review will establish which outcomes are measured in published oropharyngeal cancer randomised controlled trials (RCTs). Secondly, qualitative interviews with patients and carers in the UK and the USA will aim to establish which outcomes are important to these stakeholders. Data from these first two stages will be used to develop a comprehensive list of outcomes to be considered for inclusion in the core outcome set. In the third stage, patients and clinicians will participate in an iterative consensus exercise known as a Delphi study to refine the contents of the core outcome set. This protocol lays out the methodology to be implemented in the CONSENSUS study. Discussion A core outcome set defines a minimum outcome reporting standard for clinical trials in a particular area of health or healthcare. Its consistent implementation in oropharyngeal cancer clinical trials will improve the quality and relevance of research. Trials and registration This study is registered at the National Institute for Health Research (NIHR) Clinical Research Network (CRN) portfolio, ID 13823 (17 January 2013). PMID:24885068

A comparative analysis of clustering algorithms: O{sub 2} migration in truncated hemoglobin I from transition networks

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cazade, Pierre-André; Berezovska, Ganna; Meuwly, Markus, E-mail: m.meuwly@unibas.ch

2015-01-14

The ligand migration network for O{sub 2}–diffusion in truncated Hemoglobin N is analyzed based on three different clustering schemes. For coordinate-based clustering, the conventional k–means and the kinetics-based Markov Clustering (MCL) methods are employed, whereas the locally scaled diffusion map (LSDMap) method is a collective-variable-based approach. It is found that all three methods agree well in their geometrical definition of the most important docking site, and all experimentally known docking sites are recovered by all three methods. Also, for most of the states, their population coincides quite favourably, whereas the kinetics of and between the states differs. One of themore » major differences between k–means and MCL clustering on the one hand and LSDMap on the other is that the latter finds one large primary cluster containing the Xe1a, IS1, and ENT states. This is related to the fact that the motion within the state occurs on similar time scales, whereas structurally the state is found to be quite diverse. In agreement with previous explicit atomistic simulations, the Xe3 pocket is found to be a highly dynamical site which points to its potential role as a hub in the network. This is also highlighted in the fact that LSDMap cannot identify this state. First passage time distributions from MCL clusterings using a one- (ligand-position) and two-dimensional (ligand-position and protein-structure) descriptor suggest that ligand- and protein-motions are coupled. The benefits and drawbacks of the three methods are discussed in a comparative fashion and highlight that depending on the questions at hand the best-performing method for a particular data set may differ.« less

A comparative analysis of clustering algorithms: O2 migration in truncated hemoglobin I from transition networks.

PubMed

Cazade, Pierre-André; Zheng, Wenwei; Prada-Gracia, Diego; Berezovska, Ganna; Rao, Francesco; Clementi, Cecilia; Meuwly, Markus

2015-01-14

The ligand migration network for O2-diffusion in truncated Hemoglobin N is analyzed based on three different clustering schemes. For coordinate-based clustering, the conventional k-means and the kinetics-based Markov Clustering (MCL) methods are employed, whereas the locally scaled diffusion map (LSDMap) method is a collective-variable-based approach. It is found that all three methods agree well in their geometrical definition of the most important docking site, and all experimentally known docking sites are recovered by all three methods. Also, for most of the states, their population coincides quite favourably, whereas the kinetics of and between the states differs. One of the major differences between k-means and MCL clustering on the one hand and LSDMap on the other is that the latter finds one large primary cluster containing the Xe1a, IS1, and ENT states. This is related to the fact that the motion within the state occurs on similar time scales, whereas structurally the state is found to be quite diverse. In agreement with previous explicit atomistic simulations, the Xe3 pocket is found to be a highly dynamical site which points to its potential role as a hub in the network. This is also highlighted in the fact that LSDMap cannot identify this state. First passage time distributions from MCL clusterings using a one- (ligand-position) and two-dimensional (ligand-position and protein-structure) descriptor suggest that ligand- and protein-motions are coupled. The benefits and drawbacks of the three methods are discussed in a comparative fashion and highlight that depending on the questions at hand the best-performing method for a particular data set may differ.

First-principles study of the elastic and thermodynamic properties of CaSiO(3) perovskite.

PubMed

Liu, Z J; Sun, X W; Chen, Q F; Cai, L C; Wu, H Y; Ge, S H

2007-06-20

The thermodynamic and elastic properties of CaSiO(3) perovskite are investigated at high pressures and temperatures using the plane wave pseudopotential method within the local density approximation. The athermal elastic moduli of CaSiO(3) perovskite are calculated as a function of pressure up to 200 GPa. The calculated results are in excellent agreement with available experimental data at high pressure, and compare favourably with other pseudopotential predictions over the pressure regime studied. It is also found that the elastic anisotropy drops rapidly with the increase of pressure initially, and then decreases more slowly at higher pressures. The thermodynamic properties of CaSiO(3) perovskite are predicted using the quasi-harmonic Debye model for the first time; the heat capacity and the thermal expansion coefficient agree with the observed values at ambient conditions and the other calculations at high pressures and temperatures.

Three point-advancement closure for skin defects.

PubMed

Tamir, G; Birkby, C S; Berg, D

1999-10-01

Circular skin defects are common following Mohs' surgery. Traditional closure (primary, flap, or graft) may involve extensive surgery. Multidirectional advancement closures such as the purse-string closure have been advocated as another useful tool in such cases. To describe a variation on purse-string closure that, in certain cases, is an excellent alternative to other reconstructions, and will provide good cosmetic and functional outcome. A three-point anchoring suture is placed after undermining to advance the surrounding tissue toward the centre, creating a "Mercedes Benz" or tripod closure following removal of "dog-ears." Circular wounds in designated areas can be more easily closed, creating well-tolerated, favourable scars. Large wounds may be closed with the advantage of avoidance of larger flaps, of decreased wound healing compared to second intention, and of minimizing removal of healthy tissue. An initial trial of closure with this method does not limit subsequent use of other repairs should it be less than satisfactory.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jesus, J.F.; Valentim, R.; Andrade-Oliveira, F., E-mail: jfjesus@itapeva.unesp.br, E-mail: valentim.rodolfo@unifesp.br, E-mail: felipe.oliveira@port.ac.uk

Creation of Cold Dark Matter (CCDM), in the context of Einstein Field Equations, produces a negative pressure term which can be used to explain the accelerated expansion of the Universe. In this work we tested six different spatially flat models for matter creation using statistical criteria, in light of SNe Ia data: Akaike Information Criterion (AIC), Bayesian Information Criterion (BIC) and Bayesian Evidence (BE). These criteria allow to compare models considering goodness of fit and number of free parameters, penalizing excess of complexity. We find that JO model is slightly favoured over LJO/ΛCDM model, however, neither of these, nor Γmore » = 3α H {sub 0} model can be discarded from the current analysis. Three other scenarios are discarded either because poor fitting or because of the excess of free parameters. A method of increasing Bayesian evidence through reparameterization in order to reducing parameter degeneracy is also developed.« less

Bayesian analysis of CCDM models

NASA Astrophysics Data System (ADS)

Jesus, J. F.; Valentim, R.; Andrade-Oliveira, F.

2017-09-01

Creation of Cold Dark Matter (CCDM), in the context of Einstein Field Equations, produces a negative pressure term which can be used to explain the accelerated expansion of the Universe. In this work we tested six different spatially flat models for matter creation using statistical criteria, in light of SNe Ia data: Akaike Information Criterion (AIC), Bayesian Information Criterion (BIC) and Bayesian Evidence (BE). These criteria allow to compare models considering goodness of fit and number of free parameters, penalizing excess of complexity. We find that JO model is slightly favoured over LJO/ΛCDM model, however, neither of these, nor Γ = 3αH0 model can be discarded from the current analysis. Three other scenarios are discarded either because poor fitting or because of the excess of free parameters. A method of increasing Bayesian evidence through reparameterization in order to reducing parameter degeneracy is also developed.

Laser writing of single-crystalline gold substrates for surface enhanced Raman spectroscopy

NASA Astrophysics Data System (ADS)

Singh, Astha; Sharma, Geeta; Ranjan, Neeraj; Mittholiya, Kshitij; Bhatnagar, Anuj; Singh, B. P.; Mathur, Deepak; Vasa, Parinda

2017-07-01

Surface enhanced Raman scattering (SERS) spectroscopy, a powerful contemporary tool for studying low-concentration analytes via surface plasmon induced enhancement of local electric field, is of utility in biochemistry, material science, threat detection, and environmental studies. We have developed a simple, fast, scalable, and relatively low-cost optical method of fabricating and characterizing large-area, reusable and broadband SERS substrates with long storage lifetime. We use tightly focused, intense infra-red laser pulses to write gratings on single-crystalline, Au (1 1 1) gold films on mica which act as SERS substrates. Our single-crystalline SERS substrates compare favourably, in terms of surface quality and roughness, to those fabricated in poly-crystalline Au films. Tests show that our SERS substrates have the potential of detecting urea and 1,10-phenantroline adulterants in milk and water, respectively, at 0.01 ppm (or lower) concentrations.

[Is there still a place for extemporaneous exam in breast cancer?].

PubMed

Michy, T; Le Bouëdec, G; Mishellany, F; Penault-Llorca, F; Dauplat, J

2006-02-01

The rise of preoperative diagnosis thanks to new methods of micro and macrobiopsy and the development of sentinel lymph node have dramatically modified the surgical management of patients with breast tumor. The purpose of this study is to know if extemporaneous exams still have a place in the management of breast cancer. Retrospective study which compares the qualitiative evolution of frozen sections in breast tumor at Jean-Perrin center before the practice of percutaneous strereotaxic biopsy and after the training of sentinel lymph node operative biopsy. The results were in favour of a different distribution of anatomocytopathological activity with a decrease of frozen section in breast tumor and an increase of cytological imprints on sentinel nodes. The interest of histologic preoperative diagnosis and the failure of consensus in the sentinel lymph node just leave a restrictive position to frozen section in breast cancer.

Relevance of infiltration analgesia in pain relief after total knee arthroplasty

PubMed Central

Znojek-Tymborowska, Justyna; Kęska, Rafał; Paradowski, Przemysław T.; Witoński, Dariusz

2013-01-01

OBJECTIVE: The aim of the study was to assess the effect of different types of anesthesia on pain intensity in early postoperative period. PATIENTS AND METHODS: A total of 87 patients (77 women, 10 men) scheduled for total knee arthroplasty (TKA) were assigned to receive either subarachnoid anesthesia alone or in combination with local soft tissue anesthesia, local soft tissue anesthesia and femoral nerve block and pre-emptive infiltration together with local soft tissue anesthesia. We assessed the pain intensity, opioid consumption, knee joint mobility, and complications of surgery. RESULTS: Subjects with pre-emptive infiltration and local soft tissue anesthesia had lower pain intensity on the first postoperative day compared to those with soft tissue anesthesia and femoral nerve block (P=0.012, effect size 0.68). Subjects who received pre-emptive infiltration and local soft-tissue anesthesia had the greatest range of motion in the operated knee at discharge (mean 90 grades [SD 7], P=0.01 compared to those who received subarachnoid anesthesia alone, and P=0.001 compared to those with subarachnoid together with soft tissue anesthesia). CONCLUSION: Despite the differences in postoperative pain and knee mobility, the results obtained throughout the postoperative period do not enable us to favour neither local nor regional infiltration anesthesia in TKA. Level of Evidence II, Prospective Comparative Study. PMID:24453679

The impact of online visual on users' motivation and behavioural intention - A comparison between persuasive and non-persuasive visuals

NASA Astrophysics Data System (ADS)

Ibrahim, Nurulhuda; Shiratuddin, Mohd Fairuz; Wong, Kok Wai

2016-08-01

Research related to the first impression has highlighted the importance of visual appeal in influencing the favourable attitude towards a website. In the perspective of impression formation, it is proposed that the users are actually attracted to certain characteristics or aspects of the visual properties of a website, while ignoring the rests. Therefore, this study aims to investigate which visual strongly appeals to the users by comparing the impact of common visuals with the persuasive visuals. The principles of social influence are proposed as the added value to the persuasiveness of the web visuals. An experimental study is conducted and the PLS-SEM method is employed to analyse the obtained data. The result of the exploratory analyses demonstrated that the structural model has better quality when tested with persuasive data sample compared to non-persuasive data sample, evident with stronger coefficient of determination and path coefficients. Thus, it is concluded that persuasive visual provides better impact towards users' attitude and behavioural intention of a website.

An Investigation of Science Teaching Practices in Indonesian Rural Secondary Schools

NASA Astrophysics Data System (ADS)

Wahyudi; Treagust, David F.

2004-08-01

This study reports on teaching practices in science classrooms of Indonesian lower secondary schools in rural areas. Using six schools from three districts in the province of Kalimantan Selatan as the sample, this study found that most teaching practices in science classrooms in rural schools were teacher-centred with students copying notes. However, the study also found unique teaching practices of an exemplary science teacher whose teaching style can be described as both student-centred and teacher-centred, with students encouraged to be active learners. Four features of exemplary teaching practices were identified: The teacher managed the classroom effectively; used a variety of questioning techniques; employed various teaching approaches instead of traditional methods; and created a favourable learning environment. Data from classroom observations, interviews with teachers, and students responses to a questionnaire were used to compare the exemplary teacher and his colleagues. This study identified internal factors that may affect teaching practices such as a teachers content knowledge and beliefs about teaching. Compared to the other teachers, the exemplary teacher possessed more content knowledge and had a relatively stronger belief in his ability to teach.

Polymerase chain reaction for screening clinical isolates of corynebacteria for the production of diphtheria toxin.

PubMed

Pallen, M J; Hay, A J; Puckey, L H; Efstratiou, A

1994-04-01

To assess the performance of the polymerase chain reaction (PCR) when used to screen rapidly large numbers of corynebacteria for toxin production; and to determine the incidence of false positive PCR results with non-toxigenic Corynebacterium diphtheriae isolates. Eighty seven recent British isolates of corynebacteria were assayed by PCR. All isolates were assayed from both blood and tellurite agar within a five day period. Thirty three non-toxigenic isolates of C diphtheriae from six countries were also tested by PCR and by the Elek immunodiffusion assay. There was complete concordance between the results of PCR and traditional methods on the recent British isolates, with one exception: an Elek positive "C ulcerans" isolate, which was PCR positive from tellurite but not from blood agar. One of the thirty three (3%) non-toxigenic isolates of C diphtheriae was PCR positive. These results suggest that PCR compares favourably with traditional methods for the detection of toxigenic corynebacteria and that it represents a powerful new tool in the diagnosis of an old disease.

Collection and collation: theory and practice of Linnaean botany.

PubMed

Müller-Wille, Staffan

2007-09-01

Historians and philosophers of science have interpreted the taxonomic theory of Carl Linnaeus (1707-1778) as an 'essentialist', 'Aristotelian', or even 'scholastic' one. This interpretation is flatly contradicted by what Linnaeus himself had to say about taxonomy in Systema naturae (1735), Fundamenta botanica (1736) and Genera plantarum (1737). This paper straightens out some of the more basic misinterpretations by showing that: (1) Linnaeus's species concept took account of reproductive relations among organisms and was therefore not metaphysical, but biological; (2) Linnaeus did not favour classification by logical division, but criticized it for necessarily failing to represent what he called 'natural' genera; (3) Linnaeus's definitions of 'natural' genera and species were not essentialist, but descriptive and polytypic; (4) Linnaeus's method in establishing 'natural' definitions was not deductive, but consisted in an inductive, bottom-up procedure of comparing concrete specimens. The conclusion will discuss the fragmentary and provisional nature of Linnaeus's 'natural method'. I will argue in particular that Linnaeus opted for inductive strategies not on abstract epistemological grounds, but in order to confer stability and continuity to the explorative practices of contemporary natural history.

Development of Virtual Blade Model for Modelling Helicopter Rotor Downwash in OpenFOAM

DTIC Science & Technology

2013-12-01

UNCLASSIFIED Development of Virtual Blade Model for Modelling Helicopter Rotor Downwash in OpenFOAM Stefano Wahono Aerospace...Georgia Institute of Technology. The OpenFOAM predicted result was also shown to compare favourably with ANSYS Fluent predictions. RELEASE...UNCLASSIFIED Development of Virtual Blade Model for Modelling Helicopter Rotor Downwash in OpenFOAM Executive Summary The Infrared

Tensions between Cultural and Utilitarian Dimensions of Language: A Comparative Analysis of "Multilingual" Education Policies in France and Germany

ERIC Educational Resources Information Center

Garcia, Nuria

2015-01-01

Through a comparison of France and Germany, this article investigates why the overall conception of multilingualism promoted by the education systems of the two countries favours the teaching of "useful" European standard languages over that of minority and migrant languages that are conceived in merely cultural terms. Adopting a…

Evaluation of the binding effect of human serum albumin on the properties of granules.

PubMed

Kristó, Katalin; Bajdik, János; Eros, István; Pintye-Hódi, Klára

2008-11-01

The main objective of this study was the application of a solution of human serum albumin as a granulating fluid. The properties of the granules formed were evaluated and compared with those when a conventional binder was applied in the same concentration. The powder mixture contained a soluble (mannitol) and an insoluble component (different types of cellulose). The protein solution applied exerted an appropriate aggregating effect if the system contained microcrystalline celluloses. Powdered cellulose was not suitable for the granulation with human serum albumin solution. As compared with the same concentration of the conventionally applied cellulose ethers as binder, the prepared granules exhibited a larger particle size, a significantly better compressibility, a higher breaking hardness and a favourable deformation process. These findings mainly reflect the good adhesive properties of the protein. The best compressibility and mechanical behaviour were attained on the application of the microcrystalline cellulose Vivapur type 105. This favourable behaviour may be connected with the wettability of cellulose. These results suggest that the formulation of tablets may be easier from an active agent in the serum that binds to albumin (e.g. interferon) since the amount of additives (binder) can be reduced.

Favourable prognosis of cystadeno- over adenocarcinoma of the pancreas after curative resection.

PubMed

Ridder, G J; Maschek, H; Klempnauer, J

1996-06-01

This report details nine patients after curative surgical resection of histologically proven mucinous cystadenocarcinoma of the pancreas and compares the prognosis with ductal adenocarcinomas. Cystadenocarcinomas represented 2.1% (10/ 466) of a total of 466 patients who underwent surgical exploration and 5.5%, of all curatively resected carcinomas of the exocrine pancreas at Hanover Medical School from 1971 to 1994. Forty percent of adenocarcinomas and 90% of cystadenocarcinomas were resectable. A curative R0 resection was possible in all patients with cystadenocarcinoma and 85 % with adenocarcinoma. Six of the patients with cystadenocarcinoma were female and three were male. Their median age was 54 +/- 12 years (range: 44 to 81 years). Four cystic neoplasms were located in the head, one in the head and body, three in the tail, and one in the body and tail of the pancreas. There was no hospital mortality in this group. The prognosis after resection of cystadenocarcinomas was significantly better compared to ductal adenocarcinomas of the pancreas. The Kaplan-Meier survival was 89% vs 52% after 1 year, and 56% vs 13% at 5 years. Our results indicate the favourable prognosis of cystadeno- over ductal adenocarcinomas of the pancreas in a cohort of patients with curative tumour resection.

Frequent shopping by men and women increases survival in the older Taiwanese population.

PubMed

Chang, Yu-Hung; Chen, Rosalind Chia-Yu; Wahlqvist, Mark L; Lee, Meei-Shyuan

2012-07-01

Active ageing is a key to healthy ageing; shopping behaviour is an economically relevant activity of the elderly. Analysis was based on the NAHSIT 1999-2000 dataset. A total of 1841 representative free-living elderly Taiwanese people were selected and information included demographics, socioeconomic status, health behaviours, shopping frequencies, physical function and cognitive function. These data were linked to official death records. Cox proportional hazard models were used to evaluate shopping frequency on death from 1999-2008 with possible covariate adjustment. Highly frequent shopping compared to never or rarely predicted survival (HR 0.54, 95% CI 0.43 to 0.67) with adjustment for physical function and cognitive function and other covariates HR was 0.73 (95% CI 0.56 to 0.93). Elderly who shopped every day have 27% less risk of death than the least frequent shoppers. Men benefited more from everyday shopping than women with decreased HR 28% versus 23% compared to the least. Shopping behaviour favourably predicts survival. Highly frequent shopping may favour men more than women. Shopping captures several dimensions of personal well-being, health and security as well as contributing to the community's cohesiveness and economy and may represent or actually confer increased longevity.

A comparative analysis of experimental selection on the stickleback pelvis.

PubMed

Miller, S E; Barrueto, M; Schluter, D

2017-06-01

Mechanisms of natural selection can be identified using experimental approaches. However, such experiments often yield nonsignificant effects and imprecise estimates of selection due to low power and small sample sizes. Combining results from multiple experimental studies might produce an aggregate estimate of selection that is more revealing than individual studies. For example, bony pelvic armour varies conspicuously among stickleback populations, and predation by vertebrate and insect predators has been hypothesized to be the main driver of this variation. Yet experimental selection studies testing these hypotheses frequently fail to find a significant effect. We experimentally manipulated length of threespine stickleback (Gasterosteus aculeatus) pelvic spines in a mesocosm experiment to test whether prickly sculpin (Cottus asper), an intraguild predator of stickleback, favours longer spines. The probability of survival was greater for stickleback with unclipped pelvic spines, but this effect was noisy and not significant. We used meta-analysis to combine the results of our mesocosm experiment with previously published experimental studies of selection on pelvic armour. We found evidence that fish predation indeed favours increased pelvic armour, with a moderate effect size. The same approach found little evidence that insect predation favours reduced pelvic armour. The causes of reduced pelvic armour in many stickleback populations remain uncertain. © 2017 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2017 European Society For Evolutionary Biology.

[Perceived quality in hospitals of the Andalusia Healthcare System. The case of neurosurgery departments].

PubMed

Cordero Tous, N; Horcajadas Almansa, Á; Bermúdez González, G J; Tous Zamora, D

2014-01-01

To analyse the characteristics of the perceived quality in hospitals of the Andalusia healthcare system and compare this with that in Andalusian Neurosurgery departments. Randomised surveys, adjusted for working age, were performed in Andalusia using a telephone questionnaire based on the SERVQUAL model with the appropriate modification, with the subsequent selection of a subgroup associated with neurosurgery. Perceived quality was classified as; technical, functional and infrastructure quality. The overall satisfaction was 76.3%. Frequency analysis found that variables related to the technical quality (good doctors, successful operations, trained staff, etc.) obtained more favourable outcomes. Those related to time (wait, consulting, organizing schedules) obtained worse outcomes. The care of families variables obtained poor results. There was no difference between the overall Andalusian healthcare system and neurosurgery departments. In the mean analysis, women and older people gave more favourable responses, especially for variables related to infrastructure quality. In the "cluster" analysis, there were more favourable responses by elderly people, with no differences in gender (P<.009). There is no difference in perceived quality between the Andalusian healthcare system overall and neurosurgery departments. The perceived quality of the Andalusian healthcare system is higher in the elderly people. The analysis of perceived quality is useful for promoting projects to improve clinical management. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

During early to mid adolescence, moderate to vigorous physical activity is associated with restoring sleep, psychological functioning, mental toughness and male gender.

PubMed

Brand, Serge; Kalak, Nadeem; Gerber, Markus; Clough, Peter J; Lemola, Sakari; Sadeghi Bahmani, Dena; Pühse, Uwe; Holsboer-Trachsler, Edith

2017-03-01

Numerous studies showed that regular physical activity (PA) is associated with both favourable and restorative sleep and improved psychological functioning (PF). However, there is little research on the topic covering the early to mid-adolescence period. Moreover, curiosity and exploratory behaviour (CEB) and mental toughness (MT) as a result of PA remains thus far uninvestigated, as do possible gender differences. The aim of the present study was to explore the associations between PA, subjective sleep (sS), PF, CEB, and MT during early to mid-adolescence. A total of 1361 participants (mean age = 13.37 years; range: 11-16 years; 51.2% female) took part in the study. They completed questionnaires covering PA, sS, PF, CEB, and MT. Greater PA was related to improved PF, better sS, and increased CEB and MT. Compared to male participants, females reported less PA, poorer sS, and had lower PF and MT scores. The present pattern of results suggests that during early and mid-adolescence greater PA was associated with more favourable sS and better PF, including CEB and MT, and that female participants reported lower scores in PA, sS, and PF. Accordingly, if PA has a favourable impact on sleep and psychological functioning, then data suggest that sports participation should be more tailored to increase motivation among female adolescents.

Building a protein name dictionary from full text: a machine learning term extraction approach.

PubMed

Shi, Lei; Campagne, Fabien

2005-04-07

The majority of information in the biological literature resides in full text articles, instead of abstracts. Yet, abstracts remain the focus of many publicly available literature data mining tools. Most literature mining tools rely on pre-existing lexicons of biological names, often extracted from curated gene or protein databases. This is a limitation, because such databases have low coverage of the many name variants which are used to refer to biological entities in the literature. We present an approach to recognize named entities in full text. The approach collects high frequency terms in an article, and uses support vector machines (SVM) to identify biological entity names. It is also computationally efficient and robust to noise commonly found in full text material. We use the method to create a protein name dictionary from a set of 80,528 full text articles. Only 8.3% of the names in this dictionary match SwissProt description lines. We assess the quality of the dictionary by studying its protein name recognition performance in full text. This dictionary term lookup method compares favourably to other published methods, supporting the significance of our direct extraction approach. The method is strong in recognizing name variants not found in SwissProt.

Building a protein name dictionary from full text: a machine learning term extraction approach

PubMed Central

Shi, Lei; Campagne, Fabien

2005-01-01

Background The majority of information in the biological literature resides in full text articles, instead of abstracts. Yet, abstracts remain the focus of many publicly available literature data mining tools. Most literature mining tools rely on pre-existing lexicons of biological names, often extracted from curated gene or protein databases. This is a limitation, because such databases have low coverage of the many name variants which are used to refer to biological entities in the literature. Results We present an approach to recognize named entities in full text. The approach collects high frequency terms in an article, and uses support vector machines (SVM) to identify biological entity names. It is also computationally efficient and robust to noise commonly found in full text material. We use the method to create a protein name dictionary from a set of 80,528 full text articles. Only 8.3% of the names in this dictionary match SwissProt description lines. We assess the quality of the dictionary by studying its protein name recognition performance in full text. Conclusion This dictionary term lookup method compares favourably to other published methods, supporting the significance of our direct extraction approach. The method is strong in recognizing name variants not found in SwissProt. PMID:15817129

Defining the structure of undergraduate medical leadership and management teaching and assessment in the UK.

PubMed

Stringfellow, Thomas D; Rohrer, Rebecca M; Loewenthal, Lola; Gorrard-Smith, Connor; Sheriff, Ibrahim H N; Armit, Kirsten; Lees, Peter D; Spurgeon, Peter C

2014-10-10

Abstract Medical leadership and management (MLM) skills are essential in preventing failings of healthcare; it is unknown how these attitudes can be developed during undergraduate medical education. This paper aims to quantify interest in MLM and recommends preferred methods of teaching and assessment at UK medical schools. Two questionnaires were developed, one sent to all UK medical school faculties, to assess executed and planned curriculum changes, and the other sent to medical students nationally to assess their preferences for teaching and assessment. Forty-eight percent of UK medical schools and 260 individual student responses were recorded. Student responses represented 60% of UK medical schools. 65% of schools valued or highly valued the importance of teaching MLM topics, compared with 93.2% of students. Students' favoured teaching methods were seminars or lectures (89.4%) and audit and quality improvement (QI) projects (77.8%). Medical schools preferred portfolio entries (55%) and presentations (35%) as assessment methods, whilst simulation exercises (76%) and audit reports (61%) were preferred by students. Preferred methods encompass experiential learning or simulation and a greater emphasis should be placed on encouraging student audit and QI projects. The curriculum changes necessary could be achieved via further integration into future editions of Tomorrow's Doctors.

Economic evaluations of Internet interventions for mental health: a systematic review.

PubMed

Donker, T; Blankers, M; Hedman, E; Ljótsson, B; Petrie, K; Christensen, H

2015-12-01

Internet interventions are assumed to be cost-effective. However, it is unclear how strong this evidence is, and what the quality of this evidence is. A comprehensive literature search (1990-2014) in Medline, EMBASE, the Cochrane Central Register of Controlled Trials, NHS Economic Evaluations Database, NHS Health Technology Assessment Database, Office of Health Economics Evaluations Database, Compendex and Inspec was conducted. We included economic evaluations alongside randomized controlled trials of Internet interventions for a range of mental health symptoms compared to a control group, consisting of a psychological or pharmaceutical intervention, treatment-as-usual (TAU), wait-list or an attention control group. Of the 6587 abstracts identified, 16 papers met the inclusion criteria. Nine studies featured a societal perspective. Results demonstrated that guided Internet interventions for depression, anxiety, smoking cessation and alcohol consumption had favourable probabilities of being more cost-effective when compared to wait-list, TAU, group cognitive behaviour therapy (CBGT), attention control, telephone counselling or unguided Internet CBT. Unguided Internet interventions for suicide prevention, depression and smoking cessation demonstrated cost-effectiveness compared to TAU or attention control. In general, results from cost-utility analyses using more generic health outcomes (quality of life) were less favourable for unguided Internet interventions. Most studies adhered reasonably to economic guidelines. Results of guided Internet interventions being cost-effective are promising with most studies adhering to publication standards, but more economic evaluations are needed in order to determine cost-effectiveness of Internet interventions compared to the most cost-effective treatment currently available.

Efficacy and safety of the low-molecular weight heparin enoxaparin compared with unfractionated heparin across the acute coronary syndrome spectrum: a meta-analysis.

PubMed

Murphy, Sabina A; Gibson, Charles Michael; Morrow, David A; Van de Werf, Frans; Menown, Ian B; Goodman, Shaun G; Mahaffey, Kenneth W; Cohen, Marc; McCabe, Carolyn H; Antman, Elliott M; Braunwald, Eugene

2007-09-01

To determine whether the low-molecular weight heparin enoxaparin remains favourable when compared with unfractionated heparin (UFH) among patients with acute coronary syndromes (ACS) when incorporating efficacy and safety of these adjunctive therapies using a net clinical endpoint. We performed a meta-analysis of randomized trials of enoxaparin vs. UFH in ST-elevation-MI (STEMI) or non-ST-elevation-ACS (NSTEACS) (n = 49,088 patients in 12 trials). The net clinical endpoint was defined as death, MI, or major bleeding by 30 days. Death or myocardial infarction (MI) was significantly reduced with enoxaparin when compared with UFH (9.8 vs. 11.4%, OR 0.84, P < 0.001). The net clinical endpoint occurred less frequently with enoxaparin than UFH (12.5 vs. 13.5%, OR 0.90, P = 0.051). Major bleeding was higher with enoxaparin (4.3 vs. 3.4%, OR 1.25, P = 0.019). Among STEMI trials, the net clinical endpoint was significantly lower with enoxaparin (OR 0.84, P = 0.015), but there was no difference in NSTEACS trials (OR 0.97). When compared with UFH, enoxaparin was associated with superior efficacy as adjunctive antithrombin therapy among >49 000 patients across the ACS spectrum. Although bleeding was increased with enoxaparin, this increase was offset by a reduction in death or MI. The net clinical benefit in favour of enoxaparin was evident among the STEMI population and was neutral among the NSTEACS population.

Surgical versus medical methods for second trimester induced abortion.

PubMed

Lohr, P A; Hayes, J L; Gemzell-Danielsson, K

2008-01-23

Determining the optimal method of performing second-trimester abortions is important, since they account for a disproportionate amount of abortion-related morbidity and mortality. To compare surgical and medical methods of inducing abortion in the second trimester of pregnancy with regard to efficacy, side effects, adverse events, and acceptability. We identified trials using Pub Med, EMBASE, POPLINE, and the Cochrane Central Register of Controlled Trials (CENTRAL). We also searched the reference lists of identified studies, relevant review articles, book chapters, and conference proceedings for additional, previously unidentified studies. We contacted experts in the field for information on other published or unpublished research. Randomised trials comparing any surgical to any medical method of inducing abortion at >/= 13 weeks' gestation were included. We assessed the validity of each study using the methods suggested in the Cochrane Handbook. Investigators were contacted as needed to provide additional information regarding trial conduct or outcomes. Two reviewers abstracted the data. Odds ratios and 95% confidence intervals were calculated for dichotomous variables using RevMan 4.2. The trials did not have uniform interventions, therefore, we were unable to combine them into a meta-analysis. Two studies met criteria for this review. One compared dilation and evacuation (D&E) to intra-amniotic instillation of prostaglandin F(2) (alpha). The second study compared D&E to induction with mifepristone and misoprostol. Compared with prostaglandin instillation, the combined incidence of minor complications was lower with D&E (OR 0.17, 95% CI 0.04-0.65) as was the total number of minor and major complications (OR 0.12, 95% CI 0.03-0.46). The number of women experiencing adverse events was also lower with D&E than with mifepristone and misoprostol (OR 0.06, 95% CI 0.01-0.76). Although women treated with mifepristone and misoprostol reported significantly more pain than those undergoing D&E, efficacy and acceptability were the same in both groups. In both trials, fewer subjects randomised to D&E required overnight hospitalisation. Dilation and evacuation is superior to instillation of prostaglandin F(2) (alpha). The current evidence also appears to favour D&E over mifepristone and misoprostol, however larger randomised trials are needed.

Determining a carbohydrate profile for Hansenula polymorpha

NASA Technical Reports Server (NTRS)

Petersen, G. R.

1985-01-01

The determination of the levels of carbohydrates in the yeast Hansenula polymorpha required the development of new analytical procedures. Existing fractionation and analytical methods were adapted to deal with the problems involved with the lysis of whole cells. Using these new procedures, the complete carbohydrate profiles of H. polymorpha and selected mutant strains were determined and shown to correlate favourably with previously published results.

Influence of Mobile Learning Training on Pre-Service Social Studies Teachers' Technology and Mobile Phone Self-Efficacies

ERIC Educational Resources Information Center

Gloria, Adedoja; Oluwadara, Abimbade

2016-01-01

Current instructional deliveries favour the use of mobile technology because of its inherent potentials and benefits such as portability, ease of use cost and others. Despite these benefits, many teachers especially in Sub-Saharan Africa still prefer the conventional method and use mobile phones for social engagements such as texting, chatting,…

A needs assessment study of undergraduate surgical education.

PubMed

Kaur, Navneet; Gupta, Ankit; Saini, Pradeep

2011-01-01

A needs assessment is the process of identifying performance requirements or 'gaps' between what is required and what exists at present. To identify these gaps, the inputs of all stakeholders are needed. In medical education, graduating medical students are important stakeholders who can provide valuable feedback on deficiencies in their training. To know the students' perceptions about effectiveness of their surgical training, an anonymous questionnaire seeking their opinion on the duration, content, methods of teaching and assessment was administered. Their responses were analysed using descriptive statistics. The students were largely in favour of active methods of learning and there was very little preference for didactic lectures. For clinical teaching, involvement in ward rounds and patient care activities, in addition to case discussions, was considered to facilitate learning. A clerkship model of clinical training was favoured. Any teaching-learning activity in small groups of 8-10 students were preferred. As regards their evaluation, besides internal assessment, the students felt the need for direct constructive feedback from teachers on how to improve their performance. A large number (73.5%) were opposed to attendance being considered a qualifying criterion for taking the examination. Students' feedback about their 'perceived needs' should be considered when revising training programmes.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Szcześ, Aleksandra, E-mail: aszczes@poczta.umcs.lublin.pl; Czemierska, Magdalena; Jarosz-Wilkołazka, Anna

Extracellular polymeric substance (EPS) extracted from Rhodococcus opacus bacterial strain was used as a matrix for calcium carbonate precipitation using the vapour diffusion method. The total exopolymer and water-soluble exopolymer fraction of different concentrations were spread on the mica surface by the spin-coating method. The obtained layers were characterized using the atomic force microscopy measurement and XPS analysis. The effects of polymer concentration, initial pH of calcium chloride solution and precipitation time on the obtained crystals properties were investigated. Raman spectroscopy and scanning electron microscopy were used to characterize the precipitated minerals. It was found that the type of precipitatedmore » CaCO{sub 3} polymorph and the crystal size depend on the kind of EPS fraction. The obtained results indicates that the water soluble fraction favours vaterite dissolution and calcite growth, whereas the total EPS stabilizes vaterite and this effect is stronger at basic pH. It seems to be due to different contents of the functional group of EPS fractions. - Highlights: • CaCO{sub 3} crystal size and polymorph can be controlled by EPS substance obtained from R. opacus. • The water soluble fraction favours vaterite dissolution and calcite growth. • The total EPS stabilizes vaterite. • This effect is stronger at basic pH.« less

Comparison of the diagnostic accuracy of a rapid immunochromatographic test and the rapid plasma reagin test for antenatal syphilis screening in Mozambique.

PubMed Central

Montoya, Pablo J.; Lukehart, Sheila A.; Brentlinger, Paula E.; Blanco, Ana J.; Floriano, Florencia; Sairosse, Josefa; Gloyd, Stephen

2006-01-01

OBJECTIVE: Programmes to control syphilis in developing countries are hampered by a lack of laboratory services, delayed diagnosis, and doubts about current screening methods. We aimed to compare the diagnostic accuracy of an immunochromatographic strip (ICS) test and the rapid plasma reagin (RPR) test with the combined gold standard (RPR, Treponema pallidum haemagglutination assay and direct immunofluorescence stain done at a reference laboratory) for the detection of syphilis in pregnancy. METHODS: We included test results from 4789 women attending their first antenatal visit at one of six health facilities in Sofala Province, central Mozambique. We compared diagnostic accuracy (sensitivity, specificity, and positive and negative predictive values) of ICS and RPR done at the health facilities and ICS performed at the reference laboratory. We also made subgroup comparisons by human immunodeficiency virus (HIV) and malaria status. FINDINGS: For active syphilis, the sensitivity of the ICS was 95.3% at the reference laboratory, and 84.1% at the health facility. The sensitivity of the RPR at the health facility was 70.7%. Specificity and positive and negative predictive values showed a similar pattern. The ICS outperformed RPR in all comparisons (P<0.001). CONCLUSION: The diagnostic accuracy of the ICS compared favourably with that of the gold standard. The use of the ICS in Mozambique and similar settings may improve the diagnosis of syphilis in health facilities, both with and without laboratories. PMID:16501726

Aesthetic outcome of single-tooth implant restorations following early implant placement and guided bone regeneration: crown and soft tissue dimensions compared with contralateral teeth.

PubMed

Cosyn, Jan; De Rouck, Tim

2009-10-01

The aim of this study was to compare crown and soft tissue dimensions of single-tooth implant restorations following early implant placement and guided bone regeneration (GBR) with contralateral non-restored teeth. Twenty-seven patients treated by one and the same surgeon and prosthodontist to restore a single-tooth gap with a class I bone defect in the premaxilla by means of an implant-supported restoration were reviewed. Patients were examined at least 6 months following placement of the crown. All implants had been inserted 6-8 weeks following tooth extraction in conjunction with GBR. At evaluation, crown dimensions, soft tissue dimensions, clinical conditions and patients' aesthetic satisfaction were assessed by one clinician who had not been involved in the treatment. Implant-supported crowns were not significantly longer than contralateral teeth and midfacial soft tissues showed comparable levels after on average 21 months of function. Our data also indicated significant papilla loss especially at the distal aspect of the implants. As the patient's aesthetic appreciation was favourable in 88% of the cases, this appeared to be of trivial importance. Favourable aesthetics may be achieved for single-tooth implant restorations following early implant placement and GBR. The impact of the latter on papilla levels, however, remains to be determined in longitudinal studies.

A general method for decomposing the causes of socioeconomic inequality in health.

PubMed

Heckley, Gawain; Gerdtham, Ulf-G; Kjellsson, Gustav

2016-07-01

We introduce a general decomposition method applicable to all forms of bivariate rank dependent indices of socioeconomic inequality in health, including the concentration index. The technique is based on recentered influence function regression and requires only the application of OLS to a transformed variable with similar interpretation. Our method requires few identifying assumptions to yield valid estimates in most common empirical applications, unlike current methods favoured in the literature. Using the Swedish Twin Registry and a within twin pair fixed effects identification strategy, our new method finds no evidence of a causal effect of education on income-related health inequality. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Student and staff opinion of electronic capture of data related to clinical activity.

PubMed

Oliver, R G

1997-02-01

To seek the opinion of staff and students of a new electronic method for collection of data related to student clinical activity. Questionnaire survey. Staff and students in the Department of Child Dental Health, Dental School, Cardiff, and staff in the Community Dental Service who undertake clinical supervision. A questionnaire was circulated to all 2nd and 3rd clinical year dental undergraduate students seeking their opinion on a range of issues associated with the recently introduced bar code system of data gathering of their clinical activity and achievement. A similar questionnaire was circulated to staff who have responsibility for clinical supervision of these students. A total of 102 replies were received. With the exception of 2 aspects, there was no disagreement between staff and students. An overall majority preferred the use of bar codes to other methods of data collection; bar codes were perceived to be more accurate and reliable than other methods; students were satisfied with the method of quality assessment; staff were dissatisfied (P < 0.05). Staff were strongly in favour of extension of the use of bar codes to other clinics, whereas students were less strongly in favour (P < 0.001); there was little enthusiasm to extend bar codes for recording attendance at lectures, seminars and other such activity. The new system has been accepted by staff and students alike. It has proven to be satisfactory for its intended purpose. As a result of this survey, minor adjustments to procedures will take place, and the method of assessment of clinical work will be reconsidered.

Spectrophotometric Methods for Simultaneous Determination of Oxytetracycline HCl and Flunixin Meglumine in Their Veterinary Pharmaceutical Formulation

PubMed Central

Abd-Elmonem, Mahmmoud S.; Nazlawy, Hagar N.; Zaazaa, Hala E.

2017-01-01

Four precise, accurate, selective, and sensitive UV-spectrophotometric methods were developed and validated for the simultaneous determination of a binary mixture of Oxytetracycline HCl (OXY) and Flunixin Meglumine (FLU). The first method, dual wavelength (DW), depends on measuring the difference in absorbance (ΔA 273.4–327 nm) for the determination of OXY where FLU is zero while FLU is determined at ΔA 251.7–275.7 nm. The second method, first-derivative spectrophotometric method (1D), depends on measuring the peak amplitude of the first derivative selectively at 377 and 266.7 nm for the determination of OXY and FLU, respectively. The third method, ratio difference method, depends on the difference in amplitudes of the ratio spectra at ΔP 286.5–324.8 nm and ΔP 249.6–286.3 nm for the determination of OXY and FLU, respectively. The fourth method, first derivative of ratio spectra method (1DD), depends on measuring the amplitude peak to peak of the first derivative of ratio spectra at 296.7 to 369 nm and 259.1 to 304.7 nm for the determination of OXY and FLU, respectively. Different factors affecting the applied spectrophotometric methods were studied. The proposed methods were validated according to ICH guidelines. Satisfactory results were obtained for determination of both drugs in laboratory prepared mixture and pharmaceutical dosage form. The developed methods are compared favourably with the official ones. PMID:28811956

Efficacy of soft tissue augmentation around dental implants and in partially edentulous areas: a systematic review.

PubMed

Thoma, Daniel S; Buranawat, Borvornwut; Hämmerle, Christoph H F; Held, Ulrike; Jung, Ronald E

2014-04-01

To review the dental literature in terms of efficacy of soft tissue augmentation procedures around dental implants and in partially edentulous sites. A Medline search was performed for human studies augmenting keratinized mucosa (KM) and soft tissue volume around implants and in partially edentulous areas. Due to heterogeneity in between the studies, no meta-analyses could be performed. Nine (KM) and eleven (volume) studies met the inclusion criteria. An apically positioned flap/vestibuloplasty (APF/V) plus a graft material [free gingival graft (FGG)/subepithelial connective tissue graft (SCTG)/collagen matrix (CM)] resulted in an increase of keratinized tissue (1.4-3.3 mm). Statistically significantly better outcomes were obtained for APF/V plus FGG/SCTG compared with controls (APF/V alone; no treatment) (p < 0.05). For surgery time and patient morbidity, statistically significantly more favourable outcomes were reported for CM compared to SCTGs (p < 0.05) in two randomized controlled clinical trials (RCTs), even though rendering less keratinized tissue. SCTGs were the best-documented method for gain of soft tissue volume at implant sites and partially edentulous sites. Aesthetically at immediate implant sites, better papilla fill and higher marginal mucosal levels were obtained using SCTGs compared to non-grafted sites. An APF/V plus FGG/SCTG was the best-documented and most successful method to increase the width of KM. APF/V plus CM demonstrated less gain in KM, but also less patient morbidity and surgery time compared to APF/V plus SCTG based on two RCTs. Autogenous grafts (SCTG) rendered an increase in soft tissue thickness and better aesthetics compared to non-grafted sites. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Antiangiogenic therapy with anti-vascular endothelial growth factor modalities for neovascular age-related macular degeneration

PubMed Central

Vedula, Satyanarayana S; Krzystolik, Magdalena

2014-01-01

Background Age-related macular degeneration (AMD) is a common cause of severe vision loss in people 55 years and older. Objectives The objective of this review was to investigate the effects of anti-VEGF (vascular endothelial growth factor) modalities for treating neovascular AMD. Search strategy We searched CENTRAL, MEDLINE, EMBASE and LILACS. We handsearched ARVO abstracts for 2006, 2007 for ongoing trials. Selection criteria We included randomized controlled trials (RCTs). Data collection and analysis Two review authors independently extracted data. We contacted trial authors for additional data. We summarized outcomes as relative risks (RR), number needed to treat (NNT) and weighted mean differences. Main results We included five RCTs of good methodological quality. All five trials were conducted by pharmaceutical companies. An intention-to-treat analysis using the last observation carried forward method was done in most trials. Two trials compared pegaptanib versus sham. One trial compared ranibizumab versus sham, another compared ranibizumab/sham verteporfin PDT versus verteporfin PDT/sham ranibizumab, and the final trial compared ranibizumab plus verteporfin PDT versus verteporfin PDT alone. Fewer patients treated with pegaptanib lost 15 or more letters of visual acuity at one year follow-up compared to sham (pooled relative risk (RR) 0.71; 95% confidence interval (CI) 0.61 to 0.84). The NNT was 6.67 (95% CI 4.35 to 14.28) for 0.3 mg pegaptanib, 6.25 (95% CI 4.17 to 12.5) for 1 mg pegaptanib and 14.28 (95% CI 6.67 to 100) for 3 mg pegaptanib. In a trial of ranibizumab versus sham, RR for loss of 15 or more letters visual acuity at one year was 0.14 (95% CI 0.1 to 0.22) in favour of ranibizumab. The NNT was 3.13 (95% CI 2.56 to 3.84) for 0.3 mg ranibizumab and 3.13 (95% CI 2.56 to 3.84) for 0.5 mg ranibizumab. In a trial of ranibizumab versus verteporfin PDT, RR for loss of 15 or more letters at one year was 0.13 (95% CI 0.07 to 0.23) favouring ranibizumab. The NNT was 3.33 (95% CI 2.56 to 4.76) for 0.3 mg ranibizumab and 3.12 (95% CI 2.43 to 4.17) for 0.5 mg ranibizumab. In another trial of combined ranibizumab plus verteporfin PDT versus verteporfin PDT, RR for loss of 15 or more letters at one year favoured combined therapy (RR 0.3 (95% CI 0.15 to 0.60). The NNT was 4.35 (95% CI 2.78 to 11.11). Pooled RR for gain of 15 or more letters visual acuity at one year was 5.81 (95% CI 3.29 to 10.26) for ranibizumab versus sham, 6.79 (95% CI 3.41 to 13.54) for ranibizumab/sham verteporfin PDT versus verteporfin PDT/sham ranibizumab, and 4.44 (95% CI 1.40 to 14.08) for ranibizumab plus verteporfin PDT versus verteporfin PDT. Frequency of endophthalmitis in included studies was between 0.7% to 4.7% with ranibizumab and 1.3% with pegaptanib. Improvement in vision-specific quality of life was reported for both treatments. Authors' conclusions Pegaptanib and ranibizumab reduce the risk of visual acuity loss in patients with neovascular AMD. Ranibizumab causes gains in visual acuity in many eyes. Quality of life and cost will be important for treatment decisions. Other agents blocking VEGF are being tested in ongoing trials. PMID:18425911

Identification of flame transfer functions in the presence of intrinsic thermoacoustic feedback and noise

NASA Astrophysics Data System (ADS)

Jaensch, Stefan; Merk, Malte; Emmert, Thomas; Polifke, Wolfgang

2018-05-01

The Large Eddy Simulation/System Identification (LES/SI) approach is a general and efficient numerical method for deducing a Flame Transfer Function (FTF) from the LES of turbulent reacting flow. The method may be summarised as follows: a simulated flame is forced with a broadband excitation signal. The resulting fluctuations of the reference velocity and of the global heat release rate are post-processed via SI techniques in order to estimate a low-order model of the flame dynamics. The FTF is readily deduced from the low-order model. The SI method most frequently applied in aero- and thermo-acoustics has been Wiener-Hopf Inversion (WHI). This method is known to yield biased estimates in situations with feedback, thus it was assumed that non-reflective boundary conditions are required to generate accurate results with the LES/SI approach. Recent research has shown that the FTF is part of the so-called Intrinsic ThermoAcoustic (ITA) feedback loop. Hence, identifying an FTF from a compressible LES is always a closed-loop problem, and consequently one should expect that the WHI would yield biased results. However, several studies proved that WHI results compare favourably with validation data. To resolve this apparent contradiction, a variety of identification methods are compared against each other, including models designed for closed-loop identification. In agreement with theory, we show that the estimate given by WHI does not converge to the actual FTF. Fortunately, the error made is small if excitation amplitudes can be set such that the signal-to-noise ratio is large, but not large enough to trigger nonlinear flame dynamics. Furthermore, we conclude that non-reflective boundary conditions are not essentially necessary to apply the LES/SI approach.

[SPA therapy for pain of patients with chronic low back pain, knee osteo-arthritis and fibromyalgia].

PubMed

Roques, Christian-François; Queneau, Patrice

2016-03-01

The data of 33 randomized controlled trials suggest that chronic pain of patients with chronic low back pain, knee osteo-arthritis, fibromyalgia is significantly improved by balneotherapy and significantly better improved than by control treatments. For chronic low back pain (10 RCT, 1192 patients) pain was better improved in balneotherapy group and the weighted mean of the differential improvement was 19.66 (95 % CI: 16.6 ; 22.8) and the effect size was 1.1 (95 %CI: 0.82 ; 1.38) favouring balneotherapy. For knee osteo-arthritis pain (17 RCT, 1428 patients) pain was better improved in balneotherapy group and the weighted mean of the differential improvement was 13.24 (95 % CI: 5.52 ; 20.96) and the effect size was 0.72 (95 %CI: 0.51 ; 0.93) favouring balneotherapy. For fibromyalgia (6 RCT, 398 patients) pain was better improved in balneotherapy group and the weighted mean of the differential improvement was 19.32 (95 % CI: 10.62 ; 29.2) and the effect size was 0.79 (95 %CI: 0.27 ; 1.31) favouring balneotherapy. Mineral waters and healing muds appear to have a more powerful analgesic action: 13 RCT (701) patients) compared mineral water bathing to tap water bathing or peloid application to hot-apcks or neutral muds application : the effect size was 0.75 (95 % CI :0.71 ; 0.79) favouring balneotherapy. Balneotherapy is a safe treatment as only 1 % of the patients receiving balneotherapy had to interrupt the treatment. However several methodological biases were observed in many trials, mainly a lack of statistical power due to a limited enrolment of patients, an insufficient duration of follow-up, an inhomogeneity of treatments. The clinical benefit has to be confirmed by stronger data of evidence but these data are sufficient to perform a more complete scientific analysis (meta-analysis) ; but further clinical investigations with a better methodological quality remain necessary.

The H II galaxy Hubble diagram strongly favours Rh = ct over ΛCDM

NASA Astrophysics Data System (ADS)

Wei, Jun-Jie; Wu, Xue-Feng; Melia, Fulvio

2016-12-01

We continue to build support for the proposal to use H II galaxies (HIIGx) and giant extragalactic H II regions (GEHR) as standard candles to construct the Hubble diagram at redshifts beyond the current reach of Type Ia supernovae. Using a sample of 25 high-redshift HIIGx, 107 local HIIGx, and 24 GEHR, we confirm that the correlation between the emission-line luminosity and ionized-gas velocity dispersion is a viable luminosity indicator, and use it to test and compare the standard model ΛCDM and the Rh = ct universe by optimizing the parameters in each cosmology using a maximization of the likelihood function. For the flat ΛCDM model, the best fit is obtained with Ω _m= 0.40_{-0.09}^{+0.09}. However, statistical tools, such as the Akaike (AIC), Kullback (KIC) and Bayes (BIC) Information Criteria favour Rh = ct over the standard model with a likelihood of ≈94.8-98.8 per cent versus only ≈1.2-5.2 per cent. For wCDM (the version of ΛCDM with a dark-energy equation of state wde ≡ pde/ρde rather than wde = wΛ = -1), a statistically acceptable fit is realized with Ω _m=0.22_{-0.14}^{+0.16} and w_de= -0.51_{-0.25}^{+0.15} which, however, are not fully consistent with their concordance values. In this case, wCDM has two more free parameters than Rh = ct, and is penalized more heavily by these criteria. We find that Rh = ct is strongly favoured over wCDM with a likelihood of ≈92.9-99.6 per cent versus only 0.4-7.1 per cent. The current HIIGx sample is already large enough for the BIC to rule out ΛCDM/wCDM in favour of Rh = ct at a confidence level approaching 3σ.

Sperm competition games: sperm selection by females.

PubMed

Ball, M A; Parker, G A

2003-09-07

We analyse a co-evolutionary sexual conflict game, in which males compete for fertilizations (sperm competition) and females operate sperm selection against unfavourable ejaculates (cryptic female choice). For simplicity, each female mates with two males per reproductive event, and the competing ejaculates are of two types, favourable (having high viability or success) or unfavourable (where progeny are less successful). Over evolutionary time, females can increase their level of sperm selection (measured as the proportion of unfavourable sperm eliminated) by paying a fecundity cost. Males can regulate sperm allocations depending on whether they will be favoured or disfavoured, but increasing sperm allocation reduces their mating rate. The resolution of this game depends on whether males are equal, or unequal. Males could be equal: each is favoured with probability, p, reflecting the proportion of females in the population that favour his ejaculate (the 'random-roles' model); different males are favoured by different sets of females. Alternatively, males could be unequal: given males are perceived consistently by all females as two distinct types, favoured and disfavoured, where p is now the frequency of the favoured male type in the population (the 'constant-types' model). In both cases, the evolutionarily stable strategy (ESS) is for females initially to increase sperm selection from zero as the viability of offspring from unfavourable ejaculates falls below that of favourable ejaculates. But in the random-roles model, sperm selection decreases again towards zero as the unfavourable ejaculates become disastrous (i.e. as their progeny viability decreases towards zero). This occurs because males avoid expenditure in unfavourable matings, to conserve sperm for matings in the favoured role where their offspring have high viability, thus allowing females to relax sperm selection. If sperm selection is costly to females, ESS sperm selection is high across a region of intermediate viabilities. If it is uncostly, there is no ESS in this region unless sperm limitation (i.e. some eggs fail to be fertilized because sperm numbers are too low) is included into the model. In the constant-types model, no relaxation of sperm selection occurs at very low viabilities of disfavoured male progeny. If sperm selection is sufficiently costly, ESS sperm selection increases as progeny viability decreases down towards zero; but if it is uncostly, there is no ESS at the lowest viabilities, and unlike the random-roles model, this cannot be stabilized by including sperm limitation. Sperm allocations in the ESS regions differ between the two models. With random roles, males always allocate more sperm in the favoured role. With constant types, the male type that is favoured allocates less sperm than the disfavoured type. These results suggests that empiricists studying cryptic female choice and sperm allocation patterns need to determine whether sperm selection is applied differently, or consistently, on given males by different females in the same population.

The treat-and-extend injection regimen versus alternate dosing strategies in age-related macular degeneration: a systematic review and meta-analysis.

PubMed

Okada, Mali; Kandasamy, Rathika; Chong, Elaine W; McGuiness, Myra; Guymer, Robyn H

2018-06-06

To assess outcomes of the treat-and-extend (T&E) injection regimen for neovascular age related macular degeneration (AMD) as compared to either a monthly or a pro-re-nata (PRN) treatment strategy. Systematic review and meta-analysis METHODS: Studies that compared the T&E regimen with either monthly or PRN dosing for treatment-naïve AMD were included. Trial eligibility, data extraction and risk of bias were assessed according to Cochrane review methods. Estimates were pooled using random effects meta-analysis. Four eligible studies were identified, all using ranibizumab (total n=940 eyes), including two randomized controlled trials comparing T&E to monthly and two retrospective reviews comparing T&E to PRN. No studies evaluating aflibercept were identified. Improvements in vision and central retinal thickness were similar between T&E and monthly at 12 months, with a mean difference of -1.79 letters (95% CI: 3.70, 0.13) and 3.76μm (95% CI: -13.78, 21.30) in favour of monthly injections. In contrast, visual gains were higher in the T&E compared to PRN group (difference of +6.18 letters, 95% CI: 3.28, 9.08). Fewer injections were required using the T&E regimen when compared to monthly (mean of -1.6 and -6.9 injections less at 12 and 24 months respectively). A mean of 1.44 more injections was required for the T&E compared to PRN regimen at 12 months, however this was achieved with fewer visits. Despite the growing preference for the T&E regimen, there is limited head-to-head evidence comparing dosing strategies. The evidence available however, suggests that at 12 months, T&E is comparable to monthly and superior to PRN dosing for both efficacy and safety outcomes when using ranibizumab. Copyright © 2018 Elsevier Inc. All rights reserved.

PhD by Publication as an Argument for Innovation and Technology Transfer: With Emphasis on Africa

ERIC Educational Resources Information Center

Asongu, Simplice A.; Nwachukwu, Jacinta C.

2018-01-01

The contribution of African researchers to knowledge by means of scientific publications is low compared to other regions of the world. This paper presents an argument in favour of PhD by publication as a tool for innovation and technology transfer. The conception of PhD by publication used in this study is more suited for doctorates in science…

The causes of functional psychoses as seen by patients and their relatives. II. The relatives' point of view.

PubMed

Angermeyer, M C; Klusmann, D; Walpuski, O

1988-01-01

The concepts of relatives of patients suffering from functional psychoses regarding the causes of the illness were investigated using the same methodological approach as with the patients. Relatives, like patients, favoured psychosocial over biological explanations. However, when compared pairwise the concordance between relatives and patients was very low. Some methodological refinements recommended for further research are proposed.

A Multicentre and stratified study of the attitude of medical students towards organ donation in Spain.

PubMed

Ríos, A; López-Navas, A; López-López, A; Gómez, F J; Iriarte, J; Herruzo, R; Blanco, G; Llorca, F J; Asunsolo, A; Sánchez, P; Gutiérrez, P R; Fernández, A; de Jesús, M T; Martínez Alarcón, L; Lana, A; Fuentes, L; Hernández, J R; Virseda, J; Yelamos, J; Bondía, J A; Hernández, A M; Ayala, M A; Ramírez, P; Parrilla, P

2017-06-30

Medical students represent a new generation of medical thought, and if they have a favourable attitude towards organ donation this will greatly encourage its promotion. To analyse the attitude of medical students in Spanish universities towards the donation of their own organs and to determine the factors affecting this attitude. Type of study: A sociological, interdisciplinary, multicentre, and observational study in Spain. Students studying a degree in medicine enrolled in Spain (n = 34,000). A sample of 9598 students (confidence of 99% and precision of ±1%), stratified by geographical area and academic year. Instrument of measurement: A validated questionnaire of attitude towards organ donation and transplantation (PCID-DTO RIOS) was self-administered and completed anonymously. The questionnaire completion rate was 95.7% (n = 9.275). 80% were in favour of donation, 2% against and 18% were undecided. The following main variables were related to a favourable attitude: being of the female sex (Odds Ratio = 1.739); being in the sixth year of the degree (OR = 2.506); knowing a donor (OR = 1.346); having spoken about the subject with one's family (OR = 2.132) and friends (OR = 1.333); having a family circle that is in favour, more specifically, having a father (OR = 1.841), mother (OR = 2.538) or partner in favour (OR = 2.192); being a blood donor (OR = 2.824); acceptance of the mutilation of the body if it were necessary (OR = 2.958); and being an atheist or an agnostic (OR = 1.766). Spanish medical students generally have a favourable attitude towards organ donation, although 20% are not in favour.

Patient preferences for partner notification.

PubMed

Apoola, A; Radcliffe, K W; Das, S; Robshaw, V; Gilleran, G; Kumari, B S; Boothby, M; Rajakumar, R

2006-08-01

To identify patient preferences for notification of sexual contacts when a sexually transmitted infection (STI) is diagnosed. A questionnaire survey of 2544 patients attending three large genitourinary clinics at Derby, Birmingham, and Coventry in the United Kingdom. The median age of the respondents was 24 with 1474 (57.9%) women, 1835 (72.1%) white, 1826 (71.8%) single. The most favoured method of partner notification was patient referral, which was rated a "good" method by 65.8% when they had to be contacted because a sexual partner has an STI. Notifying contacts by letter as a method of provider partner notification is more acceptable than phoning, text messaging, or email. Respondents with access to mobile telephones, private emails, and private letters were more likely to rate a method of partner notification using that mode of communication as "good" compared to those without. With provider referral methods of partner notification respondents preferred to receive a letter, email, or text message asking them to contact the clinic rather than a letter, email or text message informing them that they may have an STI. Most respondents think that being informed directly by a partner is the best method of being notified of the risk of an STI. Some of the newer methods may not be acceptable to all but a significant minority of respondents prefer these methods of partner notification. The wording of letters, emails, or text messages when used for partner notification has an influence on the acceptability of the method and may influence success of the partner notification method. Services should be flexible enough to utilise the patients' preferred method of partner notification.

[A case of favourable outcome of the treatment of extremely severe acute poisoning with methanol].

PubMed

Batotsyrenov, B V; Livanov, G A; Vasil'ev, S A; Fedorov, A V; Antrianov, A Iu

2013-01-01

A case of favourable outcome of the treatment of extremely severe acute poisoning after prolonged exposure to lethal doses of methanol is reported. The complex treatment included urgent and effective elimination of the poison (multiple gastric lavage, hemodialysis), antidote therapy (administration of ethanol), correction of decompensated metabolic acidosis (alkali therapy and infusion therapy with reamberin). These measures had beneficial effect on the clinical course of poisoning and ensured its favourable outcome.

Favourable effects of consuming a Palaeolithic-type diet on characteristics of the metabolic syndrome: a randomized controlled pilot-study.

PubMed

Boers, Inge; Muskiet, Frits Aj; Berkelaar, Evert; Schut, Erik; Penders, Ria; Hoenderdos, Karine; Wichers, Harry J; Jong, Miek C

2014-10-11

The main goal of this randomized controlled single-blinded pilot study was to study whether, independent of weight loss, a Palaeolithic-type diet alters characteristics of the metabolic syndrome. Next we searched for outcome variables that might become favourably influenced by a Paleolithic-type diet and may provide new insights in the pathophysiological mechanisms underlying the metabolic syndrome. In addition, more information on feasibility and designing an innovative dietary research program on the basis of a Palaeolithic-type diet was obtained. Thirty-four subjects, with at least two characteristics of the metabolic syndrome, were randomized to a two weeks Palaeolithic-type diet (n = 18) or an isoenergetic healthy reference diet, based on the guidelines of the Dutch Health Council (n = 14). Thirty-two subjects completed the study. Measures were taken to keep bodyweight stable. As primary outcomes oral glucose tolerance and characteristics of the metabolic syndrome (abdominal circumference, blood pressure, glucose, lipids) were measured. Secondary outcomes were intestinal permeability, inflammation and salivary cortisol. Data were collected at baseline and after the intervention. Subjects were 53.5 (SD9.7) year old men (n = 9) and women (n = 25) with mean BMI of 31.8 (SD5.7) kg/m2. The Palaeolithic-type diet resulted in lower systolic blood pressure (-9.1 mmHg; P = 0.015), diastolic blood pressure (-5.2 mmHg; P = 0.038), total cholesterol (-0.52 mmol/l; P = 0.037), triglycerides (-0.89 mmol/l; P = 0.001) and higher HDL-cholesterol (+0.15 mmol/l; P = 0.013), compared to reference. The number of characteristics of the metabolic syndrome decreased with 1.07 (P = 0.010) upon the Palaeolithic-type diet, compared to reference. Despite efforts to keep bodyweight stable, it decreased in the Palaeolithic group compared to reference (-1.32 kg; P = 0.012). However, favourable effects remained after post-hoc adjustments for this unintended weight loss. No changes were observed for intestinal permeability, inflammation and salivary cortisol. We conclude that consuming a Palaeolithic-type diet for two weeks improved several cardiovascular risk factors compared to a healthy reference diet in subjects with the metabolic syndrome. Nederlands Trial Register NTR3002.

Parental effects and the evolution of phenotypic memory.

PubMed

Kuijper, B; Johnstone, R A

2016-02-01

Despite growing evidence for nongenetic inheritance, the ecological conditions that favour the evolution of heritable parental or grandparental effects remain poorly understood. Here, we systematically explore the evolution of parental effects in a patch-structured population with locally changing environments. When selection favours the production of a mix of offspring types, this mix differs according to the parental phenotype, implying that parental effects are favoured over selection for bet-hedging in which the mixture of offspring phenotypes produced does not depend on the parental phenotype. Positive parental effects (generating a positive correlation between parental and offspring phenotype) are favoured in relatively stable habitats and when different types of local environment are roughly equally abundant, and can give rise to long-term parental inheritance of phenotypes. By contrast, unstable habitats can favour negative parental effects (generating a negative correlation between parental and offspring phenotype), and under these circumstances, even slight asymmetries in the abundance of local environmental states select for marked asymmetries in transmission fidelity. © 2015 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2015 European Society For Evolutionary Biology.

Interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults

PubMed Central

Desroches, Sophie; Lapointe, Annie; Ratté, Stéphane; Gravel, Karine; Légaré, France; Turcotte, Stéphane

2016-01-01

Background It has been recognized that poor adherence can be a serious risk to the health and wellbeing of patients, and greater adherence to dietary advice is a critical component in preventing and managing chronic diseases. Objectives To assess the effects of interventions for enhancing adherence to dietary advice for preventing and managing chronic diseases in adults. Search methods We searched the following electronic databases up to 29 September 2010: The Cochrane Library (issue 9 2010), PubMed, EMBASE (Embase.com), CINAHL (Ebsco) and PsycINFO (PsycNET) with no language restrictions. We also reviewed: a) recent years of relevant conferences, symposium and colloquium proceedings and abstracts; b) web-based registries of clinical trials; and c) the bibliographies of included studies. Selection criteria We included randomized controlled trials that evaluated interventions enhancing adherence to dietary advice for preventing and managing chronic diseases in adults. Studies were eligible if the primary outcome was the client’s adherence to dietary advice. We defined ‘client’ as an adult participating in a chronic disease prevention or chronic disease management study involving dietary advice. Data collection and analysis Two review authors independently assessed the eligibility of the studies. They also assessed the risk of bias and extracted data using a modified version of the Cochrane Consumers and Communication Review Group data extraction template. Any discrepancies in judgement were resolved by discussion and consensus, or with a third review author. Because the studies differed widely with respect to interventions, measures of diet adherence, dietary advice, nature of the chronic diseases and duration of interventions and follow-up, we conducted a qualitative analysis. We classified included studies according to the function of the intervention and present results in a narrative table using vote counting for each category of intervention. Main results We included 38 studies involving 9445 participants. Among studies that measured diet adherence outcomes between an intervention group and a control/usual care group, 32 out of 123 diet adherence outcomes favoured the intervention group, 4 favoured the control group whereas 62 had no significant difference between groups (assessment was impossible for 25 diet adherence outcomes since data and/or statistical analyses needed for comparison between groups were not provided). Interventions shown to improve at least one diet adherence outcome are: telephone follow-up, video, contract, feedback, nutritional tools and more complex interventions including multiple interventions. However, these interventions also shown no difference in some diet adherence outcomes compared to a control/usual care group making inconclusive results about the most effective intervention to enhance dietary advice. The majority of studies reporting a diet adherence outcome favouring the intervention group compared to the control/usual care group in the short-term also reported no significant effect at later time points. Studies investigating interventions such as a group session, individual session, reminders, restriction and behaviour change techniques reported no diet adherence outcome showing a statistically significant difference favouring the intervention group. Finally, studies were generally of short duration and low quality, and adherence measures varied widely. Authors’ conclusions There is a need for further, long-term, good-quality studies using more standardized and validated measures of adherence to identify the interventions that should be used in practice to enhance adherence to dietary advice in the context of a variety of chronic diseases. PMID:23450587

Environmental quality and evolutionary potential: lessons from wild populations

PubMed Central

Charmantier, Anne; Garant, Dany

2005-01-01

An essential requirement to determine a population's potential for evolutionary change is to quantify the amount of genetic variability expressed for traits under selection. Early investigations in laboratory conditions showed that the magnitude of the genetic and environmental components of phenotypic variation can change with environmental conditions. However, there is no consensus as to how the expression of genetic variation is sensitive to different environmental conditions. Recently, the study of quantitative genetics in the wild has been revitalized by new pedigree analyses based on restricted maximum likelihood, resulting in a number of studies investigating these questions in wild populations. Experimental manipulation of environmental quality in the wild, as well as the use of naturally occurring favourable or stressful environments, has broadened the treatment of different taxa and traits. Here, we conduct a meta-analysis on recent studies comparing heritability in favourable versus unfavourable conditions in non-domestic and non-laboratory animals. The results provide evidence for increased heritability in more favourable conditions, significantly so for morphometric traits but not for traits more closely related to fitness. We discuss how these results are explained by underlying changes in variance components, and how they represent a major step in our understanding of evolutionary processes in wild populations. We also show how these trends contrast with the prevailing view resulting mainly from laboratory experiments on Drosophila. Finally, we underline the importance of taking into account the environmental variation in models predicting quantitative trait evolution. PMID:16011915

Financial incentives to encourage healthy behaviour: an analysis of U.K. media coverage.

PubMed

Parke, Hannah; Ashcroft, Richard; Brown, Rebecca; Marteau, Theresa M; Seale, Clive

2013-09-01

Policies to use financial incentives to encourage healthy behaviour are controversial. Much of this controversy is played out in the mass media, both reflecting and shaping public opinion. To describe U.K. mass media coverage of incentive schemes, comparing schemes targeted at different client groups and assessing the relative prominence of the views of different interest groups. Thematic content analysis. National and local news coverage in newspapers, news media targeted at health-care providers and popular websites between January 2005 and February 2010. U.K. mass media. The study included 210 articles. Fifteen separate arguments favourable towards schemes, and 19 unfavourable, were identified. Overall, coverage was more favourable than unfavourable, although most articles reported a mix of views. Arguments about the prevalence and seriousness of the health problems targeted by incentive schemes were uncontested. Moral and ethical objections to such schemes were common, focused in particular on recipients such as drug users or the overweight who were already stereotyped as morally deficient, and these arguments were largely uncontested. Arguments about the effectiveness of schemes and their potential for benefit or harm were areas of greater contestation. Government, public health and other health-care provider interests dominated favourable coverage; opposition came from rival politicians, taxpayers' representatives, certain charities and from some journalists themselves. Those promoting incentive schemes for people who might be regarded as 'undeserving' should plan a media strategy that anticipates their public reception. © 2011 John Wiley & Sons Ltd.

Pregabalin and gabapentin for the treatment of sciatica.

PubMed

Robertson, Kelvin; Marshman, Laurence A G; Plummer, David

2016-04-01

Whilst pregabalin (PGB) and gabapentin (GBP) are both used to treat neuropathic pain, their relative role in sciatica is unclear. Our aim was to extensively review the roles of PGB and GBP in treating sciatica. The efficacy, side effects (SE) profile and cost of PGB and GBP in neuropathic pain states were reviewed with special reference to sciatica. Eleven articles matched the criteria: seven systematic reviews, one retrospective cross-sectional study, one placebo-controlled-crossover study, one randomized placebo-controlled double-blind study and one case report. GBP and PGB appeared to demonstrate comparable efficacy and SE. However, the amount and quality of evidence was low, and only indirect comparisons were available. Importantly, no direct "head-to-head" study existed. Globally, costs varied widely (by up to 31 times) and unpredictably (PGB cheaper than GBP, or vice versa). Formulary regulator rulings were globally disparate; however, many exclusively favoured the more expensive drug (whether GBP or PGB). No studies assessed PGB-GBP interchange. Weak evidence suggests that efficacy and SE with GBP and PGB are probably similar; however, firm conclusions are precluded. Despite weak data, and having cited minor titration, but definite cost, advantages, UK National Institute for Health and Clinical Excellence favoured PGB over GBP. Given that no evidence supports unhindered PGB-GBP interchange, neither drug should probably be favoured. Prospective "head-to-head" studies are urgently required to provide robust evidence-based knowledge for choice of GBP or PGB in sciatica. Copyright © 2015 Elsevier Ltd. All rights reserved.

Glycans: bioactive signals decoded by lectins.

PubMed

Gabius, Hans-Joachim

2008-12-01

The glycan part of cellular glycoconjugates affords a versatile means to build biochemical signals. These oligosaccharides have an exceptional talent in this respect. They surpass any other class of biomolecule in coding capacity within an oligomer (code word). Four structural factors account for this property: the potential for variability of linkage points, anomeric position and ring size as well as the aptitude for branching (first and second dimensions of the sugar code). Specific intermolecular recognition is favoured by abundant potential for hydrogen/co-ordination bonds and for C-H/pi-interactions. Fittingly, an array of protein folds has developed in evolution with the ability to select certain glycans from the natural diversity. The thermodynamics of this reaction profits from the occurrence of these ligands in only a few energetically favoured conformers, comparing favourably with highly flexible peptides (third dimension of the sugar code). Sequence, shape and local aspects of glycan presentation (e.g. multivalency) are key factors to regulate the avidity of lectin binding. At the level of cells, distinct glycan determinants, a result of enzymatic synthesis and dynamic remodelling, are being defined as biomarkers. Their presence gains a functional perspective by co-regulation of the cognate lectin as effector, for example in growth regulation. The way to tie sugar signal and lectin together is illustrated herein for two tumour model systems. In this sense, orchestration of glycan and lectin expression is an efficient means, with far-reaching relevance, to exploit the coding potential of oligosaccharides physiologically and medically.

Financial incentives to encourage healthy behaviour: an analysis of UK media coverage

PubMed Central

Parke, Hannah; Ashcroft, Richard; Brown, Rebecca; Marteau, Theresa M; Seale, Clive

2011-01-01

Abstract Background  Policies to use financial incentives to encourage healthy behaviour are controversial. Much of this controversy is played out in the mass media, both reflecting and shaping public opinion. Objective  To describe UK mass media coverage of incentive schemes, comparing schemes targeted at different client groups and assessing the relative prominence of the views of different interest groups. Design  Thematic content analysis. Subjects  National and local news coverage in newspapers, news media targeted at health‐care providers and popular websites between January 2005 and February 2010. Setting  UK mass media. Results  The study included 210 articles. Fifteen separate arguments favourable towards schemes, and 19 unfavourable, were identified. Overall, coverage was more favourable than unfavourable, although most articles reported a mix of views. Arguments about the prevalence and seriousness of the health problems targeted by incentive schemes were uncontested. Moral and ethical objections to such schemes were common, focused in particular on recipients such as drug users or the overweight who were already stereotyped as morally deficient, and these arguments were largely uncontested. Arguments about the effectiveness of schemes and their potential for benefit or harm were areas of greater contestation. Government, public health and other health‐care provider interests dominated favourable coverage; opposition came from rival politicians, taxpayers’ representatives, certain charities and from some journalists themselves. Conclusions  Those promoting incentive schemes for people who might be regarded as ‘undeserving’ should plan a media strategy that anticipates their public reception. PMID:21771227

Silver spoons in the rough: can environmental enrichment improve survival of hatchery Atlantic salmon Salmo salar in the wild?

PubMed

Roberts, L J; Taylor, J; Gough, P J; Forman, D W; Garcia de Leaniz, C

2014-12-01

This study tested the 'silver spoon' hypothesis which posits that individuals that develop under favourable conditions should enjoy a fitness advantage later in life because they are more likely to recognize and settle in high-quality habitats. Atlantic salmon Salmo salar of two age classes (0+ and 1+ years) were reared in environmentally enriched or standard hatchery tanks for a short period (c. 10 weeks), were then released into a natural river and sampled on repeated occasions to test for silver-spoon effects. Compared with controls, enriched fish had a 6.4% higher recapture rate and settled in higher velocity habitats when they were stocked as 0+ year fry, but not when they were stocked as 1+ year parr. The opportunity for selection was generally higher for environmentally enriched fish than for controls, and also higher for 0+ than for 1+ year fish. Selection favoured individuals with high condition factor, extensive fat reserves and longer than average pectoral fins in both age classes but favoured a small body size in 1+ year and a large body size in 0+ year releases. Stomach analysis showed that enriched fish ate more, and adapted quicker to natural prey than controls. These results provide support for silver-spoon effects in fish and indicate that enrichment can improve post-release performance in conservation programmes, but seemingly only if fish are not kept in captivity for too long. © 2014 The Fisheries Society of the British Isles.

Effects of a psychiatric intensive care unit in an acute psychiatric department.

PubMed

Vaaler, A E; Morken, G; Fløvig, J C; Iversen, V C; Linaker, O M

2006-01-01

Psychiatric acute units use different levels of segregation to satisfy needs for containment and decrease in sensory input for behaviourally disturbed patients. Controlled studies evaluating the effects of the procedure are lacking. The aim of the present study was to compare effects in acutely admitted patients with the use of a psychiatric intensive care unit (PICU) and not in a psychiatric acute department. In a naturalistic study, one group of consecutively referred patients had access only to the PICU, the other group to the whole acute unit. Data were obtained for 56 and 62 patients using several scales. There were significant differences in reduction of behaviour associated with imminent, threatening incidents (Broset Violence Checklist), and actual number of such incidents (Staff Observation Aggression Scale-Revised) in favour of the group that was treated in a PICU. The principles of patient segregation in PICUs have favourable effects on behaviours associated with and the actual numbers of violent and threatening incidents.

Simulation of stream discharge and transport of nitrate and selected herbicides in the Mississippi River Basin

USGS Publications Warehouse

Broshears, R.E.; Clark, G.M.; Jobson, H.E.

2001-01-01

Stream discharge and the transport of nitrate, atrazine, and metolachlor in the Mississippi River Basin were simulated using the DAFLOW/BLTM hydrologic model. The simulated domain for stream discharge included river reaches downstream from the following stations in the National Stream Quality Accounting Network: Mississippi River at Clinton, IA; Missouri River at Hermann, MO: Ohio River at Grand Chain, IL: And Arkansas River at Little Rock, AR. Coefficients of hydraulic geometry were calibrated using data from water year 1996; the model was validated by favourable simulation of observed discharges in water years 1992-1994. The transport of nitrate, atrazine, and metolachlor was simulated downstream from the Mississippi River at Thebes, IL, and the Ohio River at Grand Chain. Simulated concentrations compared favourably with observed concentrations at Baton Rouge, LA. Development of this model is a preliminary step in gaining a more quantitative understanding of the sources and fate of nutrients and pesticides delivered from the Mississippi River Basin to the Gulf of Mexico.

Influence of gender in choosing a career amongst engineering fields: a survey study from Turkey

NASA Astrophysics Data System (ADS)

Bucak, Seyda; Kadirgan, Neset

2011-10-01

The aim of this study is to understand the motivating factors behind students' choices in their decision-making process and also get an insight on their perception of different engineering branches. A survey was prepared and the results were evaluated amongst 1163 answers. Two major influences on student's decision in their professional choices are shown to be career services and family members. Generally, students have claimed to choose a profession based on 'finding a job' and 'being happy'. Some engineering branches such as Genetic and Bioengineering, Chemical Engineering, Environmental Engineering and Industrial Engineering, are shown to be distinctly preferred by female students, whereas mechanical, civil and electronic engineering are favourites for male students. The survey results were also compared with the distribution of male and female students in various engineering departments. This study clearly shows that certain engineering branches are perceived as more appropriate for women and are thus favoured by female students, while those perceived as more appropriate for men are favoured by male students.

Identification of JAK/STAT pathway regulators—Insights from RNAi screens

PubMed Central

Müller, Patrick; Boutros, Michael; Zeidler, Martin P.

2008-01-01

While many core JAK/STAT pathway components have been discovered in Drosophila via classical genetic approaches, the identification of pathway regulators has been more challenging. Recently two cell-based RNAi screens for JAK/STAT pathway regulators have been undertaken using libraries of double-stranded RNAs targeting a large proportion of the predicted Drosophila transcriptome. While both screens identified multiple regulators, only relatively few loci are common to both data sets. Here we compare the two screens and discuss these differences. Although many factors are likely to be contributory, differences in the assay design are of key importance. Low levels of stimulation favouring the identification of negative pathway regulators and high levels of stimulation favouring the identification of positively acting factors. Ultimately, the results from both screens are likely to be largely complementary and have identified a range of novel candidate regulators of JAK/STAT pathway activity as a starting point for new research directions in the future. PMID:18586112

A comparison of the clinical, haemodynamic and angiographic features in right ventricular endomyocardial fibrosis and Ebstein's anomaly of the tricuspid valve.

PubMed

Balakrishnan, K G; Sapru, R P; Sasidharan, K; Venkitachalam, C G

1982-01-01

The clinical, haemodynamic and angiographic features of 18 patients with right ventricular endomyocardial fibrosis (RVEMF) and 8 patients with Ebstein's anomaly of the tricuspid valve (EATV) have been compared. Diagnosis was confirmed by selective angiography. The position of the tricuspid annulus was identified from selective right ventricular angiograms and confirmed by selective right coronary angiography. In 83% of RVEMF patients the tricuspid annulus was displaced to the left of the spine. A false impression of displacement of the tricuspid leaflet can thus be created. However, a tricuspid leaflet displaced away from the tricuspid annulus was found only in patients with EATV. A considerable overlap exists between the wide spectrum of clinical presentations of the two conditions. Helpful distinguishing features that favour EATV were, the presence of a scratchy diastolic murmur and polyphasic QRS complexes in the ECG. Atrial fibrillation in the ECG, and myocardial calcification or pericardial effusion, whenever present, favour RVEMF.

Energy harvesting from coupled bending-twisting oscillations in carbon-fibre reinforced polymer laminates

NASA Astrophysics Data System (ADS)

Xie, Mengying; Zhang, Yan; Kraśny, Marcin J.; Rhead, Andrew; Bowen, Chris; Arafa, Mustafa

2018-07-01

The energy harvesting capability of resonant harvesting structures, such as piezoelectric cantilever beams, can be improved by utilizing coupled oscillations that generate favourable strain mode distributions. In this work, we present the first demonstration of the use of a laminated carbon fibre reinforced polymer to create cantilever beams that undergo coupled bending-twisting oscillations for energy harvesting applications. Piezoelectric layers that operate in bending and shear mode are attached to the bend-twist coupled beam surface at locations of maximum bending and torsional strains in the first mode of vibration to fully exploit the strain distribution along the beam. Modelling of this new bend-twist harvesting system is presented, which compares favourably with experimental results. It is demonstrated that the variety of bend and torsional modes of the harvesters can be utilized to create a harvester that operates over a wider range of frequencies and such multi-modal device architectures provides a unique approach to tune the frequency response of resonant harvesting systems.

[2-year results of leg amputation in Hungary based on a nationwide data base].

PubMed

Kullmann, L; Belicza, E; László, G

1997-09-14

Authors review nation-wide hospital data of amputees over two years in order to make comparison with similar data gathered about 20 years ago. Data were provided by the National Medical Records Centre and processed by own developed programmes. The quality level of data validity is slightly criticised. The cause of amputation was most often vascular disease, amputees were elderly and large majority of amputation surgery was carried out on the lower limb. The rate of below-knee amputation has gone up favourably over the 20 years, but there are large regional differences within the country. Mortality parameters remarkably exceed those of foreign countries. Regarding compromised data accuracy, still there are ways of exploiting data in favour of quality improvement of care, e.g. improve below-knee amputation rate, reduce mortality. Publication of data can be of bench-marking importance for hospitals by enabling them to compare own results with those of other hospitals, as well as develop and improve performance.

Differences between patients' and clinicians' research priorities from the Anaesthesia and Peri-operative Care Priority Setting Partnership.

PubMed

Boney, O; Nathanson, M H; Grocott, M P W; Metcalf, L

2017-09-01

The James Lind Alliance Anaesthesia and Peri-operative Care Priority Setting Partnership was a recent collaborative venture bringing approximately 2000 patients, carers and clinicians together to agree priorities for future research into anaesthesia and critical care. This secondary analysis compares the research priorities of 303 service users, 1068 clinicians and 325 clinicians with experience as service users. All three groups prioritised research to improve patient safety. Service users prioritised research about improving patient experience, whereas clinicians prioritised research about clinical effectiveness. Clinicians who had experience as service users consistently prioritised research more like clinicians than like service users. Individual research questions about patient experience were more popular with patients and carers than with clinicians in all but one case. We conclude that patients, carers and clinicians prioritise research questions differently. All groups prioritise research into patient safety, but service users also favour research into patient experience, whereas clinicians favour research into clinical effectiveness. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

Is Diet Flexibility an Adaptive Life Trait for Relictual and Peri-Urban Populations of the Endangered Primate Macaca sylvanus?

PubMed Central

Maibeche, Yasmina; Moali, Aissa; Yahi, Nassima; Menard, Nelly

2015-01-01

Habitat loss, fragmentation and urban expansion may drive some species to marginal habitats while others succeed in exploiting urban areas. Species that show dietary flexibility are more able to take advantage of human activities to supplement their diet with anthropogenically abundant and accessible resources. The Barbary macaque (Macaca sylvanus) is an endangered species due to the loss of its habitat, and human pressure. The population of Gouraya National Park (Algeria) lives in a relictual habitat that constitutes about 0.6% of the species range. In addition, this population is a unique case where urban expansion favours contact zones between Barbary macaque habitats and a big city (Bejaia). We quantified the dietary composition of Gouraya macaques over an annual cycle with the objective to understand how diet flexibility of this species may help it adapt to a relictual habitat or cope with urban expansion. We recorded the phenology of plant species every month. This study shows that Gouraya macaques, compared to those living in other forest types of the distribution area, are under lower seasonal constraints. They consume a greater amount of fruit and seeds that are available throughout much of the year, and a lesser amount of costly to find and extract subterranean foods. Therefore the Gouraya relictual habitat appears as a favourable environment compared to other major habitats of that species. This study also shows that colonizing peri-urban zones increases the availability and species richness of diet resources for Barbary macaques as they consume more human foods and exotic plants than in farther sites. Adult males eat more human foods than adult females and immatures do. The exploitation of high-energy anthropogenic food could favour macaque population growth and expansion towards the city center associated with human/macaque conflicts. We recommend applying management actions to restore macaques back to their natural habitat. PMID:25714476

A randomized trial comparing methotrexate and vinblastine (MV) with cisplatin, methotrexate and vinblastine (CMV) in advanced transitional cell carcinoma: results and a report on prognostic factors in a Medical Research Council study. MRC Advanced Bladder Cancer Working Party.

PubMed Central

Mead, G. M.; Russell, M.; Clark, P.; Harland, S. J.; Harper, P. G.; Cowan, R.; Roberts, J. T.; Uscinska, B. M.; Griffiths, G. O.; Parmar, M. K.

1998-01-01

Transitional cell carcinomas may arise at any site within the urinary tract and are a source of considerable morbidity and mortality. In particular, patients with metastatic disease have a poor prognosis, with less than 5% alive at 5 years. A multicentre randomized trial comparing methotrexate and vinblastine (MV) with cisplatin, methotrexate and vinblastine (CMV) in advanced or metastatic transitional cell carcinoma was conducted in the UK. From April 1991 to June 1995, 214 patients were entered by 16 centres, 108 randomized to CMV and 106 to MV. A total of 204 patients have died. The hazard ratio (relative risk of dying) was 0.68 (95% CI 0.51-0.90, P-value = 0.0065) in favour of CMV. This translates to an absolute improvement in 1-year survival of 13%, 16% in MV and 29% in CMV. The median survival for CMV and MV was 7 months and 4.5 months respectively. Two hundred and eight patients objectively progressed or died. The hazard ratio was 0.55 (95% CI 0.41-0.73, P-value = 0.0001) in favour of CMV. Two hundred and nine patients symptomatically progressed or died. The hazard ratio was 0.48 (95% CI 0.36-0.64, P-value = 0.0001) in favour of CMV. The most important pretreatment factors influencing overall survival were WHO performance status and extent of disease. These two factors were used to derive a prognostic index which could be used to categorize patients into three prognostic groups. We conclude that the addition of cisplatin to methotrexate and vinblastine should be considered in patients with transitional cell carcinoma, taking into account the increased toxicity. PMID:9792152

Surgical versus non-surgical approach in primary desmoid-type fibromatosis patients: A nationwide prospective cohort from the French Sarcoma Group.

PubMed

Penel, Nicolas; Le Cesne, Axel; Bonvalot, Sylvie; Giraud, Antoine; Bompas, Emmanuelle; Rios, Maria; Salas, Sébastien; Isambert, Nicolas; Boudou-Rouquette, Pascaline; Honore, Charles; Italiano, Antoine; Ray-Coquard, Isabelle; Piperno-Neumann, Sophie; Gouin, François; Bertucci, François; Ryckewaert, Thomas; Kurtz, Jean-Emmanuel; Ducimetiere, Françoise; Coindre, Jean-Michel; Blay, Jean-Yves

2017-09-01

The outcome of desmoid-type fibromatosis (DTF) is unpredictable. Currently, a wait-and-see approach tends to replace large en bloc resection as the first therapeutic approach. Nevertheless, there are no validated factors to guide the treatment choice. We conducted a prospective study of 771 confirmed cases of DTF. We analysed event-free survival (EFS) based on the occurrence of relapse after surgery, progressive disease during the wait-and-see approach, or change in therapeutic strategy. Identification of prognostic factors was performed using classical methods (log-rank test and Cox model). Overall, the 2-year EFS was 56%; this value did not differ between patients undergoing an operation and those managed by the wait-and-see approach (53% versus 58%, p = 0.415). In univariate analysis, two prognostic factors significantly influenced the outcome: the nature of diagnostic sampling (p = 0.466) and primary location (p = 0.0001). The 2-year EFS was only 32% after open biopsy. The 2-year EFS was 66% for favourable locations (abdominal wall, intra-abdominal, breast, digestive viscera and lower limb) and 41% for unfavourable locations. Among patients with favourable locations, the 2-year EFS was similar in patients treated by both surgery (70%) and the wait-and-see approach (63%; p = 0.413). Among patients with unfavourable locations, the 2-year EFS was significantly enhanced in patients initially managed with the wait-and-see approach (52%) compared with those who underwent initial surgery (25%; p = 0.001). The location of DTF is a major prognostic factor for EFS. If these findings are confirmed by independent analysis, personalised management of DTF must consider this easily obtained parameter. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Hawthorne Effect: a randomised, controlled trial

PubMed Central

McCarney, Rob; Warner, James; Iliffe, Steve; van Haselen, Robbert; Griffin, Mark; Fisher, Peter

2007-01-01

Background The 'Hawthorne Effect' may be an important factor affecting the generalisability of clinical research to routine practice, but has been little studied. Hawthorne Effects have been reported in previous clinical trials in dementia but to our knowledge, no attempt has been made to quantify them. Our aim was to compare minimal follow-up to intensive follow-up in participants in a placebo controlled trial of Ginkgo biloba for treating mild-moderate dementia. Methods Participants in a dementia trial were randomised to intensive follow-up (with comprehensive assessment visits at baseline and two, four and six months post randomisation) or minimal follow-up (with an abbreviated assessment at baseline and a full assessment at six months). Our primary outcomes were cognitive functioning (ADAS-Cog) and participant and carer-rated quality of life (QOL-AD). Results We recruited 176 participants, mainly through general practices. The main analysis was based on Intention to treat (ITT), with available data. In the ANCOVA model with baseline score as a co-variate, follow-up group had a significant effect on outcome at six months on the ADAS-Cog score (n = 140; mean difference = -2.018; 95%CI -3.914, -0.121; p = 0.037 favouring the intensive follow-up group), and on participant-rated quality of life score (n = 142; mean difference = -1.382; 95%CI -2.642, -0.122; p = 0.032 favouring minimal follow-up group). There was no significant difference on carer quality of life. Conclusion We found that more intensive follow-up of individuals in a placebo-controlled clinical trial of Ginkgo biloba for treating mild-moderate dementia resulted in a better outcome than minimal follow-up, as measured by their cognitive functioning. Trial registration Current controlled trials: ISRCTN45577048 PMID:17608932

Higher maternal education is associated with favourable growth of young children in different countries

PubMed Central

Lakshman, Rajalakshmi; Zhang, Jing; Zhang, Jianduan; Koch, Felix S; Marcus, Claude; Ludvigsson, Johnny; Ong, Ken K; Sobko, Tanja

2013-01-01

Background Childhood growth affects long-term health and could contribute to health inequalities that persist throughout life. Methods We compared growth data of 4-6 year old children born 1997-2002 in UK (n=15,168), Sweden (n=6,749) and rural China (n=10,327). Standard deviation scores (SDS) were calculated against the WHO Standard. Obesity and overweight were defined by International Obesity Taskforce cut-offs, and stunting, underweight and thinness by height, weight or BMI < −2 SDS. Associations with maternal education were standardised by calculating the Slope Index of Inequality (SII). Results Mean SDS height, weight and BMI in UK (−0.01; 0.42; 0.62, respectively) and Sweden (0.45; 0.59; 0.45) were higher than in China (−0.98, −0.82, −0.29). Higher maternal education was consistently associated with taller offspring height SDS (SII: UK 0.25; Sweden 0.17; China 1.06). Underweight and stunting were less common in UK (prevalence: 0.6% and 2.2%, respectively) and Sweden (0.3% and 0.6%) than in China (9.5% and 16.4%), where these outcomes were inversely associated with maternal education (SII: −25.8% and −12.7%). Obesity prevalence in UK, Sweden and China was 4.8%, 3.7% and 0.4%, respectively. Maternal education was inversely associated with offspring obesity in UK (SII: −3.3%) and Sweden (−2.8%), but not in China (+0.3%). Conclusions Higher maternal education was associated with more favourable growth in young children: lower obesity and overweight in UK and Sweden, and lower stunting and underweight in rural China. Public health strategies to optimize growth in early childhood need to acknowledge socioeconomic factors, but possibly with a different emphasis in different settings. PMID:23450064

Effect of opicapone multiple‐dose regimens on levodopa pharmacokinetics

PubMed Central

Rocha, José‐Francisco; Sicard, Éric; Fauchoux, Nicolas; Falcão, Amílcar; Santos, Ana; Loureiro, Ana I.; Pinto, Roberto; Bonifácio, Maria João; Nunes, Teresa; Almeida, Luís

2016-01-01

Aims To compare the levodopa/carbidopa (LC) and levodopa/benserazide (LB) pharmacokinetic profiles following repeated doses of opicapone (OPC) administered apart from levodopa. Methods Two randomized, double blind, sex‐balanced, placebo‐controlled studies in four groups of 12 or 18 healthy subjects each. In each group, enrolled subjects received a once‐daily morning (5, 15 and 30 mg) or evening (5, 15 and 50 mg) administration of OPC or placebo for up to 28 days. On the morning of Day 11, 12 h after the OPC or placebo evening dose, or the morning of Day 21, 1 h after the OPC or placebo dose, a single dose of immediate‐release 100/25 mg LC was administered. Similarly, on Day 18 morning, 12 h after the OPC or placebo evening dose, or Day 28 morning, 1 h after the OPC or placebo dose, a single dose of immediate‐release 100/25 mg LB was administered. Results All OPC treatments, in relation to the placebo group, presented a higher extent of exposure (AUC) to levodopa following either LC or LB doses. A relevant but not dose‐dependent increase in the levodopa AUC occurred with all OPC dose groups in relation to placebo. All active treatments significantly inhibited both peak (Emax) and extent (AUEC) of the catechol‐O‐methyltransferase activity in relation to placebo. The tolerability profile was favourable. Conclusion Opicapone, as once‐daily oral evening regimen and/or 1 h apart from levodopa therapy, increases the bioavailability of levodopa associated with its pronounced, long‐lasting and sustained catechol‐O‐methyltransferase inhibition. The tolerability profile was favourable and similar between OPC and placebo. PMID:27763682

Comparison of Technical and Clinical Outcome of Transjugular Portosystemic Shunt Placement Between a Bare Metal Stent and a PTFE-Stentgraft Device

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lauermann, J., E-mail: jostlauermann@gmail.com; Potthoff, A.; Mc Cavert, M.

PurposeTo analyse technical and clinical success of transjugular intrahepatic portosystemic shunt (TIPS) in patients with portal hypertension and compare a stent and a stentgraft with regard to clinical and technical outcome and associated costs.Materials and Methods170 patients (56 ± 12 years, 32.9 % females) treated with TIPS due to portal hypertension were reviewed. 80 patients received a stent (group 1) and 83 a stentgraft (group 2), and seven interventions were unsuccessful. Technical data, periprocedural imaging, follow-up ultrasound and clinical data were analysed with focus on technical success, patency, clinical outcome and group differences. Cost analysis was performed.ResultsPortal hypertension was mainly caused by ethyltoxicmore » liver cirrhosis with ascites as dominant symptom (80 %). Technical success was 93.5 % with mean portosystemic gradient decrease from 16.1 ± 4.8 to 5.1 ± 2.1 mmHg. No significant differences in technical success and portosystemic gradient decrease between the groups were observed. Kaplan–Meier analysis yielded significant differences in primary patency after 14 days, 6 months and 2 years in favour of the stentgraft. Both groups showed good clinical results without significant difference in 1-year survival and hepatic encephalopathy rate. Costs to establish TIPS and to manage 2-year follow-up with constant patency and clinical success were 8876 € (group 1) and 9394 € (group 2).ConclusionTIPS is a safe and effective procedure to manage portal hypertension. Stent and stentgraft enabled good technical and clinical results with a low complication rate. Primary patency rates are clearly in favour of the stentgraft, whereas the stent was more cost effective with similar clinical results in both groups.« less

Physical frailty and pulmonary rehabilitation in COPD: a prospective cohort study

PubMed Central

Maddocks, Matthew; Kon, Samantha S C; Canavan, Jane L; Jones, Sarah E; Nolan, Claire M; Labey, Alex; Polkey, Michael I; Man, William D-C

2016-01-01

Background Frailty is an important clinical syndrome that is consistently associated with adverse outcomes in older people. The relevance of frailty to chronic respiratory disease and its management is unknown. Objectives To determine the prevalence of frailty among patients with stable COPD and examine whether frailty affects completion and outcomes of pulmonary rehabilitation. Methods 816 outpatients with COPD (mean (SD) age 70 (10) years, FEV1% predicted 48.9 (21.0)) were recruited between November 2011 and January 2015. Frailty was assessed using the Fried criteria (weight loss, exhaustion, low physical activity, slowness and weakness) before and after pulmonary rehabilitation. Predictors of programme non-completion were identified using multivariate logistic regression, and outcomes were compared using analysis of covariance, adjusting for age and sex. Results 209/816 patients (25.6%, 95% CI 22.7 to 28.7) were frail. Prevalence of frailty increased with age, Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage, Medical Research Council (MRC) score and age-adjusted comorbidity burden (all p≤0.01). Patients who were frail had double the odds of programme non-completion (adjusted OR 2.20, 95% CI 1.39 to 3.46, p=0.001), often due to exacerbation and/or hospital admission. However, rehabilitation outcomes favoured frail completers, with consistently better responses in MRC score, exercise performance, physical activity level and health status (all p<0.001). After rehabilitation, 71/115 (61.3%) previously frail patients no longer met case criteria for frailty. Conclusions Frailty affects one in four patients with COPD referred for pulmonary rehabilitation and is an independent predictor of programme non-completion. However, patients who are frail respond favourably to rehabilitation and their frailty can be reversed in the short term. PMID:27293209

Gender Differences in Fat Distribution and Inflammatory Markers among Arabs

PubMed Central

Farooq, Abdulaziz; Knez, Wade L.; Knez, Kelly; Al-Noaimi, Asma; Grantham, Justin; Mohamed-Ali, Vidya

2013-01-01

Recent studies from the Gulf region suggest that compared to men, women have a greater risk of developing metabolic syndrome (MeS). Objective. To investigate gender differences in body composition, adipokines, inflammatory markers, and aerobic fitness in a cohort of healthy Qatari adults. Participants. Healthy Qatari (n = 58) were matched for age, gender, and body mass index. Methods. Body composition and regional fat distribution were determined by dual-energy X-ray absorptiometry and computerized tomography. Laboratory assessments included serum levels of fasting glucose, insulin, lipid profile analysis, adipokines, and inflammatory markers. Subjects were also evaluated for aerobic fitness. Results. Women had more adipose tissue in the total abdominal (P = 0.04) and abdominal subcutaneous (P = 0.07) regions compared to men. Waist circumference and indices of insulin sensitivity were similar; however, women had a more favourable lipid profile than men. Serum adiponectin and leptin levels were significantly higher in women, whereas inflammatory profiles were not different between men and women. Aerobic fitness was lower in women and was associated with abdominal fat accumulation. Conclusion. In premenopausal women, higher levels of adiponectin may support maintenance of insulin sensitivity and normolipidemia despite greater adiposity. However, poor aerobic fitness combined with abdominal fat accumulation may explain their greater future risk of MeS compared with men. PMID:24227909

Novel fiber-based pure chitosan scaffold for tendon augmentation: biomechanical and cell biological evaluation.

PubMed

Nowotny, J; Aibibu, D; Farack, J; Nimtschke, U; Hild, M; Gelinsky, M; Kasten, P; Cherif, Ch

2016-07-01

One possibility to improve the mechanical properties after tendon ruptures is augmentation with a scaffold. Based on wet spinning technology, chitosan fibres were processed to a novel pure high-grade multifilament yarn with reproducible quality. The fibres were braided to obtain a 3D tendon scaffold. The CS fibres and scaffolds were evaluated biomechanically and compared to human supraspinatus (SSP) tendons. For the cytobiological characterization, in vitro cell culture experiments with human mesenchymal stem cells (hMSC) were performed. Three types of 3D circular braided scaffolds were fabricated. Significantly, higher ultimate stress values were measured for scaffold with larger filament yarn, compared to scaffold with smaller filament yarn. During cultivation over 28 days, the cells showed in dependence of isolation method and/or donor a doubling or tripling of the cell number or even a six-fold increase on the CS scaffold, which was comparable to the control (polystyrene) or in the case of cells obtained from human biceps tendon even higher proliferation rates. After 14 days, the scaffold surface was covered homogeneously with a cell layer. In summary, the present work demonstrates that braided chitosan scaffolds constitute a straightforward approach for designing tendon analogues, maintaining important flexibility in scaffold design and providing favourable mechanical properties of the resulting construct.

[Contraception during the perimenopause: indications, security, and non contraceptive benefits].

PubMed

Cantero Pérez, P; Klingemann, J; Yaron, M; Irion, N Fournet; Streuli, I

2015-10-28

Although patients' fertility is diminished in the period of perimenopause, they still need efficient contraception. Thorough knowledge of the physiological changes occuring during this period of transition is essential in order to provide optimal care. Until the age of 50, no contraceptive method is specifically considered unsuitable due to age alone. The choice of contraceptive needs to be adapted to the patient, assessing the individual risk factors and favouring the potential non-contraceptive advantages of the method selected. Long-term contraceptive methods (e.g., the copper intrauterine device (IUD), the Mirena IUD or a subcutaneous implant) offer an excellent solution on both levels.

A comparison of different postures for scaffold end-frame disassembly.

PubMed

Cutlip, R; Hsiao, H; Garcia, R; Becker, E; Mayeux, B

2000-10-01

Overexertion and fall injuries comprise the largest category of nonfatal injuries among scaffold workers. This study was conducted to identify the most favourable scaffold end-frame disassembly techniques and evaluate the associated slip potential by measuring whole-body isometric strength capability and required coefficient of friction (RCOF) to reduce the incidence of injury. Forty-six male construction workers were used to study seven typical postures associated with scaffold end-frame disassembly. An analysis of variance (ANOVA) showed that the isometric forces (334.4-676.3 N) resulting from the seven postures were significantly different (p < 0.05). Three of the disassembly postures resulted in considerable biomechanical stress to workers. The symmetric front-lift method with hand locations at knuckle height would be the most favourable posture; at least 93% of the male construction worker population could handle the end frame with minimum overexertion risk. The static RCOF value resulting from this posture during the disassembly phase was less than 0.2, thus the likelihood of a slip should be low.

Investigating protein-protein interaction surfaces using a reduced stereochemical and electrostatic model.

PubMed

Warwicker, J

1989-03-20

A method of calculating the electrostatic potential energy between two molecules, using finite difference potential, is presented. A reduced charge set is used so that the interaction energy can be calculated as the two static molecules explore their full six-dimensional configurational space. The energies are contoured over surfaces fixed to each molecule with an interactive computer graphics program. For two crystal structures (trypsin-trypsin inhibitor and anti-lysozyme Fab-lysozyme), it is found that the complex corresponds to highly favourable interacting regions in the contour plots. These matches arise from a small number of protruding basic residues interacting with enhanced negative potential in each case. The redox pair cytochrome c peroxidase-cytochrome c exhibits an extensive favourably interacting surface within which a possible electron transfer complex may be defined by an increased electrostatic complementarity, but a decreased electrostatic energy. A possible substrate transfer configuration for the glycolytic enzyme pair glyceraldehyde phosphate dehydrogenase-phosphoglycerate kinase is presented.

[Antifibrillatory activity of anti-arrhythmia agents in maximally high ligation of the coronary artery and its reperfusion in cats].

PubMed

Storozhuk, B G

1985-01-01

Experiments on anesthesized cats were performed to study antifibrillatory action of the basic antiarrhythmic remedies and a new Soviet drug, phenicaberan. It was established that phenicaberan and lidocaine compare very favourably with other drugs under study as regards the antifibrillatory effect. For that reason these drugs can be recommended for use in the prophylaxis of fatal arrhythmias.

Tenofovir alafenamide (TAF) treatment of HBV, what are the unanswered questions?

PubMed

Viganò, Mauro; Loglio, Alessandro; Grossi, Glenda; Lampertico, Pietro

2018-02-01

Tenofovir disoproxil fumarate (TDF), an ester prodrug of tenofovir (TFV), is one of the recommended drugs for chronic hepatitis B (CHB) patients. However, reduced kidney function and loss of bone mineral density have been reported in some CHB patients treated with TDF. Consequent to these safety issues, tenofovir alafenamide (TAF) [Vemlidy®], a phosphonate prodrug of TFV, was developed for the treatment of CHB patients. Areas covered: The favourable pharmacological profile of TAF allows a marked reduction in dosage (25 mg/day) thus reducing systemic exposure to tenofovir and improving the bone and renal safety, keeping however the same virological efficacy, compared to TDF 300 mg/day. In two ongoing 96-week phase III trials in mainly treatment-naive HBeAg-positive or -negative patients, TAF showed similar viral suppression but was associated with significantly higher alanine aminotransferase normalization rates and more favourable renal and bone safety compared to TDF. In a 48-week TAF switch study enrolling patients treated with TDF for 96 weeks, glomerular, tubular and bone safety parameters rapidly improved while virological suppression was maintained. Expert commentary: Waiting long-term large scale clinical practice studies aimed to confirm these advantages, TAF represents an helpful treatment option for both naïve and TDF-exposed CHB patients.

Associations between the combined physical activity environment, socioeconomic status, and obesity: a cross-sectional study.

PubMed

Hobbs, M; Griffiths, C; Green, M A; Jordan, H; Saunders, J; McKenna, J

2018-05-01

This study investigates associations between the combined physical activity environment and obesity and explores any sub-group effects by individual-level socioeconomic status. In a large cross-sectional cohort ( n = 22,889) from the Yorkshire Health Study, body mass index was calculated using self-reported height and weight and obesity was defined as a body mass index ≥ 30. The physical activity environment was split into 'unfavourable physical activity', 'moderately favourable physical activity' and 'favourable physical activity' environments. This was based on the count of parks and physical activity facilities within a 2 km radial buffer centred on home addresses. A favourable physical activity environment was defined as having ≥1 physical activity facility and ≥1 park, unfavourable as having no physical activity facility and park and any other combinations defined as moderately favourable. Logistic regression (odds ratios) identified associations with obesity. Relative to 'unfavourable physical activity environments', individuals within favourable physical activity environments were less likely to be obese (odds ratio = 0.90; 95% confidence interval = 0.82-0.97), and there was no effect for moderately favourable environment. Furthermore, once stratified by education level, this relationship was only present for those of higher education. Our findings provide novel UK evidence and is one of the first papers internationally that highlights the importance of considering the interplay of individual-level socioeconomic factors when investigating associations between the physical activity environment and obesity.

Influence of experimental parameters on the microencapsulation of a photopolymerizable phase.

PubMed

Pernot, J M; Brun, H; Pouyet, B; Sergent, M; Phan-Tan-Luu, R

1993-01-01

Conditions of microencapsulation by in situ polycondensation, using melamine-formaldehyde as wall material, are influenced by the chemical nature of the core to encapsulate. In our study concerning the encapsulation of a photopolymerizable phase containing an electrically charged compound, it was necessary to modify the experimental process to obtain capsules of good quality. We used the factorial design method of screening by utilization of an asymmetric matrix, according to the collapsing principle of Addleman. The advantage of this method is that it allows determination of the simultaneous influences of the 11 experimental parameters involved in this preparation. The calculation method can be applied to more than two levels for some of the factors. The continuously varying parameters were altered between two extreme levels, chosen to allow encapsulation. For discontinuous factors, such as the molecular weight of the modifying system or nature of the aminoplast, we used the commercially available compounds, respectively three and four kinds. The results of the obtained capsules were determined by comparing microphotographic pictures. With 16 experiments we found four more factors influencing quality of capsules. We also determined the most favourable levels for the other seven parameters. The results allowed us to find optimal conditions in the experimental field. We obtained capsules of a satisfactory quality for this purpose, using only minimum experimentation.

Swallowing outcomes following Intensity Modulated Radiation Therapy (IMRT) for head & neck cancer - a systematic review.

PubMed

Roe, Justin W G; Carding, Paul N; Dwivedi, Raghav C; Kazi, Rehan A; Rhys-Evans, Peter H; Harrington, Kevin J; Nutting, Christopher M

2010-10-01

A systematic review to establish what evidence is available for swallowing outcomes following IMRT for head and neck cancer. Online electronic databases were searched to identify papers published in English from January 1998 to December 2009. Papers were independently appraised by two reviewers for methodological quality, method of swallowing evaluation and categorized according to the World Health Organisation's International Classification of Health Functions. The impact of radiation dose to dysphagia aspiration risk structures (DARS) was also evaluated. Sixteen papers met the inclusion criteria. The literature suggests that limiting the radiation dose to certain structures may result in favourable swallowing outcomes. Methodological limitations included variable assessment methods and outcome measures and heterogeneity of patients. There are only limited prospective data, especially where pre-treatment measures have been taken and compared to serial post-treatment assessment. Few studies have investigated the impact of IMRT on swallow function and the impact on everyday life. Initial studies have reported potential benefits but are limited in terms of study design and outcome data. Further well designed, prospective, longitudinal swallowing studies including multidimensional evaluation methods are required to enable a more comprehensive understanding of dysphagia complications and inform pre-treatment counselling and rehabilitation planning. Copyright © 2010 Elsevier Ltd. All rights reserved.

Does Prop-2-ynylideneamine, HC≡CCH=NH, Exist in Space? A Theoretical and Computational Investigation

PubMed Central

Osman, Osman I.; Elroby, Shaaban A.; Aziz, Saadullah G.; Hilal, Rifaat H.

2014-01-01

MP2, DFT and CCSD methods with 6-311++G** and aug-cc-pvdz basis sets have been used to probe the structural changes and relative energies of E-prop-2-ynylideneamine (I), Z-prop-2-ynylideneamine (II), prop-1,2-diene-1-imine (III) and vinyl cyanide (IV). The energy near-equivalence and provenance of preference of isomers and tautomers were investigated by NBO calculations using HF and B3LYP methods with 6-311++G** and aug-cc-pvdz basis sets. All substrates have Cs symmetry. The optimized geometries were found to be mainly theoretical method dependent. All elected levels of theory have computed I/II total energy of isomerization (ΔE) of 1.707 to 3.707 kJ/mol in favour of II at 298.15 K. MP2 and CCSD methods have indicated clearly the preference of II over III; while the B3LYP functional predicted nearly similar total energies. All tested levels of theory yielded a global II/IV tautomerization total energy (ΔE) of 137.3–148.4 kJ/mol in support of IV at 298.15 K. The negative values of ΔS indicated that IV is favoured at low temperature. At high temperature, a reverse tautomerization becomes spontaneous and II is preferred. The existence of II in space was debated through the interpretation and analysis of the thermodynamic and kinetic studies of this tautomerization reaction and the presence of similar compounds in the Interstellar Medium (ISM). PMID:24950178

Distribution and Numbers of Pygmies in Central African Forests

PubMed Central

Olivero, Jesús; Fa, John E.; Farfán, Miguel A.; Lewis, Jerome; Hewlett, Barry; Breuer, Thomas; Carpaneto, Giuseppe M.; Fernández, María; Germi, Francesco; Hattori, Shiho; Head, Josephine; Ichikawa, Mitsuo; Kitanaishi, Koichi; Knights, Jessica; Matsuura, Naoki; Migliano, Andrea; Nese, Barbara; Noss, Andrew; Ekoumou, Dieudonné Ongbwa; Paulin, Pascale; Real, Raimundo; Riddell, Mike; Stevenson, Edward G. J.; Toda, Mikako; Vargas, J. Mario; Yasuoka, Hirokazu; Nasi, Robert

2016-01-01

Pygmy populations occupy a vast territory extending west-to-east along the central African belt from the Congo Basin to Lake Victoria. However, their numbers and actual distribution is not known precisely. Here, we undertake this task by using locational data and population sizes for an unprecedented number of known Pygmy camps and settlements (n = 654) in five of the nine countries where currently distributed. With these data we develop spatial distribution models based on the favourability function, which distinguish areas with favourable environmental conditions from those less suitable for Pygmy presence. Highly favourable areas were significantly explained by presence of tropical forests, and by lower human pressure variables. For documented Pygmy settlements, we use the relationship between observed population sizes and predicted favourability values to estimate the total Pygmy population throughout Central Africa. We estimate that around 920,000 Pygmies (over 60% in DRC) is possible within favourable forest areas in Central Africa. We argue that fragmentation of the existing Pygmy populations, alongside pressure from extractive industries and sometimes conflict with conservation areas, endanger their future. There is an urgent need to inform policies that can mitigate against future external threats to these indigenous peoples’ culture and lifestyles. PMID:26735953

Distribution and Numbers of Pygmies in Central African Forests.

PubMed

Olivero, Jesús; Fa, John E; Farfán, Miguel A; Lewis, Jerome; Hewlett, Barry; Breuer, Thomas; Carpaneto, Giuseppe M; Fernández, María; Germi, Francesco; Hattori, Shiho; Head, Josephine; Ichikawa, Mitsuo; Kitanaishi, Koichi; Knights, Jessica; Matsuura, Naoki; Migliano, Andrea; Nese, Barbara; Noss, Andrew; Ekoumou, Dieudonné Ongbwa; Paulin, Pascale; Real, Raimundo; Riddell, Mike; Stevenson, Edward G J; Toda, Mikako; Vargas, J Mario; Yasuoka, Hirokazu; Nasi, Robert

2016-01-01

Pygmy populations occupy a vast territory extending west-to-east along the central African belt from the Congo Basin to Lake Victoria. However, their numbers and actual distribution is not known precisely. Here, we undertake this task by using locational data and population sizes for an unprecedented number of known Pygmy camps and settlements (n = 654) in five of the nine countries where currently distributed. With these data we develop spatial distribution models based on the favourability function, which distinguish areas with favourable environmental conditions from those less suitable for Pygmy presence. Highly favourable areas were significantly explained by presence of tropical forests, and by lower human pressure variables. For documented Pygmy settlements, we use the relationship between observed population sizes and predicted favourability values to estimate the total Pygmy population throughout Central Africa. We estimate that around 920,000 Pygmies (over 60% in DRC) is possible within favourable forest areas in Central Africa. We argue that fragmentation of the existing Pygmy populations, alongside pressure from extractive industries and sometimes conflict with conservation areas, endanger their future. There is an urgent need to inform policies that can mitigate against future external threats to these indigenous peoples' culture and lifestyles.

How to Correct Teaching Methods That Favour Plagiarism: Recommendations from Teachers and Students in a Spanish Language Distance Education University

ERIC Educational Resources Information Center

Arce Espinoza, Lourdes; Monge Nájera, Julián

2015-01-01

The presentation of the intellectual work of others as their own by students is believed to be common worldwide. Punishments and detection software have failed to solve the problem and have important limitations themselves. To go to the root of the problem, we applied an online questionnaire to 344 university students and their 13 teachers. Our…

The Influence of Family Socialisation on the Success of Girls from Poor Urban Communities in Brazil at School

ERIC Educational Resources Information Center

Carvalho, Marília

2015-01-01

The principle focus of this article is to understand the influence of socialisation in the family on the success of girls at school. Eight low-income families with children of both sexes in the city of São Paulo, Brazil were studied through interviews and observation methods. It was found that socialisation in the family favoured in girls, and not…

Crop changes from the XVI century to the present in a hill/mountain area of eastern Liguria (Italy)

PubMed Central

Gentili, Rodolfo; Gentili, Elio; Sgorbati, Sergio

2009-01-01

Background Chronological information on the composition and structure of agrocenoses and detailed features of land cover referring to specific areas are uncommon in ethnobotanical studies, especially for periods before the XIX century. The aim of this study was to analyse the type of crop or the characteristics of soil cover from the XVI century to the present. Methods This diachronic analysis was accomplished through archival research on the inventories of the Parish of St. Mary and those of the Municipality of Pignone and from recent surveys conducted in an area of eastern Liguria (Italy). Results Archival data revealed that in study area the primary means of subsistence during the last five centuries, until the first half of the XX century, was chestnuts. In the XVIII and XIX centuries, crop diversification strongly increased in comparison with previous and subsequent periods. In more recent times, the abandonment of agricultural practices has favoured the re-colonisation of mixed woodland or cluster-pine woodland. Conclusion Ancient documents in the ecclesiastic or municipal inventories can be a very useful tool for enhancing the knowledge of agricultural practice, as well as of subsistence methods favoured by local populations during a particular time and for reconstructing land use change over time. PMID:19361339

Conflicts of interest and the evolution of decision sharing

PubMed Central

Conradt, Larissa; Roper, Timothy J.

2008-01-01

Social animals regularly face consensus decisions whereby they choose, collectively, between mutually exclusive actions. Such decisions often involve conflicts of interest between group members with respect to preferred action. Conflicts could, in principle, be resolved, either by sharing decisions between members (‘shared decisions’) or by one ‘dominant’ member making decisions on behalf of the whole group (‘unshared decisions’). Both, shared and unshared decisions, have been observed. However, it is unclear as to what favours the evolution of either decision type. Here, after a brief literature review, we present a novel method, involving a combination of self-organizing system and game theory modelling, of investigating the evolution of shared and unshared decisions. We apply the method to decisions on movement direction. We find that both, shared and unshared, decisions can evolve without individuals having a global overview of the group's behaviour or any knowledge about other members' preferences or intentions. Selection favours unshared over shared decisions when conflicts are high relative to grouping benefits, and vice versa. These results differ from those of group decision models relating to activity timings. We attribute this to fundamental differences between collective decisions about modalities that are disjunct (here, space) or continuous (here, time) with respect to costs/benefits. PMID:19073479

Application of Machine Learning in Urban Greenery Land Cover Extraction

NASA Astrophysics Data System (ADS)

Qiao, X.; Li, L. L.; Li, D.; Gan, Y. L.; Hou, A. Y.

2018-04-01

Urban greenery is a critical part of the modern city and the greenery coverage information is essential for land resource management, environmental monitoring and urban planning. It is a challenging work to extract the urban greenery information from remote sensing image as the trees and grassland are mixed with city built-ups. In this paper, we propose a new automatic pixel-based greenery extraction method using multispectral remote sensing images. The method includes three main steps. First, a small part of the images is manually interpreted to provide prior knowledge. Secondly, a five-layer neural network is trained and optimised with the manual extraction results, which are divided to serve as training samples, verification samples and testing samples. Lastly, the well-trained neural network will be applied to the unlabelled data to perform the greenery extraction. The GF-2 and GJ-1 high resolution multispectral remote sensing images were used to extract greenery coverage information in the built-up areas of city X. It shows a favourable performance in the 619 square kilometers areas. Also, when comparing with the traditional NDVI method, the proposed method gives a more accurate delineation of the greenery region. Due to the advantage of low computational load and high accuracy, it has a great potential for large area greenery auto extraction, which saves a lot of manpower and resources.

Starch-entrapped microspheres show a beneficial fermentation profile and decrease in potentially harmful bacteria during in vitro fermentation in faecal microbiota obtained from patients with inflammatory bowel disease.

PubMed

Rose, Devin J; Venema, Koen; Keshavarzian, Ali; Hamaker, Bruce R

2010-05-01

The purpose of this research was to test the hypothesis that starch-entrapped microspheres would produce favourable fermentation profiles and microbial shifts during in vitro fermentation with the faecal microbiota from patients with inflammatory bowel disease (IBD). In vitro fermentation was carried out using a validated, dynamic, computer-controlled model of the human colon (Toegepast Natuurwetenschappelijk Onderzoek gastro-intestinal model-2) after inoculation with pooled faeces from healthy individuals, patients with inactive IBD (Crohn's disease (CD)) or patients with active IBD (ulcerative colitis (UC)). Starch-entrapped microspheres fermented more slowly and produced more butyrate than fructo-oligosaccharides (FOS) when fermented with the faecal microbiota from patients with active UC. When fermented with the microbiota from patients with inactive CD, starch-entrapped microspheres also fermented more slowly but produced similar amounts of butyrate compared with FOS. Starch-entrapped microspheres showed a greater ability to maintain a low pH during simulated-distal colon conditions compared with FOS. After fermentation with the microbiota from inactive CD patients, starch-entrapped microspheres resulted in lower concentrations of some potentially harmful gut bacteria, included in Bacteroides, Enterococcus, Fusobacterium and Veillonella, compared with FOS. These findings suggest that slow fermenting starch-entrapped microspheres may induce a favourable colonic environment in patients with IBD through high butyrate production, maintenance of low pH in the distal colon and inhibition of the growth of potentially harmful bacteria.

Economic Evaluation Plan (EEP) for A Very Early Rehabilitation Trial (AVERT): An international trial to compare the costs and cost-effectiveness of commencing out of bed standing and walking training (very early mobilization) within 24 h of stroke onset with usual stroke unit care.

PubMed

Sheppard, Lauren; Dewey, Helen; Bernhardt, Julie; Collier, Janice M; Ellery, Fiona; Churilov, Leonid; Tay-Teo, Kiu; Wu, Olivia; Moodie, Marj

2016-06-01

A key objective of A Very Early Rehabilitation Trial is to determine if the intervention, very early mobilisation following stroke, is cost-effective. Resource use data were collected to enable an economic evaluation to be undertaken and a plan for the main economic analyses was written prior to the completion of follow up data collection. To report methods used to collect resource use data, pre-specify the main economic evaluation analyses and report other intended exploratory analyses of resource use data. Recruitment to the trial has been completed. A total of 2,104 participants from 56 stroke units across three geographic regions participated in the trial. Resource use data were collected prospectively alongside the trial using standardised tools. The primary economic evaluation method is a cost-effectiveness analysis to compare resource use over 12 months with health outcomes of the intervention measured against a usual care comparator. A cost-utility analysis is also intended. The primary outcome in the cost-effectiveness analysis will be favourable outcome (modified Rankin Scale score 0-2) at 12 months. Cost-utility analysis will use health-related quality of life, reported as quality-adjusted life years gained over a 12 month period, as measured by the modified Rankin Scale and the Assessment of Quality of Life. Outcomes of the economic evaluation analysis will inform the cost-effectiveness of very early mobilisation following stroke when compared to usual care. The exploratory analysis will report patterns of resource use in the first year following stroke. © 2016 World Stroke Organization.

Comparing groundwater recharge and storage variability from GRACE satellite observations with observed water levels and recharge model simulations

NASA Astrophysics Data System (ADS)

Allen, D. M.; Henry, C.; Demon, H.; Kirste, D. M.; Huang, J.

2011-12-01

Sustainable management of groundwater resources, particularly in water stressed regions, requires estimates of groundwater recharge. This study in southern Mali, Africa compares approaches for estimating groundwater recharge and understanding recharge processes using a variety of methods encompassing groundwater level-climate data analysis, GRACE satellite data analysis, and recharge modelling for current and future climate conditions. Time series data for GRACE (2002-2006) and observed groundwater level data (1982-2001) do not overlap. To overcome this problem, GRACE time series data were appended to the observed historical time series data, and the records compared. Terrestrial water storage anomalies from GRACE were corrected for soil moisture (SM) using the Global Land Data Assimilation System (GLDAS) to obtain monthly groundwater storage anomalies (GRACE-SM), and monthly recharge estimates. Historical groundwater storage anomalies and recharge were determined using the water table fluctuation method using observation data from 15 wells. Historical annual recharge averaged 145.0 mm (or 15.9% of annual rainfall) and compared favourably with the GRACE-SM estimate of 149.7 mm (or 14.8% of annual rainfall). Both records show lows and peaks in May and September, respectively; however, the peak for the GRACE-SM data is shifted later in the year to November, suggesting that the GLDAS may poorly predict the timing of soil water storage in this region. Recharge simulation results show good agreement between the timing and magnitude of the mean monthly simulated recharge and the regional mean monthly storage anomaly hydrograph generated from all monitoring wells. Under future climate conditions, annual recharge is projected to decrease by 8% for areas with luvisols and by 11% for areas with nitosols. Given this potential reduction in groundwater recharge, there may be added stress placed on an already stressed resource.

The evolution of autodigestion in the mushroom family Psathyrellaceae (Agaricales) inferred from Maximum Likelihood and Bayesian methods.

PubMed

Nagy, László G; Urban, Alexander; Orstadius, Leif; Papp, Tamás; Larsson, Ellen; Vágvölgyi, Csaba

2010-12-01

Recently developed comparative phylogenetic methods offer a wide spectrum of applications in evolutionary biology, although it is generally accepted that their statistical properties are incompletely known. Here, we examine and compare the statistical power of the ML and Bayesian methods with regard to selection of best-fit models of fruiting-body evolution and hypothesis testing of ancestral states on a real-life data set of a physiological trait (autodigestion) in the family Psathyrellaceae. Our phylogenies are based on the first multigene data set generated for the family. Two different coding regimes (binary and multistate) and two data sets differing in taxon sampling density are examined. The Bayesian method outperformed Maximum Likelihood with regard to statistical power in all analyses. This is particularly evident if the signal in the data is weak, i.e. in cases when the ML approach does not provide support to choose among competing hypotheses. Results based on binary and multistate coding differed only modestly, although it was evident that multistate analyses were less conclusive in all cases. It seems that increased taxon sampling density has favourable effects on inference of ancestral states, while model parameters are influenced to a smaller extent. The model best fitting our data implies that the rate of losses of deliquescence equals zero, although model selection in ML does not provide proper support to reject three of the four candidate models. The results also support the hypothesis that non-deliquescence (lack of autodigestion) has been ancestral in Psathyrellaceae, and that deliquescent fruiting bodies represent the preferred state, having evolved independently several times during evolution. Copyright © 2010 Elsevier Inc. All rights reserved.

Superior ab initio identification, annotation and characterisation of TEs and segmental duplications from genome assemblies.

PubMed

Zeng, Lu; Kortschak, R Daniel; Raison, Joy M; Bertozzi, Terry; Adelson, David L

2018-01-01

Transposable Elements (TEs) are mobile DNA sequences that make up significant fractions of amniote genomes. However, they are difficult to detect and annotate ab initio because of their variable features, lengths and clade-specific variants. We have addressed this problem by refining and developing a Comprehensive ab initio Repeat Pipeline (CARP) to identify and cluster TEs and other repetitive sequences in genome assemblies. The pipeline begins with a pairwise alignment using krishna, a custom aligner. Single linkage clustering is then carried out to produce families of repetitive elements. Consensus sequences are then filtered for protein coding genes and then annotated using Repbase and a custom library of retrovirus and reverse transcriptase sequences. This process yields three types of family: fully annotated, partially annotated and unannotated. Fully annotated families reflect recently diverged/young known TEs present in Repbase. The remaining two types of families contain a mixture of novel TEs and segmental duplications. These can be resolved by aligning these consensus sequences back to the genome to assess copy number vs. length distribution. Our pipeline has three significant advantages compared to other methods for ab initio repeat identification: 1) we generate not only consensus sequences, but keep the genomic intervals for the original aligned sequences, allowing straightforward analysis of evolutionary dynamics, 2) consensus sequences represent low-divergence, recently/currently active TE families, 3) segmental duplications are annotated as a useful by-product. We have compared our ab initio repeat annotations for 7 genome assemblies to other methods and demonstrate that CARP compares favourably with RepeatModeler, the most widely used repeat annotation package.

Superior ab initio identification, annotation and characterisation of TEs and segmental duplications from genome assemblies

PubMed Central

Zeng, Lu; Kortschak, R. Daniel; Raison, Joy M.

2018-01-01

Transposable Elements (TEs) are mobile DNA sequences that make up significant fractions of amniote genomes. However, they are difficult to detect and annotate ab initio because of their variable features, lengths and clade-specific variants. We have addressed this problem by refining and developing a Comprehensive ab initio Repeat Pipeline (CARP) to identify and cluster TEs and other repetitive sequences in genome assemblies. The pipeline begins with a pairwise alignment using krishna, a custom aligner. Single linkage clustering is then carried out to produce families of repetitive elements. Consensus sequences are then filtered for protein coding genes and then annotated using Repbase and a custom library of retrovirus and reverse transcriptase sequences. This process yields three types of family: fully annotated, partially annotated and unannotated. Fully annotated families reflect recently diverged/young known TEs present in Repbase. The remaining two types of families contain a mixture of novel TEs and segmental duplications. These can be resolved by aligning these consensus sequences back to the genome to assess copy number vs. length distribution. Our pipeline has three significant advantages compared to other methods for ab initio repeat identification: 1) we generate not only consensus sequences, but keep the genomic intervals for the original aligned sequences, allowing straightforward analysis of evolutionary dynamics, 2) consensus sequences represent low-divergence, recently/currently active TE families, 3) segmental duplications are annotated as a useful by-product. We have compared our ab initio repeat annotations for 7 genome assemblies to other methods and demonstrate that CARP compares favourably with RepeatModeler, the most widely used repeat annotation package. PMID:29538441

Comparing the effectiveness of laser vs. conventional endoforehead lifting.

PubMed

Chang, Cheng-Jen; Yu, De-Yi; Chang, Shu-Ying; Hsiao, Yen-Chang

2018-04-01

The objective of this study was to compare the efficacy and safety of laser versus conventional endoforehead lifting. Over a period of 12 years (January 2000-January 2012), a total of 110 patients with hyperactive muscles over the frontal region have been collected for a retrospective study. The SurgiLase 150XJ CO 2 laser system, in conjunction with the flexible FIBERLASE, was used. The endoscope was 4 mm in diameter with an angle of 30°. The primary efficacy measurement was the assessment of the final outcome for using laser vs. conventional methods. Both groups were observed at three weeks, six weeks and six months after surgery. The most common complication in early convalescence (three weeks) was swelling. This was followed by local paraesthesia, ecchymosis, localized hematomas and scar with alopecia. All these problems disappeared completely after the 6-month study period. Based on a chi-square analysis, there were clinically and statistically significant differences favouring the laser endoforehead surgery in the operative time, early and late complications. All patients achieved significant improvement after both laser and conventional endoforehead surgery in the final outcome. However, the early and late complications indicated a greater difference in the laser group.

An equilibrium-point model of electromyographic patterns during single-joint movements based on experimentally reconstructed control signals.

PubMed

Latash, M L; Goodman, S R

1994-01-01

The purpose of this work has been to develop a model of electromyographic (EMG) patterns during single-joint movements based on a version of the equilibrium-point hypothesis, a method for experimental reconstruction of the joint compliant characteristics, the dual-strategy hypothesis, and a kinematic model of movement trajectory. EMG patterns are considered emergent properties of hypothetical control patterns that are equally affected by the control signals and peripheral feedback reflecting actual movement trajectory. A computer model generated the EMG patterns based on simulated movement kinematics and hypothetical control signals derived from the reconstructed joint compliant characteristics. The model predictions have been compared to published recordings of movement kinematics and EMG patterns in a variety of movement conditions, including movements over different distances, at different speeds, against different-known inertial loads, and in conditions of possible unexpected decrease in the inertial load. Changes in task parameters within the model led to simulated EMG patterns qualitatively similar to the experimentally recorded EMG patterns. The model's predictive power compares it favourably to the existing models of the EMG patterns. Copyright © 1994. Published by Elsevier Ltd.

The influence of sorghum grain decortication on bioethanol production and quality of the distillers' dried grains with solubles using cold and conventional warm starch processing.

PubMed

Nkomba, Edouard Y; van Rensburg, Eugéne; Chimphango, Annie F A; Görgens, Johann F

2016-03-01

Very high gravity hydrolysis-fermentation of whole and decorticated sorghum grains were compared using conventional and cold hydrolysis methods to assess the extent by which decortication could minimize enzymes dosages and affect the quality of the distillers' dried grains with solubles (DDGS). All processing configurations achieved ethanol concentrations between 126 and 132 g/L (16.0-16.7%v/v), although decortication resulted in a decreased ethanol yield. Decortication resulted in a decreased volumetric productivity during warm processing from 1.55 to 1.25 g L(-1)h(-1), whereas the required enzyme dosage for cold processing was decreased from 250 to 221 μl/100 gstarch. Cold processing decreased the average acid detergent fibre (ADF) from 35.59% to 29.32% and neutral detergent fibre (NDF) from 44.04% to 32.28% in the DDGS compared to the conventional (warm) processing. Due to lower enzyme requirements, the use of decorticated grains combined with cold processing presents a favourable process configuration and source of DDGS for non-ruminants. Copyright © 2015 Elsevier Ltd. All rights reserved.

A study on the physicochemical properties of hydroalcoholic solutions to improve the direct exfoliation of natural graphite down to few-layers graphene

NASA Astrophysics Data System (ADS)

Fedi, Filippo; Miglietta, Maria Lucia; Polichetti, Tiziana; Ricciardella, Filiberto; Massera, Ettore; Ninno, Domenico; Di Francia, Girolamo

2015-03-01

Straightforward methods to produce pristine graphene flakes in large quantities are based on the liquid-phase exfoliation processes. These one-step physical transformations of graphite into graphene offer many unique advantages. To date, a large number of liquids have been employed as exfoliation media exploiting their thermodynamic and chemical features as compared to those of graphene. Here, we pursued the goal of realizing water based mixtures to exfoliate graphite and disperse graphene without the aid of surfactants. To this aim, aqueous mixtures with suitable values of surface tension and Hansen solubility parameters (HSPs), were specifically designed and used. The very high water surface tension was decreased by the addition of solvents with lower surface tensions such as alcohols, obtaining, in this way, more favourable HSP distances. The specific role of each of these thermodynamic features was finally investigated. The results showed that the designed hydroalcoholic solutions were effective in both the graphite exfoliation and dispersion without the addition of any surfactants or other stabilizing agents. Stable graphene suspensions were obtained at concentration comparable to those produced with low-boiling solvents and water/surfactants.

Genotyping the factor VIII intron 22 inversion locus using fluorescent in situ hybridization.

PubMed

Sheen, Campbell R; McDonald, Margaret A; George, Peter M; Smith, Mark P; Morris, Christine M

2011-02-15

The factor VIII intron 22 inversion is the most common cause of hemophilia A, accounting for approximately 40% of all severe cases of the disease. Southern hybridization and multiplex long distance PCR are the most commonly used techniques to detect the inversion in a diagnostic setting, although both have significant limitations. Here we describe our experience establishing a multicolor fluorescent in situ hybridization (FISH) based assay as an alternative to existing methods for genetic diagnosis of the inversion. Our assay was designed to apply three differentially labelled BAC DNA probes that when hybridized to interphase nuclei would exhibit signal patterns that are consistent with the normal or the inversion locus. When the FISH assay was applied to five normal and five inversion male samples, the correct genotype was assignable with p<0.001 for all samples. When applied to carrier female samples the assay could not assign a genotype to all female samples, probably due to a lower proportion of informative nuclei in female samples caused by the added complexity of a second X chromosome. Despite this complication, these pilot findings show that the assay performs favourably compared to the commonly used methods. Copyright © 2010 Elsevier Inc. All rights reserved.

Novel Conjugated Polymers Prepared by Direct (Hetero) arylation: An Eco-Friendly Tool for Organic Electronics.

PubMed

Liu, Fuchuan; Zhang, Yangqian; Wang, Hang; Zhang, Shiming

2018-02-13

The phthalimide (PhI) moiety has been attracting more attention as an excellent acceptor building block in donor-acceptor (D-A) conjugated polymers. In this paper; three D-A conjugated polymers with or without thiocarbonyl moieties are successfully prepared by the direct (hetero)-arylation polymerization (DHAP), which is an atom efficient and facile synthetic strategy to obtain polymer materials. Compared with the traditional carbon-carbon coupling reactions, this method possesses more advantages, including: fewer synthetic steps, avoidance of the preparation of the organometallic reagents, higher atom economy and fewer toxic byproducts, better compatibility with chemically sensitive functional groups and so on. All three of these designed PhI-based polymers exhibited favourable optoelectronic and thermal performance. The optical, thermodynamic and electrochemical properties of the synthesized polymers were systematically investigated using ultraviolet-visible (UV-vis) spectroscopy, thermogravimetric analysis (TGA), differential scanning calorimetry (DSC) and cyclic voltammetry (CV). The results of these three polymers indicated that thionation of the carbonyl was a highly effective methods to improve the properties of PhI-based polymers; and provided impetus for the development of thionated PhI derivatives for organic electronic applications.

Dialectical dividends: fostering hybridity of new pedagogical practices and partnerships in science education and outreach

NASA Astrophysics Data System (ADS)

Martins Gomes, Diogo; McCauley, Veronica

2016-09-01

Science literacy has become socially and economically very important. European countries stress that science graduates are fundamental for economic growth. Nevertheless, there is a declining student participation in science. In response, there has been a call to change the way science is taught in schools, which focuses on inquiry methods rooted in constructivism. Universities and other organisations have responded by developing outreach programmes to improve student engagement in science. Given this context, there is a necessity for research to ascertain if this new relationship between outreach and education is worthwhile. This study examines and compares primary teachers and outreach practitioners understanding and perceptions of constructivist science pedagogy, in an effort to understand the potential of a teacher-outreach partnership. For this, qualitative and quantitative methods were employed, taking a dialectic pragmatic stance. Contradicting the recurrent view, teachers and outreach providers revealed favourable views in relation to constructivism, despite recognising barriers to its implementation. These results support a partnership between teachers and outreach practitioners and the realisation of the hybrid role of each participant. The results also reveal an important dynamic in outreach access to schools. Specifically, the outreach connected teachers acted as gatekeepers by negotiating access into their colleagues classrooms.

Collective antibiotic treatment of trachoma

PubMed Central

Reinhards, J.; Weber, A.; Maxwell-Lyons, F.

1959-01-01

By the early 1950's, it was clear from numerous independent reports that certain of the broad-spectrum antibiotics were effective against the agent of trachoma. It seemed, however, that treatment had to be continued over long periods to effect a cure of the average case. With the assistance of WHO, comparative trials on a scale hitherto unprecedented in the disease—involving more than 9000 schoolchildren with active trachoma—have been conducted in Morocco since 1953 in order to assess the value of local treatment of trachoma with chlortetracycline and to develop simple and economic methods of treatment, for which there was a pressing need. Local application of 1% chlortetracycline ointment two or three times daily for 60 days gave almost 80% cures under reasonably favourable conditions and nearly 100% cures after re-treatment of cases not cured by the first course. Equally good results followed intermittent short-term treatment over longer periods. Relapse and reinfection rates were low. Collective mass treatment with antibiotics is clearly a valuable method of trachoma control. The use of intermittent treatment allows for a great economy both in antibiotics and in staff and other campaign expenses and makes possible the wide expansion of mass treatment programmes. PMID:14437176

Imaging of the small bowel in Crohn's disease: A review of old and new techniques

PubMed Central

Saibeni, Simone; Rondonotti, Emanuele; Iozzelli, Andrea; Spina, Luisa; Tontini, Gian Eugenio; Cavallaro, Flaminia; Ciscato, Camilla; de Franchis, Roberto; Sardanelli, Francesco; Vecchi, Maurizio

2007-01-01

The investigation of small bowel morphology is often mandatory in many patients with Crohn’s disease. Traditional radiological techniques (small bowel enteroclysis and small bowel follow-through) have long been the only suitable methods for this purpose. In recent years, several alternative imaging techniques have been proposed. To review the most recent advances in imaging studies of the small bowel, with particular reference to their possible application in Crohn’s disease, we conducted a complete review of the most important studies in which traditional and newer imaging methods were performed and compared in patients with Crohn’s disease. Several radiological and endoscopic techniques are now available for the study of the small bowel; each of them is characterized by a distinct profile of favourable and unfavourable features. In some cases, they may also be used as complementary rather than alternative techniques. In everyday practice, the choice of the technique to be used stands upon its availability and a careful evaluation of diagnostic accuracy, clinical usefulness, safety and cost. The recent development of innovative imaging techniques has opened a new and exciting area in the exploration of the small bowel in Crohn’s disease patients. PMID:17659666

Selected Schizosaccharomyces pombe Strains Have Characteristics That Are Beneficial for Winemaking

PubMed Central

Benito, Ángel; Jeffares, Daniel; Palomero, Felipe; Calderón, Fernando; Bai, Feng-Yan; Bähler, Jürg; Benito, Santiago

2016-01-01

At present, wine is generally produced using Saccharomyces yeast followed by Oenococus bacteria to complete malolactic fermentation. This method has some unsolved problems, such as the management of highly acidic musts and the production of potentially toxic products including biogenic amines and ethyl carbamate. Here we explore the potential of the fission yeast Schizosaccharomyces pombe to solve these problems. We characterise an extensive worldwide collection of S. pombe strains according to classic biochemical parameters of oenological interest. We identify three genetically different S. pombe strains that appear suitable for winemaking. These strains compare favourably to standard Saccharomyces cerevisiae winemaking strains, in that they perform effective malic acid deacidification and significantly reduce levels of biogenic amines and ethyl carbamate precursors without the need for any secondary bacterial malolactic fermentation. These findings indicate that the use of certain S. pombe strains could be advantageous for winemaking in regions where malic acid is problematic, and these strains also show superior performance with respect to food safety. PMID:27007548

Heat storage with an incongruently melting salt hydrate as storage medium based on the extra water principle

NASA Astrophysics Data System (ADS)

Furbo, S.

1980-12-01

The extra water principle, a heat of fusion storage method, is described. The extra water principle uses an inorganic, incongruently melting salt hydrate as a reliable and stable storage medium in an inexpensive way. Different heat storages using the extra water principle are described. The advantages of using a heat fusion storage unit based on Na2S2O(3).5H2O and the extra water principle instead of a traditional hot water tank in small solar heating systems for domestic hot water supply are shown. In small solar heating systems the heat fusion storage supplies all the wanted hot water in the summer during longer periods than an ordinary hot water storage. It is concluded that the heat of fusion storage is favourable in domestic hot water supply systems with an auxiliary energy source which during the summer have a large energy consumption compared with the energy demands for the hot water supply.

Determination of acrylamide and acrylic acid by isocratic liquid chromatography with pulsed electrochemical detection.

PubMed

Casella, Innocenzo G; Pierri, Marianna; Contursi, Michela

2006-02-24

The electrochemical behaviour of the polycrystalline platinum electrode towards the oxidation/reduction of short-chain unsaturated aliphatic molecules such as acrylamide and acrylic acid was investigated in acidic solutions. Analytes were separated by reverse phase liquid chromatographic and quantified using a pulsed amperometric detection. A new two-step waveform, is introduced for detection of acrylamide and acrylic acid. Detection limits (LOD) of 20 nM (1. 4 microg/kg) and 45 nM (3.2 microg/kg) were determined in water solutions containing acrylamide and acrylic acid, respectively. Compared to the classical three-step waveform, the proposed two-step waveform shows favourable analytical performance in terms of LOD, linear range, precision and improved long-term reproducibility. The proposed analytical method combined with clean-up procedure accomplished by Carrez clearing reagent and subsequent extraction with a strong cation exchanger cartridges (SPE), was successfully used for the quantification of low concentrations of acrylamide in foodstuffs such as coffee and potato fries.

Harnessing speckle for a sub-femtometre resolved broadband wavemeter and laser stabilization

PubMed Central

Metzger, Nikolaus Klaus; Spesyvtsev, Roman; Bruce, Graham D.; Miller, Bill; Maker, Gareth T.; Malcolm, Graeme; Mazilu, Michael; Dholakia, Kishan

2017-01-01

The accurate determination and control of the wavelength of light is fundamental to many fields of science. Speckle patterns resulting from the interference of multiple reflections in disordered media are well-known to scramble the information content of light by complex but linear processes. However, these patterns are, in fact, exceptionally rich in information about the illuminating source. We use a fibre-coupled integrating sphere to generate wavelength-dependent speckle patterns, in combination with algorithms based on the transmission matrix method and principal component analysis, to realize a broadband and sensitive wavemeter. We demonstrate sub-femtometre wavelength resolution at a centre wavelength of 780 nm, and a broad calibrated measurement range from 488 to 1,064 nm. This compares favourably to the performance of conventional wavemeters. Using this speckle wavemeter as part of a feedback loop, we stabilize a 780 nm diode laser to achieve a linewidth better than 1 MHz. PMID:28580938

Face recognition: a convolutional neural-network approach.

PubMed

Lawrence, S; Giles, C L; Tsoi, A C; Back, A D

1997-01-01

We present a hybrid neural-network for human face recognition which compares favourably with other methods. The system combines local image sampling, a self-organizing map (SOM) neural network, and a convolutional neural network. The SOM provides a quantization of the image samples into a topological space where inputs that are nearby in the original space are also nearby in the output space, thereby providing dimensionality reduction and invariance to minor changes in the image sample, and the convolutional neural network provides partial invariance to translation, rotation, scale, and deformation. The convolutional network extracts successively larger features in a hierarchical set of layers. We present results using the Karhunen-Loeve transform in place of the SOM, and a multilayer perceptron (MLP) in place of the convolutional network for comparison. We use a database of 400 images of 40 individuals which contains quite a high degree of variability in expression, pose, and facial details. We analyze the computational complexity and discuss how new classes could be added to the trained recognizer.

Measurement of trace levels of antibiotics in river water using on-line enrichment and triple-quadrupole LC-MS/MS.

PubMed

Dinh, Quoc Tuc; Alliot, Fabrice; Moreau-Guigon, Elodie; Eurin, Joëlle; Chevreuil, Marc; Labadie, Pierre

2011-09-15

This study presents the development of an automated on-line solid phase extraction (SPE)-liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the determination of 23 antibiotics in environmental water samples. After optimisation of LC-MS/MS conditions, SPE parameters such as sorbent type, sample pH or sample volume were optimised. Antibiotic recoveries ranged from 64% to 98% and compared favourably with those achieved using off-line SPE. Limits of detection were in the range 0.5-13.7 ng L(-1). This on-line SPE-LC-MS/MS procedure was applied to the analysis of water samples taken in three rivers within the Seine River basin, near Paris (France). The obtained results revealed the occurrence of 12 antibiotics, including tylosin, erythromycin, tetracycline, amoxicillin, trimethoprim, sulfamethoxazole, oxolinic acid, flumequine, norfloxacin, ciprofloxacin, ofloxacin, and vancomycin (2-1435 ng L(-1)). Copyright © 2011 Elsevier B.V. All rights reserved.

Would a "one-handed" scientist lack rigor? How scientists discuss the work-relatedness of musculoskeletal disorders in formal and informal communications.

PubMed

Premji, Stephanie; Messing, Karen; Lippel, Katherine

2008-03-01

When research results concerning occupational health are expressed ambiguously, compensation and prevention can be affected. This study examined the language used by scientists to discuss the relation between work and musculoskeletal disorders (MSDs). Language regarding work and MSDs in twenty articles from two peer-reviewed journals was compared with that in 94 messages on MSDs posted by published scientists to an internet list. Almost all the articles found some link between work and MSDs. However, few articles expressed belief in such a link unambiguously in the title or abstract, and language on links was often hard for a non-health scientist to interpret. Language and methods gave excess weight to negative results. On the listserve, many scientists expressed unambiguous views on linkages between work and MSDs. Scientists must express their opinions more forthrightly if they wish their results to be used to favour prevention and to foster access to workers' compensation.

Quantum Monte Carlo study of the phase diagram of solid molecular hydrogen at extreme pressures

PubMed Central

Drummond, N. D.; Monserrat, Bartomeu; Lloyd-Williams, Jonathan H.; Ríos, P. López; Pickard, Chris J.; Needs, R. J.

2015-01-01

Establishing the phase diagram of hydrogen is a major challenge for experimental and theoretical physics. Experiment alone cannot establish the atomic structure of solid hydrogen at high pressure, because hydrogen scatters X-rays only weakly. Instead, our understanding of the atomic structure is largely based on density functional theory (DFT). By comparing Raman spectra for low-energy structures found in DFT searches with experimental spectra, candidate atomic structures have been identified for each experimentally observed phase. Unfortunately, DFT predicts a metallic structure to be energetically favoured at a broad range of pressures up to 400 GPa, where it is known experimentally that hydrogen is non-metallic. Here we show that more advanced theoretical methods (diffusion quantum Monte Carlo calculations) find the metallic structure to be uncompetitive, and predict a phase diagram in reasonable agreement with experiment. This greatly strengthens the claim that the candidate atomic structures accurately model the experimentally observed phases. PMID:26215251

Fully automated measuring setup for tactile coordinate measuring machine for three dimensional measurement of freeform eyeglass frames

NASA Astrophysics Data System (ADS)

Rückwardt, M.; Göpfert, A.; Correns, M.; Schellhorn, M.; Linß, G.

2010-07-01

Coordinate measuring machines are high precession all-rounder in three dimensional measuring. Therefore the versatility of parameters and expandability of additionally hardware is very comprehensive. Consequently you need much expert knowledge of the user and mostly a lot of advanced information about the measuring object. In this paper a coordinate measuring machine and a specialized measuring machine are compared at the example of the measuring of eyeglass frames. For this case of three dimensional measuring challenges the main focus is divided into metrological and economical aspects. At first there is shown a fully automated method for tactile measuring of this abstract form. At second there is shown a comparison of the metrological characteristics of a coordinate measuring machine and a tracer for eyeglass frames. The result is in favour to the coordinate measuring machine. It was not surprising in these aspects. At last there is shown a comparison of the machine in front of the economical aspects.

Effectiveness of group body psychotherapy for negative symptoms of schizophrenia: multicentre randomised controlled trial†

PubMed Central

Priebe, S.; Savill, M.; Wykes, T.; Bentall, R. P.; Reininghaus, U.; Lauber, C.; Bremner, S.; Eldridge, S.; Röhricht, F.

2016-01-01

Background Negative symptoms of schizophrenia have a severe impact on functional outcomes and treatment options are limited. Arts therapies are currently recommended but more evidence is required. Aims To assess body psychotherapy as a treatment for negative symptoms compared with an active control (trial registration: ISRCTN84216587). Method Schizophrenia out-patients were randomised into a 20-session body psychotherapy or Pilates group. The primary outcome was negative symptoms at end of treatment. Secondary outcomes included psychopathology, functional, social and treatment satisfaction outcomes at treatment end and 6-months later. Results In total, 275 participants were randomised. The adjusted difference in negative symptoms was 0.03 (95% CI −1.11 to 1.17), indicating no benefit from body psychotherapy. Small improvements in expressive deficits and movement disorder symptoms were detected in favour of body psychotherapy. No other outcomes were significantly different. Conclusions Body psychotherapy does not have a clinically relevant beneficial effect in the treatment of patients with negative symptoms of schizophrenia. PMID:27151073

A Theoretically Consistent Framework for Modelling Lagrangian Particle Deposition in Plant Canopies

NASA Astrophysics Data System (ADS)

Bailey, Brian N.; Stoll, Rob; Pardyjak, Eric R.

2018-06-01

We present a theoretically consistent framework for modelling Lagrangian particle deposition in plant canopies. The primary focus is on describing the probability of particles encountering canopy elements (i.e., potential deposition), and provides a consistent means for including the effects of imperfect deposition through any appropriate sub-model for deposition efficiency. Some aspects of the framework draw upon an analogy to radiation propagation through a turbid medium with which to develop model theory. The present method is compared against one of the most commonly used heuristic Lagrangian frameworks, namely that originally developed by Legg and Powell (Agricultural Meteorology, 1979, Vol. 20, 47-67), which is shown to be theoretically inconsistent. A recommendation is made to discontinue the use of this heuristic approach in favour of the theoretically consistent framework developed herein, which is no more difficult to apply under equivalent assumptions. The proposed framework has the additional advantage that it can be applied to arbitrary canopy geometries given readily measurable parameters describing vegetation structure.

Study of Thermodynamics of Liquid Noble-Metals Alloys Through a Pseudopotential Theory

NASA Astrophysics Data System (ADS)

Vora, Aditya M.

2010-09-01

The Gibbs-Bogoliubov (GB) inequality is applied to investigate the thermodynamic properties of some equiatomic noble metal alloys in liquid phase such as Au-Cu, Ag-Cu, and Ag-Au using well recognized pseudopotential formalism. For description of the structure, well known Percus-Yevick (PY) hard sphere model is used as a reference system. By applying a variation method the best hard core diameters have been found which correspond to minimum free energy. With this procedure the thermodynamic properties such as entropy and heat of mixing have been computed. The influence of local field correction function viz; Hartree (H), Taylor (T), Ichimaru-Utsumi (IU), Farid et al. (F), and Sarkar et al. (S) is also investigated. The computed results of the excess entropy compares favourably in the case of liquid alloys while the agreement with experiment is poor in the case of heats of mixing. This may be due to the sensitivity of the heats of mixing with the potential parameters and the dielectric function.

In vivo proton range verification: a review

NASA Astrophysics Data System (ADS)

Knopf, Antje-Christin; Lomax, Antony

2013-08-01

Protons are an interesting modality for radiotherapy because of their well defined range and favourable depth dose characteristics. On the other hand, these same characteristics lead to added uncertainties in their delivery. This is particularly the case at the distal end of proton dose distributions, where the dose gradient can be extremely steep. In practice however, this gradient is rarely used to spare critical normal tissues due to such worries about its exact position in the patient. Reasons for this uncertainty are inaccuracies and non-uniqueness of the calibration from CT Hounsfield units to proton stopping powers, imaging artefacts (e.g. due to metal implants) and anatomical changes of the patient during treatment. In order to improve the precision of proton therapy therefore, it would be extremely desirable to verify proton range in vivo, either prior to, during, or after therapy. In this review, we describe and compare state-of-the art in vivo proton range verification methods currently being proposed, developed or clinically implemented.

Why do patients decline surgical trials? Findings from a qualitative interview study embedded in the Cancer Research UK BOLERO trial (Bladder cancer: Open versus Lapararoscopic or RObotic cystectomy).

PubMed

Harrop, Emily; Kelly, John; Griffiths, Gareth; Casbard, Angela; Nelson, Annmarie

2016-01-19

Surgical trials have typically experienced recruitment difficulties when compared with other types of oncology trials. Qualitative studies have an important role to play in exploring reasons for low recruitment, although to date few such studies have been carried out that are embedded in surgical trials. The BOLERO trial (Bladder cancer: Open versus Lapararoscopic or RObotic cystectomy) is a study to determine the feasibility of randomisation to open versus laparoscopic access/robotic cystectomy in patients with bladder cancer. We describe the results of a qualitative study embedded within the clinical trial that explored why patients decline randomisation. Ten semi-structured interviews with patients who declined randomisation to the clinical trial, and two interviews with recruiting research nurses were conducted. Data were analysed for key themes. The majority of patients declined the trial because they had preferences for a particular treatment arm, and in usual practice could choose which surgical method they would be given. In most cases the robotic option was preferred. Patients described an intuitive 'sense' that favoured the new technology and had carried out their own inquiries, including Internet research and talking with previous patients and friends and family with medical backgrounds. Medical histories and lifestyle considerations also shaped these personalised choices. Of importance too, however, were the messages patients perceived from their clinical encounters. Whilst some patients felt their surgeon favoured the robotic option, others interpreted 'indirect' cues such as the 'established' reputation of the surgeon and surgical method and comments made during clinical assessments. Many patients expressed a wish for greater direction from their surgeon when making these decisions. For trials where the 'new technology' is available to patients, there will likely be difficulties with recruitment. Greater attention could be paid to how messages about treatment options and the trial are conveyed across the whole clinical setting. However, if it is too difficult to challenge such messages, then questions should be asked about whether genuine and convincing equipoise can be presented and perceived in such trials. This calls for consideration of whether alternative methods of generating evidence could be used when evaluating surgical techniques which are established and routinely available. ISRCTN38528926 (11 December 2008).

Effectiveness and Economic Evaluation of Chiropractic Care for the Treatment of Low Back Pain: A Systematic Review of Pragmatic Studies

PubMed Central

Blanchette, Marc-André; Stochkendahl, Mette Jensen; Borges Da Silva, Roxane; Boruff, Jill; Harrison, Pamela; Bussières, André

2016-01-01

Background Context Low back pain (LBP) is one of the leading causes of disability worldwide and among the most common reasons for seeking primary sector care. Chiropractors, physical therapists and general practitioners are among those providers that treat LBP patients, but there is only limited evidence regarding the effectiveness and economic evaluation of care offered by these provider groups. Purpose To estimate the clinical effectiveness and to systematically review the literature of full economic evaluation of chiropractic care compared to other commonly used care approaches among adult patients with non-specific LBP. Study Design Systematic reviews of interventions and economic evaluations. Methods A comprehensive search strategy was conducted to identify 1) pragmatic randomized controlled trials (RCTs) and/or 2) full economic evaluations of chiropractic care for low back pain compared to standard care delivered by other healthcare providers. Studies published between 1990 and 4th June 2015 were considered. Primary outcomes included pain, functional status and global improvement. Study selection, critical quality appraisal and data extraction were conducted by two independent reviewers. Data from RCTs with low risk of bias were included in a meta-analysis to determine effect estimates. Cost estimates of full economic evaluations were converted to 2015 USD and results summarized using Slavin’s qualitative best-evidence synthesis. Results Six RCTs and three full economic evaluations were scientifically admissible. Five RCTs with low risk of bias compared chiropractic care to exercise therapy (n = 1), physical therapy (n = 3) and medical care (n = 1). Overall, we found similar effects for chiropractic care and the other types of care and no reports of serious adverse events. Three low to high quality full economic evaluations studies (one cost-effectiveness, one cost-minimization and one cost-benefit) compared chiropractic to medical care. Given the divergent conclusions (favours chiropractic, favours medical care, equivalent options), mixed-evidence was found for economic evaluations of chiropractic care compared to medical care. Conclusion Moderate evidence suggests that chiropractic care for LBP appears to be equally effective as physical therapy. Limited evidence suggests the same conclusion when chiropractic care is compared to exercise therapy and medical care although no firm conclusion can be reached at this time. No serious adverse events were reported for any type of care. Our review was also unable to clarify whether chiropractic or medical care is more cost-effective. Given the limited available evidence, the decision to seek or to refer patients for chiropractic care should be based on patient preference and values. Future studies are likely to have an important impact on our estimates as these were based on only a few admissible studies. PMID:27487116

Prevention methods for pest control and their use in Poland.

PubMed

Matyjaszczyk, Ewa

2015-04-01

Prevention methods can still be a cost-effective and efficient tool for pest control. Rational use of prevention methods is a feasible way to reduce dependency on chemical protection in agriculture. Costs, workload and farmers' awareness are key issues, however. In Poland, crop rotation is used as a method for pest control only to a limited extent owing to the high share of cereals in the crop structure. The choice of resistant varieties is satisfactory, but farmers should make use of qualified seed material more often. Liming is recommended on the majority of farms on account of widespread soil acidity. Favourable aspects as regards the prevention of pest development are biodiversity and the popularity of prevention cultivation techniques. © 2014 Society of Chemical Industry.

A selective spectrophotometric method for determination of rosoxacin antibiotic using sodium nitroprusside as a chromogenic reagent

NASA Astrophysics Data System (ADS)

Askal, Hassan F.; Refaat, Ibrahim H.; Darwish, Ibrahim A.; Marzouq, Mostafa A.

2008-04-01

A selective spectrophotometric method for the determination of rosoxacin (ROS), a 4-quinolone antimicrobial agent, has been developed and validated. The method was based on the reaction of ROS with alkaline sodium nitroprusside (SNP) reagent at room temperature forming a red colored chromogen measured at 455 nm. The conditions affecting the reaction (SNP concentration, pH, color-developing time, temperature, diluting solvent and chromogen stability time) were optimized. Under the optimum conditions, good linear relationship ( r = 0.9987) was obtained between the absorbance and the concentration of ROS in the range of 20-50 μg ml -1. The assay limits of detection and quantitation were 2.5 and 8.4 μg ml -1, respectively. The method was successfully applied to the analysis of bulk drug and laboratory-prepared tablets; the mean percentage recoveries were 100.1 ± 0.33 and 101.24 ± 1.28%, respectively. The results were compared favourably with those obtained by the reported method; no significant difference in the accuracy and precision as revealed by the accepted values of t- and F-tests, respectively. The robustness and ruggedness of the method was checked and satisfactory results were obtained. The proposed method was found to be highly selective for ROS among the fluoroquinolone antibiotics. The reaction mechanism was proposed and it proceeded in two steps; the formation of nitroferrocyanide by the action of sodium hydroxide alkalinity on SNP and the subsequent formation of the colored nitrosyl-ROS derivative by the attack at position 6 of ROS.

Systematic review and network meta-analysis of the efficacy and safety of tumour necrosis factor inhibitor–methotrexate combination therapy versus triple therapy in rheumatoid arthritis

PubMed Central

Fleischmann, Roy; Tongbram, Vanita; van Vollenhoven, Ronald; Tang, Derek H; Chung, James; Collier, David; Urs, Shilpa; Ndirangu, Kerigo; Wells, George; Pope, Janet

2017-01-01

Objective Clinical trials have not consistently demonstrated differences between tumour necrosis factor inhibitor (TNFi) plus methotrexate and triple therapy (methotrexate plus hydroxychloroquine plus sulfasalazine) in rheumatoid arthritis (RA). The study objective was to estimate the efficacy, radiographic benefits, safety and patient-reported outcomes of TNFi–methotrexate versus triple therapy in patients with RA. Methods A systematic review and network meta-analysis (NMA) of randomised controlled trials of TNFi–methotrexate or triple therapy as one of the treatment arms in patients with an inadequate response to or who were naive to methotrexate was conducted. American College of Rheumatology 70% response criteria (ACR70) at 6 months was the prespecified primary endpoint to evaluate depth of response. Data from direct and indirect comparisons between TNFi–methotrexate and triple therapy were pooled and quantitatively analysed using fixed-effects and random-effects Bayesian models. Results We analysed 33 studies in patients with inadequate response to methotrexate and 19 in patients naive to methotrexate. In inadequate responders, triple therapy was associated with lower odds of achieving ACR70 at 6 months compared with TNFi–methotrexate (OR 0.35, 95% credible interval (CrI) 0.19 to 0.64). Most secondary endpoints tended to favour TNFi–methotrexate in terms of OR direction; however, no clear increased likelihood of achieving these endpoints was observed for either therapy. The odds of infection were lower with triple therapy than with TNFi−methotrexate (OR 0.08, 95% CrI 0.00 to 0.57). There were no differences observed between the two regimens in patients naive to methotrexate. Conclusions In this NMA, triple therapy was associated with 65% lower odds of achieving ACR70 at 6 months compared with TNFi–methotrexate in patients with inadequate response to methotrexate. Although secondary endpoints numerically favoured TNFi–methotrexate, no clear differences were observed. The odds of infection were greater with TNFi–methotrexate. No differences were observed for patients naive to methotrexate. These results may help inform care of patients who fail methotrexate first-line therapy. PMID:28123782

Combined oral contraceptives and/or antiandrogens versus insulin sensitizers for polycystic ovary syndrome: a systematic review and meta-analysis.

PubMed

Luque-Ramírez, Manuel; Nattero-Chávez, Lía; Ortiz Flores, Andrés E; Escobar-Morreale, Héctor F

2017-12-27

Androgen excess is a key pathogenetic mechanism in polycystic ovary syndrome (PCOS), although hyperinsulinism also contributes to androgen secretion. Therapeutic approaches for adult patients not seeking fertility include combined oral contraceptives (COC), antiandrogens (AA) and/or insulin sensitizers, although these practices are supported by limited high-quality evidence. We aimed to assess the efficacy and safety of these common treatments for PCOS by conducting a meta-analysis of RCTs with the following review questions: Which is the more appropriate therapeutic approach for hyperandrogenic symptoms, hyperandrogenemia, and ovulatory dysfunction in adult women with PCOS not seeking fertility; What is the impact on classic cardiometabolic risk factors of the more common treatments used in those women; Does the combination of the antiandrogenic therapy plus metformin have any impact on efficacy or cardiometabolic profile? We searched PubMed and EMBASE for articles published up to 16 September 2017. After deleting duplicates, the abstracts of 1522 articles were analysed. We subsequently excluded 1446 articles leaving 76 studies for full-text assessment of eligibility. Of them, 43 articles were excluded. Hence, 33 studies and 1521 women were included in the quantitative synthesis and in the meta-analyses. Meta-analyses calculated mean differences (MD), standardized mean differences (SMD), odds ratio (OR) and 95% CIs. Heterogeneity and inconsistency across studies was assessed by χ2 test and Higgins's I2 statistics. Quality and risk of bias of individual studies were assessed according to the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0. We then used the approach recommended by the Grading of Recommendations, Assessments, Development, and Evaluation (GRADE) group to indicate the global quality of evidence for a selection of primary outcomes. Regarding efficacy, the MD in hirsutism score between COC and/or AA and metformin were not significant. The exclusion of one single study including most women with severe hirsutism yielded a significant effect in favour of COC and/or AA. When only those studies including an AA were compared with metformin, there were significant differences favouring antiandrogenic therapy. The combination of COC and/or AA with metformin was similar to COC and/or AA therapy alone in the whole group of patients. Post-intervention OR for the presence of regular menses favoured COC therapy. In terms of cardiometabolic impact, the MD in BMI were in favour of metformin. The negative effect of COC therapy on BMI was blunted by its combination with metformin. The MD in homoeostasis model assessment of insulin resistance (HOMA-IR) were also in favour of metformin therapy compared to COC and/or AA. The combination of COC and/or AA and metformin decreased MD in HOMA with respect to antiandrogenic therapy alone. There were no significant post-intervention SMD in circulating glucose levels between COC and/or AA and metformin. However, adding metformin to COC and/or AA yielded a beneficial effect on fasting glucose levels. Post-intervention OR for abnormal glucose tolerance showed no significant differences between COC and/or AA and metformin, although after excluding studies including an AA as a comparator (without COC) a significant effect in favour of metformin therapy was observed. There were no significant differences among therapies in lipid profile, blood pressure or prevalence of hypertension. The global quality of evidence was very low when addressing the impact of the treatments explored on prevalence of hypertension and lipid profiles, low in the case of hirsutism, BMI and blood pressure values, and high for endometrial protection and glucose tolerance. These data provide further scientific evidence for the choice of treatment of women with PCOS. COC and AA are more effective than metformin for hyperandrogenic symptoms and endometrial protection. Their combination with metformin adds a positive effect on BMI and glucose tolerance. CRD42016053457. © The Author(s) 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Ruthenium concentrations in geological boundary deposits and their correlation with Iridium by RIMS

NASA Astrophysics Data System (ADS)

Xu, X. Y.; Xin, X. B.; Ji, W. X.; Mao, X. Y.; Chai, C. F.

1995-04-01

The reason the biological mass extinctions in the earth history is a great concern of geologists. A method using RIMS to determine the concentration of Ru has been developed. The Ru/Ir concentration ratios favour the impact model of extraterrestrial material on the earth to explain the dinosaur extinction at the end of the Cretaceous. This is the first data on Ru abundances in geological boundary deposits analyzed by RIMS.

The CONSENSUS study: protocol for a mixed methods study to establish which outcomes should be included in a core outcome set for oropharyngeal cancer.

PubMed

Waters, Aoife Mi; Tudur Smith, Catrin; Young, Bridget; Jones, Terry M

2014-05-13

The incidence of oropharyngeal cancer is increasing in the developed world. This has led to a large rise in research activity and clinical trials in this area, yet there is no consensus on which outcomes should be measured. As a result, the outcomes measured often differ between trials of comparable interventions, making the combination or comparison of results between trials impossible. Outcomes may also be 'cherry-picked', such that favourable results are reported, and less favourable results withheld. The development of a minimum outcome reporting standard, known as a core outcome set, goes some way to addressing these problems. Core outcome sets are ideally developed using a patient-centred approach so that the outcomes measured are relevant to patients and clinical practice. Core outcome sets drive up the quality and relevance of research by ensuring that the right outcomes are consistently measured and reported in trials in specific areas of health or healthcare. This is a mixed methods study involving three phases to develop a core outcome set for oropharyngeal cancer clinical trials. Firstly, a systematic review will establish which outcomes are measured in published oropharyngeal cancer randomised controlled trials (RCTs). Secondly, qualitative interviews with patients and carers in the UK and the USA will aim to establish which outcomes are important to these stakeholders. Data from these first two stages will be used to develop a comprehensive list of outcomes to be considered for inclusion in the core outcome set. In the third stage, patients and clinicians will participate in an iterative consensus exercise known as a Delphi study to refine the contents of the core outcome set. This protocol lays out the methodology to be implemented in the CONSENSUS study. A core outcome set defines a minimum outcome reporting standard for clinical trials in a particular area of health or healthcare. Its consistent implementation in oropharyngeal cancer clinical trials will improve the quality and relevance of research. This study is registered at the National Institute for Health Research (NIHR) Clinical Research Network (CRN) portfolio, ID 13823 (17 January 2013).

Allele frequency changes due to hitch-hiking in genomic selection programs

PubMed Central

2014-01-01

Background Genomic selection makes it possible to reduce pedigree-based inbreeding over best linear unbiased prediction (BLUP) by increasing emphasis on own rather than family information. However, pedigree inbreeding might not accurately reflect loss of genetic variation and the true level of inbreeding due to changes in allele frequencies and hitch-hiking. This study aimed at understanding the impact of using long-term genomic selection on changes in allele frequencies, genetic variation and level of inbreeding. Methods Selection was performed in simulated scenarios with a population of 400 animals for 25 consecutive generations. Six genetic models were considered with different heritabilities and numbers of QTL (quantitative trait loci) affecting the trait. Four selection criteria were used, including selection on own phenotype and on estimated breeding values (EBV) derived using phenotype-BLUP, genomic BLUP and Bayesian Lasso. Changes in allele frequencies at QTL, markers and linked neutral loci were investigated for the different selection criteria and different scenarios, along with the loss of favourable alleles and the rate of inbreeding measured by pedigree and runs of homozygosity. Results For each selection criterion, hitch-hiking in the vicinity of the QTL appeared more extensive when accuracy of selection was higher and the number of QTL was lower. When inbreeding was measured by pedigree information, selection on genomic BLUP EBV resulted in lower levels of inbreeding than selection on phenotype BLUP EBV, but this did not always apply when inbreeding was measured by runs of homozygosity. Compared to genomic BLUP, selection on EBV from Bayesian Lasso led to less genetic drift, reduced loss of favourable alleles and more effectively controlled the rate of both pedigree and genomic inbreeding in all simulated scenarios. In addition, selection on EBV from Bayesian Lasso showed a higher selection differential for mendelian sampling terms than selection on genomic BLUP EBV. Conclusions Neutral variation can be shaped to a great extent by the hitch-hiking effects associated with selection, rather than just by genetic drift. When implementing long-term genomic selection, strategies for genomic control of inbreeding are essential, due to a considerable hitch-hiking effect, regardless of the method that is used for prediction of EBV. PMID:24495634

Conflict between biotic and climatic selective pressures acting on an extended phenotype in a subarctic, but not temperate, environment.

PubMed

Rohwer, V G; Bonier, F; Martin, P R

2015-10-22

Climatic selective pressures are thought to dominate biotic selective pressures at higher latitudes. However, few studies have experimentally tested how these selective pressures differentially act on traits across latitudes because traits can rarely be manipulated independently of the organism in nature. We overcame this challenge by using an extended phenotype-active bird nests-and conducted reciprocal transplant experiments between a subarctic and temperate site, separated by 14° of latitude. At the subarctic site, biotic selective pressures (nest predation) favoured smaller, non-local temperate nests, whereas climatic selective pressures (temperature) favoured larger local nests, particularly at colder temperatures. By contrast, at the temperate site, climatic and biotic selective pressures acted similarly on temperate and subarctic nests. Our results illustrate a functional trade-off in the subarctic between nest morphologies favoured by biotic versus climatic selective pressures, with climate favouring local nest morphologies. At our temperate site, however, allocative trade-offs in the time and effort devoted to nest construction favour smaller, local nests. Our findings illustrate a conflict between biotic and climatic selective pressures at the northern extremes of a species geographical range, and suggest that trade-offs between trait function and trait elaboration act differentially across latitude to create broad geographic variation in traits. © 2015 The Author(s).

Conflict between biotic and climatic selective pressures acting on an extended phenotype in a subarctic, but not temperate, environment

PubMed Central

Rohwer, V. G.; Bonier, F.; Martin, P. R.

2015-01-01

Climatic selective pressures are thought to dominate biotic selective pressures at higher latitudes. However, few studies have experimentally tested how these selective pressures differentially act on traits across latitudes because traits can rarely be manipulated independently of the organism in nature. We overcame this challenge by using an extended phenotype—active bird nests—and conducted reciprocal transplant experiments between a subarctic and temperate site, separated by 14° of latitude. At the subarctic site, biotic selective pressures (nest predation) favoured smaller, non-local temperate nests, whereas climatic selective pressures (temperature) favoured larger local nests, particularly at colder temperatures. By contrast, at the temperate site, climatic and biotic selective pressures acted similarly on temperate and subarctic nests. Our results illustrate a functional trade-off in the subarctic between nest morphologies favoured by biotic versus climatic selective pressures, with climate favouring local nest morphologies. At our temperate site, however, allocative trade-offs in the time and effort devoted to nest construction favour smaller, local nests. Our findings illustrate a conflict between biotic and climatic selective pressures at the northern extremes of a species geographical range, and suggest that trade-offs between trait function and trait elaboration act differentially across latitude to create broad geographic variation in traits. PMID:26490789

Nematic liquid crystals on sinusoidal channels: the zigzag instability.

PubMed

Silvestre, Nuno M; Romero-Enrique, Jose M; Telo da Gama, Margarida M

2017-01-11

Substrates which are chemically or topographically patterned induce a variety of liquid crystal textures. The response of the liquid crystal to competing surface orientations, typical of patterned substrates, is determined by the anisotropy of the elastic constants and the interplay of the relevant lengths scales, such as the correlation length and the surface geometrical parameters. Transitions between different textures, usually with different symmetries, may occur under a wide range of conditions. We use the Landau-de Gennes free energy to investigate the texture of nematics in sinusoidal channels with parallel anchoring bounded by nematic-air interfaces that favour perpendicular (hometropic) anchoring. In micron size channels 5CB was observed to exhibit a non-trivial texture characterized by a disclination line, within the channel, which is broken into a zigzag pattern. Our calculations reveal that when the elastic anisotropy of the nematic does not favour twist distortions the defect is a straight disclination line that runs along the channel, which breaks into a zigzag pattern with a characteristic period, when the twist elastic constant becomes sufficiently small when compared to the splay and bend constants. The transition occurs through a twist instability that drives the defect line to rotate from its original position. The interplay between the energetically favourable twist distortions that induce the defect rotation and the liquid crystal anchoring at the surfaces leads to the zigzag pattern. We investigate in detail the dependence of the periodicity of the zigzag pattern on the geometrical parameters of the sinusoidal channels, which in line with the experimental results is found to be non-linear.

Potential beneficial effect of some adipokines positively correlated with the adipose tissue content on the cardiovascular system.

PubMed

Sawicka, Magdalena; Janowska, Joanna; Chudek, Jerzy

2016-11-01

Obesity is a risk factor of cardiovascular diseases. However, in the case of heart failure, obese and overweight patients have a more favourable prognosis compared to patients who have a normal body weight. This phenomenon is referred to as the "obesity paradox," and it is explained by, among others, a positive effect of adipokines produced by adipose tissue, particularly by the tissue located in the direct vicinity of the heart and blood vessels. The favourable effect on the cardiovascular system is mostly associated with adiponectin and omentin, but the levels of these substances are reduced in obese patients. Among the adipokines which levels are positively correlated with the adipose tissue content, favourable activity is demonstrated by apelin, progranulin, chemerin, TNF-α (tumour necrosis factor-)α, CTRP-3 (C1q/tumour necrosis factor (TNF) related protein), leptin, visfatin and vaspin. This activity is associated with the promotion of regeneration processes in the damaged myocardium, formation of new blood vessels, reduction of the afterload, improvement of metabolic processes in cardiomyocytes and myocardial contractile function, inhibition of apoptosis and fibrosis of the myocardium, as well as anti-inflammatory and anti-atheromatous effects. The potential use of these properties in the treatment of heart failure and ischaemic heart disease, as well as in pulmonary hypertension, arterial hypertension and the limitation of the loss of cardiomyocytes during cardioplegia-requiring cardiosurgical procedures, is studied. The most advanced studies focus on analogues of apelin and progranulin. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Unifying mechanism for Aplysia ADP-ribosyl cyclase and CD38/NAD(+) glycohydrolases.

PubMed Central

Cakir-Kiefer, C; Muller-Steffner, H; Schuber, F

2000-01-01

Highly purified Aplysia californica ADP-ribosyl cyclase was found to be a multifunctional enzyme. In addition to the known transformation of NAD(+) into cADP-ribose this enzyme is able to catalyse the solvolysis (hydrolysis and methanolysis) of cADP-ribose. This cADP-ribose hydrolase activity, which becomes detectable only at high concentrations of the enzyme, is amplified with analogues such as pyridine adenine dinucleotide, in which the cleavage rate of the pyridinium-ribose bond is much reduced compared with NAD(+). Although the specificity ratio V(max)/K(m) is in favour of NAD(+) by 4 orders of magnitude, this multifunctionality allowed us to propose a 'partitioning' reaction scheme for the Aplysia enzyme, similar to that established previously for mammalian CD38/NAD(+) glycohydrolases. This mechanism involves the formation of a single oxocarbenium-type intermediate that partitions to cADP-ribose and solvolytic products via competing pathways. In favour of this mechanism was the finding that the enzyme also catalysed the hydrolysis of NMN(+), a substrate that cannot undergo cyclization. The major difference between the mammalian and the invertebrate enzymes resides in their relative cyclization/hydrolysis rate-constant ratios, which dictate their respective yields of cADP-ribose (ADP-ribosyl cyclase activity) and ADP-ribose (NAD(+) glycohydrolase activity). For the Aplysia enzyme's catalysed transformation of NAD(+) we favour a mechanism where the formation of cADP-ribose precedes that of ADP-ribose; i.e. macroscopically the invertebrate ADP-ribosyl cyclase conforms to a sequential reaction pathway as a limiting form of the partitioning mechanism. PMID:10861229

Favourable IFNL3 genotypes are associated with spontaneous clearance and are differentially distributed in Aboriginals in Canadian HIV-hepatitis C co-infected individuals.

PubMed

Moqueet, Nasheed; Infante-Rivard, Claire; Platt, Robert W; Young, Jim; Cooper, Curtis; Hull, Mark; Walmsley, Sharon; Klein, Marina B

2015-03-20

Canadian Aboriginals are reported to clear Hepatitis C (HCV) more frequently. We tested the association of spontaneous clearance and three single nucleotide polymorphisms (SNPs) near the Interferon-lambda 3 (IFNL3) gene (rs12979860, rs8099917, functional variant rs8103142) and compared the SNP frequencies between HIV-HCV co-infected whites and Aboriginals from the Canadian Co-infection Cohort. HCV treatment-naïve individuals with at least two HCV RNA tests were included (n = 538). A spontaneous clearance case was defined as someone with two consecutive HCV RNA-negative tests, at least six months apart. Data were analyzed using Cox proportional hazards adjusted for sex and ethnicity. Advantageous variants and haplotypes were more common in Aboriginals than Caucasians: 57% vs. 46% had the rs12979860 CC genotype, respectively; 58% vs. 48%, rs8103142 TT; 74% vs. 67%, the rs12979860 C allele; and 67% vs. 64% the TCT haplotype with three favourable alleles. The adjusted Hazard Ratios (95% CI) for spontaneous clearance were: rs12979860: 3.80 (2.20, 6.54); rs8099917: 5.14 (2.46, 10.72); and rs8103142: 4.36 (2.49, 7.62). Even after adjusting for rs12979860, Aboriginals and females cleared HCV more often, HR (95% CI) = 1.53 (0.89, 2.61) and 1.42 (0.79, 2.53), respectively. Our results suggest that favourable IFNL3 genotypes are more common among Aboriginals than Caucasians, and may partly explain the higher HCV clearance rates seen among Aboriginals.

Calcium, nutrient and food intake of Greek Orthodox Christian monks during a fasting and non-fasting week.

PubMed

Papadaki, Angeliki; Vardavas, Constantine; Hatzis, Christos; Kafatos, Anthony

2008-10-01

To assess the Ca, nutrient and food intake of Greek Orthodox Christian monks during a vegetarian-type fasting week, compared with their normal diet. Dietary data collection (using 7 d weighed food records), anthropometric and blood pressure measurements, as well as serum glucose and lipid analyses, were performed during Palm Sunday week (fasting) and the week following Pentecost Sunday (non-fasting). Mean daily nutrient and food (g/d) intakes were calculated from the food records. The study took place in two monasteries in the Municipality of Heraklion, Crete. The study involved ten healthy monks aged 25-65 years, with BMI > 30 kg/m2, who had been performing fasts for the last 24.4 (SD 10.4) years and lived in monasteries in Crete during April-June 2005. Nutrient and food intake profiles were more favourable during the fasting week, when participants had lower intakes of total and saturated fat and trans-fatty acids, and higher intakes of dietary fibre, Fe, folate, legumes and fish/seafood. Ca intake was lower when participants fasted, whereas consumption of dairy products, meat and eggs increased significantly in the non-fasting week. Systolic blood pressure was significantly higher, whereas blood lipid levels were more favourable during the fasting week. The periodic vegetarianism recommended by the Greek Orthodox Church contributes to the favourable profiles of several biomarkers of health among this sample of monks. The fasting rituals described are an important component of the traditional diet of Crete and should be emphasised in nutrition education programmes promoting this Mediterranean eating pattern.

Decision support in psychiatry – a comparison between the diagnostic outcomes using a computerized decision support system versus manual diagnosis

PubMed Central

Bergman, Lars G; Fors, Uno GH

2008-01-01

Background Correct diagnosis in psychiatry may be improved by novel diagnostic procedures. Computerized Decision Support Systems (CDSS) are suggested to be able to improve diagnostic procedures, but some studies indicate possible problems. Therefore, it could be important to investigate CDSS systems with regard to their feasibility to improve diagnostic procedures as well as to save time. Methods This study was undertaken to compare the traditional 'paper and pencil' diagnostic method SCID1 with the computer-aided diagnostic system CB-SCID1 to ascertain processing time and accuracy of diagnoses suggested. 63 clinicians volunteered to participate in the study and to solve two paper-based cases using either a CDSS or manually. Results No major difference between paper and pencil and computer-supported diagnosis was found. Where a difference was found it was in favour of paper and pencil. For example, a significantly shorter time was found for paper and pencil for the difficult case, as compared to computer support. A significantly higher number of correct diagnoses were found in the diffilt case for the diagnosis 'Depression' using the paper and pencil method. Although a majority of the clinicians found the computer method supportive and easy to use, it took a longer time and yielded fewer correct diagnoses than with paper and pencil. Conclusion This study could not detect any major difference in diagnostic outcome between traditional paper and pencil methods and computer support for psychiatric diagnosis. Where there were significant differences, traditional paper and pencil methods were better than the tested CDSS and thus we conclude that CDSS for diagnostic procedures may interfere with diagnosis accuracy. A limitation was that most clinicians had not previously used the CDSS system under study. The results of this study, however, confirm that CDSS development for diagnostic purposes in psychiatry has much to deal with before it can be used for routine clinical purposes. PMID:18261222

[Control of anticoagulation in patients with non-valvular atrial fibrillation in a primary care clinical practice setting in the different autonomous communities. PAULA study].

PubMed

Polo García, J; Barrios Alonso, V; Escobar Cervantes, C; Prieto Valiente, L; Lobos Bejarano, J M; Vargas Ortega, D; Prieto Díaz, M Á; Alonso Moreno, F J; Barquilla García, A

2017-04-01

To determine the differences between regions in the level of control of patients with non-valvular atrial fibrillation treated with vitamin K antagonists, included in the PAULA study. Observational, and coss-sectional/retrospective study, including 139 Primary Care physicians from 99 Health Care centres in all autonomous communities (except La Rioja). Anticoagulation control was defined as the time in therapeutic range assessed by either the direct method (poor control <60%), or the Rosendaal method (poor control <65%). A total of 1,524 patients were included. Small differences in baseline characteristics of the patients were observed. Differences in the percentage of time in therapeutic range were observed, according to the Rosendaal method (mean 69.0±17.7%), from 78.1%±16.6 (Basque Country) to 61.5±14% (Balearic Islands), by the direct method (mean 63.2±17.9%) from 73.6%±16.6 (Basque Country) to 57.5±15.7% (Extremadura). When comparing regions, in those where the Primary Care physicians assumed full control without restrictions on prescription, the percentage of time in therapeutic range by the direct method was 63.89 vs. 60.95% in those with restrictions (p=.006), by Rosendaal method, 69.39% compared with 67.68% (p=.1036). There are significant differences in the level of control between some regions are still inadequate. Regions in which the Primary Care physicians assumed the management of anticoagulation and without restrictions, time in therapeutic range was somewhat higher, and showed a favourable trend for better control. These findings may have clinical implications, and deserve consideration and specific analysis. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Enhanced lithium storage in Fe2O3-SnO2-C nanocomposite anode with a breathable structure

NASA Astrophysics Data System (ADS)

Rahman, Md Mokhlesur; Glushenkov, Alexey M.; Ramireddy, Thrinathreddy; Tao, Tao; Chen, Ying

2013-05-01

A novel nanocomposite architecture of a Fe2O3-SnO2-C anode, based on clusters of Fe2O3 and SnO2 nanoparticles dispersed along the conductive chains of Super P Li™ carbon black (Timcal Ltd.), is presented as a breathable structure in this paper for lithium-ion batteries. The synthesis of the nanocomposite is achieved by combining a molten salt precipitation process and a ball milling method for the first time. The crystalline structure, morphology, and electrochemical characterization of the synthesised product are investigated systematically. Electrochemical results demonstrate that the reversible capacity of the composite anode is 1110 mA h g-1 at a current rate of 158 mA g-1 with only 31% of initial irreversible capacity in the first cycle. A high reversible capacity of 502 mA h g-1 (higher than the theoretical capacity of graphite, ~372 mA h g-1) can be obtained at a high current rate of 3950 mA g-1. The electrochemical performance is compared favourably with those of Fe2O3-SnO2 and Fe2O3-SnO2-C composite anodes for lithium-ion batteries reported in the literature. This work reports a promising method for the design and preparation of nanocomposite electrodes for lithium-ion batteries.A novel nanocomposite architecture of a Fe2O3-SnO2-C anode, based on clusters of Fe2O3 and SnO2 nanoparticles dispersed along the conductive chains of Super P Li™ carbon black (Timcal Ltd.), is presented as a breathable structure in this paper for lithium-ion batteries. The synthesis of the nanocomposite is achieved by combining a molten salt precipitation process and a ball milling method for the first time. The crystalline structure, morphology, and electrochemical characterization of the synthesised product are investigated systematically. Electrochemical results demonstrate that the reversible capacity of the composite anode is 1110 mA h g-1 at a current rate of 158 mA g-1 with only 31% of initial irreversible capacity in the first cycle. A high reversible capacity of 502 mA h g-1 (higher than the theoretical capacity of graphite, ~372 mA h g-1) can be obtained at a high current rate of 3950 mA g-1. The electrochemical performance is compared favourably with those of Fe2O3-SnO2 and Fe2O3-SnO2-C composite anodes for lithium-ion batteries reported in the literature. This work reports a promising method for the design and preparation of nanocomposite electrodes for lithium-ion batteries. Electronic supplementary information (ESI) available: Electrochemical Impedance Spectroscopy (EIS). See DOI: 10.1039/c3nr00690e

The balance between the pro-inflammatory effect of plasma noradrenaline and the anti-inflammatory effect of neuronal noradrenaline determines the peripheral effects of noradrenaline.

PubMed

Crotty, T P

2015-11-01

Experiments on canine lateral saphenous vein segments have shown that noradrenaline causes potent, flow dependent effects, at a threshold concentration comparable to that of plasma noradrenaline, when it stimulates a segment by diffusion from its microcirculation (vasa vasorum). The effects it causes contrast with those neuronal noradrenaline causes in vivo and that, in the light of the principle that all information is transmitted in patterns that need contrast to be detected - star patterns need darkness, sound patterns, quietness - has generated the hypothesis that plasma noradrenaline provides the obligatory contrast tissues need to detect and respond to the regulatory information encrypted in the diffusion pattern of neuronal noradrenaline. Based on the implications of that hypothesis, the controlled variable of the peripheral noradrenergic system is believed to be the maintenance of a set point balance between the contrasting effects of plasma and neuronal noradrenaline on a tissue. The hypothalamic sympathetic centres are believed to monitor that balance through the level of afferent sympathetic traffic they receive from a tissue and to correct any deviation it detects in the balance by adjusting the level of efferent sympathetic input it projects to the tissue. The failure of the centres to maintain the correct balance is believed to be responsible for inflammatory and genetic disorders. When the failure causes the balance to be polarised in favour of the effect of plasma noradrenaline that is believed to cause inflammatory diseases like dilator cardiac failure, renal hypertension, varicose veins and aneurysms; when it causes it to be polarised in favour of the effect of neuronal noradrenaline that is believed to cause genetic diseases like hypertrophic cardiopathy, pulmonary hypertension and stenoses and when, in pregnancy, a factor causes the polarity to favour plasma noradrenaline in all the maternal tissues except the uterus and conceptus, where it favours neuronal noradrenaline, that is believed to cause preeclampsia. Finally, the shift in the balance caused by the slow physiological increase in plasma noradrenaline concentration in life is believed to be responsible for ageing. Copyright © 2014 Elsevier Ltd. All rights reserved.

Health economic evaluations comparing insulin glargine with NPH insulin in patients with type 1 diabetes: a systematic review

PubMed Central

2011-01-01

Background Compared to conventional human basal insulin (neutral protamine Hagedorn; NPH) the long-acting analogue insulin glargine (GLA) is associated with a number of advantages regarding metabolic control, hypoglycaemic events and convenience. However, the unit costs of GLA exceed those of NPH. This study aims to systematically review the economic evidence comparing GLA with NPH in basal-bolus treatment (intensified conventional therapy; ICT) of type 1 diabetes in order to facilitate informed decision making in clinical practice and health policy. Methods A systematic literature search was performed for the period of January 1st 2000 to December 1st 2009 via Embase, Medline, the Cochrane Library, the databases GMS (German Medical Science) and DAHTA (Deutsche Agentur für Health Technology Assessment), and the abstract books of relevant international scientific congresses. Retrieved studies were reviewed based on predefined inclusion criteria, methodological and quality aspects. In order to allow comparison between studies, currencies were converted using purchasing power parities (PPP). Results A total of 7 health economic evaluations from 4 different countries fulfilled the predefined criteria: 6 modelling studies, all of them cost-utility analyses, and one claims data analysis with a cost-minimisation design. One cost-utility analysis showed dominance of GLA over NPH. The other 5 cost-utility analyses resulted in additional costs per quality adjusted life year (QALY) gained for GLA, ranging from € 3,859 to € 57,002 (incremental cost effectiveness ratio; ICER). The cost-minimisation analysis revealed lower annual diabetes-specific costs in favour of NPH from the perspective of the German Statutory Health Insurance (SHI). Conclusions The incremental cost-utility-ratios (ICER) show favourable values for GLA with considerable variation. If a willingness-to-pay threshold of £ 30,000 (National Institute of Clinical Excellence, UK) is adopted, GLA is cost-effective in 4 of 6 cost utility analyses (CUA) included. Thus insulin glargine (GLA) seems to offer good value for money. Comparability between studies is limited because of methodological and country specific aspects. The results of this review underline that evaluation of insulin therapy should use evidence on efficacy of therapy from information synthesis. The concept of relating utility decrements to fear of hypoglycaemia is a plausible approach but needs further investigation. Also future evaluations of basal-bolus insulin therapy should include costs of consumables such as needles for insulin injection as well as test strips and lancets for blood glucose self monitoring. PMID:21978524

A cost-minimisation analysis comparing photoselective vaporisation (PVP) and transurethral resection of the prostate (TURP) for the management of symptomatic benign prostatic hyperplasia (BPH) in Queensland, Australia.

PubMed

Whitty, Jennifer A; Crosland, Paul; Hewson, Kaye; Narula, Rajan; Nathan, Timothy R; Campbell, Peter A; Keller, Andrew; Scuffham, Paul A

2014-03-01

To compare the costs of photoselective vaporisation (PVP) and transurethral resection of the prostate (TURP) for management of symptomatic benign prostatic hyperplasia (BPH) from the perspective of a Queensland public hospital provider. A decision-analytic model was used to compare the costs of PVP and TURP. Cost inputs were sourced from an audit of patients undergoing PVP or TURP across three hospitals. The probability of re-intervention was obtained from secondary literature sources. Probabilistic and multi-way sensitivity analyses were used to account for uncertainty and test the impact of varying key assumptions. In the base case analysis, which included equipment, training and re-intervention costs, PVP was AU$ 739 (95% credible interval [CrI] -12 187 to 14 516) more costly per patient than TURP. The estimate was most sensitive to changes in procedural costs, fibre costs and the probability of re-intervention. Sensitivity analyses based on data from the most favourable site or excluding equipment and training costs reduced the point estimate to favour PVP (incremental cost AU$ -684, 95% CrI -8319 to 5796 and AU$ -100, 95% CrI -13 026 to 13 678, respectively). However, CrIs were wide for all analyses. In this cost minimisation analysis, there was no significant cost difference between PVP and TURP, after accounting for equipment, training and re-intervention costs. However, PVP was associated with a shorter length of stay and lower procedural costs during audit, indicating PVP potentially provides comparatively good value for money once the technology is established. © 2013 The Authors. BJU International © 2013 BJU International.

Usage and appraisal of educational media by homeopathic therapists – A cross sectional survey

PubMed Central

2012-01-01

Background During recent years the market for homeopathic education media has increasingly diversified with old (books, seminars) and new media (video-seminars, pc-programs, homeo-wiki and internet-courses). However, little is known about homeopaths’ preferences in using educational media and their requirements of this topic. Aim This survey was designed to gain a better understanding of the usage and appraisal of educational media by homeopaths. Methods 192 homeopathic practitioners (GPs and health practitioners) at a educational conference were asked to answer a standardized questionnaire covering the topics “formal education and context of work” (9 items), “homeopathic practise and usage (24 items), “utilization of educational media” (9 items) and “favoured attributes for educational media” (11 items). Results Out of 192 homeopaths who attended the conference, 118 completed the questionnaire (response rate 61.5%). For their continuing homeopathic education they predominantly indicated to use books (scale value from 0 = never to 2 = always: 1.72) and seminars (1.54) whereas journals (0.98) and the internet (0.65) were used less often. The most favoured attributes concerning medical education media were reliability (1.76), relevance for clinical practice (1.74) and user friendliness (1.6). Less favoured attributes were inexpensiveness (1.1), graphical material (0.92) and interactivity (0.88). Conclusions The survey illustrates the current situation of medical education media in homeopathy. Although there are parallels to earlier research conducted in conventional GPs, homeopaths are more likely to refer to classical media. New education tools should be designed according to these preferences. PMID:22794310

Mechanism and kinetics of the atmospheric degradation of 2-formylcinnamaldehyde with O3 and hydroxyl OH radicals - a theoretical study

NASA Astrophysics Data System (ADS)

Thangamani, D.; Shankar, R.; Vijayakumar, S.; Kolandaivel, P.

2016-10-01

In the present investigation, the reaction mechanism and kinetics of 2-formylcinnamaldehyde (2-FC) with O3 and hydroxyl OH radicals were studied. The reaction of 2-FC with O3 radical are initiated by the formation of primary ozonide, whereas the reaction of 2-FC with the hydroxyl OH radical are initiated by two different ways: (1). H-atom abstraction by hydroxyl OH radical from the -CHO and -CH = CHCHO group of 2-FC (2). Hydroxyl OH addition to the -CH = CHCHO group to the ring-opened 2-FC. These reactions lead to the formation of an alkyl radical. The reaction pathways corresponding to the reactions between 2-FC with O3 and hydroxyl OH radicals have been analysed using density functionals of B3LYP and M06-2X level of methods with the 6-31+G(d,p) basis set. Single-point energy calculations for the most favourable reactive species are determined by B3LYP/6-311++G(d,p) and CCSD(T)/6-31+G(d,p) levels of theory. From the obtained results, the hydroxyl OH addition at C8 position of 2-FC are most favourable than the C9 position of 2-FC. The subsequent reactions of the alkyl radicals, formed from the hydroxyl OH addition at C8 position, are analysed in detail. The individual and overall rate constant for the most favourable reactions are calculated by canonical variational transition theory with small-curvature tunnelling corrections over the temperature range of 278-350 K. The calculated theoretical rate constants are in good agreement with the available experimental data. The Arrhenius plot of the rate constants with the temperature are fitted and the atmospheric lifetimes of the 2-FC with hydroxyl OH radical reaction in the troposphere calculate for the first time, which can be applied to the study on the atmospheric implications. The condensed Fukui function has been verified for the most favourable reaction sites. This study can be regarded as an attempt to investigate the O3-initiated and hydroxyl OH-initiated reaction mechanisms of 2-FC in the atmosphere.

Autologous serum supplement favours in vitro regenerative paracrine factors synthesis.

PubMed

Haque, Nazmul; Kasim, Noor Hayaty Abu; Kassim, Noor Lide Abu; Rahman, Mohammad Tariqur

2017-08-01

Foetal bovine serum (FBS) is often the serum supplement of choice for in vitro human cell culture. This study compares the effect of FBS and autologous human serum (AuHS) supplement in human peripheral blood mononuclear cell (PBMC) culture to prepare secretome. The PBMC (n = 7) were cultured either in RPMI-1640 containing L-glutamine and 50 units/ml Penicillin-Streptomycin (BM) or in BM with either AuHS or FBS. Viability, proliferation and differentiation of PBMC were evaluated. Paracrine factors present in the secretomes (n = 6) were analysed using ProcartaPlex Human Cytokine panel (17 plex). Ingenuity Pathway Analysis (IPA) was performed to predict activation or inhibition of biological functions related to tissue regeneration. The viability of PBMC that were cultured with FBS supplement was significantly reduced at 96 h compared to those at 0 and 24 h (P < .05). While the reduction of the viability of PBMC that were cultured with AuHS supplement was not significantly different compared to those at 0 and 24 h. The FBS secretomes prepared at 24 h was found to contain significantly higher amount of EGF (P < .05) compared to that in AuHS or BM secretome. The AuHS secretomes contained significantly higher amount of HGF at 24 (P < .05) and 96 h (P < .01), and VEGF-A at 24 h (P < .05) compared to those in the FBS secretomes. SDF-1 was not detected in the FBS secretomes prepared at either 24 or 96 hours. Double immunocytochemical staining revealed a marked increase in co-localization of SDF-1 and its receptor in PBMC that were cultured with AuHS supplement compared to that cultured with FBS supplement. In secretome preparation, AuHS supplement favours synthesis of paracrine factors that are needed for regenerative therapy. © 2017 John Wiley & Sons Ltd.

Effects of health-oriented descriptors on combustible cigarette and electronic cigarette packaging: an experiment among adult smokers in the United States.

PubMed

Sanders-Jackson, Ashley; Tan, Andy S L; Yie, Kyeungyeun

2017-10-05

Certain tobacco companies use health-oriented descriptors (eg, 100% organic) on product packaging and advertising of combustible cigarettes or electronic cigarettes (e-cigarettes) that create a 'health halo' around smoking and vaping. Previous observational research suggests that such language may be associated with more favourable attitudes and reduced risk perceptions toward these brands compared with others. This study aimed to determine the effects of health-oriented descriptors on smokers' attitude toward the brand, perception of packaging information, comparative harm versus other brands and intention to purchase either combustible cigarettes or e-cigarettes. US adult smokers were randomly assigned to view either a health-oriented language package ('100% organic,' 'all natural' or 'no additives'), traditional marketing language package ('fine quality,' 'premium blend' or '100% original') or a no-language package of a combustible cigarette brand (Study 1, n=405) or an e-cigarette brand (Study 2, n=396) in an experimental design. Study 1: Participants in the health-oriented condition reported more favourable perceptions toward the package information, lower comparative harm and higher intention to purchase combustible cigarettes versus the no language control. In addition, participants in the health-oriented condition reported more positive attitude toward the brand and lower comparative harm versus the traditional marketing condition. Study 2: Compared with the traditional marketing condition, participants in the health-oriented condition reported greater intention to purchase Absolute e-cigarettes. There were no significant differences in attitude toward the brand, perception of packaging information and comparative harm versus other brands across conditions. The effect of health-oriented language was significant for combustible cigarettesand e-cigarette packages. Policies to restrict health-oriented language on cigarette and e-cigarette packaging are recommended. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Stability-indicating methods for the determination of piretanide in presence of the alkaline induced degradates.

PubMed

Youssef, Nadia F

2005-10-04

Stability-indicating high performance liquid chromatography (HPLC), thin-layer chromatography (TLC) and first-derivative of ratio spectra (1DD) methods are developed for the determination of piretanide in presence of its alkaline induced degradates. HPLC method depends on separation of piretanide from its degradates on mu-Bondapak C18 column using methanol:water:acetic acid (70:30:1, v/v/v) as a mobile phase at flow rate 1.0 ml/min and UV detector at 275 nm. TLC densitometic method is based on the difference in Rf-values between the intact drug and its degradates on thin-layer silica gel. Iso-propanol:ammonia 33% (8:2, v/v) was used as a developing mobile phase and the chromatogram was scanned at 275 nm. The derivative of ratio spectra method (1DD) depends on the measurement of the absorbance at 288 nm in the first-derivative of ratio spectra for the determination of the cited drug in the presence of its degradates. Calibration graphs of the three suggested methods are linear in the concentration ranges 0.02-0.3 microg/20 microl, 0.5-10 microg/spot and 5-50 microg/ml, with mean percentage recovery 99.27+/-0.52, 99,17+/-1.01 and 99.65+/-1.01%, respectively. The three proposed methods were successfully applied for the determination of piretanide in bulk powder, laboratory-prepared mixtures and pharmaceutical dosage form with good accuracy and precision. The results were statistically analyzed and compared with those obtained by the official method. Validation of the method was determined with favourable specificity, linearity, precision, and accuracy was assessed by applying the standard addition technique.

SCMPSP: Prediction and characterization of photosynthetic proteins based on a scoring card method.

PubMed

Vasylenko, Tamara; Liou, Yi-Fan; Chen, Hong-An; Charoenkwan, Phasit; Huang, Hui-Ling; Ho, Shinn-Ying

2015-01-01

Photosynthetic proteins (PSPs) greatly differ in their structure and function as they are involved in numerous subprocesses that take place inside an organelle called a chloroplast. Few studies predict PSPs from sequences due to their high variety of sequences and structues. This work aims to predict and characterize PSPs by establishing the datasets of PSP and non-PSP sequences and developing prediction methods. A novel bioinformatics method of predicting and characterizing PSPs based on scoring card method (SCMPSP) was used. First, a dataset consisting of 649 PSPs was established by using a Gene Ontology term GO:0015979 and 649 non-PSPs from the SwissProt database with sequence identity <= 25%.- Several prediction methods are presented based on support vector machine (SVM), decision tree J48, Bayes, BLAST, and SCM. The SVM method using dipeptide features-performed well and yielded - a test accuracy of 72.31%. The SCMPSP method uses the estimated propensity scores of 400 dipeptides - as PSPs and has a test accuracy of 71.54%, which is comparable to that of the SVM method. The derived propensity scores of 20 amino acids were further used to identify informative physicochemical properties for characterizing PSPs. The analytical results reveal the following four characteristics of PSPs: 1) PSPs favour hydrophobic side chain amino acids; 2) PSPs are composed of the amino acids prone to form helices in membrane environments; 3) PSPs have low interaction with water; and 4) PSPs prefer to be composed of the amino acids of electron-reactive side chains. The SCMPSP method not only estimates the propensity of a sequence to be PSPs, it also discovers characteristics that further improve understanding of PSPs. The SCMPSP source code and the datasets used in this study are available at http://iclab.life.nctu.edu.tw/SCMPSP/.

Patterns produced when soil is transferred to bras by placing and dragging actions: The application of digital photography and image processing to support visible observations.

PubMed

Murray, Kathleen R; Fitzpatrick, Robert W; Bottrill, Ralph; Kobus, Hilton

2017-07-01

A series of soil transference experiments (STEs) were undertaken to determine whether patterns identified in laboratory experiments could also be recognised at a simulated crime scene in the field. A clothed 55kg human rescue dummy dressed in a padded bra was either dragged or merely placed on a soil surface at sites with natural and anthropogenic soil types under both wet and dry soil conditions. Transfer patterns produced by dragging compared favourably with those of laboratory experiments. Twelve patterns were identified when a clothed human rescue dummy was dragged across the two soil types in the field. This expanded the original set of eight soil transfer patterns identified from dragging weighted fabric across soil samples in the laboratory. Soil transferred by placing the human rescue dummy resulted in a set of six transfer patterns that were different to those produced by dragging. By comparing trace soil patterns transferred to bras using each transfer method, it was revealed that certain transfer patterns on bras could indicate how the fabric had made contact with a soil surface. A photographic method was developed for crime scene examiners to capture this often subtle soil evidence before a body is transported or the clothing removed. This improved understanding of the dynamics of soil transference to bras and related clothing fabric may assist forensic investigators reconstruct the circumstances of a variety of forensic events. Copyright © 2017 Elsevier B.V. All rights reserved.

Analysis of how people with intellectual disabilities organize information using computerized guidance.

PubMed

Lussier-Desrochers, Dany; Sauzéon, Hélène; Consel, Charles; Roux, Jeannie; Balland, Émilie; Godin-Tremblay, Valérie; N'Kaoua, Bernard; Lachapelle, Yves

2017-04-01

Access to residential settings for people with intellectual disabilities (ID) contributes to their social participation, but presents particular challenges. Assistive technologies can help people perform activities of daily living. However, the majority of the computerized solutions offered use guidance modes with a fixed, unchanging sequencing that leaves little room for self-determination to emerge. The objective of the project was to develop a flexible guidance mode and to test it with participants, to describe their information organization methods. This research used a descriptive exploratory design and conducted a comparison between five participants with ID and five participants with no ID. The results showed a difference in the information organization methods for both categories of participants. The people with ID used more diversified organization methods (categorical, schematic, action-directed) than the neurotypical participants (visual, action-directed). These organization methods varied depending on the people, but also on the characteristics of the requested task. Furthermore, several people with ID presented difficulties when switching from virtual to real mode. These results demonstrate the importance of developing flexible guidance modes adapted to the users' cognitive strategies, to maximize their benefits. Studies using experimental designs will have to be conducted to determine the impacts of more-flexible guidance modes Implications for rehabilitation Intervention approaches favouring, self-determination, decision making, action analysis and results anticipation must be promoted with people with intellectual disabilities. Fixed and rigid technological guidance mode, like those currently favoured in interventions, is appropriate for only some people's profiles or may depend on the nature of the task. It seems that people with ID use a wide spectrum of organization strategies and that adapting guidance modes to all these strategies is relevant.

Fuzzy inductive reasoning: a consolidated approach to data-driven construction of complex dynamical systems

NASA Astrophysics Data System (ADS)

Nebot, Àngela; Mugica, Francisco

2012-10-01

Fuzzy inductive reasoning (FIR) is a modelling and simulation methodology derived from the General Systems Problem Solver. It compares favourably with other soft computing methodologies, such as neural networks, genetic or neuro-fuzzy systems, and with hard computing methodologies, such as AR, ARIMA, or NARMAX, when it is used to predict future behaviour of different kinds of systems. This paper contains an overview of the FIR methodology, its historical background, and its evolution.

Maritime Laser Communications Trial 98152-19703

DTIC Science & Technology

2012-06-01

of the optical transmitters (typically 0.1 to 5 milliradians ) implies a low probability of detection and interception (LPD and LPI). In addition...it has a ±25° acceptance cone, which compares favourably with an f/1 lens of the same diameter that has a field-of-view of ±8°. An optical bandpass...to set- up the scintillometer. However, the optical link equipment was shown to be operating correctly. 5.2 Shore-to-shore link across water

Negotiating an ecological barrier: crossing the Sahara in relation to winds by common swifts

PubMed Central

2016-01-01

The Sahara Desert is one of the largest land-based barriers on the Earth, crossed twice each year by billions of birds on migration. Here we investigate how common swifts migrating between breeding sites in Sweden and wintering areas in sub-Saharan Africa perform the desert crossing with respect to route choice, winds, timing and speed of migration by analysing 72 geolocator tracks recording migration. The swifts cross western Sahara on a broad front in autumn, while in spring they seem to use three alternative routes across the Sahara, a western, a central and an eastern route across the Arabian Peninsula, with most birds using the western route. The swifts show slower migration and travel speeds, and make longer detours with more stops in autumn compared with spring. In spring, the stopover period in West Africa coincided with mostly favourable winds, but birds remained in the area, suggesting fuelling. The western route provided more tailwind assistance compared with the central route for our tracked swifts in spring, but not in autumn. The ultimate explanation for the evolution of a preferred western route is presumably a combination of matching rich foraging conditions (swarming insects) and favourable winds enabling fast spring migration. This article is part of the themed issue ‘Moving in a moving medium: new perspectives on flight’. PMID:27528783

Trust transitivity in social networks.

PubMed

Richters, Oliver; Peixoto, Tiago P

2011-04-05

Non-centralized recommendation-based decision making is a central feature of several social and technological processes, such as market dynamics, peer-to-peer file-sharing and the web of trust of digital certification. We investigate the properties of trust propagation on networks, based on a simple metric of trust transitivity. We investigate analytically the percolation properties of trust transitivity in random networks with arbitrary in/out-degree distributions, and compare with numerical realizations. We find that the existence of a non-zero fraction of absolute trust (i.e. entirely confident trust) is a requirement for the viability of global trust propagation in large systems: The average pair-wise trust is marked by a discontinuous transition at a specific fraction of absolute trust, below which it vanishes. Furthermore, we perform an extensive analysis of the Pretty Good Privacy (PGP) web of trust, in view of the concepts introduced. We compare different scenarios of trust distribution: community- and authority-centered. We find that these scenarios lead to sharply different patterns of trust propagation, due to the segregation of authority hubs and densely-connected communities. While the authority-centered scenario is more efficient, and leads to higher average trust values, it favours weakly-connected "fringe" nodes, which are directly trusted by authorities. The community-centered scheme, on the other hand, favours nodes with intermediate in/out-degrees, in detriment of the authorities and its "fringe" peers.

Trust Transitivity in Social Networks

PubMed Central

Richters, Oliver; Peixoto, Tiago P.

2011-01-01

Non-centralized recommendation-based decision making is a central feature of several social and technological processes, such as market dynamics, peer-to-peer file-sharing and the web of trust of digital certification. We investigate the properties of trust propagation on networks, based on a simple metric of trust transitivity. We investigate analytically the percolation properties of trust transitivity in random networks with arbitrary in/out-degree distributions, and compare with numerical realizations. We find that the existence of a non-zero fraction of absolute trust (i.e. entirely confident trust) is a requirement for the viability of global trust propagation in large systems: The average pair-wise trust is marked by a discontinuous transition at a specific fraction of absolute trust, below which it vanishes. Furthermore, we perform an extensive analysis of the Pretty Good Privacy (PGP) web of trust, in view of the concepts introduced. We compare different scenarios of trust distribution: community- and authority-centered. We find that these scenarios lead to sharply different patterns of trust propagation, due to the segregation of authority hubs and densely-connected communities. While the authority-centered scenario is more efficient, and leads to higher average trust values, it favours weakly-connected “fringe” nodes, which are directly trusted by authorities. The community-centered scheme, on the other hand, favours nodes with intermediate in/out-degrees, in detriment of the authorities and its “fringe” peers. PMID:21483683

Favourable and Unfavourable Conditions for Children's Confidence Judgments

ERIC Educational Resources Information Center

Roebers, Claudia M.; von der Linden, Nicole; Howie, Pauline

2007-01-01

Two studies are presented in which favourable and unfavourable conditions for children's meta-cognitive monitoring processes are examined. Previously reported findings have shown that especially children's uncertainty monitoring (in contrast to certainty monitoring) poses specific problems for children in their elementary school years. When…

The economic consequences of ageing populations.

PubMed Central

Mirrlees, J A

1997-01-01

The effect of low birth rates and lengthening lives on the economy is discussed. Two extreme cases are examined: where pensions are entirely on a pay-as-you-go basis, and where they are entirely funded. It is argued that the economy would grow faster in the latter case. The impact on the levels of consumption of each age cohort during its lifetime is assessed. The possible magnitude of changes in consumption as a result of an increase in the retired part of the population is illustrated. It is shown that, comparing later cohorts to earlier cohorts, the former are better off under a funded system. An argument is then sketched showing that a pay-as-you-go system favours earlier cohorts too much; while most probably, but not certainly, a fully funded system favours the later cohorts excessively. It is claimed that a gradual introduction of partial funding, and some increase in the length of working lives, can deal with the effects of an ageing population without an excessive burden on any cohort or age-group. PMID:9460073

Simulation of stream discharge and transport of nitrate and selected herbicides in the Mississippi River Basin

NASA Astrophysics Data System (ADS)

Broshears, Robert E.; Clark, Gregory M.; Jobson, Harvey E.

2001-05-01

Stream discharge and the transport of nitrate, atrazine, and metolachlor in the Mississippi River Basin were simulated using the DAFLOW/BLTM hydrologic model. The simulated domain for stream discharge included river reaches downstream from the following stations in the National Stream Quality Accounting Network: Mississippi River at Clinton, IA; Missouri River at Hermann, MO; Ohio River at Grand Chain, IL; and Arkansas River at Little Rock, AR. Coefficients of hydraulic geometry were calibrated using data from water year 1996; the model was validated by favourable simulation of observed discharges in water years 1992-1994. The transport of nitrate, atrazine, and metolachlor was simulated downstream from the Mississippi River at Thebes, IL, and the Ohio River at Grand Chain. Simulated concentrations compared favourably with observed concentrations at Baton Rouge, LA. Development of this model is a preliminary step in gaining a more quantitative understanding of the sources and fate of nutrients and pesticides delivered from the Mississippi River Basin to the Gulf of Mexico. Published in 2001 by John Wiley & Sons, Ltd.

In Iranian female and male adolescents, romantic love is related to hypomania and low depressive symptoms, but also to higher state anxiety.

PubMed

Bajoghli, Hafez; Joshaghani, Narges; Gerber, Markus; Mohammadi, Mohammad-Reza; Holsboer-Trachsler, Edith; Brand, Serge

2013-06-01

Experiencing romantic love is important in individual development. Little is known about romantic love among adolescents in non-Western countries. The aim of the present study was to explore romantic love among Iranian male and female adolescents. A total of 201 adolescents (mean age: 17.73 years) took part in the study; of these, 81 indicated they were experiencing romantic love at the time of survey, and 120 indicated they were not in love. Participants answered questionnaires related to affective states (hypomania, depressive symptoms, state and trait anxiety) and exercise, and completed a sleep log for seven consecutive nights. Compared to controls, participants in love displayed favourable hypomania scores, fewer depressive symptoms and increased concentration during the day. However, participants in love also had higher state anxiety scores. Moreover, hypomanic-like stages increased with duration of relationship in female, but not in male participants. The pattern of results suggests a favourable association between being currently in love and emotional and cognitive processes. Sleep, however, seemed unrelated to this specific state.

Modulation of spatial Stroop by object-based attention but not by space-based attention.

PubMed

Luo, Chunming; Lupiáñez, Juan; Funes, María Jesús; Fu, Xiaolan

2010-03-01

Earlier studies have shown that the spatial Stroop effect systematically decreases when a peripheral precue is presented at the same location as the target, compared to an uncued location condition. In this study, two experiments were conducted to explore whether the cueing modulation of spatial Stroop is object based and/or space based. In Experiment 1, we found evidence favouring the view that the cueing modulation of the spatial Stroop effect is entirely object based, as no differences were found in conflict reduction for the same-location and same-object conditions. In Experiment 2, the cue was predictive, and a similar object-based modulation of spatial Stroop was still observed. However, the direction of such modulation was affected by the rectangles' orientation. Overall, the pattern of results obtained favours the object-integration (Lupiáñez & Milliken, 1999; Lupiáñez, Milliken, Solano, Weaver, & Tipper, 2001) and referential-coding accounts (Danziger, Kingstone, & Ward, 2001) and seems to provide evidence against the attention-shift account (Rubichi, Nicoletti, Iani, & Umilta, 1997; Stoffer, 1991).

Pollinator Foraging Adaptation and Coexistence of Competing Plants.

PubMed

Revilla, Tomás A; Křivan, Vlastimil

2016-01-01

We use the optimal foraging theory to study coexistence between two plant species and a generalist pollinator. We compare conditions for plant coexistence for non-adaptive vs. adaptive pollinators that adjust their foraging strategy to maximize fitness. When pollinators have fixed preferences, we show that plant coexistence typically requires both weak competition between plants for resources (e.g., space or nutrients) and pollinator preferences that are not too biased in favour of either plant. We also show how plant coexistence is promoted by indirect facilitation via the pollinator. When pollinators are adaptive foragers, pollinator's diet maximizes pollinator's fitness measured as the per capita population growth rate. Simulations show that this has two conflicting consequences for plant coexistence. On the one hand, when competition between pollinators is weak, adaptation favours pollinator specialization on the more profitable plant which increases asymmetries in plant competition and makes their coexistence less likely. On the other hand, when competition between pollinators is strong, adaptation promotes generalism, which facilitates plant coexistence. In addition, adaptive foraging allows pollinators to survive sudden loss of the preferred plant host, thus preventing further collapse of the entire community.

Population dynamics of Corbicula fluminea (Müller, 1774) in mesohaline and oligohaline habitats: Invasion success in a Southern Europe estuary

USGS Publications Warehouse

Franco, J.N.; Ceia, F.R.; Patricio, J.; Thompson, John; Marques, J.C.; Neto, J.M.

2012-01-01

Due to its range expansion and potential ecological effects, Corbicula fluminea is considered one of the most important non-indigenous species (NIS) in aquatic ecosystems. Its presence since 2003 in the upstream area of Mondego estuary (oligohaline and mesohaline sectors) was studied during thirteen months, from December 2007 to December 2008. Monthly mean abundance and biomass ranged from 542 to 11142 individuals m-2 and 13.1–20.4 g Ash Free Dry Weight m-2, respectively. Populations of C.fluminea were composed mostly of juveniles, always present in extremely high densities compared to other estuarine ecosystems (e.g. Minho estuary) suggesting a continuous recruitment pattern. The hydraulic regime of the River Mondego favours the downstream colonization of the upper Mondego estuary by recruits produced upstream. However, salinity in these sectors of the estuary apparently neither favours growth nor the establishment of structured populations of this species. Other factors like contaminants and predation, which were not studied, could also contribute to the community structure observed.

Weight-Loss Strategies Used by the General Population: How Are They Perceived?

PubMed Central

Julia, Chantal; Péneau, Sandrine; Andreeva, Valentina A.; Méjean, Caroline; Fezeu, Léopold; Galan, Pilar; Hercberg, Serge

2014-01-01

Background The rising prevalence of obesity and the social pressure for thinness increase the prevalence of dieting. However, little is known about the overall perception of dieting strategies actually used by the general population. Objectives Our main objective was to investigate perceptions of weight-loss practices in an observational study in order to identify the most favourable strategy. Design Adults from the ongoing Nutrinet-Santé cohort study who had reported engaging in dieting in the three previous years were included in the study. For each diet, detailed information was collected on types of diets, circumstances and perception of the diet, and outcomes. Perceptions were compared across diets using sex-specific mixed effects models. Result Among the 48 435 subjects who had completed the respective questionnaire, 12 673 (26.7%, 87.8% of women) had followed at least one weight-loss diet in the previous three years. Diet plans prescribed by health professionals and diets conforming to official dietary recommendations were the most favourably perceived among all assessed weight-loss strategies. Alternatively, commercial diet plans and self-imposed dietary restrictions were more negatively perceived (Odds ratios (OR) for adherence difficulty 1.30 (95% confidence interval (0.99;1.7)) in men and OR 1.92 (1.76;2.10) in women compared to official nutritional guidelines; OR 1.06 (0.82;1.38) in men and OR 1.39 (1.26;1.54) in women respectively) compared to official nutritional guidelines. Conclusion Official dietary recommendations could be useful tools for maintaining a dietary balance while following a weight-loss diet. PMID:24852440

Experiment ueber den Einflusse von Metaboliten und Antimetaboliten am Modell von Trichomonas Vaginalis. IV. Mitteilung: Vitamine, die das Wachstum von Trichomonas Vaginalis Beguenstigen (Experiments on the Influence of Metabolites and Antimetabolites on the Model of Trichomonas Vaginalis. IV. Communication: Vitamins Favouring the Growth of Trichomonas Vaginalis),

DTIC Science & Technology

A number of vitamins have been investigated for their influence upon Trichomonas vaginalis . At a concentration of 0.20 mg ml vitamin A has...stimulating action upon the growth of Trichomonas vaginalis . Vitamin D2 has been shown to favour Trichomonas multiplication in all experimental series...Vitamin D3 generally favours the Trichomonas vaginalis population. Addition of vitamin E resulted in enhanced multiplication of Trichomonas and longer

Blood loss associated with Ring uncemented total knee replacement: comparison between continuous and intermittent suction drainage.

PubMed Central

Wittmann, F W; Ring, P A

1984-01-01

In a retrospective comparison of blood loss following uncemented total knee replacement, in which either continuous or intermittent suction drainage was used, measured blood loss was significantly greater with continuous drainage. However, a method of calculating actual blood loss demonstrated no significant difference. With intermittent drainage, more blood remains undetected around the knee joint; this technique should therefore be abandoned in favour of continuous suction drainage. PMID:6747978

Lactobacillus casei Encapsulated in Soy Protein Isolate and Alginate Microparticles Prepared by Spray Drying

PubMed Central

2017-01-01

Summary This article presents a novel formulation for preparation of Lactobacillus casei 01 encapsulated in soy protein isolate and alginate microparticles using spray drying method. A response surface methodology was used to optimise the formulation and the central composite face-centered design was applied to study the effects of critical material attributes and process parameters on viability of the probiotic after microencapsulation and in simulated gastrointestinal conditions. Spherical microparticles were produced in high yield (64%), narrow size distribution (d50=9.7 µm, span=0.47) and favourable mucoadhesive properties, with viability of the probiotic of 11.67, 10.05, 9.47 and 9.20 log CFU/g after microencapsulation, 3 h in simulated gastric and intestinal conditions and four-month cold storage, respectively. Fourier-transform infrared spectroscopy confirmed the probiotic stability after microencapsulation, while differential scanning calorimetry and thermogravimetry pointed to high thermal stability of the soy protein isolate-alginate microparticles with encapsulated probiotic. These favourable properties of the probiotic microparticles make them suitable for incorporation into functional food or pharmaceutical products. PMID:28867947

Public knowledge and attitudes towards Human Papilloma Virus (HPV) vaccination

PubMed Central

Walsh, Charlotte Devereaux; Gera, Aradhana; Shah, Meeraj; Sharma, Amit; Powell, Judy E; Wilson, Sue

2008-01-01

Background Human Papilloma Virus (HPV) vaccine has undergone successful trials and has recently been approved for use for the primary prevention of cervical cancer. The aim of this study was to determine knowledge and attitudes towards HPV vaccination. Methods Semi-structured interview and questionnaire delivered in a street survey. Standardised HPV-related statements used to measure HPV knowledge and attitudes to vaccination. The setting was three different areas of Birmingham, to target a mix of social class and ethnicity. The sample population was composed of 16–54 year olds. Results A total of 420 participants were recruited. Poor knowledge of HPV and its links with cervical cancer were observed. 81% had a knowledge score of zero. Knowledge about HPV was associated with different ethnic group and socio-economic group. The majority (88%) of participants were in favour of vaccination, with 83.6% indicating that they would allow a child under their care to be vaccinated. Conclusion Initial responses to the proposed HPV vaccination within the UK public are favourable. However, knowledge levels are poor and media and health professional promotion are required to raise awareness. PMID:18947430

Counterintuitive electron localisation from density-functional theory with polarisable solvent models

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dale, Stephen G., E-mail: sdale@ucmerced.edu; Johnson, Erin R., E-mail: erin.johnson@dal.ca

2015-11-14

Exploration of the solvated electron phenomena using density-functional theory (DFT) generally results in prediction of a localised electron within an induced solvent cavity. However, it is well known that DFT favours highly delocalised charges, rendering the localisation of a solvated electron unexpected. We explore the origins of this counterintuitive behaviour using a model Kevan-structure system. When a polarisable-continuum solvent model is included, it forces electron localisation by introducing a strong energetic bias that favours integer charges. This results in the formation of a large energetic barrier for charge-hopping and can cause the self-consistent field to become trapped in local minimamore » thus converging to stable solutions that are higher in energy than the ground electronic state. Finally, since the bias towards integer charges is caused by the polarisable continuum, these findings will also apply to other classical polarisation corrections, as in combined quantum mechanics and molecular mechanics (QM/MM) methods. The implications for systems beyond the solvated electron, including cationic DNA bases, are discussed.« less

Arabian nights—1001 tales of how pharmaceutical companies cater to the material needs of doctors: case report

PubMed Central

Giannakakis, Ioannis A; Ioannidis, John P A

2000-01-01

Objective To describe how pharmaceutical companies cater to the material needs of doctors. Design Case report of memoirs. Setting Facilities that have nothing to do with medicine, somewhere in the Arabian peninsula. Patient population Random sample of doctors. Interventions Promotion by the pharmaceutical industry. Main outcome measures Short term outcomes were travel, pleasure, amusement, and gifts, and long term outcomes were the market share of specific companies. Results Short term outcomes were heterogeneous, underlying the diversity of the means employed by the pharmaceutical industry to subvert, divert, and influence medical practice. Overall, 200 doctors were dressed in white gowns, a doctor in preventive medicine quoted Hippocrates in favour of smoking, a senior doctor became a poet, a doctor trying to understand the Methods section of a poster paper wondered whether he should have been sunbathing at the beach instead, and two women doctors were kidnapped by Bedouin warriors. Long term outcomes on the sales of the company drugs are pending but are likely to be most favourable. Conclusions Eat, drink, be merry, and boost prescriptions. PMID:11124175

Reaction of Pentanol isomers with OH radical – A theoretical perspective

NASA Astrophysics Data System (ADS)

Aazaad, Basheer; Lakshmipathi, Senthilkumar

2018-05-01

The stability of all the three isomeric forms of Pentanol has been examined with relative energy analysis. Even though 2-Pentanol is predicted to be most stable isomeric form, all the three isomeric forms undergo hydrogen atom abstraction reaction with OH radical. Among the proposed 18 different hydrogen atom abstraction reaction, the abstraction from CH2 and CH functional group is found to be a favourable reactive site with low energy barrier in M06-2X/6-311+G(d,p) level of theory. Wiberg bond order analysis shows all the abstraction reactions are concreted but not synchronic in nature. Using force analysis, the calculated work done of individual reaction regions illustrates that structural rearrangements drive the reaction with higher contribution to the energy barrier. The rate constant calculated at M06-2X method for the most favourable reaction is well matched with available experimental data. Using the reported atmospheric OH concentration (1 × 106 molecules/cm3), the life time of 1-Pentanol, 2-Pentanol and 3-Pentanol has calculated to be 18.66, 0.36 and 2.86 days, respectively.

Comparing ambient, air-convection, and fluid-convection heating techniques in treating hypothermic burn patients, a clinical RCT

PubMed Central

2011-01-01

Background Hypothermia in burns is common and increases morbidity and mortality. Several methods are available to reach and maintain normal core body temperature, but have not yet been evaluated in critical care for burned patients. Our unit's ordinary technique for controlling body temperature (Bair Hugger®+ radiator ceiling + bed warmer + Hotline®) has many drawbacks e.g.; slow and the working environment is hampered. The aim of this study was to compare our ordinary heating technique with newly-developed methods: the Allon™2001 Thermowrap (a temperature regulating water-mattress), and Warmcloud (a temperature regulating air-mattress). Methods Ten consecutive burned patients (> 20% total burned surface area and a core temperature < 36.0°C) were included in this prospective, randomised, comparative study. Patients were randomly exposed to 3 heating methods. Each treatment/measuring-cycle lasted for 6 hours. Each heating method was assessed for 2 hours according to a randomised timetable. Core temperature was measured using an indwelling (bladder) thermistor. Paired t-tests were used to assess the significance of differences between the treatments within the patients. ANOVA was used to assess the differences in temperature from the first to the last measurement among all treatments. Three-way ANOVA with the Tukey HSD post hoc test and a repeated measures ANOVA was used in the same manner, but included information about patients and treatment/measuring-cycles to control for potential confounding. Data are presented as mean (SD) and (range). Probabilities of less than 0.05 were accepted as significant. Results The mean increase, 1.4 (SD 0.6°C; range 0.6-2.6°C) in core temperature/treatment/measuring-cycle highly significantly favoured the Allon™2001 Thermowrap in contrast to the conventional method 0.2 (0.6)°C (range -1.2 to 1.5°C) and the Warmcloud 0.3 (0.4)°C (range -0.4 to 0.9°C). The procedures for using the Allon™2001 Thermowrap were experienced to be more comfortable and straightforward than the conventional method or the Warmcloud. Conclusions The Allon™2001 Thermowrap was more effective than the Warmcloud or the conventional method in controlling patients' temperatures. PMID:21736717

Nutritional value of traditional Italian meat-based dishes: influence of cooking methods and recipe formulation.

PubMed

D'Evoli, L; Salvatore, P; Lucarini, M; Nicoli, S; Aguzzi, A; Gabrielli, P; Lombardi-Boccia, G

2009-01-01

The present study provides a picture of the compositional figure and nutritive value of meat-based dishes typical of Italian culinary tradition. Recipes specific for a bovine meat cut (top-side) were selected among the most widespread ones in Italy: in pan, pizzaiola, cutlet, meat ball, and escalope. The total fat and cholesterol content varied depending on the ingredients utilized (extra-virgin olive oil, parmesan, egg). Meat-based dishes that utilized extra-virgin olive oil showed a significant reduction in palmitic and stearic acids and a parallel increase in oleic acid compared with raw meat; furthermore, the ratio among saturated fatty acids, monounsaturated fatty acids and polyunsaturated fatty acids shifted in favour of monounsaturated fatty acids. B vitamins were affected at different extent by heating; by contrast, vitamin E content increased because of the new sources of this vitamin, which masked losses due to heating. Ingredients (parmesan, discretionary salt) induced significant increases in the calcium and sodium concentrations compared with raw meat. The total iron content did not show marked differences in most of the meat-based dishes compared with raw meat; by contrast, losses in the heme-iron concentration were detected depending on the severity of heating treatments. Our findings suggest that heme iron, because of its important health aspects, might be a useful index of the nutritional quality of cooked meats.

[Sclerotherapy and hydrocelectomy for the management of hydrocele in outpatient and day-surgery setting].

PubMed

Erdas, Enrico; Pisano, Giuseppe; Pomata, Mariano; Pinna, Giovanni; Secci, Lucia; Licheri, Sergio; Daniele, Giovanni Maria

2006-01-01

The purpose of this report was to compare two different procedures in the treatment of idiopathic hydrocele, namely, hydrocelectomy and percutaneous sclerotherapy, both of which performed in the outpatient or day surgery setting. A detailed description of the technical local anaesthesia steps is reported together with the sclerotherapy method. The study was conducted in 71 patients with a total of 77 hydroceles treated from 1993 to 2004. Surgery was carried out in 53 cases and sclerotherapy in 24. The latter was more frequently opted for elderly subjects as well as in those patients who requested it. Local or locoregional anaesthesia was reserved to patients treated surgically. The two treatments were compared on the basis of the following parameters: age, operative time, length of hospital stay, success rate and complications. The efficacy of the two procedures was comparable (sclerotherapy 95.8% vs surgery 100%), but sclerotherapy proved more favourable in terms of simplicity, rapidity of execution, shortness of hospital stay and risk of complications. However, 41.7% of patients required more than one treatment to obtain a radical cure, whereas surgery was effective in all cases in just one step. Hospital stay and morbidity were almost the same when surgery was performed under local anaesthesia. Sclerotherapy is an efficient alternative to the classic hydrocelectomy. The choice between the two treatment modalities should be made, taking into account above all the patient's individual preference.

Quantifying the strength of the associations of prototype perceptions with behaviour, behavioural willingness and intentions: a meta-analysis.

PubMed

van Lettow, Britt; de Vries, Hein; Burdorf, Alex; van Empelen, Pepijn

2016-01-01

Prototypes (i.e., social images representing perceptions of typical persons engaging in or refraining from certain behaviour) have been shown to explain health-related behaviours. The present meta-analysis quantified the strength of the associations of prototype perceptions with health motivation and behaviour. Specifically, the analysis addressed (i) the relationship of prototype favourability (i.e., degree of likability) and similarity (i.e., perceived resemblance to the self) with behaviour, willingness and intentions; (ii) the effect of the interaction between favourability and similarity; and (iii) the extent to which health-risk and health-protective prototypes differed in their association with these outcomes. A total of 80 independent studies were identified based on 69 articles. The results indicated that prototype favourability and similarity were related to behaviour, intentions and willingness with small-to-medium effect sizes (r+ = 0.12-0.43). Direct measures of prototype perceptions generally produced larger effects than indirect measures. The interaction between favourability and similarity produced small-to-large effect sizes (r+ = .22-.54). The results suggest that both health-risk and health-protective prototypes might be useful targets for interventions (r+ = .22-.54). In order to increase health-protective behaviours, intentions and behaviour could be targeted by increasing similarity to health-protective prototypes. Health-risk behaviour might be decreased by targeting willingness by modifying health-risk prototype favourability and similarity.

Family characteristics predicting favourable changes in 10 and 11-year-old children's lifestyle-related health behaviours during an 18-month follow-up.

PubMed

Ray, Carola; Roos, Eva

2012-02-01

Lifestyle-related health behaviours such as screen time, physical activity, sleep duration, and food intake tend to change into non-favourable directions when children become young adolescents. Cross-sectional studies show that family characteristics are important determinants for children's health behaviours. This study examined whether family characteristics such as parenting practices at meals and family involvement predict a more favourable change in children's lifestyle-related health behaviours during an 18-month follow-up. 745 children in school grades 4 and 5 (response rate 65%) filled in a baseline questionnaire in the autumn of 2006. A follow-up was conducted in the spring of 2008 (91%). Several health behaviours had changed in a non-favourable direction. Baseline parenting practices at meals and family involvement predicted some of the changes in the lifestyle-related health behaviours in 2008. Parenting practices at meals predicted a smaller increase in TV, DVD viewing time, and a smaller decrease in fruit intake. Amongst family involvement determinants, less time alone at home after school predicted a smaller increase in screen time, a smaller decrease in sleep duration, and a smaller increase in soft drink intake. For conclusion several family characteristics predicted favourable changes in children's lifestyle-related health behaviours. Copyright © 2011 Elsevier Ltd. All rights reserved.

The use of light-emitting diode fluorescence to diagnose mycobacterial lymphadenitis in fine-needle aspirates from children

PubMed Central

van Wyk, A. C.; Marais, B. J.; Warren, R. M.; van Wyk, S. S.; Wright, C. A.

2011-01-01

SUMMARY BACKGROUND Fine-needle aspiration biopsy (FNAB) is a simple, safe and effective method for investigating suspected mycobacterial lymphadenitis in children. Fluorescence microscopy can provide rapid mycobacterial confirmation. Light-emitting diodes (LEDs) provide a cheap and robust excitation light source, making fluorescence microscopy feasible in resource-limited settings. OBJECTIVE To compare the diagnostic performance of LED fluorescence microscopy on Papanicolaou (PAP) stained smears with the conventional mercury vapour lamp (MVL). METHODS FNAB smears routinely collected from palpable lymph nodes in children with suspected mycobacterial disease were PAP-stained and evaluated by two independent microscopists using different excitatory light sources (MVL and LED). Mycobacterial culture results provided the reference standard. A manually rechargeable battery-powered LED power source was evaluated in a random subset. RESULTS We evaluated 182 FNAB smears from 121 children (median age 31 months, interquartile range 10–67). Mycobacterial cultures were positive in 84 of 121 (69%) children. The mean sensitivity with LED (mains-powered), LED (rechargeable battery-powered) and MVL was respectively 48.2%, 50.0% and 51.8% (specificity 78.4%, 86.7% and 78.4%). Inter-observer variation was similar for LED and MVL (κ = 0.5). CONCLUSION LED fluorescence microscopy provides a reliable alternative to conventional methods and has many favourable attributes that would facilitate improved, decentralised diagnostic services. PMID:21276297

Evaluating and comparing methods of sinkhole susceptibility mapping in the Ebro Valley evaporite karst (NE Spain)

NASA Astrophysics Data System (ADS)

Galve, J. P.; Gutiérrez, F.; Remondo, J.; Bonachea, J.; Lucha, P.; Cendrero, A.

2009-10-01

Multiple sinkhole susceptibility models have been generated in three study areas of the Ebro Valley evaporite karst (NE Spain) applying different methods (nearest neighbour distance, sinkhole density, heuristic scoring system and probabilistic analysis) for each sinkhole type separately (cover collapse sinkholes, cover and bedrock collapse sinkholes and cover and bedrock sagging sinkholes). The quantitative and independent evaluation of the predictive capability of the models reveals that: (1) The most reliable susceptibility models are those derived from the nearest neighbour distance and sinkhole density. These models can be generated in a simple and rapid way from detailed geomorphological maps. (2) The reliability of the nearest neighbour distance and density models is conditioned by the degree of clustering of the sinkholes. Consequently, the karst areas in which sinkholes show a higher clustering are a priori more favourable for predicting new occurrences. (3) The predictive capability of the best models obtained in this research is significantly higher (12.5-82.5%) than that of the heuristic sinkhole susceptibility model incorporated into the General Urban Plan for the municipality of Zaragoza. Although the probabilistic approach provides lower quality results than the methods based on sinkhole proximity and density, it helps to identify the most significant factors and select the most effective mitigation strategies and may be applied to model susceptibility in different future scenarios.

Acupuncture for treating acute ankle sprains in adults.

PubMed

Kim, Tae-Hun; Lee, Myeong Soo; Kim, Kun Hyung; Kang, Jung Won; Choi, Tae-Young; Ernst, Edzard

2014-06-23

An acute ankle sprain is a sudden-onset injury of one or more of the ankle ligaments. It is one of the most common musculoskeletal injuries in the general population as well as in athletes. In some countries, such as China and Korea, acupuncture is frequently used in the treatment of ankle sprains, either as a single treatment or a secondary intervention accompanied by standard medical treatment. To assess the effects (benefits and harms) of acupuncture for the treatment of ankle sprains in adults. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (May 2013), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2013, Issue 4), MEDLINE (1948 to May week 2 2013), EMBASE (1980 to May week 2 2013), China National Knowledge Infrastructure databases (1994 to August week 4 2013), the Cumulative Index to Nursing and Allied Health Literature (1937 to May 2013), the Allied and Complementary Medicine Database (1985 to May 2013), Science Links Japan (1996 to August week 4 2013), several Korean medical databases (August week 4 2013), the World Health Organization International Clinical Trials Registry Platform (August week 4 2013), the bibliographic references of included trials and conference proceedings. We included randomised and quasi-randomised controlled trials involving adults with acute ankle sprains. We included all types of acupuncture practices, such as needle acupuncture, electroacupuncture, laser acupuncture, pharmacoacupuncture, non-penetrating acupuncture point stimulation (e.g. acupressure and magnets) and moxibustion. Acupuncture could be compared with control (no treatment or placebo) or another standard non-surgical intervention. Two review authors independently screened the search results, assessed trial eligibility, assessed risk of bias and extracted data from the included trials. We calculated risk ratios (RRs) for dichotomous outcomes and mean differences for continuous outcomes. We conducted meta-analyses using the fixed-effect method or, where appropriate, the random-effects method, and used 95% confidence intervals (CI) throughout. We included a total of 20 heterogeneous studies (2012 participants with acute ankle sprains); three of which included more than one comparison. Seventeen trials were conducted in China. All of the studies had a high risk of bias due to lack of blinding. The results may also have been affected by selection bias, particularly as five studies were quasi-randomised controlled trials and 12 studies gave no information on their method of randomisation. Of our three prespecified primary outcomes, only cure rate was reported by the majority of studies. No study reported on patient-reported assessment of function and only one reported on adverse events (in which three participants receiving a control intervention experienced skin problems from over-the-counter Chinese herbal patches). The other 19 studies did not record or report on adverse events. We assessed the quality of evidence for cure rates as very low for all comparisons, which means we are very uncertain about the reliability of any of the estimates.The single study comparing acupuncture treatment with no treatment found acupuncture to be more effective with regard to cure rate at five days (31/31 versus 1/30; RR 20.34, 95% CI 4.27 to 96.68). Acupuncture plus another standard treatment versus that standard treatment alone was tested in eight studies; with cure rate data available for seven. Most of these studies reported higher cure rates in the acupuncture plus another standard treatment group than in the standard treatment alone group. However, while the results of an exploratory meta-analysis of cure rate data from eight trials testing acupuncture versus no acupuncture tended to favour acupuncture, the results were very inconsistent across the studies and the estimated effect was very imprecise (383/396 versus 272/355; RR 1.32, 95% CI 0.95 to 1.84; P value = 0.1; I(2) = 98%).Fourteen studies compared acupuncture with a variety of other non-surgical treatments, such as Chinese drug patches, hot and cold water, ice packs, oral Chinese herbal medicine and elastic bandage. Some studies found in favour of acupuncture, some in favour of the other treatment and some found a lack of evidence for a difference between the two interventions under test. The results of an exploratory meta-analysis of cure rate data from 11 trials testing acupuncture versus another non-surgical intervention tended to slightly favour acupuncture, but these were not statistically significant and the data were very heterogeneous (404/509 versus 416/497; RR 1.07, 95% CI 0.94 to 1.22; P value = 0.30; I(2) = 92%). The currently available evidence from a very heterogeneous group of randomised and quasi-randomised controlled trials evaluating the effects of acupuncture for the treatment of acute ankle sprains does not provide reliable support for either the effectiveness or safety of acupuncture treatments, alone or in combination with other non-surgical interventions; or in comparison with other non-surgical interventions. Future rigorous randomised clinical trials with larger sample sizes will be necessary to establish robust clinical evidence concerning the effectiveness and safety of acupuncture treatment for acute ankle sprains.

Thermodynamics of antagonist binding to rat muscarinic M2 receptors: antimuscarinics of the pridinol, sila-pridinol, diphenidol and sila-diphenidol type.

PubMed Central

Waelbroeck, M.; Camus, J.; Tastenoy, M.; Lambrecht, G.; Mutschler, E.; Kropfgans, M.; Sperlich, J.; Wiesenberger, F.; Tacke, R.; Christophe, J.

1993-01-01

1. We studied the effect of temperature on the binding to rat heart M2 muscarinic receptors of antagonists related to the carbon/silicon pairs pridinol/sila-pridinol and diphenidol/sila-diphenidol (including three germanium compounds) and six structurally related pairs of enantiomers [(R)- and (S)-procyclidine, (R)- and (S)-trihexyphenidyl, (R)- and (S)-tricyclamol, (R)- and (S)-trihexyphenidyl methiodide, (R)- and (S)-hexahydro-diphenidol and (R)- and (S)-hexbutinol]. Binding affinities were determined in competition experiments using [3H]-N-methyl-scopolamine chloride as radioligand. The reference drugs were scopolamine and N-methyl-scopolamine bromide. 2. The affinity of the antagonists either increased or decreased with temperature. van't Hoff plots were linear in the 278-310 degrees K temperature range. Binding of all antagonists was entropy driven. Enthalpy changes varied from large negative values (down to -29 kJ mol-1) to large positive values (up to +30 kJ mol-1). 3. (R)-configurated drugs had a 10 to 100 fold greater affinity for M2 receptors than the corresponding (S)-enantiomers. Enthalpy and entropy changes of the respective enantiomers were different but no consistent pattern was observed. 4. When silanols (R3SiOH) were compared to carbinols (R3COH), the affinity increase caused by C/Si exchange varied between 3 and 10 fold for achiral drugs but was negligible in the case of chiral drugs. Silanols induced more favourable enthalpy and less favourable entropy changes than the corresponding carbinols when binding. Organogermanium compounds (R4Ge) when compared to their silicon counterparts (R4Si) showed no significant difference in affinity as well as in enthalpy and entropy changes. 5. Exchange of a cyclohexyl by a phenyl moiety was associated with an increase or a decrease in drug affinity (depending on the absolute configuration in the case of chiral drugs) and generally also with a more favourable enthalpy change and a less favourable entropy change of drug binding. 6. Replacement of a pyrrolidino by a piperidino group and increasing the length of the alkylene chain bridging the amino group and the central carbon or silicon atom were associated with either an increase or a decrease of entropy and enthalpy changes of drug binding. However, there was no clear correlation between these structural variations and the thermodynamic effects. 7. Taken together, these results suggest that hydrogen bond-forming OH groups and, to a lesser extent, polarizable phenyl groups contribute significantly to the thermodynamics of interactions between these classes of muscarinic antagonists and M2 muscarinic receptors. PMID:8102927

Formative assessment: a student perspective.

PubMed

Hill, D A; Guinea, A I; McCarthy, W H

1994-09-01

An educator's view would be that formative assessment has an important role in the learning process. This study was carried out to obtain a student perspective of the place of formative assessment in the curriculum. Final-year medical students at Royal Prince Alfred Hospital took part in four teaching sessions, each structured to integrate teaching with assessment. Three assessment methods were used; the group objective structured clinical examination (G-OSCE), structured short answer (SSA) questions and a pre/post-test multiple choice questionnaire (MCQ). Teaching sessions were conducted on the subject areas of traumatology, the 'acute abdomen', arterial disorders and cancer. Fifty-five students, representing 83% of those who took part in the programme, responded to a questionnaire where they were asked to rate (on a 5-point Likert scale) their response to general questions about formative assessment and 13 specific questions concerning the comparative value of the three assessment modalities. Eighty-nine per cent of respondents felt that formative assessment should be incorporated into the teaching process. The SSA assessment was regarded as the preferred modality to reinforce previous teaching and test problem-solving skills. The MCQ was the least favoured assessment method. The effect size variable between the total scores for the SSA and MCQ was 0.64. The variable between G-OSCE and SSA/MCQ was 0.26 and 0.33 respectively. Formative assessment is a potentially powerful method to direct learning behaviour. Students should have input into the methods used.

Simultaneous determination of methocarbamol and aspirin by RP-HPLC using fluorescence detection with time programming: its application to pharmaceutical dosage form.

PubMed

El-Din, M Sharaf; Eid, M; Zeid, A M

2013-01-01

A new simple, rapid and sensitive reversed-phase liquid chromatographic method was developed and validated for the simultaneous determination of methocarbamol (MET) and aspirin (ASP) in their combined dosage form. The separation of these compounds was achieved within 6.0 min on a CLC Shim-pack C8 column (250 × 4.6 mm, 5 µm particle size) using isocratic mobile phase consisting of acetonitrile and 0.02 M dihydrogenphosphate buffer (30:70, v/v) at pH = 5.0. The analysis was performed at a flow rate of 1.0 mL/min with fluorescence detection at 277/313 nm for MET and 298/410 nm for ASP using real-time programming. The selectivity, linearity of calibration, accuracy, inter- and intra-day precision and recovery were examined as parts of the method validation. The concentration-response relationship was linear over concentration ranges of 0.02-0.20 and 0.02-0.40 µg/mL for MET and ASP, respectively, with a limit of detection of 6 and 32 ng/mL for MET and ASP, respectively. The proposed method was successfully applied for the analysis of both MET and ASP in prepared tablets with average recoveries of 99.88 ± 0.65% for MET and 100.44 ± 0.78% for ASP. The results were favourably compared to those obtained by a reference method. Copyright © 2012 John Wiley & Sons, Ltd.

A Comparison Between a Synthetic Over-Sampling Equilibrium and Observed Subsets of Data for Epidemic Vector Classification

NASA Astrophysics Data System (ADS)

Fusco, Terence; Bi, Yaxin; Nugent, Chris; Wu, Shengli

2016-08-01

We can see that the data imputation approach using the Regression CTA has performed more favourably when compared with the alternative methods on this dataset. We now have the evidence to show that this method is viable moving forward with further research in this area. The weighted distribution experiments have provided us with a more balanced and appropriate ratio for snail density classification purposes when using either the 3 or 5 category combination. The most desirable results are found when using 3 categories of SD with the weighted distribution of classes being 20-60-20. This information reflects the optimum classification accuracy across the data range and can be applied to any novel environment feature dataset pertaining to Schistosomiasis vector classification. ITSVM has provided us with a method of labelling SD data which we can use for classification with epidemic disease prediction research. The confidence level selection enables consistent labelling accuracy for bespoke requirements when classifying the data from each year. The SMOTE Equilibrium proposed method has yielded a slight increase with each multiple of synthetic instances that are compounded to the training dataset. The reduction of overfitting and increase of data instances has shown a gradual classification accuracy increase across the data for each year. We will now test to see what the optimum synthetic instance incremental increase is across our data and apply this to our experiments with this research.

Adaptation of gastrointestinal nematode parasites to host genotype: single locus simulation models

PubMed Central

2013-01-01

Background Breeding livestock for improved resistance to disease is an increasingly important selection goal. However, the risk of pathogens adapting to livestock bred for improved disease resistance is difficult to quantify. Here, we explore the possibility of gastrointestinal worms adapting to sheep bred for low faecal worm egg count using computer simulation. Our model assumes sheep and worm genotypes interact at a single locus, such that the effect of an A allele in sheep is dependent on worm genotype, and the B allele in worms is favourable for parasitizing the A allele sheep but may increase mortality on pasture. We describe the requirements for adaptation and test if worm adaptation (1) is slowed by non-genetic features of worm infections and (2) can occur with little observable change in faecal worm egg count. Results Adaptation in worms was found to be primarily influenced by overall worm fitness, viz. the balance between the advantage of the B allele during the parasitic stage in sheep and its disadvantage on pasture. Genetic variation at the interacting locus in worms could be from de novo or segregating mutations, but de novo mutations are rare and segregating mutations are likely constrained to have (near) neutral effects on worm fitness. Most other aspects of the worm infection we modelled did not affect the outcomes. However, the host-controlled mechanism to reduce faecal worm egg count by lowering worm fecundity reduced the selection pressure on worms to adapt compared to other mechanisms, such as increasing worm mortality. Temporal changes in worm egg count were unreliable for detecting adaptation, despite the steady environment assumed in the simulations. Conclusions Adaptation of worms to sheep selected for low faecal worm egg count requires an allele segregating in worms that is favourable in animals with improved resistance but less favourable in other animals. Obtaining alleles with this specific property seems unlikely. With support from experimental data, we conclude that selection for low faecal worm egg count should be stable over a short time frame (e.g. 20 years). We are further exploring model outcomes with multiple loci and comparing outcomes to other control strategies. PMID:23714384

Unification of favourable intermediate-, unfavourable intermediate-, and very high-risk stratification criteria for prostate cancer.

PubMed

Zumsteg, Zachary S; Zelefsky, Michael J; Woo, Kaitlin M; Spratt, Daniel E; Kollmeier, Marisa A; McBride, Sean; Pei, Xin; Sandler, Howard M; Zhang, Zhigang

2017-11-01

To improve on the existing risk-stratification systems for prostate cancer. This was a retrospective investigation including 2 248 patients undergoing dose-escalated external beam radiotherapy (EBRT) at a single institution. We separated National Comprehensive Cancer Network (NCCN) intermediate-risk prostate cancer into 'favourable' and 'unfavourable' groups based on primary Gleason pattern, percentage of positive biopsy cores (PPBC), and number of NCCN intermediate-risk factors. Similarly, NCCN high-risk prostate cancer was stratified into 'standard' and 'very high-risk' groups based on primary Gleason pattern, PPBC, number of NCCN high-risk factors, and stage T3b-T4 disease. Patients with unfavourable-intermediate-risk (UIR) prostate cancer had significantly inferior prostate-specific antigen relapse-free survival (PSA-RFS, P < 0.001), distant metastasis-free survival (DMFS, P < 0.001), prostate cancer-specific mortality (PCSM, P < 0.001), and overall survival (OS, P < 0.001) compared with patients with favourable-intermediate-risk (FIR) prostate cancer. Similarly, patients with very high-risk (VHR) prostate cancer had significantly worse PSA-RFS (P < 0.001), DMFS (P < 0.001), and PCSM (P = 0.001) compared with patients with standard high-risk (SHR) prostate cancer. Moreover, patients with FIR and low-risk prostate cancer had similar outcomes, as did patients with UIR and SHR prostate cancer. Consequently, we propose the following risk-stratification system: Group 1, low risk and FIR; Group 2, UIR and SHR; and Group 3, VHR. These groups have markedly different outcomes, with 8-year distant metastasis rates of 3%, 9%, and 29% (P < 0.001) for Groups 1, 2, and 3, respectively, and 8-year PCSM of 1%, 4%, and 13% (P < 0.001) after EBRT. This modified stratification system was significantly more accurate than the three-tiered NCCN system currently in clinical use for all outcomes. Modifying the NCCN risk-stratification system to group FIR with low-risk patients and UIR with SHR patients, results in modestly improved prediction of outcomes, potentially allowing better personalisation of therapeutic recommendations. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

Determinants of completion of advance directives: a cross-sectional comparison of 649 outpatients from private practices versus 2158 outpatients from a university clinic

PubMed Central

Pfirstinger, Jochen; Bleyer, Bernhard; Blum, Christian; Rechenmacher, Michael; Wiese, Christoph H; Gruber, Hans

2017-01-01

Objectives To compare outpatients from private practices and outpatients from a university clinic regarding the determinants of completion of advance directives (AD) in order to generalise results of studies from one setting to the other. Five determinants of completion of AD were studied: familiarity with AD, source of information about AD, prior experiences with own life-threatening diseases or family members in need of care and motives in favour and against completion of AD. Design Observational cross-sectional study. Setting Private practices and a university clinic in Germany in 2012. Participants 649 outpatients from private practices and 2158 outpatients from 10 departments of a university clinic. Outcome measures Completion of AD, familiarity with AD, sources of information about AD (consultation), prior experiences (with own life-threatening disease and family members in need of care), motives in favour of or against completion of AD, sociodemographic data. Results Determinants of completion of AD did not differ between outpatients from private practices versus university clinic outpatients. Prior experience with severe disease led to a significantly higher rate of completion of AD (33%/36% with vs 24%/24% without prior experience). Participants with completion of AD had more often received legal than medical consultation before completion, but participants without completion of AD are rather aiming for medical consultation. The motives in favour of or against completion of AD indicated inconsistent patterns. Conclusions Determinants of completion of AD are comparable in outpatients from private practices and outpatients from a university clinic. Generalisations from university clinic samples towards a broader context thus seem to be legitimate. Only one-third of patients with prior experience with own life-threatening diseases or family members in need of care had completed an AD as expression of their autonomous volition. The participants’ motives for or against completion of AD indicate that ADs are considered a kind of ‘negative autonomy’ as instruments to prevent particular forms of therapy. Interactive, repeated and situation-based AD discussions might reach a higher percentage of patients and concurrently enable personal volitions and thereby strengthen individual ‘positive autonomy’. PMID:29273648

Synthesis and exploration of novel radiolabeled bombesin peptides for targeting receptor positive tumor.

PubMed

De, Kakali; Banerjee, Indranil; Sinha, Samarendu; Ganguly, Shantanu

2017-03-01

Increasing evidence of peptide receptor overexpression in various cancer cells, warrant the development of receptor specific radiolabeled peptides for molecular imaging and therapy in nuclear medicine. Gastrin-releasing-peptide (GRP) receptor, are overexpressed in a variety of human cancer cells. The present study report the synthesis and biological evaluation of new bombesin (BBN) analogs, HYNIC-Asp-[Phe 13 ]BBN(7-13)-NH-CH 2 -CH 2 -CH3:BA1, HYNIC-Pro-[Tyr 13 Met 14 ]BBN(7-14)NH 2 :BA2 as prospective tumor imaging agent with compare to BBN(7-14)NH 2 :BS as standard. The pharmacophores were radiolabeled in high yields with 99m Tc, characterized for their stability in serum and saline, cysteine/histidine and were found to be substantially stable. Internalization/externalization and receptor binding studies were assessed using MDA-MB-231 cells and showed high receptor binding-affinity and favourable internalization. Fluorescence studies revealed that BA1 changed the morphology of the cells and could localize in the nucleus more effectively than BA2/BS. Cell-viability studies displayed substantial antagonistic and nuclear-internalization effect of BA1. BA1 also exhibited antiproliferative effect on MDA-MB-231 cell by inducing apoptosis. In vivo behaviour of the radiopeptides was evaluated in GRP receptor positive tumor bearing mice. The 99m Tc-BA1/ 99m Tc-BA2 demonstrated rapid blood/urinary clearance through the renal pathway and comparatively more significant tumor uptake image and favourable tumor-to-non-target ratios provided by 99m Tc-BA1. The specificity of the in vivo uptake was confirmed by co-injection with BS. Moreover, 99m Tc-BA1 provided a much clearer tumor image in scintigraphic studies than others. Thus the combination of favourable in vitro and in vivo properties renders BA1 as more potential antagonist bombesin-peptide for targeting GRP-receptor positive tumor. These properties are encouraging to carry out further experiments for non-invasive receptor targeting potential diagnostinc and therapeutic agent for tumors. Copyright © 2017 Elsevier Inc. All rights reserved.

Cyclic phase change in a cylindrical thermal energy storage capsule

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hasan, M.; Mujumdar, A.S.; Weber, M.E.

1983-12-01

This paper is concerned with a practical melting/freezing problem in conjunction with the more realistic case of a cyclic phase change thermal energy storage device. In this model the phase change medium is encapsulated in long cylindrical tubes, the surface temperature of which is allowed to vary sinusoidally with time about the discrete freezing temperature. Initial temperature of the medium is assumed to be constant at a temperature above or below the freezing/melting temperature. Natural convection in the melt is assumed to be negligible and the variations in the depth of freezing and/or melting in each half cycle is ignored.more » Depending on the half-cycle parameters the problem is simplified to either freezing or melting. The governing one-dimensional heat diffusion equations for both phases are solved by the Finite Integral Transform techniques. The kernels for the transformation are the time-dependent eigen functions separately defined for each phases. This extended transform method can accomodate any time-dependent surface temperature variation. The application of the transform generated a series of coupled, nonlinear first order differential equations, which are solved by Runge Kutta-Verner fifth and sixth order method. Dimensionless solutions of temperature variations in both phases, fusion front position and the fraction solidified (or melted) are displayed graphically to aid in practical calculations. For the special case of a constant surface temperature, comparisons are made between the present results and the existing integral and purely numerical results. The results are found to compare favourably. Results for fractional solidification (or melting and interface position are also compared with the simple Conduction Shape Factor method, after allowing for the time-dependent boundary conditions. Once again the results agree reasonably well.« less

Cementless total knee arthroplasty

PubMed Central

Risitano, Salvatore; Sabatini, Luigi; Giachino, Matteo; Agati, Gabriele; Massè, Alessandro

2016-01-01

Interest for uncemented total knee arthroplasty (TKA) has greatly increased in recent years. This technique, less used than cemented knee replacement in the last decades, sees a revival thanks an advance in prosthetic design, instrumentation and operative technique. The related literature in some cases shows conflicting data on survival and on the revision’s rate, but in most cases a success rate comparable to cemented TKA is reported. The optimal fixation in TKA is a subject of debate with the majority of surgeons favouring cemented fixation. PMID:27162779

Beaver lodge location on the upstream Loire River.

PubMed

Fustec, Joëlle; Cormier, Jean-Paul; Lodé, Thierry

2003-08-01

In the part of the Loire River recently colonized by Eurasian beavers, we compared habitat characteristics among sites with lodges, sites with cut trees and sites without beaver. The absence of sandbank and canopy cover (by 10-15-m tall trees, by tall Salicaceae, and by bushy Salicaceae) appeared as good predictors for lodge settling. Based on this model, the number of proper lodge sites was estimated for the next downstream 36 kilometers stretch. The number of favourable sites decreases as anthropization increases.

Schoolgirls' experience and appraisal of menstrual absorbents in rural Uganda: a cross-sectional evaluation of reusable sanitary pads.

PubMed

Hennegan, Julie; Dolan, Catherine; Wu, Maryalice; Scott, Linda; Montgomery, Paul

2016-12-07

Governments, multinational organisations, and charities have commenced the distribution of sanitary products to address current deficits in girls' menstrual management. The few effectiveness studies conducted have focused on health and education outcomes but have failed to provide quantitative assessment of girls' preferences, experiences of absorbents, and comfort. Objectives of the study were, first, to quantitatively describe girls' experiences with, and ratings of reliability and acceptability of different menstrual absorbents. Second, to compare ratings of freely-provided reusable pads (AFRIpads) to other existing methods of menstrual management. Finally, to assess differences in self-reported freedom of activity during menses according to menstrual absorbent. Cross-sectional, secondary analysis of data from the final survey of a controlled trial of reusable sanitary padand puberty education provision was undertaken. Participants were 205 menstruating schoolgirls from eight schools in rural Uganda. 72 girls who reported using the intervention-provided reusable pads were compared to those using existing improvised methods (predominately new or old cloth). Schoolgirls using reusable pads provided significantly higher ratings of perceived absorbent reliability across activities, less difficulties changing absorbents, and less disgust with cleaning absorbents. There were no significant differences in reports of outside garment soiling (OR 1.00 95%CI 0.51-1.99), or odour (0.84 95%CI 0.40-1.74) during the last menstrual period. When girls were asked if menstruation caused them to miss daily activities there were no differences between those using reusable pads and those using other existing methods. However, when asked about activities avoided during menstruation, those using reusable pads participated less in physical sports, working in the field, fetching water, and cooking. Reusable pads were rated favourably. This translated into some benefits for self-reported involvement in daily activities, although reports of actual soiling and missing activities due to menstruation did not differ. More research is needed comparing the impact of menstrual absorbents on girls' daily activities, and validating outcome measures for menstrual management research.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Peressutti, D; Schipaanboord, B; Kadir, T

Purpose: To investigate the effectiveness of atlas selection methods for improving atlas-based auto-contouring in radiotherapy planning. Methods: 275 H&N clinically delineated cases were employed as an atlas database from which atlases would be selected. A further 40 previously contoured cases were used as test patients against which atlas selection could be performed and evaluated. 26 variations of selection methods proposed in the literature and used in commercial systems were investigated. Atlas selection methods comprised either global or local image similarity measures, computed after rigid or deformable registration, combined with direct atlas search or with an intermediate template image. Workflow Boxmore » (Mirada-Medical, Oxford, UK) was used for all auto-contouring. Results on brain, brainstem, parotids and spinal cord were compared to random selection, a fixed set of 10 “good” atlases, and optimal selection by an “oracle” with knowledge of the ground truth. The Dice score and the average ranking with respect to the “oracle” were employed to assess the performance of the top 10 atlases selected by each method. Results: The fixed set of “good” atlases outperformed all of the atlas-patient image similarity-based selection methods (mean Dice 0.715 c.f. 0.603 to 0.677). In general, methods based on exhaustive comparison of local similarity measures showed better average Dice scores (0.658 to 0.677) compared to the use of either template image (0.655 to 0.672) or global similarity measures (0.603 to 0.666). The performance of image-based selection methods was found to be only slightly better than a random (0.645). Dice scores given relate to the left parotid, but similar results patterns were observed for all organs. Conclusion: Intuitively, atlas selection based on the patient CT is expected to improve auto-contouring performance. However, it was found that published approaches performed marginally better than random and use of a fixed set of representative atlases showed favourable performance. This research was funded via InnovateUK Grant 600277 as part of Eurostars Grant E!9297. DP,BS,MG,TK are employees of Mirada Medical Ltd.« less

Transient ischaemic attack clinic: an evaluation of diagnoses and clinical decision making.

PubMed

Lee, Will; Frayne, Judith

2015-04-01

The diagnosis of transient ischaemic attack (TIA) is based largely on the patient's symptom recall and clinical judgement. This decision-making process is highly subjective and the inter-observer reliability of TIA diagnosis is at best moderate, even among neurologists. The aim of this study is to examine the presenting features and final diagnoses of referrals to a TIA clinic and to evaluate characteristics that favoured the diagnosis of TIA over other TIA "mimics". Consecutive new referrals to a tertiary metropolitan hospital TIA clinic over a 9month period were examined. Characteristics between TIA and non-TIA diagnoses were compared and analysed. Eighty-two patients were recruited. Eighteen (22%) were given a final diagnosis of TIA or stroke. Major alternative diagnoses included migraine (n=17, 21%), presyncope/syncope (n=13, 16%) and anxiety (n=7, 9%). Four (5%) patients had unclassifiable symptoms with no clear final diagnosis. Mean age was 67±a standard deviation of 17years and patients diagnosed with TIA/stroke were on average older than those with non-TIA diagnoses (77±10 versus 64±17years, p=0.003). A diagnosis of TIA/stroke was favoured in the presence of moderate to severe weakness (p=0.032), dysphasia (p=0.037) or dysarthria (p=0.005). Unclassifiable symptoms (for example, palpitations, confusion, headache) were reported in 27 patients (33%) and their presence favoured non-TIA diagnoses (p=0.0003). TIA constituted a minority of the referrals to our clinic. Accurate clinical diagnosis of TIA facilitates early stroke prevention and avoids unnecessary investigations and prescriptions. Attempts to improve diagnostic accuracy of TIA should target improving the education and awareness of frontline medical practitioners. Copyright © 2014 Elsevier Ltd. All rights reserved.

Depigmented-polymerised allergoids favour regulatory over effector T cells: enhancement by 1α, 25-dihydroxyvitamin D3.

PubMed

Urry, Zoe L; Richards, David F; Black, Cheryl; Morales, Maria; Carnés, Jerónimo; Hawrylowicz, Catherine M; Robinson, Douglas S

2014-05-29

Allergen immunotherapy (SIT) is the only treatment for allergic disease capable of modifying disease long term. To reduce the risk of anaphylaxis from SIT, allergen-extracts have been modified by polymerisation with glutaraldehyde to reduce IgE binding. It is suggested that these allergoid extracts also have reduced T cell activity, which could compromise clinical efficacy. Effective SIT is thought to act through regulatory T cells (Tregs) rather than activation of effector T cells. There is no published data on the activity of modified extracts on Tregs. We compared the capacity of modified (depigmented-polymerised) versus unmodified (native) allergen extracts of grass pollen and house dust mite to stimulate proliferation/cytokine production and to modulate Treg/effector T cell frequency in cultures of peripheral blood mononuclear cells (PBMC), from volunteers sensitised to both allergens in vitro. Depigmented-polymerised allergen extracts stimulated less proliferation of PBMC, and reduced effector cell numbers after 7 days in culture than did native extracts. However, the frequency of Foxp3+ Tregs in cultures were similar to those seen with native extract so that ratios of regulatory to effector T cells were significantly increased in cultures stimulated with depigmented-polymerised extracts. Addition of 1α, 25-dihydroxyvitamin D3 further favoured Treg, and reduced effector cytokine production, but not interleukin-10. Depigmented-polymerised allergen extracts appear to favour Treg expansion over activation of effector T cells and this may relate to their demonstrated efficacy and safety in SIT. 1α, 25-dihydroxyvitamin D3 further reduces effector T cell activation by allergen extracts and may be a useful adjuvant for SIT.

Depigmented-polymerised allergoids favour regulatory over effector T cells: enhancement by 1α, 25-dihydroxyvitamin D3

PubMed Central

2014-01-01

Background Allergen immunotherapy (SIT) is the only treatment for allergic disease capable of modifying disease long term. To reduce the risk of anaphylaxis from SIT, allergen-extracts have been modified by polymerisation with glutaraldehyde to reduce IgE binding. It is suggested that these allergoid extracts also have reduced T cell activity, which could compromise clinical efficacy. Effective SIT is thought to act through regulatory T cells (Tregs) rather than activation of effector T cells. There is no published data on the activity of modified extracts on Tregs. Results We compared the capacity of modified (depigmented-polymerised) versus unmodified (native) allergen extracts of grass pollen and house dust mite to stimulate proliferation/cytokine production and to modulate Treg/effector T cell frequency in cultures of peripheral blood mononuclear cells (PBMC), from volunteers sensitised to both allergens in vitro. Depigmented-polymerised allergen extracts stimulated less proliferation of PBMC, and reduced effector cell numbers after 7 days in culture than did native extracts. However, the frequency of Foxp3+ Tregs in cultures were similar to those seen with native extract so that ratios of regulatory to effector T cells were significantly increased in cultures stimulated with depigmented-polymerised extracts. Addition of 1α, 25-dihydroxyvitamin D3 further favoured Treg, and reduced effector cytokine production, but not interleukin-10. Conclusions Depigmented-polymerised allergen extracts appear to favour Treg expansion over activation of effector T cells and this may relate to their demonstrated efficacy and safety in SIT. 1α, 25-dihydroxyvitamin D3 further reduces effector T cell activation by allergen extracts and may be a useful adjuvant for SIT. PMID:24884430

Fruit and vegetables and cancer risk: a review of southern European studies.

PubMed

Turati, Federica; Rossi, Marta; Pelucchi, Claudio; Levi, Fabio; La Vecchia, Carlo

2015-04-01

High intakes of fruit and vegetables may reduce the risk of cancer at several sites. Evidence has been derived mainly from case-control studies. We reviewed the relationship between consumption of vegetables and fruit and the risk of several common cancers in a network of Italian and Swiss case-control studies including over 10,000 cases of fourteen different cancers and about 17,000 controls. Data were suggestive of a protective role of vegetable intake on the risk of several common epithelial cancers. OR for the highest compared with the lowest levels of consumption ranged from 0.2 (larynx, oral cavity and pharynx) to 0.9 (prostate). Inverse associations were found for both raw and cooked vegetables, although for upper digestive tract cancers the former were somewhat stronger. Similar inverse associations were found for cruciferous vegetables. Frequent consumption of allium vegetables was also associated with reduced risk of several cancers. Fruit was a favourable correlate of the risk of several cancers, particularly of the upper digestive tract, with associations generally weaker than those reported for vegetables. A reduced risk of cancers of the digestive tract and larynx was found for high consumption of citrus fruit. Suggestive protections against several forms of cancer, mainly digestive tract cancers, were found for high consumption of apples and tomatoes. High intakes of fibres, flavonoids and proanthocyanidins were inversely related to various forms of cancer. In conclusion, data from our series of case-control studies suggested a favourable role of high intakes of fruit and vegetables in the risk of many common cancers, particularly of the digestive tract. This adds evidence to the indication that aspects of the Mediterranean diet may have a favourable impact not only on CVD, but also on several common (epithelial) cancers, particularly of the digestive tract.

Early breastfeeding practices: Descriptive analysis of recent Demographic and Health Surveys

PubMed Central

Benova, Lenka; Macleod, David; Lynch, Caroline A.; Campbell, Oona M. R.

2017-01-01

Abstract The aim of this study was to describe early breastfeeding practices (initiation within 1 hr of birth, no prelacteal feeding, and a combination of both—“optimal” early breastfeeding) according to childbirth location in low‐ and middle‐income countries. Using data from the most recent Demographic and Health Survey (2000–2013) for 57 countries, we extracted information on the most recent birth for women aged 15–49 with a live birth in the preceding 24 months. Childbirth setting was self‐reported by location (home or facility) and subtype (home delivery with or without a skilled birth attendant; public or private facility). We produced overall world and four region‐level summary statistics by applying national population adjusted survey weights. Overall, 39% of children were breastfed within 1 hr of birth (region range 31–60%), 49% received no prelacteal feeding (41–65%), and 28% benefited from optimal early breastfeeding (21–46%). In South/Southeast Asia and Sub‐Saharan Africa, early breastfeeding outcomes were more favourable for facility births compared to home births; trends were less consistent in Latin America and Middle East/Europe. Among home deliveries, there was a higher prevalence of positive breastfeeding practices for births with a skilled birth attendant across all regions other than Latin America. For facility births, breastfeeding practices were more favourable among those taking place in the public sector. This study is the most comprehensive assessment to date of early breastfeeding practices by childbirth location. Our results suggest that skilled delivery care—particularly care delivered in public sector facilities—appears positively correlated with favourable breastfeeding practices. PMID:29034551

Effect of major lifestyle risk factors, independent and jointly, on life expectancy with and without cardiovascular disease: results from the Consortium on Health and Ageing Network of Cohorts in Europe and the United States (CHANCES).

PubMed

O'Doherty, Mark G; Cairns, Karen; O'Neill, Vikki; Lamrock, Felicity; Jørgensen, Torben; Brenner, Hermann; Schöttker, Ben; Wilsgaard, Tom; Siganos, Galatios; Kuulasmaa, Kari; Boffetta, Paolo; Trichopoulou, Antonia; Kee, Frank

2016-05-01

Seldom have studies taken account of changes in lifestyle habits in the elderly, or investigated their impact on disease-free life expectancy (LE) and LE with cardiovascular disease (CVD). Using data on subjects aged 50+ years from three European cohorts (RCPH, ESTHER and Tromsø), we used multi-state Markov models to calculate the independent and joint effects of smoking, physical activity, obesity and alcohol consumption on LE with and without CVD. Men and women aged 50 years who have a favourable lifestyle (overweight but not obese, light/moderate drinker, non-smoker and participates in vigorous physical activity) lived between 7.4 (in Tromsø men) and 15.7 (in ESTHER women) years longer than those with an unfavourable lifestyle (overweight but not obese, light/moderate drinker, smoker and does not participate in physical activity). The greater part of the extra life years was in terms of "disease-free" years, though a healthy lifestyle was also associated with extra years lived after a CVD event. There are sizeable benefits to LE without CVD and also for survival after CVD onset when people favour a lifestyle characterized by salutary behaviours. Remaining a non-smoker yielded the greatest extra years in overall LE, when compared to the effects of routinely taking physical activity, being overweight but not obese, and drinking in moderation. The majority of the overall LE benefit is in disease free years. Therefore, it is important for policy makers and the public to know that prevention through maintaining a favourable lifestyle is "never too late".

Resveratrol food supplements: a survey on the role of individual consumer characteristics in predicting the attitudes and adoption intentions of US American and Danish respondents.

PubMed

Aschemann-Witzel, Jessica; Grunert, Klaus G

2015-02-10

Consumers increasingly choose food supplements in addition to their diet. Research on supplement users finds they are likely to be female, older and well-educated; Furthermore, supplement users are often characterised as being especially health-oriented, an observation which is termed the 'inverse supplement hypothesis'. However, results are dependent on the substance in question. Little is known so far about botanicals in general, and more specifically, little is known about resveratrol. The psychographic variables of food supplement users are yet relatively underexplored. By comparing US and Danish respondents, we aimed to identify whether sociodemographic variables, health status, health beliefs and behaviour and interest in food aspects specifically relevant to resveratrol (e.g., naturalness, indulgence, and Mediterranean food) explain favourable attitudes and adoption intentions toward resveratrol supplements. A survey sent to a representative online panel in the United States and Denmark was analysed using linear regression. We find that sociodemographic variables contribute little to explaining favourable attitudes toward and adoption intentions of resveratrol supplements, except for the negative association with higher education in the United States. The inverse supplement hypothesis was not confirmed. Belief in the favourable health effects of resveratrol and usage of complementary and alternative medicine positively affect attitudes and adoption intention. An interest in the indulgence dimension of food explains positive attitudes in the United States and adoption intentions in both countries. The results indicate that potential consumers of resveratrol supplements are identified by their usage of complementary and alternative medicine, rather than by sociodemographic variables. They are not characterised by especially healthy behaviours, which contradicts the inverse supplement hypothesis. Instead, potential consumers of resveratrol supplements may be characterised by their focus on the indulgence dimension of food.

Quality of care in for-profit and not-for-profit nursing homes: systematic review and meta-analysis

PubMed Central

Comondore, Vikram R; Zhou, Qi; Stone, Samuel B; Busse, Jason W; Ravindran, Nikila C; Burns, Karen E; Haines, Ted; Stringer, Bernadette; Cook, Deborah J; Walter, Stephen D; Sullivan, Terrence; Berwanger, Otavio; Bhandari, Mohit; Banglawala, Sarfaraz; Lavis, John N; Petrisor, Brad; Schünemann, Holger; Walsh, Katie; Bhatnagar, Neera; Guyatt, Gordon H

2009-01-01

Objective To compare quality of care in for-profit and not-for-profit nursing homes. Design Systematic review and meta-analysis of observational studies and randomised controlled trials investigating quality of care in for-profit versus not-for-profit nursing homes. Results A comprehensive search yielded 8827 citations, of which 956 were judged appropriate for full text review. Study characteristics and results of 82 articles that met inclusion criteria were summarised, and results for the four most frequently reported quality measures were pooled. Included studies reported results dating from 1965 to 2003. In 40 studies, all statistically significant comparisons (P<0.05) favoured not-for-profit facilities; in three studies, all statistically significant comparisons favoured for-profit facilities, and the remaining studies had less consistent findings. Meta-analyses suggested that not-for-profit facilities delivered higher quality care than did for-profit facilities for two of the four most frequently reported quality measures: more or higher quality staffing (ratio of effect 1.11, 95% confidence interval 1.07 to 1.14, P<0.001) and lower pressure ulcer prevalence (odds ratio 0.91, 95% confidence interval 0.83 to 0.98, P=0.02). Non-significant results favouring not-for-profit homes were found for the two other most frequently used measures: physical restraint use (odds ratio 0.93, 0.82 to 1.05, P=0.25) and fewer deficiencies in governmental regulatory assessments (ratio of effect 0.90, 0.78 to 1.04, P=0.17). Conclusions This systematic review and meta-analysis of the evidence suggests that, on average, not-for-profit nursing homes deliver higher quality care than do for-profit nursing homes. Many factors may, however, influence this relation in the case of individual institutions. PMID:19654184

Attitudes towards people with physical or intellectual disabilities among nursing, social work and medical students.

PubMed

Kritsotakis, George; Galanis, Petros; Papastefanakis, Emmanouil; Meidani, Flora; Philalithis, Anastas E; Kalokairinou, Athena; Sourtzi, Panayota

2017-12-01

To examine and compare undergraduate healthcare students' attitudes towards people with physical or intellectual disabilities in Greece. The experience that people with disabilities have with health care is a complex interaction between their medical condition and the social and physical environment. Attitudes of the nursing and healthcare staff affect the quality of care and people's adaptation to their disability, self-image and rehabilitation outcomes. Descriptive cross-sectional survey. Nursing, Social Work and Medicine students (N = 1007, 79.4% female) attending three universities (Athens, Crete) completed during 2014-2016 two standardised scales regarding physical (ATDP-B) and intellectual disability (CLAS-ID). Descriptive and multivariate logistic regression analyses were performed. Attitudes towards people with physical disabilities in Greece (ATDP-B scores) were poor with scores just above the mid-point. Medical studies and higher knowledge and work with individuals with physical disabilities signified marginally more positive attitudes. Gender and age displayed no associations with attitudes. Regarding intellectual disability (CLAS-ID scores), nursing students had slightly less positive attitudes in "Similarity" but more positive attitudes in "Sheltering" subscales. Previous work and contact was related to more favourable and higher age to less favourable "Similarity" and "Sheltering" attitudes. Males had higher "Exclusion" scores. Those who knew people with intellectual disabilities had less favourable "Empowerment" attitudes. Knowledge was related to more positive attitudes in all four CLAS-ID subscales. Greek health and social care students showed poor attitudes towards people with physical and intellectual disability. When holding unfavourable attitudes, healthcare professionals become less involved with the people they care for and they do not provide nursing care to the best of their abilities. Undergraduate and continuing education, along with workplace enhancements, should aim to provide high-quality health care to people with disabilities. © 2017 John Wiley & Sons Ltd.

An ESS treatment of the pattern of female arrival at the mating site in the yellow dung fly scathophaga stercoraria (L.)

PubMed

Reuter; Ward; Blanckenhorn

1998-12-07

In most previous work on the yellow dung fly Scathophaga stercoraria (L.), as on other species, adaptive explanations have been sought for male behaviour whereas female behaviour has not been examined in similar detail. Here, the arrival of females at the mating site, fresh cattle droppings, is investigated. While almost all males are present shortly after pat deposition females arrive at a low, decreasing rate over an interval of about 5 hours. We propose that the distribution of female arrival times represents a mixed Evolutionarily Stable Strategy (ESS), formed by different trade-offs between costs and benefits of early and late arrival. Early arrival could be favoured by advantages due to better conditions for oviposition, faster egg development of reduced larval competition. Late arrival could be favoured by negative effects on females of male-male competition being weaker later after deposition. Computer simulations with distributions of arrival times deviating from the natural one were performed to "measure" the costs for females arriving at different times. These costs were compared with estimated benefits corresponding to the females' arrival times. This procedure revealed that females coming to the pat later in a population of females arriving shortly after deposition would be favoured. In a population arriving according to a uniform distribution, early females would have fitness advantages. Thus, evolution should lead to an intermediate distribution of arrival times, as in nature, i.e. female arrival behaviour is probably adaptive. The simulations also revealed that the intensity of sexual selection though male-male competition is highest with the natural pattern of female arrival. Therefore, natural selection generating this pattern amplifies the intensity of male-male interaction as a by-product. Copyright 1998 Academic Press

Does the addition of two exercise-focussed home visits to usual care improve outcomes for patients with balance impairments? A randomized controlled trial.

PubMed

Whitbourne, Craig; Shields, Nora; Tacey, Mark; Koh, Kenneth Wz; Lawler, Katherine; Hill, Keith D

2018-03-01

To investigate whether two additional home visits improve outcomes for rehabilitation outpatients with balance impairments compared to usual care. Randomized controlled trial. Outpatient rehabilitation. Fifty with balance impairments. Both groups received usual care including weekly group exercise over eight weeks. The intervention group received two home visits to individualize home exercises. Primary outcome measure was the Balance Outcome Measure for Elder Rehabilitation (BOOMER) score, and secondary outcomes included force platform measures using the NeuroCom Balance Master ® , assessed at baseline, after intervention and three-month follow-up. There was no between-group difference for BOOMER score. There were significant between-group differences in favour of the intervention group for limits of stability reaction time at week 9 (mean difference (MD) -0.27, 95% confidence interval (CI) -0.44 to -0.09) and week 22 (MD -0.28, 95% CI -0.45 to -0.10) and for limits of stability maximal excursion at week 9 (MD 8.66, 95% CI 1.67 to 15.65) and week 22 (MD 14.58, 95% CI 7.59 to 21.57). Significant between-group differences favoured the control group for Clinical Test of Sensory Interaction of Balance at week 9 (MD 0.40, 95% CI 0.13 to 0.66) and week 22 (MD 0.45, 95% CI 0.18 to 0.72) and step quick turn time at week 9 (MD 0.56, 95% CI 0.02 to 1.10). Two exercise-focussed home visits improved some dynamic balance outcomes in older patients with balance impairments. Some outcomes showed significant improvements with small effect sizes in favour of the control group which may be chance findings or because they completed a standard home exercise programme.

Comparative study on the treatment of Rockwood type III acute acromioclavicular dislocation: Clinical results from the TightRope® technique vs. K-wire fixation.

PubMed

Horst, K; Garving, C; Thometzki, T; Lichte, P; Knobe, M; Dienstknecht, T; Hofman, M; Pape, H-C

2017-04-01

The aim of this study was to address the inconsistency regarding the operative treatment of Rockwood type III acromioclavicular joint separation. We compared results after single- and double TightRope ® reduction with results after acromioclavicular transfixation via K-wires only and additional ligament augmentation in acute acromioclavicular (AC) joint separations graded Rockwood type III, and hypothesized that the TightRope ® technique leads to better clinical and radiological results. We conducted a retrospective clinical cohort study and included 42 consecutive patients (mean age 43 years [24-66]) diagnosed and operatively treated between 2004 and 2012 (mean follow-up was 54.6 months [15-118]). Specific shoulder scores as well as scores reflecting the patients' overall mental and physical health status were used. Radiological evaluation was also performed. The SF12 test revealed comparability between all subgroups. Specific shoulder tests and a visual analogue scale demonstrated comparable results. Radiographic measurements showed a significant reduction in the AC distance and CC distance after surgery in all subgroups. The early complication rate was 9.5% for all patients, while late complications occurred in 14.3% of all cases. Compared to the established methods, the operative TightRope ® procedures represent a safe alternative in Rockwood III injuries. All investigated techniques predominantly led to good and excellent clinical results in acute Rockwood type III AC joint instabilities. Avoidance of material removal and shorter hospital stays appear to speak in favour for the TightRope ® technique. IV. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Extracorporeal life support during cardiac arrest and cardiogenic shock: a systematic review and meta-analysis.

PubMed

Ouweneel, Dagmar M; Schotborgh, Jasper V; Limpens, Jacqueline; Sjauw, Krischan D; Engström, A E; Lagrand, Wim K; Cherpanath, Thomas G V; Driessen, Antoine H G; de Mol, Bas A J M; Henriques, José P S

2016-12-01

Veno-arterial extracorporeal life support (ECLS) is increasingly used in patients during cardiac arrest and cardiogenic shock, to support both cardiac and pulmonary function. We performed a systematic review and meta-analysis of cohort studies comparing mortality in patients treated with and without ECLS support in the setting of refractory cardiac arrest and cardiogenic shock complicating acute myocardial infarction. We systematically searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and the publisher subset of PubMed updated to December 2015. Thirteen studies were included of which nine included cardiac arrest patients (n = 3098) and four included patients with cardiogenic shock after acute myocardial infarction (n = 235). Data were pooled by a Mantel-Haenzel random effects model and heterogeneity was examined by the I 2 statistic. In cardiac arrest, the use of ECLS was associated with an absolute increase of 30 days survival of 13 % compared with patients in which ECLS was not used [95 % CI 6-20 %; p < 0.001; number needed to treat (NNT) 7.7] and a higher rate of favourable neurological outcome at 30 days (absolute risk difference 14 %; 95 % CI 7-20 %; p < 0.0001; NNT 7.1). Propensity matched analysis, including 5 studies and 438 patients (219 in both groups), showed similar results. In cardiogenic shock, ECLS showed a 33 % higher 30-day survival compared with IABP (95 % CI, 14-52 %; p < 0.001; NNT 13) but no difference when compared with TandemHeart/Impella (-3 %; 95 % CI -21 to 14 %; p = 0.70; NNH 33). In cardiac arrest, the use of ECLS was associated with an increased survival rate as well as an increase in favourable neurological outcome. In the setting of cardiogenic shock there was an increased survival with ECLS compared with IABP.

Is body-weight-supported treadmill training or robotic-assisted gait training superior to overground gait training and other forms of physiotherapy in people with spinal cord injury? A systematic review.

PubMed

Mehrholz, J; Harvey, L A; Thomas, S; Elsner, B

2017-08-01

Systematic review about randomised trials comparing different training strategies to improve gait in people with spinal cord injuries (SCI). The aim of this systematic review was to compare the effectiveness of body-weight-supported treadmill training (BWSTT) and robotic-assisted gait training with overground gait training and other forms of physiotherapy in people with traumatic SCI. Systematic review conducted by researchers from Germany and Australia. An extensive search was conducted for randomised controlled trials involving people with traumatic SCI that compared either BWSTT or robotic-assisted gait training with overground gait training and other forms of physiotherapy. The two outcomes of interest were walking speed (m s -1 ) and walking distance (m). BWSTT and robotic-assisted gait training were analysed separately, and data were pooled across trials to derive mean between-group differences using a random-effects model. Thirteen randomised controlled trials involving 586 people were identified. Ten trials involving 462 participants compared BWSTT to overground gait training and other forms of physiotherapy, but only nine trials provided useable data. The pooled mean (95% confidence interval (CI)) between-group differences for walking speed and walking distance were -0.03 m s -1 (-0.10 to 0.04) and -7 m (-45 to 31), respectively, favouring overground gait training. Five trials involving 344 participants compared robotic-assisted gait training to overground gait training and other forms of physiotherapy but only three provided useable data. The pooled mean (95% CI) between-group differences for walking speed and walking distance were -0.04 m s -1 (95% CI -0.21 to 0.13) and -6 m (95% CI -86 to 74), respectively, favouring overground gait training. BWSTT and robotic-assisted gait training do not increase walking speed more than overground gait training and other forms of physiotherapy do, but their effects on walking distance are not clear.

Robust extraction of functional signals from gene set analysis using a generalized threshold free scoring function

PubMed Central

2009-01-01

Background A central task in contemporary biosciences is the identification of biological processes showing response in genome-wide differential gene expression experiments. Two types of analysis are common. Either, one generates an ordered list based on the differential expression values of the probed genes and examines the tail areas of the list for over-representation of various functional classes. Alternatively, one monitors the average differential expression level of genes belonging to a given functional class. So far these two types of method have not been combined. Results We introduce a scoring function, Gene Set Z-score (GSZ), for the analysis of functional class over-representation that combines two previous analysis methods. GSZ encompasses popular functions such as correlation, hypergeometric test, Max-Mean and Random Sets as limiting cases. GSZ is stable against changes in class size as well as across different positions of the analysed gene list in tests with randomized data. GSZ shows the best overall performance in a detailed comparison to popular functions using artificial data. Likewise, GSZ stands out in a cross-validation of methods using split real data. A comparison of empirical p-values further shows a strong difference in favour of GSZ, which clearly reports better p-values for top classes than the other methods. Furthermore, GSZ detects relevant biological themes that are missed by the other methods. These observations also hold when comparing GSZ with popular program packages. Conclusion GSZ and improved versions of earlier methods are a useful contribution to the analysis of differential gene expression. The methods and supplementary material are available from the website http://ekhidna.biocenter.helsinki.fi/users/petri/public/GSZ/GSZscore.html. PMID:19775443

Different Views about Work-Hour Limitations in Medicine: A Qualitative Content Analysis of Surgeons', Lawyers', and Pilots' Positive and Negative Arguments

PubMed Central

Businger, Adrian P.; Kaderli, Reto M.

2014-01-01

Background Whereas work-hour regulations have been taken for granted since 1940 in other occupational settings, such as commercial aviation, they have been implemented only recently in medical professions, where they lead to a lively debate. The aim of the present study was to evaluate arguments in favour of and against work-hour limitations in medicine given by Swiss surgeons, lawyers, and pilots. Methods An electronic questionnaire survey with four free-response items addressing the question of what arguments speak in favour of or against work-hour limitations in general and in medicine was sent to a random sample of board-certified surgeons, lawyers in labour law, and pilots from SWISS International Airlines Ltd. Results In all, 279/497 (56%) of the respondents answered the survey: 67/117 surgeons, 92/226 lawyers, and 120/154 pilots. Support for work-hour limitations in general and in medicine was present and higher among lawyers and pilots than it was in surgeons (p<0.001). The latter agreed more with work-hour limitations in general than in medicine (p<0.001). The most often cited arguments in favour of work-hour limitations were “quality and patient safety,” “health and fitness,” and “leisure and work-family balance,” whereas the lack of “flexibility” was the most important argument against. Surgeons expected more often that their “education” and the “quality of their work” would be threatened (p<0.001). Conclusions Work-hour limitations should be supported in medicine also, but a way must be found to reduce problems resulting from discontinuity in patient care and to minimise the work in medicine, which has no education value. PMID:25419712

Relationship between physical activity and cognitive function in apparently healthy young to middle-aged adults: A systematic review.

PubMed

Cox, Eka Peng; O'Dwyer, Nicholas; Cook, Rebecca; Vetter, Melanie; Cheng, Hoi Lun; Rooney, Kieron; O'Connor, Helen

2016-08-01

There is increasing evidence that physical activity (PA) positively affects cognitive function (CF). Existing research has focussed on this association in children and the elderly, with less research available in young to middle-aged adults who constitute a substantial proportion of the population. A systematic review investigating the relationship between habitual PA (≥12 months) and CF in young to middle-aged adults (18-50 years). A search was conducted using AMED, CINAHL, MEDLINE, PsychINFO, AUSPORT MED and SPORTDiscus databases. Eligible studies had to report descriptive statistics for CF and PA levels in healthy participants 18-50 years. Effect sizes (ES) (Hedges g) were calculated where possible. The initial search netted 26,988 potentially relevant manuscripts, with four more identified through hand searching. Fourteen were included for review. A range of validated platforms assessed CF across three domains: executive function (12 studies), memory (four studies) and processing speed (seven studies). Habitual PA was assessed via questionnaire/self-report methods (n=13, 8 validated) or accelerometers (n=1). In studies of executive function, five found a significant ES in favour of higher PA, ranging from small to large. Although three of four studies in the memory domain reported a significant benefit of higher PA, there was only one significant ES, which favoured low PA. Only one study examining processing speed had a significant ES, favouring higher PA. A limited body of evidence supports a positive effect of PA on CF in young to middle-aged adults. Further research into this relationship at this age stage is warranted. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Association between funding, risk of bias, and outcome of randomised controlled trials in oral and maxillofacial surgery.

PubMed

Oomens, M A E M; Lazzari, S; Heymans, M W; Forouzanfar, T

2016-01-01

The influence of funding on the main outcome of a random control trial (RCT) is important, as it could potentially lead to bias towards industry, and results that are too optimistic. We investigated the association between funding, the published outcome, and the risk of bias in trials in oral and maxillofacial surgery (OMFS) published from January 2000 to May 2013 listed in PubMed. The methods used were scored using the risk of bias items given in a Delphi List. Sources of funding were recorded and categorised five ways: not funded, funded by industry, not funded by industry, supported by industry, and source of funds not clear. A total of 390 RCT met the inclusion criteria, and there was a correlation between funding and favourable main outcomes, although this was not significant. There was no correlation between the risk of bias and favourable results of the main outcome of a trial, or between the risk of bias and the reported source of funding in post-hoc analysis. We were unable to show a significant correlation between funding and a higher likelihood of a favourable result for the primary outcome in RCT in OMFS. We also failed to show a significant correlation between the risk of bias of a trial and its main outcome. In contrast, the source of funding proved to affect the risk of bias of a trial significantly, although not in post-hoc analysis. Funded trials were better organised, and so had a lower risk of bias. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Is pollen removal or seed set favoured by flower longevity in a hummingbird-pollinated Salvia species?

PubMed Central

Aximoff, Izar Araujo; Freitas, Leandro

2010-01-01

Background and Aims The period between the beginning of anthesis and flower senescence modulates the transport of pollen by pollinators among conspecific flowers, and its length may therefore influence reproductive success. This study evaluated whether floral longevity favours pollen removal from the anthers over fecundity (seed set) in an ornithophilous species that does not undergo pollen limitation. Methods Field investigations were conducted on floral longevity, nectar production, pollinator behaviour, and variations in fruit set (FS), mean number of seeds per fruit (MSF) and pollen removal by hummingbirds (PR) during the anthesis of Salvia sellowiana in south-east Brazil. Key Results Anthesis of flowers exposed to pollinators lasted 4 d, as well as on flowers with pollen removed from the anthers or deposited on the stigma. The longevity of bagged flowers was significantly higher (approx. 9 d). FS and PR reached 87·2 and 90 %, respectively, in natural conditions. PR increased gradually over the period of anthesis; however, FS and MSF reached their maxima in the first hours of anthesis. Nectar production was continuous, but the secretion rate was reduced after pollination. The removal of nectar from non-pollinated flowers stimulated its production. Conclusions The longevity of anthesis in S. sellowiana seems to be related to the mechanism of gradual dispensing of pollen, resulting in greater male reproductive success. This is in agreement with the pollen-donation hypothesis. The small number of ovules (four) of S. sellowiana and the high frequency and the foraging mode of its pollinators may favour the selection for floral longevity driven by male fitness in this system. PMID:20622254

The Physics of Thermoelectric Energy Conversion

NASA Astrophysics Data System (ADS)

Goldsmid, H. Julian

2017-04-01

This book outlines the principles of thermoelectric generation and refrigeration from the discovery of the Seebeck and Peltier effects in the 19th century through the introduction of semiconductor thermoelements in the mid-20th century to the more recent development of nanostructured materials. The conditions for favourable electronic properties are discussed. The methods for selecting materials with a low lattice thermal conductivity are outlined and the ways in which the scattering of phonons can be enhanced are described. The book is aimed at readers without specialised knowledge.

Trends in risk factors for coronary heart disease in the Netherlands.

PubMed

Koopman, C; Vaartjes, I; Blokstra, A; Verschuren, W M M; Visser, M; Deeg, D J H; Bots, M L; van Dis, I

2016-08-19

Favourable trends in risk factor levels in the general population may partly explain the decline in coronary heart disease (CHD) morbidity and mortality. Our aim was to present long-term national trends in established risk factors for CHD. Data were obtained from five data sources including several large scale population based surveys, cohort studies and general practitioner registers between 1988 and 2012. We applied linear regression models to age-standardized time trends to test for statistical significant trends. Analyses were stratified by sex and age (younger <65 and older ≥65 years adults). The results demonstrated favourable trends in smoking (except in older women) and physical activity (except in older men). Unfavourable trends were found for body mass index (BMI) and diabetes mellitus prevalence. Although systolic blood pressure (SBP) and total cholesterol trends were favourable for older persons, SBP and total cholesterol remained stable in younger persons. Four out of six risk factors for CHD showed a favourable or stable trend. The rise in diabetes mellitus and BMI is worrying with respect to CHD morbidity and mortality.

Nanostructured KTaTeO6 and Ag-doped KTaTeO6 Defect Pyrochlores: Promising Photocatalysts for Dye Degradation and Water Splitting

NASA Astrophysics Data System (ADS)

Venkataswamy, Perala; Sudhakar Reddy, CH.; Gundeboina, Ravi; Sadanandam, Gullapelli; Veldurthi, Naveen Kumar; Vithal, M.

2018-03-01

In this study, the nanostructured parent KTaTeO6 (KTTO) and Ag-doped KTaTeO6 (ATTO) catalysts with defect pyrochlore structure were prepared by solid-state and ion-exchange methods, respectively. The synthesized materials were characterized by various techniques to determine their chemical composition, morphology and microstructural features. The XRD studies show that both KTTO and ATTO have cubic structure (space group Fd3m) with high crystallinity. The doping of Ag altered the BET surface area of parent KTTO. The nano nature of the samples was studied by TEM images. A considerable red-shift in the absorption edge is observed for ATTO compared to KTTO. Incorporation of Ag+ in the KTTO lattice is clearly identified from EDX, elemental mapping and XPS results. Degradation of methyl violet and solar water splitting reactions were used to access the photocatalytic activity of KTTO and ATTO. The results obtained suggest that compared to KTTO, the ATTO showed higher photocatalytic activity in both cases. The favourable properties such as high surface area, more surface hydroxyl groups, stronger light absorption in visible region and narrower band gap energy were supposed to be the reasons for the high activity observed in ATTO.

Advances in satellite remote sensing of environmental variables for epidemiological applications.

PubMed

Goetz, S J; Prince, S D; Small, J

2000-01-01

Earth-observing satellites have provided an unprecedented view of the land surface but have been exploited relatively little for the measurement of environmental variables of particular relevance to epidemiology. Recent advances in techniques to recover continuous fields of air temperature, humidity, and vapour pressure deficit from remotely sensed observations have significant potential for disease vector monitoring and related epidemiological applications. We report on the development of techniques to map environmental variables with relevance to the prediction of the relative abundance of disease vectors and intermediate hosts. Improvements to current methods of obtaining information on vegetation properties, canopy and surface temperature and soil moisture over large areas are also discussed. Algorithms used to measure these variables incorporate visible, near-infrared and thermal infrared radiation observations derived from time series of satellite-based sensors, focused here primarily but not exclusively on the Advanced Very High Resolution Radiometer (AVHRR) instruments. The variables compare favourably with surface measurements over a broad array of conditions at several study sites, and maps of retrieved variables captured patterns of spatial variability comparable to, and locally more accurate than, spatially interpolated meteorological observations. Application of multi-temporal maps of these variables are discussed in relation to current epidemiological research on the distribution and abundance of some common disease vectors.

Nitrogen and sulfur dual-doped chitin-derived carbon/graphene composites as effective metal-free electrocatalysts for dye sensitized solar cells

NASA Astrophysics Data System (ADS)

Di, Yi; Xiao, Zhanhai; Yan, Xiaoshuang; Ru, Geying; Chen, Bing; Feng, Jiwen

2018-05-01

The photovoltaic performance of dye-sensitized solar cell (DSSC) is strongly influenced by the electrocatalytic ability of its counter electrode (CE) materials. To obtain the affordable and high-performance electrocatalysts, the N/S dual-doped chitin-derived carbon materials SCCh were manufactured via in-situ S-doped method in the annealing process, where richer active sites are created compared to the pristine chitin-derived carbon matrix CCh, thus enhancing the intrinsic catalytic activity of carbon materials. When SCCh is incorporated with graphene, the yielded composites hold a further boosted catalytic activity due to facilitating the electronic fast transfer. The DSSC assembled with the optimizing rGO-SCCh-3 composite CE shows a favourable power conversion efficiency of 6.36%, which is comparable with that of the Pt-sputtering electrode (6.30%), indicate of the outstanding I3- reduction ability of the composite material. The electrochemical characterizations demonstrate that the low charge transfer resistance and excellent electrocatalytic activity all contribute to the superior photovoltaic performance. More importantly, the composite CE exhibits good electrochemical stability in the practical operation. In consideration of the low cost and the simple preparation procedure, the present metal-free carbonaceous composites could be used as a promising counter electrode material in future large scale production of DSSCs.

Land-based crop phenotyping by image analysis: Accurate estimation of canopy height distributions using stereo images.

PubMed

Cai, Jinhai; Kumar, Pankaj; Chopin, Joshua; Miklavcic, Stanley J

2018-01-01

In this paper we report on an automated procedure to capture and characterize the detailed structure of a crop canopy by means of stereo imaging. We focus attention specifically on the detailed characteristic of canopy height distribution-canopy shoot area as a function of height-which can provide an elaborate picture of canopy growth and health under a given set of conditions. We apply the method to a wheat field trial involving ten Australian wheat varieties that were subjected to two different fertilizer treatments. A novel camera self-calibration approach is proposed which allows the determination of quantitative plant canopy height data (as well as other valuable phenotypic information) by stereo matching. Utilizing the canopy height distribution to provide a measure of canopy height, the results compare favourably with manual measurements of canopy height (resulting in an R2 value of 0.92), and are indeed shown to be more consistent. By comparing canopy height distributions of different varieties and different treatments, the methodology shows that different varieties subjected to the same treatment, and the same variety subjected to different treatments can respond in much more distinctive and quantifiable ways within their respective canopies than can be captured by a simple trait measure such as overall canopy height.

Parking, energy consumption and air pollution.

PubMed

Höglund, Paul G

2004-12-01

This paper examines the impacts of different ways of parking on environmental effects, mainly vehicle emissions and air pollution. Vehicle energy consumption and the urban air quality at street level, related to location and design of parking establishments, need to be assessed and quantified. In addition, the indoor parking environment needs attention. This paper gives a description of a methodological approach when comparing different parking establishments. The paper also briefly describes a Swedish attempt to create methods and models for assessing and quantifying such problem. The models are the macrolevel model BRAHE, for regional traffic exhaust emission, and the micromodel SimPark, a parking search model attempt combined with emission models. Until now, very limited knowledge exists regarding the various aspects of vehicle parking and environmental effects in the technical field as well as in the social and human behaviour aspects. This requires an interdisciplinary approach to this challenging area for research, development and more directly practically implemented surveys and field studies. In order to illustrate the new evaluation methodology, the paper also contains some results from a pilot study in Stockholm. Given certain assumptions, a study of vehicle emissions from parking in an underground garage compared with kerbside parking has given an emission reduction of about 40% in favour of the parking garage. This study has been done using the models mentioned above.

Comparison of Transverse Intraosseous Loop Technique and Pull Out Suture for Reinsertion of the Flexor Digitorum Profundus tendon. A Retrospective Study.

PubMed

Rigó, István Zoltán; Røkkum, Magne

2013-12-01

We compared the results of two methods for reinsertion of flexor digitorum profundus tendons retrospectively. In 35 fingers of 29 patients pull-out suture and in 13 fingers of 11 patients transverse intraosseous loop technique was performed with a mean follow-up of 8 and 6 months, respectively. Eleven and nine fingers achieved "excellent" or "good" function according to Strickland and Glogovac at 8 weeks; 20 and ten at the last control in the pull-out and transverse intraosseous loop groups, respectively. The difference at 8 weeks was statistically significant in favour of the transverse intraosseous loop group. Ten patients underwent 12 complications in the pull-out group (four superficial infections; one rerupture, one PIP and one DIP joint contracture, one adhesion, two granulomas, one nail deformity and one carpal tunnel syndrome) and four of them were reoperated (one carpal tunnel release, one teno-arthrolysis and two resections of granuloma). There was no complication and no reoperation in the transverse intraosseous loop group, the difference being statistically significant for the former. In our study the transverse intraosseous loop technique seemed to be a safe alternative with possibly better functional results compared to the pull-out suture.

Enhancement of biogas production from food waste and sewage sludge - Environmental and economic life cycle performance.

PubMed

Eriksson, Ola; Bisaillon, Mattias; Haraldsson, Mårten; Sundberg, Johan

2016-06-15

Management of municipal solid waste is an efficient method to increase resource efficiency, as well as to replace fossil fuels with renewable energy sources due to that (1) waste to a large extent is renewable as it consists of food waste, paper, wood etc. and (2) when energy and materials are recovered from waste treatment, fossil fuels can be substituted. In this paper results from a comprehensive system study of future biological treatment of readily degradable waste in two Swedish regions are presented. Different collection and separation systems for food waste in households have been applied as well as technical improvements of the biogas process as to reduce environmental impact. The results show that central sorting of a mixed fraction into recyclables, combustibles, biowaste and inert is a competitive option compared to source separation. Use of pellets is beneficial compared to direct spreading as fertiliser. Fuel pellets seem to be the most favourable option, which to a large extent depends on the circumstances in the energy system. Separation and utilisation of nitrogen in the wet part of the digestion residue is made possible with a number of technologies which decreases environmental impact drastically, however to a substantial cost in some cases. Copyright © 2016 Elsevier Ltd. All rights reserved.

The effect of age, genotype and sex on carcass traits, meat quality and sensory attributes of geese

PubMed Central

2018-01-01

Objective The aim of this study was to compare carcass traits, meat quality and sensory attributes in two different genotypes of geese according to age and sex. Methods The experiment was carried out on 160 birds of two genotypes of geese: the Czech Goose (CG) breed and a Eskildsen Schwer (ES) hybrid. One-d-old goslings were divided into four groups according to genotype and sex. Two dates for slaughtering (at 8 and 16 wk of age of goslings) were undertaken. Results The slaughter weight, cold carcass weight and dressing percentage were affected by all the studied factors, and significant interactions between age, genotype and sex were detected in the slaughter weight (p<0.001) and cold carcass weight (p = 0.004). The pH was not affected by any of studied factors, whereas in terms of meat colour parameters there were observed significant effects of age on L* and b* value and a significant effect of sex on a* value. The meat fat content was higher (p = 0.002) in ES. Higher score for overall acceptance of goose meat was recorded for ES at both ages compared to CG. Conclusion ES had higher dressing percentage and better sensory attributes, whereas CG exceled in the favourable nutritional value of the meat. PMID:28823138

Comparing reliabilities of strip and conventional patch testing.

PubMed

Dickel, Heinrich; Geier, Johannes; Kreft, Burkhard; Pfützner, Wolfgang; Kuss, Oliver

2017-06-01

The standardized protocol for performing the strip patch test has proven to be valid, but evidence on its reliability is still missing. To estimate the parallel-test reliability of the strip patch test as compared with the conventional patch test. In this multicentre, prospective, randomized, investigator-blinded reliability study, 132 subjects were enrolled. Simultaneous duplicate strip and conventional patch tests were performed with the Finn Chambers ® on Scanpor ® tape test system and the patch test preparations nickel sulfate 5% pet., potassium dichromate 0.5% pet., and lanolin alcohol 30% pet. Reliability was estimated by the use of Cohen's kappa coefficient. Parallel-test reliability values of the three standard patch test preparations turned out to be acceptable, with slight advantages for the strip patch test. The differences in reliability were 9% (95%CI: -8% to 26%) for nickel sulfate and 23% (95%CI: -16% to 63%) for potassium dichromate, both favouring the strip patch test. The standardized strip patch test method for the detection of allergic contact sensitization in patients with suspected allergic contact dermatitis is reliable. Its application in routine clinical practice can be recommended, especially if the conventional patch test result is presumably false negative. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

PEG spacer gel and adaptive planning vs single plan in external prostate radiotherapy—clinical dosimetry evaluation

PubMed Central

2015-01-01

Objective: Spacer gel is used to reduce the rectal dose in prostate radiotherapy. It is injected to increase the distance between the prostate and rectum. During the course of external radiotherapy treatment, physiological changes in rectal volume exist. When using polyethylene glycol material, such as DuraSeal® (Covidien, Mansfield, MA), gel resorption also occurs. Together, these factors alter the original dose plan distribution. Methods: External dose planning and calculations were simulated using images acquired from 10 patients who were treated with brachytherapy and gel. The CT series was taken relative to gel injection: pre 1 day, post 1 day, post 1 month and post 2 months. Adaptive planning was compared with a single plan. Results: Adaptive planning shows better results compared with the single plan used in the total treatment course; however, the effect is minor. Conclusion: Gel usage is clearly favourable to rectal DVH. Using adaptive planning with gel improves rectal DVH but is not necessary according to this study. Advances in knowledge: Spacer gel is used in prostate radiotherapy to increase distance between the prostate and the rectum, thus reducing the rectal doses. During the treatment course, gel resorption exists which affects the rectal doses. The usefulness of adaptive planning to compensate this resorption effect has not been studied before. PMID:26370300

Validation of an automatic system (DoubleCage) for detecting the location of animals during preference tests.

PubMed

Tsai, P P; Nagelschmidt, N; Kirchner, J; Stelzer, H D; Hackbarth, H

2012-01-01

Preference tests have often been performed for collecting information about animals' acceptance of environmental refinement objects. In numerous published studies animals were individually tested during preference experiments, as it is difficult to observe group-housed animals with an automatic system. Thus, videotaping is still the most favoured method for observing preferences of socially-housed animals. To reduce the observation workload and to be able to carry out preference testing of socially-housed animals, an automatic recording system (DoubleCage) was developed for determining the location of group-housed animals in a preference test set-up. This system is able to distinguish the transition of individual animals between two cages and to record up to 16 animals at the same time (four animals per cage). The present study evaluated the reliability of the DoubleCage system. The data recorded by the DoubleCage program and the data obtained by human observation were compared. The measurements of the DoubleCage system and manual observation of the videotapes are comparable and significantly correlated (P < 0.0001) with good agreement. Using the DoubleCage system enables precise and reliable recording of the preferences of group-housed animals and a considerable reduction of animal observation time.

Robust Notion Vision For A Vehicle Moving On A Plane

NASA Astrophysics Data System (ADS)

Moni, Shankar; Weldon, E. J.

1987-05-01

A vehicle equipped with a cemputer vision system moves on a plane. We show that subject to certain constraints, the system can determine the motion of the vehicle (one rotational and two translational degrees of freedom) and the depth of the scene in front of the vehicle. The constraints include limits on the speed of the vehicle, presence of texture on the plane and absence of pitch and roll in the vehicular motion. It is possible to decouple the problems of finding the vehicle's motion and the depth of the scene in front of the vehicle by using two rigidly connected cameras. One views a field with known depth (i.e. the ground plane) and estimates the motion parameters and the other determines the depth map knowing the motion parameters. The motion is constrained to be planar to increase robustness. We use a least squares method of fitting the vehicle motion to observer brightness gradients. With this method, no correspondence between image points needs to be established and information fran the entire image is used in calculating notion. The algorithm performs very reliably on real image sequences and these results have been included. The results compare favourably to the performance of the algorithm of Negandaripour and Horn [2] where six degrees of freedom are assumed.

Management of primary achalasia: The role of endoscopy

PubMed Central

Luján-Sanchis, Marisol; Suárez-Callol, Patricia; Monzó-Gallego, Ana; Bort-Pérez, Inmaculada; Plana-Campos, Lydia; Ferrer-Barceló, Luis; Sanchis-Artero, Laura; Llinares-Lloret, María; Tuset-Ruiz, Juan Antonio; Sempere-Garcia-Argüelles, Javier; Canelles-Gamir, Pilar; Medina-Chuliá, Enrique

2015-01-01

Achalasia is an oesophageal motor disorder which leads to the functional obstruction of the lower oesophageal sphincter (LES) and is currently incurable. The main objective of all existing therapies is to achieve a reduction in the obstruction of the distal oesophagus in order to improve oesophageal transit, relieve the symptomatology, and prevent long-term complications. The most common treatments used are pneumatic dilation (PD) and laparoscopic Heller myotomy, which involves partial fundoplication with comparable short-term success rates. The most economic non-surgical therapy is PD, with botulinum toxin injections reserved for patients with a higher surgical risk for whom the former treatment option is unsuitable. A new technology is peroral endoscopic myotomy, postulated as a possible non-invasive alternative to surgical myotomy. Other endoluminal treatments subject to research more recently include injecting ethanolamine into the LES and using a temporary self-expanding metallic stent. At present, there is not enough evidence permitting a routine recommendation of any of these three novel methods. Patients must undergo follow-up after treatment to guarantee that their symptoms are under control and to prevent complications. Most experts are in favour of some form of endoscopic follow-up, however no established guidelines exist in this respect. The prognosis for patients with achalasia is good, although a recurrence after treatment using any method requires new treatment. PMID:26078828

Evaluation of a real-time PCR assay for malaria diagnosis in patients from Vietnam and in returned travellers.

PubMed

Vo, Thi Kim Duy; Bigot, Patricia; Gazin, Pierre; Sinou, Veronique; De Pina, Jean Jacques; Huynh, Dinh Chien; Fumoux, Francis; Parzy, Daniel

2007-05-01

Real-time PCR diagnosis of malaria has advantages over traditional microscopic methods, especially when parasitaemia is low and when dealing with mixed infections. We have developed a new real-time PCR with specific genes in each Plasmodium species present only in one copy to identify the four pathogenic Plasmodium spp. for humans. The sensitivity was less than 25 parasites/microl. No cross-hybridisation was observed with human DNA or among the four Plasmodium spp. Using LightCycler PCR and conventional microscopy, we compared the diagnosis of malaria in patients from Vietnam and in returned European travellers with suspicion of malaria. In patients from Vietnam with suspicion of malaria, one mixed infection was observed by PCR only; the remaining data (54 of 55 patients) correlated with microscopy. In 79 patients without symptoms, low parasitaemia was detected in 7 samples by microscopy and in 16 samples by PCR. In returned travellers, PCR results were correlated with microscopy for all four species in 48 of 56 samples. The eight discrepant results were resolved in favour of real-time PCR diagnosis. This new real-time PCR is a rapid, accurate and efficient method for malaria diagnosis in returned travellers as well as for epidemiological studies or antimalarial efficiency trials in the field.

Insulin Dynamics in Young Women with Polycystic Ovary Syndrome and Normal Glucose Tolerance across Categories of Body Mass Index

PubMed Central

Manco, Melania; Castagneto-Gissey, Lidia; Arrighi, Eugenio; Carnicelli, Annamaria; Brufani, Claudia; Luciano, Rosa; Mingrone, Geltrude

2014-01-01

Background Evidence favours insulin resistance and compensatory hyperinsulinemia as the predominant, perhaps primary, defects in polycystic ovary syndrome (PCOS). The aim of the present study was to evaluate insulin metabolism in young women with PCOS but normal glucose tolerance as compared with age, body mass index and insulin resistance-matched controls to answer the question whether women with PCOS hypersecrete insulin in comparison to appropriately insulin resistance-matched controls. Research Design and Methods Sixty-nine cases were divided according to their body mass index (BMI) in normal-weight (N = 29), overweight (N = 24) and obese patients (N = 16). Controls were 479 healthy women (age 16–49 y). Whole body Insulin Sensitivity (WBISI), fasting, and total insulin secretion were estimated following an oral glucose tolerance test (C-peptide deconvolution method). Results Across classes of BMI, PCOS patients had greater insulin resistance than matched controls (p<0.0001 for all the comparisons), but they showed higher fasting and total insulin secretion than their age, BMI and insulin resistance-matched peers (p<0.0001 for all the comparisons). Conclusion Women with PCOS show higher insulin resistance but also larger insulin secretion to maintain normal glucose homeostasis than age-, BMI- and insulin resistance-matched controls. PMID:24705280

The Effects of Exercise Training in Addition to Energy Restriction on Functional Capacities and Body Composition in Obese Adults during Weight Loss: A Systematic Review

PubMed Central

Miller, Clint T.; Fraser, Steve F.; Levinger, Itamar; Straznicky, Nora E.; Dixon, John B.; Reynolds, John; Selig, Steve E.

2013-01-01

Background Obesity is associated with impairments of physical function, cardiovascular fitness, muscle strength and the capacity to perform activities of daily living. This review examines the specific effects of exercise training in relation to body composition and physical function demonstrated by changes in cardiovascular fitness, and muscle strength when obese adults undergo energy restriction. Methods Electronic databases were searched for randomised controlled trials comparing energy restriction plus exercise training to energy restriction alone. Studies published to May 2013 were included if they used multi-component methods for analysing body composition and assessed measures of fitness in obese adults. Results Fourteen RCTs met the inclusion criteria. Heterogeneity of study characteristics prevented meta-analysis. Energy restriction plus exercise training was more effective than energy restriction alone for improving cardiovascular fitness, muscle strength, and increasing fat mass loss and preserving lean body mass, depending on the type of exercise training. Conclusion Adding exercise training to energy restriction for obese middle-aged and older individuals results in favourable changes to fitness and body composition. Whilst weight loss should be encouraged for obese individuals, exercise training should be included in lifestyle interventions as it offers additional benefits. PMID:24409219

Parenting style in relation to pathogenic and protective factors of Type A behaviour pattern.

PubMed

Castro, J; de Pablo, J; Toro, J; Valdés, M

1999-07-01

Studies of type A behaviour pattern suggest that it can be promoted as a whole by certain parental rearing styles. However, the association of the different components of the type A behaviour with specific rearing practices has not been clarified. The relationship between parents' rearing style and the different type A behaviour components of their children was analysed in a sample of 312 university students. Parental rearing style was assessed with the EMBU, a Swedish measure originally designed to assess one's recollections concerning one's parents rearing behaviour. Type A pattern was measured by the JAS, a self-administered questionnaire that gives the global type A score and three of its components. Hard Driving was related to Rejection and Favouring Subject in males. Speed-Impatience was related to Rejection and Control in both sexes, and Job Involvement was related to Control and Favouring Subject in females. In a discriminant factor analysis in males, Rejection, Control and Favouring Subject on the part of fathers classified correctly 80% of the subjects identified as having high or low Speed-Impatience and the variables of Rejection and Favouring Subject (also by fathers) classified correctly 69.23% of the subjects identified as high or low Hard Driving. In females, Control and Favouring Subject on the part of mothers and low Rejection by fathers classified correctly 70.37% of the subjects with high or low Job Involvement. These results suggest that different rearing characteristics are related to the various components of the type A behaviour pattern.

Comparing quantitative analysis on revealed comparative advantages of aquatic products trade of china and ASEAN based on 21st century maritime silk road

NASA Astrophysics Data System (ADS)

Luo, X. F.; Han, Y. H.; Li, Z. W.

2017-11-01

As the world’s leading aquaculture, aquatic production and trading country, China’s development of aquatic products trade with ASEAN is facing a historic opportunity in the favourable circumstances of construction of the 21st century Maritime Silk Road. In order to make guidance of the product selection and transformation for corresponding export enterprises, this article makes a quantitative analysis the Revealed Comparative Advantage of aquatic products trade from China and ASEAN respectively based on the HS classification and thoroughly compares the RCA indices. The comparison results show that the international competitiveness of aquatic products structures of China and ASEAN are quite different with few overlaps of strong competitive products, and there is a great gap between the two areas in many kinds of products.

Assessment of the National Park network of mainland Spain by the Insecurity Index of vertebrate species.

PubMed

Estrada, Alba; Real, Raimundo

2018-01-01

The evaluation of protected area networks on their capacity to preserve species distributions is a key topic in conservation biology. There are different types of protected areas, with National Parks those with highest level of protection. National Parks can be declared attending to many ecological features that include the presence of certain animal species. Here, we selected 37 vertebrate species that were highlighted as having relevant natural value for at least one of the 10 National Parks of mainland Spain. We modelled species distributions with the favourability function, and applied the Insecurity Index to detect the degree of protection of favourable areas for each species. Two metrics of Insecurity Index were defined for each species: the Insecurity Index in each of the cells, and the Overall Insecurity Index of a species. The former allows the identification of insecure areas for each species that can be used to establish spatial conservation priorities. The latter gives a value of Insecurity for each species, which we used to calculate the Representativeness of favourable areas for the species in the network. As expected, due to the limited extension of the National Park network, all species have high values of Insecurity; i.e., just a narrow proportion of their favourable areas are covered by a National Park. However, the majority of species favourable areas are well represented in the network, i.e., the percentage of favourable areas covered by the National Park network is higher than the percentage of mainland Spain covered by the network (result also supported by a randomization approach). Even if a reserve network only covers a low percentage of a country, the Overall Insecurity Index allows an objective assessment of its capacity to represent species. Beyond the results presented here, the Insecurity Index has the potential to be extrapolated to other areas and to cover a wide range of species.

Ethical values in emergency medical services: A pilot study.

PubMed

Bremer, Anders; Herrera, María Jiménez; Axelsson, Christer; Martí, Dolors Burjalés; Sandman, Lars; Casali, Gian Luca

2015-12-01

Ambulance professionals often address conflicts between ethical values. As individuals' values represent basic convictions of what is right or good and motivate behaviour, research is needed to understand their value profiles. To translate and adapt the Managerial Values Profile to Spanish and Swedish, and measure the presence of utilitarianism, moral rights and/or social justice in ambulance professionals' value profiles in Spain and Sweden. The instrument was translated and culturally adapted. A content validity index was calculated. Pilot tests were carried out with 46 participants. This study conforms to the ethical principles for research involving human subjects and adheres to national laws and regulations concerning informed consent and confidentiality. Spanish professionals favoured justice and Swedish professionals' rights in their ambulance organizations. Both countries favoured utilitarianism least. Gender differences across countries showed that males favoured rights. Spanish female professionals favoured justice most strongly of all. Swedes favour rights while Spaniards favour justice. Both contexts scored low on utilitarianism focusing on total population effect, preferring the opposite, individualized approach of the rights and justice perspectives. Organizational investment in a utilitarian perspective might jeopardize ambulance professionals' moral right to make individual assessments based on the needs of the patient at hand. Utilitarianism and a caring ethos appear as stark opposites. However, a caring ethos in its turn might well involve unreasonable demands on the individual carer's professional role. Since both the justice and rights perspectives portrayed in the survey mainly concern relationship to the organization and peers within the organization, this relationship might at worst be given priority over the equal treatment and moral rights of the patient. A balanced view on ethical perspectives is needed to make professionals observant and ready to act optimally - especially if these perspectives are used in patient care. Research is needed to clarify how justice and rights are prioritized by ambulance services and whether or not these organization-related values are also implemented in patient care. © The Author(s) 2014.

Characteristics and outcomes of young adults who suffered an out-of-hospital cardiac arrest (OHCA).

PubMed

Chia, Michael Yih-Chong; Lu, Qing Shu; Rahman, Nik Hisamuddin; Doctor, Nausheen Edwin; Nishiuchi, Tatsuya; Leong, Benjamin Sieu-Hon; Tham, Lai Peng; Goh, E-Shaun; Tiah, Ling; Monsomboon, Apichaya; Ong, Marcus Eng Hock

2017-02-01

There is paucity of data examining the incidence and outcomes of young OHCA adults. The aim of this study is to determine the outcomes and characteristics of young adults who suffered an OHCA and identify factors that are associated with favourable neurologic outcomes. All EMS-attended OHCA adults between the ages of 16 and 35 years in the Pan-Asian Resuscitation Outcomes Study (PAROS) registry were analysed. The primary outcome was favourable neurologic outcome (Cerebral Performance Category 1 or 2) at hospital discharge or at 30th day post OHCA if not discharged. Regression analysis was performed to identify factors associated with favourable neurologic outcomes. 66,780 OHCAs were collected between January 2009 and December 2013; 3244 young OHCAs had resuscitation attempted by emergency medical services (EMS). 56.8% of patients had unwitnessed arrest; 47.9% were of traumatic etiology. 17.2% of patients (95% CI: 15.9-18.5%) had return of spontaneous circulation; 7.8% (95% CI: 6.9-8.8%) survived to one month; 4.6% (95% CI: 4.0-5.4%) survived with favourable neurologic outcomes. Factors associated with favourable neurologic outcomes include witnessed arrest (adjusted RR=2.42, p-value<0.0001), bystander CPR (adjusted RR=1.57, p-value=0.004), first arrest shockable rhythm (adjusted RR=27.24, p-value<0.0001), and cardiac etiology (adjusted RR=3.99, p-value<0.0001). OHCA among young adults are not uncommon. Traumatic OHCA, occurring most frequently in young adults had dismal prognosis. First arrest rhythms of VF/VT/unknown shockable rhythm, cardiac etiology, bystander-witnessed arrest, and bystander CPR were associated with favourable neurological outcomes. The results of the study would be useful for planning preventive and interventional strategies, improving EMS, and guiding future research. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Discharge Planning in Chronic Conditions

PubMed Central

McMartin, K

2013-01-01

Background Chronically ill people experience frequent changes in health status accompanied by multiple transitions between care settings and care providers. Discharge planning provides support services, follow-up activities, and other interventions that span pre-hospital discharge to post-hospital settings. Objective To determine if discharge planning is effective at reducing health resource utilization and improving patient outcomes compared with standard care alone. Data Sources A standard systematic literature search was conducted for studies published from January 1, 2004, until December 13, 2011. Review Methods Reports, randomized controlled trials, systematic reviews, and meta-analyses with 1 month or more of follow-up and limited to specified chronic conditions were examined. Outcomes included mortality/survival, readmissions and emergency department (ED) visits, hospital length of stay (LOS), health-related quality of life (HRQOL), and patient satisfaction. Results One meta-analysis compared individualized discharge planning to usual care and found a significant reduction in readmissions favouring individualized discharge planning. A second meta-analysis compared comprehensive discharge planning with postdischarge support to usual care. There was a significant reduction in readmissions favouring discharge planning with postdischarge support. However, there was significant statistical heterogeneity. For both meta-analyses there was a nonsignificant reduction in mortality between the study arms. Limitations There was difficulty in distinguishing the relative contribution of each element within the terms “discharge planning” and “postdischarge support.” For most studies, “usual care” was not explicitly described. Conclusions Compared with usual care, there was moderate quality evidence that individualized discharge planning is more effective at reducing readmissions or hospital LOS but not mortality, and very low quality evidence that it is more effective at improving HRQOL or patient satisfaction. Compared with usual care, there was low quality evidence that the discharge planning plus postdischarge support is more effective at reducing readmissions but not more effective at reducing hospital LOS or mortality. There was very low quality evidence that it is more effective at improving HRQOL or patient satisfaction. Plain Language Summary Chronically ill people experience frequent changes in their health status and multiple transitions between care settings and care providers (e.g., hospital to home). Discharge planning provides support services, follow-up activities and other interventions that span pre-hospital discharge to post-hospital settings. A review of the effects of different discharge plans was conducted. After searching for relevant studies, 11 studies were found that compared discharge planning with routine discharge care. This review indicates that: Individualized discharge planning reduces initial hospital length of stay and subsequent readmission to hospital but does not reduce mortality. The effect on health-related quality of life (HRQOL) or patient satisfaction is uncertain. Discharge planning plus postdischarge support reduces readmissions but does not reduce the initial hospital length of stay or mortality after discharge. The effect on HRQOL or patient satisfaction is uncertain. PMID:24167538

Do high school chemistry examinations inhibit deeper level understanding of dynamic reversible chemical reactions?

NASA Astrophysics Data System (ADS)

Wheeldon, R.; Atkinson, R.; Dawes, A.; Levinson, R.

2012-07-01

Background and purpose : Chemistry examinations can favour the deployment of algorithmic procedures like Le Chatelier's Principle (LCP) rather than reasoning using chemical principles. This study investigated the explanatory resources which high school students use to answer equilibrium problems and whether the marks given for examination answers require students to use approaches beyond direct application of LCP. Sample : The questionnaire was administered to 162 students studying their first year of advanced chemistry (age 16/17) in three high achieving London high schools. Design and methods : The students' explanations of reversible chemical systems were inductively coded to identify the explanatory approaches used and interviews with 13 students were used to check for consistency. AS level examination questions on reversible reactions were analysed to identify the types of explanations sought and the students' performance in these examinations was compared to questionnaire answers. Results : 19% of students used a holistic explanatory approach: when the rates of forward and reverse reactions are correctly described, recognising their simultaneous and mutually dependent nature. 36% used a mirrored reactions approach when the connected nature of the forward and reverse reactions is identified, but not their mutual dependency. 42% failed to recognize the interdependence of forward and reverse reactions (reactions not connected approach). Only 4% of marks for AS examination questions on reversible chemical systems asked for responses which went beyond either direct application of LCP or recall of equilibrium knowledge. 37% of students attained an A grade in their AS national examinations. Conclusions : Examinations favour the application of LCP making it possible to obtain the highest grade with little understanding of reversible chemical systems beyond a direct application of this algorithm. Therefore students' understanding may be attenuated so that they are unable to use kinetic sub-micro level ideas which will support the building of deeper energetic conceptions at university.

The effect of girls attitudes towards the health benefits of food on selected dietary characteristics. The GEBahealth Project.

PubMed

Zaborowicz, Katarzyna; Czarnocińska, Jolanta; Wądołowska, Lidia; Kowalkowska, Joanna; Jeżewska-Zychowicz, Marzena; Babicz-Zielińska, Ewa; Sobaś, Kamila; Kozirok, Witold

2015-01-01

Dietary habits are formed at an early age and to a large extent they affect such nutritional behaviour in adulthood. Mothers in particular, influence family nutrition. In this respect, their knowledge, attitudes and behaviour about nutrition are responsible for the schooling of future generations. Many aspects of the link between food and health with nutritional behaviour in girls remain, however, unknown. To determine the effect of girls attitudes towards the health benefits of food on selected dietary characteristics. Study included 186 girls aged 13-21 years. Using a food frequency method the three dietary characteristics were obtained; food intake variety, fibre intake and fat intake, all of them expressed by a graded scale. Three validated questionnaires were used; FIVeQ, BSQFVF and BSQF. The girls attitudes towards the health benefits of food were rated from one of the survey's six parts, comprising of 8 statements from the Health and Taste Attitude Scale (HTAS) accordingly graded. Statistical analyses used logistic regression. The mean index of food intake variety was 28.7 foods/week (ranging 0-60), whilst the mean dietary intakes of fibre and fat were 16.7 points (0-36 range) and 18.2 points (0-52 range), respectively. Girls from the upper tertile with favourable attitudes on food health benefits had an odds ratio (OR) for adequate fat intake (<22 points) of 3.1 (95% CI: 1.28, 7.52; p<0.05), as compared to those from the middle-neutral attitudes tertile, with an OR = 1.00. The ORs for the relatively high food intake variety and acceptable fibre intake were 1.05 in girls from the positive-upper tertiles, which were not significant. The positive attitudes of girls towards the health benefits of food are conducive for making more favourable food choices and lowered dietary fat intake, however this did not significantly affect fibre intake nor food intake variety.

Outcome predictors of radical cystectomy in patients with cT4 prostate cancer: a multi-institutional study of 62 patients.

PubMed

Spahn, Martin; Morlacco, Alessandro; Boxler, Silvan; Joniau, Steven; Briganti, Alberto; Montorsi, Francesco; Gontero, Paolo; Bader, Pia; Frohneberg, Detlef; van Poppel, Hein; Karnes, Robert Jeffrey

2017-11-01

To identify which patients with macroscopic bladder-infiltrating T4 prostate cancer (PCa) might have favourable outcomes when treated with radical cystectomy (RC). We evaluated 62 patients with cT4cN0-1 cM0 PCa treated with RC and pelvic lymph node dissection between 1972 and 2011. In addition to descriptive statistics, the Kaplan-Meier method and log-rank tests were used to depict survival rates. Univariate and multivariate Cox regression analysis tested the association between predictors and progression-free, PCa-specific and overall survival. Of the 62 patients, 19 (30.6%) did not have clinical progression during follow-up, two (3.2%) had local recurrence, and 32 (51.6%) had haematogenous and nine (14.5%) combined pelvic and distant metastasis. Forty patients (64.5%) died, 34 (54.8%) from PCa and six (9.7%) from other causes. The median (range) survival time of the 19 patients who were metastasis-free at last follow-up was 86 (1-314) months, 8/19 patients had a follow-up of >5 years, and five patients survived metastasis-free for >15 years. Patients without seminal vesicle invasion (SVI) had the best outcomes, with an estimated 10-year PCa-specific survival of 75% compared with 24% for patients with SVI. For cT4 PCa RC can be an appropriate treatment for local control and part of a multimodality-treatment approach. Although recurrences are probable, these do not necessarily translate into cancer-specific death. Men without SVI had a 75% 10-year PCa-specific survival. Although outcomes for patients with SVI are not as favourable, there can be good local control; however, these patients are at higher risk of progression and may need more aggressive systemic treatment. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

To drink or not to drink: Harmful drinking is associated with hyperactivation of reward areas rather than hypoactivation of control areas in men

PubMed Central

Stuke, Heiner; Gutwinski, Stefan; Wiers, Corinde E.; Schmidt, Timo T.; Gröpper, Sonja; Parnack, Jenny; Gawron, Christiane; Attar, Catherine Hindi; Spengler, Stephanie; Walter, Henrik; Heinz, Andreas; Bermpohl, Felix

2016-01-01

Background The maintenance of harmful alcohol use can be considered a reiterated decision in favour of alcohol in concrete drinking occasions. These decisions are often made despite an intention to quit or reduce alcohol consumption. We tested if a hyperactive reward system and/or an impaired cognitive control system contribute to such unfavourable decision-making. Methods In this fMRI study, men with modest to harmful drinking behaviour, which was measured using the Alcohol Use Disorders Identification Test (AUDIT), repeatedly made decisions between alcoholic and nonalcoholic drinks. Based on prior individual ratings, decision pairs were created with an alcoholic decision option considered more desirable but less beneficial by the participant. By correlating AUDIT scores with brain activation during decision-making, we determined areas explicitly related to pro-alcohol decisions in men with greater drinking severity. Results Thirty-eight men participated in our study. Behaviourally, we found a positive correlation between AUDIT scores and the number of decisions for desired alcoholic drinks compared with beneficial nonalcoholic drinks. The fMRI results show that AUDIT scores were positively associated with activation in areas associated with reward and motivation processing (i.e., ventral striatum, amygdala, medial prefrontal cortex) during decisions favouring a desired, nonbeneficial alcoholic drink. Conversely, we did not find hypoactivation in areas associated with self-control (dorsolateral prefrontal cortex). These effects were not present when participants chose a desired, nonbenefical, nonalcoholic drink. Limitations The men participating in our study had to be abstinent and would potentially consume an alcoholic drink at the end of the experiment. Hence, we did not define manifest alcohol dependence as an inclusion criterion and instead focused on less severely affected individuals. Conclusion Our results indicate that with growing drinking severity, decisions for alcoholic drinks are associated with increasing activity in reward-associated neural systems, rather than decreasing activity in self-control–associated systems. PMID:26900791

Evolution under domestication: ongoing artificial selection and divergence of wild and managed Stenocereus pruinosus (Cactaceae) populations in the Tehuacán Valley, Mexico

PubMed Central

Parra, Fabiola; Casas, Alejandro; Peñaloza-Ramírez, Juan Manuel; Cortés-Palomec, Aurea C.; Rocha-Ramírez, Víctor; González-Rodríguez, Antonio

2010-01-01

Background and Aims The Tehuacán Valley in Mexico is a principal area of plant domestication in Mesoamerica. There, artificial selection is currently practised on nearly 120 native plant species with coexisting wild, silvicultural and cultivated populations, providing an excellent setting for studying ongoing mechanisms of evolution under domestication. One of these species is the columnar cactus Stenocereus pruinosus, in which we studied how artificial selection is operating through traditional management and whether it has determined morphological and genetic divergence between wild and managed populations. Methods Semi-structured interviews were conducted with 83 households of three villages to investigate motives and mechanisms of artificial selection. Management effects were studied by comparing variation patterns of 14 morphological characters and population genetics (four microsatellite loci) of 264 plants from nine wild, silvicultural and cultivated populations. Key Results Variation in fruit characters was recognized by most people, and was the principal target of artificial selection directed to favour larger and sweeter fruits with thinner or thicker peel, fewer spines and pulp colours others than red. Artificial selection operates in agroforestry systems favouring abundance (through not felling plants and planting branches) of the preferred phenotypes, and acts more intensely in household gardens. Significant morphological divergence between wild and managed populations was observed in fruit characters and plant vigour. On average, genetic diversity in silvicultural populations (HE = 0·743) was higher than in wild (HE = 0·726) and cultivated (HE = 0·700) populations. Most of the genetic variation (90·58 %) occurred within populations. High gene flow (NmFST > 2) was identified among almost all populations studied, but was slightly limited by mountains among wild populations, and by artificial selection among wild and managed populations. Conclusions Traditional management of S. pruinosus involves artificial selection, which, despite the high levels of gene flow, has promoted morphological divergence and moderate genetic structure between wild and managed populations, while conserving genetic diversity. PMID:20729372

Conflicts of interest and spin in reviews of psychological therapies: a systematic review

PubMed Central

Lieb, Klaus; von der Osten-Sacken, Jan; Stoffers-Winterling, Jutta; Reiss, Neele; Barth, Jürgen

2016-01-01

Objective To explore conflicts of interest (COI) and their reporting in systematic reviews of psychological therapies, and to evaluate spin in the conclusions of the reviews. Methods MEDLINE and PsycINFO databases were searched for systematic reviews published between 2010 and 2013 that assessed effects of psychological therapies for anxiety, depressive or personality disorders, and included at least one randomised controlled trial. Required COI disclosure by journal, disclosed COI by review authors, and the inclusion of own primary studies by review authors were extracted. Researcher allegiance, that is, that researchers concluded favourably about the interventions they have studied, as well as spin, that is, differences between results and conclusions of the reviews, were rated by 2 independent raters. Results 936 references were retrieved, 95 reviews fulfilled eligibility criteria. 59 compared psychological therapies with other forms of psychological therapies, and 36 psychological therapies with pharmacological interventions. Financial, non-financial, and personal COI were disclosed in 22, 4 and 1 review, respectively. 2 of 86 own primary studies of review authors included in 34 reviews were disclosed by review authors. In 15 of the reviews, authors showed an allegiance effect to the evaluated psychological therapy that was never disclosed. Spin in review conclusions was found in 27 of 95 reviews. Reviews with a conclusion in favour of psychological therapies (vs pharmacological interventions) were at high risk for a spin in conclusions (OR=8.31 (1.41 to 49.05)). Spin was related in trend to the inclusion of own primary studies in the systematic review (OR=2.08 (CI 0.83 to 5.18) p=0.11) and researcher allegiance (OR=2.63 (0.84 to 8.16) p=0.16). Conclusions Non-financial COI, especially the inclusion of own primary studies into reviews and researcher allegiance, are frequently seen in systematic reviews of psychological therapies and need more transparency and better management. PMID:27118287

Cardiovascular disease, diabetes and established risk factors among populations of sub-Saharan African descent in Europe: a literature review

PubMed Central

Agyemang, Charles; Addo, Juliet; Bhopal, Raj; de Graft Aikins, Ama; Stronks, Karien

2009-01-01

Background Most European countries are ethnically and culturally diverse. Globally, cardiovascular disease (CVD) is the leading cause of death. The major risk factors for CVD have been well established. This picture holds true for all regions of the world and in different ethnic groups. However, the prevalence of CVD and related risk factors vary among ethnic groups. Methods This article provides a review of current understanding of the epidemiology of vascular disease, principally coronary heart disease (CHD), stroke and related risk factors among populations of Sub-Sahara African descent (henceforth, African descent) in comparison with the European populations in Europe. Results Compared with European populations, populations of African descent have an increased risk of stroke, whereas CHD is less common. They also have higher rates of hypertension and diabetes than European populations. Obesity is highly prevalent, but smoking rate is lower among African descent women. Older people of African descent have more favourable lipid profile and dietary habits than their European counterparts. Alcohol consumption is less common among populations of African descent. The rate of physical activity differs between European countries. Dutch African-Suriname men and women are less physically active than the White-Dutch whereas British African women are more physically active than women in the general population. Literature on psychosocial stress shows inconsistent results. Conclusion Hypertension and diabetes are highly prevalent among African populations, which may explain their high rate of stroke in Europe. The relatively low rate of CHD may be explained by the low rates of other risk factors including a more favourable lipid profile and the low prevalence of smoking. The risk factors are changing, and on the whole, getting worse especially among African women. Cohort studies and clinical trials are therefore needed among these groups to determine the relative contribution of vascular risk factors, and to help guide the prevention efforts. There is a clear need for intervention studies among these populations in Europe. PMID:19671137

Physical activity and associated socio-demographic factors in adolescents from the eastern region of Poland

PubMed

Wasilewska, Małgorzata; Bergier, Józef

The introduction and maintenance of healthy habits in the field of physical activity at the early stage of life is particularly important for public health. With increasing of public awareness in physical activity, researchers are increasingly questioning its determinants in different age groups. In this paper we focus on variables such as age, sex and place of residence. To determine what selected socio-demographic factors influence the level of physical activity of school youth from the eastern region of Poland in different domains of daily life. A random sample of 916 Polish school youth from Secondary Schools from Eastern Region of Poland aged 16-18 was interviewed in spring 2016 by diagnostic survey method with the use of the official Polish long version of the International Physical Activity Questionnaire (IPAQ). Analysing the relationship between gender and the level of physical activity statistically significant differences were found in all domains in favour of boys. The level of total physical activity in girls was 5345.5 MET-min./week, whereas in boys – 6556.6 MET-min./week. In the area of total physical activity, the highest values were observed in pupils from small towns and villages, with lower values in the youth living in large and medium-sized cities. When the relationship of age with the level of physical activity in particular domains was examined, only the activity in the work/ school domain (p = 0.0129) spoke in favour of the youngest pupils (2578.7 MET-min./week) when compared to the oldest ones (2226.4 MET-min./week). The level of physical activity in young people from the Eastern region of Poland is decreasing with age, both in girls and boys. It is therefore important, especially for the group emerging adulthood, to offer a wide variety of updated, involving, age and gender-oriented school physical activity classes that could be easily practised outside the school environment to improve the level of physical activity in leisure domain

Mapping global surface water inundation dynamics using synergistic information from SMAP, AMSR2 and Landsat

NASA Astrophysics Data System (ADS)

Du, J.; Kimball, J. S.; Galantowicz, J. F.; Kim, S.; Chan, S.; Reichle, R. H.; Jones, L. A.; Watts, J. D.

2017-12-01

A method to monitor global land surface water (fw) inundation dynamics was developed by exploiting the enhanced fw sensitivity of L-band (1.4 GHz) passive microwave observations from the Soil Moisture Active Passive (SMAP) mission. The L-band fw (fwLBand) retrievals were derived using SMAP H-polarization brightness temperature (Tb) observations and predefined L-band reference microwave emissivities for water and land endmembers. Potential soil moisture and vegetation contributions to the microwave signal were represented from overlapping higher frequency Tb observations from AMSR2. The resulting fwLBand global record has high temporal sampling (1-3 days) and 36-km spatial resolution. The fwLBand annual averages corresponded favourably (R=0.84, p<0.001) with a 250-m resolution static global water map (MOD44W) aggregated at the same spatial scale, while capturing significant inundation variations worldwide. The monthly fwLBand averages also showed seasonal inundation changes consistent with river discharge records within six major US river basins. An uncertainty analysis indicated generally reliable fwLBand performance for major land cover areas and under low to moderate vegetation cover, but with lower accuracy for detecting water bodies covered by dense vegetation. Finer resolution (30-m) fwLBand results were obtained for three sub-regions in North America using an empirical downscaling approach and ancillary global Water Occurrence Dataset (WOD) derived from the historical Landsat record. The resulting 30-m fwLBand retrievals showed favourable classification accuracy for water (commission error 31.84%; omission error 28.08%) and land (commission error 0.82%; omission error 0.99%) and seasonal wet and dry periods when compared to independent water maps derived from Landsat-8 imagery. The new fwLBand algorithms and continuing SMAP and AMSR2 operations provide for near real-time, multi-scale monitoring of global surface water inundation dynamics, potentially benefiting hydrological monitoring, flood assessments, and global climate and carbon modeling.

Impact of collaterals on the efficacy and safety of endovascular treatment in acute ischaemic stroke: a systematic review and meta-analysis.

PubMed

Leng, Xinyi; Fang, Hui; Leung, Thomas W H; Mao, Chen; Miao, Zhongrong; Liu, Liping; Wong, Ka Sing; Liebeskind, David S

2016-05-01

We aimed to investigate the role of pretreatment collateral status in predicting the efficacy and safety of endovascular treatment (EVT) in acute ischaemic stroke due to cervical and/or cerebral arterial occlusions. Relevant full-text articles published since 1 January 2000, investigating correlations between collateral status and any efficacy or safety outcome in patients undergoing EVT in cohort or case-control studies, or randomised clinical trials, were retrieved by PubMed and manual search. Two authors extracted data from eligible studies and assessed study quality. Risk ratios (RR) were pooled for good versus poor collaterals for outcomes based on a random-effects model. Sensitivity and subgroup analyses were conducted. In total, 35 (3542 participants) and 23 (2652 participants) studies were included in qualitative review and quantitative meta-analysis, respectively. Overall, good pretreatment collaterals increased the rate of favourable functional outcome at 3 months (RR=1.98, 95% CI 1.64 to 2.38; p<0.001), and reduced the risks of periprocedural symptomatic intracranial haemorrhage (RR=0.59, 95% CI 0.43 to 0.81; p=0.001) and 3-month mortality (RR=0.49, 95% CI 0.38 to 0.63; p<0.001), as compared with poor collaterals, in patients with acute ischaemic stroke under EVT. No individual study could alter the estimate of overall effect of collateral status, but there were moderate to significant heterogeneities between subgroups of studies with different modes of EVT, different arterial occlusions and different collateral grading methods. Good pretreatment collateral status is associated with higher rates of favourable functional outcome, and lower rates of symptomatic intracranial haemorrhage and mortality, in patients with acute ischaemic stroke receiving endovascular therapies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Effect evaluation of a two-year complex intervention to reduce loneliness in non-institutionalised elderly Dutch people

PubMed Central

2013-01-01

Background Public health policy calls for intervention programmes to reduce loneliness in the ageing population. So far, numerous loneliness interventions have been developed, with effectiveness demonstrated for few of these interventions. The loneliness intervention described in this manuscript distinguishes itself from others by including multiple intervention components and targeting individuals and their environment. Intervention components included a mass media campaign, information meetings, psychosocial group courses, social activities organised by neighbours, and training of intermediaries. The aim of this manuscript is to study the effects of this integrated approach on initial and long-term outcomes. Methods A quasi-experimental pre-test post-test intervention study was conducted among non-institutionalised elderly people aged 65 years and over to evaluate the effectiveness of the intervention by comparing the intervention community and the control community. Data on outputs, initial and long-term outcomes, and the overall goal were collected by self-administered questionnaires. Data of 858 elderly people were available for the analyses. To assess the effect linear regression analyses with adjustments for age, gender, church attendance, and mental health were used. In addition, the process evaluation provided information about the reach of the intervention components. Results After two years, 39% of the elderly people were familiar with the intervention programme. The intervention group scored more favourably than the control group on three subscales of the initial outcome, motivation (−4.4%, 95% CI−8.3-−0.7), perceived social support (−8.2%, 95% CI−13.6-−2.4), and subjective norm (−11.5%, 95% CI−17.4-−5.4). However, no overall effects were observed for the long-term outcome, social support, and overall goal, loneliness. Conclusions Two years after its initiation the reach of the intervention programme was modest. Though no effect of the complex intervention was found on social support and loneliness, more favourable scores on loneliness literacy subscales were induced. PMID:24139287

[Indication for exercise therapy in infancy in the prevention of childhood cerebral palsy].

PubMed

Weber, S

1983-01-01

As in physiotherapy of cerebral palsy early therapy is desired, if possible even in early infancy, a period, when a safe diagnosis does not yet exist, infants at risk have to be identified. The resulting difficulties in early diagnosis and inevitability of treating a considerable number of not affected infants are discussed. The most common methods of physiotherapy are briefly described and evaluated critically concerning possible side effects as well. Superiority in effectivity improving motor efficiency of one method over another cannot be proven. It is shown, however, that in the Vojta method adverse psychological side effects cannot be excluded. Therefore, physiotherapy being a purely prophylactic and not a therapeutic procedure in the multitude of cases should be considered in ordering and selecting a particular method and the one according to Bobath should be favoured.

Quality of nursing doctoral education in seven countries: survey of faculty and students/graduates.

PubMed

Kim, Mi Ja; Park, Chang Gi; McKenna, Hugh; Ketefian, Shake; Park, So Hyun; Klopper, Hester; Lee, Hyeonkyeong; Kunaviktikul, Wipada; Gregg, Misuzu F; Daly, John; Coetzee, Siedine; Juntasopeepun, Phanida; Murashima, Sachiyo; Keeney, Sinead; Khan, Shaheen

2015-05-01

This study aimed to compare the findings of the quality of nursing doctoral education survey across seven countries and discuss the strategic directions for improving quality. No comparative evaluation of global quality of nursing doctoral education has been reported to date despite the rapid increase in the number of nursing doctoral programmes. A descriptive, cross-country, comparative design was employed. Data were collected from 2007-2010 from nursing schools in seven countries: Australia, Japan, Korea, South Africa, Thailand, UK and USA. An online questionnaire was used to evaluate quality of nursing doctoral education except for Japan, where a paper version was used. Korea and South Africa used e-mails quality of nursing doctoral education was evaluated using four domains: Programme, Faculty (referring to academic staff), Resource and Evaluation. Descriptive statistics, correlational and ordinal logistic regression were employed. A total of 105 deans/schools, 414 faculty and 1149 students/graduates participated. The perceptions of faculty and students/graduates about the quality of nursing doctoral education across the seven countries were mostly favourable on all four domains. The faculty domain score had the largest estimated coefficient for relative importance. As the overall quality level of doctoral education rose from fair to good, the resource domain showed an increased effect. Both faculty and students/graduates groups rated the overall quality of nursing doctoral education favourably. The faculty domain had the greatest importance for quality, followed by the programme domain. However, the importance of the resource domain gained significance as the overall quality of nursing doctoral education increased, indicating the needs for more attention to resources if the quality of nursing doctoral education is to improve. © 2015 John Wiley & Sons Ltd.

Comparing oncoplastic breast conserving surgery with mastectomy and immediate breast reconstruction: Case-matched patient reported outcomes.

PubMed

Kelsall, Jennett E; McCulley, Stephen J; Brock, Lisa; Akerlund, Malin T E; Macmillan, R Douglas

2017-10-01

Oncoplastic breast conserving surgery (OBCS) allows women who may otherwise have mastectomy and immediate reconstruction (MxIR) the choice to conserve their breast yet avoid deformity. We compared the outcome of these options. Two cohorts meeting study criteria were identified from prospectively audited series of women undergoing OBCS or MxIR. After case matching for age, tumour size and date of surgery, stratification by breast size and controlling for radiotherapy; body image scale (BIS) scores of psychosocial function and patient reported outcome measures (PROMs) for breast appearance and return to function were analysed. A total of 567 women (286 treated by OBCS and 281 by MxIR) fulfilled inclusion criteria. Demographics were similar between the two unmatched cohorts, except for radiotherapy, age and tumour size (all p < 0.001). Overall, BIS score (p = 0.002), self-rated breast appearance, return to work and function (all p < 0.001) significantly favoured OBCS. Case-matched women with larger breasts treated by OBCS reported better BIS scores (mean 3.30 vs. 5.37, p = 0.011) and self-rated breast appearance score (p < 0.001) than MxIR, whereas no significant difference was observed for smaller breasts. BIS and appearance favoured OBCS, regardless of whether radiotherapy would have been avoided if treated by MxIR. OBCS offers suitable women the option to avoid MxIR while providing faster recovery. Better psychosocial and self-rated satisfaction with breast appearance is achieved for OBCS in all groups, regardless of the need for radiotherapy, apart from those women with smaller breasts for whom the results are comparable. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Growth performance and feed conversion efficiency of three edible mealworm species (Coleoptera: Tenebrionidae) on diets composed of organic by-products.

PubMed

van Broekhoven, Sarah; Oonincx, Dennis G A B; van Huis, Arnold; van Loon, Joop J A

2015-02-01

Insects receive increasing attention as an alternative protein-rich food source for humans. Producing edible insects on diets composed of organic by-products could increase sustainability. In addition, insect growth rate and body composition, and hence nutritional quality, can be altered by diet. Three edible mealworm species Tenebrio molitor L., Zophobas atratus Fab. and Alphitobius diaperinus Panzer were grown on diets composed of organic by-products originating from beer brewing, bread/cookie baking, potato processing and bioethanol production. Experimental diets differed with respect to protein and starch content. Larval growth and survival was monitored. Moreover, effects of dietary composition on feed conversion efficiency and mealworm crude protein and fatty acid profile were assessed. Diet affected mealworm development and feed conversion efficiency such that diets high in yeast-derived protein appear favourable, compared to diets used by commercial breeders, with respect to shortening larval development time, reducing mortality and increasing weight gain. Diet also affected the chemical composition of mealworms. Larval protein content was stable on diets that differed 2-3-fold in protein content, whereas dietary fat did have an effect on larval fat content and fatty acid profile. However, larval fatty acid profile did not necessarily follow the same trend as dietary fatty acid composition. Diets that allowed for fast larval growth and low mortality in this study led to a comparable or less favourable n6/n3 fatty acid ratio compared to control diets used by commercial breeders. In conclusion, the mealworm species used in this study can be grown successfully on diets composed of organic by-products. Diet composition did not influence larval protein content, but did alter larval fat composition to a certain extent. Copyright © 2015 Elsevier Ltd. All rights reserved.

Comparative analysis of biofilm formation by Bacillus cereus reference strains and undomesticated food isolates and the effect of free iron.

PubMed

Hayrapetyan, Hasmik; Muller, Lisette; Tempelaars, Marcel; Abee, Tjakko; Nierop Groot, Masja

2015-05-04

Biofilm formation of Bacillus cereus reference strains ATCC 14579 and ATCC 10987 and 21 undomesticated food isolates was studied on polystyrene and stainless steel as contact surfaces. For all strains, the biofilm forming capacity was significantly enhanced when in contact with stainless steel (SS) as a surface as compared to polystyrene (PS). For a selection of strains, the total CFU and spore counts in biofilms were determined and showed a good correlation between CFU counts and total biomass of these biofilms. Sporulation was favoured in the biofilm over the planktonic state. To substantiate whether iron availability could affect B. cereus biofilm formation, the free iron availability was varied in BHI by either the addition of FeCl3 or by depletion of iron with the scavenger 2,2-Bipyridine. Addition of iron resulted in increased air-liquid interface biofilm on polystyrene but not on SS for strain ATCC 10987, while the presence of Bipyridine reduced biofilm formation for both materials. Biofilm formation was restored when excess FeCl3 was added in combination with the scavenger. Further validation of the iron effect for all 23 strains in microtiter plate showed that fourteen strains (including ATCC10987) formed a biofilm on PS. For eight of these strains biofilm formation was enhanced in the presence of added iron and for eleven strains it was reduced when free iron was scavenged. Our results show that stainless steel as a contact material provides more favourable conditions for B. cereus biofilm formation and maturation compared to polystyrene. This effect could possibly be linked to iron availability as we show that free iron availability affects B. cereus biofilm formation. Copyright © 2015 Elsevier B.V. All rights reserved.

Are dispensaries indispensable? Patient experiences of access to cannabis from medical cannabis dispensaries in Canada.

PubMed

Capler, Rielle; Walsh, Zach; Crosby, Kim; Belle-Isle, Lynne; Holtzman, Susan; Lucas, Philippe; Callaway, Robert

2017-09-01

In 2001, Canada established a federal program for cannabis for therapeutic purposes (CTP). Medical cannabis dispensaries (dispensaries) are widely accessed as a source of CTP despite storefront sales of cannabis being illegal. The discrepancy between legal status and social practice has fuelled active debate regarding the role of dispensaries. The present study aims to inform this debate by analysing CTP user experiences with different CTP sources, and comparing dispensary users to those accessing CTP from other sources. We compared sociodemographic characteristics, health related factors and patterns of cannabis use of 445 respondents, 215 who accessed CTP from dispensaries with 230 who accessed other sources. We compared patients' ratings of CTP sources (dispensaries, Health Canada's supplier, self-production, other producer, friend or acquaintance, street dealer) for quality and availability of product, safety and efficiency of access, cost, and feeling respected while accessing. Patients using dispensaries were older, more likely to have arthritis and HIV/AIDS, and less likely to have mental health conditions than those not using dispensaries. Those accessing dispensaries used larger quantities of cannabis, placed greater value on access to specific strains, and were more likely to have legal authorization for CTP. Dispensaries were rated equally to or more favourably than other sources of CTP for quality, safety, availability, efficiency and feeling respected, and less favourably than self-production and other producer for cost. Given the high endorsement of dispensaries by patients, future regulations should consider including dispensaries as a source of CTP and address known barriers to access such as cost and health care provider support. Further research should assess the impact of the addition of licensed producers on the role and perceived value of dispensaries within the Canadian medical cannabis system. Copyright © 2017 Elsevier B.V. All rights reserved.

A comparison between surgical resection in combination with WBRT or hypofractionated stereotactic irradiation in the treatment of solitary brain metastases.

PubMed

Lindvall, Peter; Bergström, Per; Löfroth, Per-Olov; Tommy Bergenheim, A

2009-09-01

The standard treatment of solitary brain metastases previously has been tumour resection in combination with whole-brain radiation therapy (WBRT). Stereotactic radiotherapy has emerged as a non-invasive treatment option especially for small brain metastases. We now report our results on resection + WBRT or hypofractionated stereotactic irradiation (HCSRT) in the treatment of solitary brain metastases. Between 1993 and 2004 patients with metastatic cancer and solitary brain metastases were selected for surgical resection + WBRT or HCSRT alone at the Umeå University Hospital. Fifty-nine patients were treated with surgical resection + WBRT (34 male, 25 female, mean age 63.3 years). Forty-seven patients were treated with HCSRT alone (15 male, 32 female, mean age 64.9 years). In patients followed radiologically, 28% treated with resection + WBRT showed a local recurrence after a median time of 8.0 months, whereas there was a lack of local control in 16% in the HCSRT group after a median time of 3.0 months. There was a significantly longer survival time for patients treated with resection + WBRT (median 7.9, mean 12.9 months) compared to HCSRT (median 5.0, mean 7.6 months). Even in patients with a tumour volume <10 cc, there was a significantly longer survival in favour of resection + WBRT (median 8.4, mean 17.4 months) compared to HCSRT (median 5.0, mean 7.9 months). This retrospective and non-randomised study indicates that surgical resection in combination with WBRT may be an option even for small brain metastases suitable for treatment with HCSRT. Since survival and local control following resection + WBRT was at least as favourable as compared to HCSRT alone, tumour location and expected neurological outcome may be the strongest aspect when selecting treatment modality.

Surgery or conservative treatment for rotator cuff tear: a meta-analysis.

PubMed

Ryösä, Anssi; Laimi, Katri; Äärimaa, Ville; Lehtimäki, Kaisa; Kukkonen, Juha; Saltychev, Mikhail

2017-07-01

Comparative evidence on treating rotator cuff tear is inconclusive. The objective of this review was to evaluate the evidence on effectiveness of tendon repair in reducing pain and improving function of the shoulder when compared with conservative treatment of symptomatic rotator cuff tear. Search on CENTRAL, MEDLINE, EMBASE, CINAHL, Web of Science and Pedro databases. Randomised controlled trials (RCT) comparing surgery and conservative treatment of rotator cuff tear. Study selection and extraction based on the Cochrane Handbook for Systematic reviews of Interventions. Random effects meta-analysis. Three identified RCTs involved 252 participants (123 cases and 129 controls). The risk of bias was considered low for all three RCTs. For Constant score, statistically insignificant effect size was 5.6 (95% CI -0.41 to 11.62) points in 1-year follow up favouring surgery and below the level of minimal clinically important difference. The respective difference in pain reduction was -0.93 (95% CI -1.65 to -0.21) cm on a 0-10 pain visual analogue scale favouring surgery. The difference was statistically significant (p = 0.012) in 1-year follow up but below the level of minimal clinically important difference. There is limited evidence that surgery is not more effective in treating rotator cuff tear than conservative treatment alone. Thus, a conservative approach is advocated as the initial treatment modality. Implications for Rehabilitation There is limited evidence that surgery is not more effective in treating rotator cuff tear than conservative treatment alone. There was no clinically significant difference between surgery and active physiotherapy in 1-year follow-up in improving Constant score or reducing pain caused by rotator cuff tear. As physiotherapy is less proneness to complications and less expensive than surgery, a conservative approach is advocated as the initial treatment modality to rotator cuff tears.