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  1. A comparative study between shielded and open coplanar waveguide discontinuities

    NASA Technical Reports Server (NTRS)

    Dib, Nihad I.; Harokopus, W. P., Jr.; Ponchak, G. E.; Katehi, L. P. B.

    1993-01-01

    A comparative study between open and shielded coplanar waveguide (CPW) discontinuities is presented. The space domain integral equation method is used to characterize several discontinuities such as the open-end CPW and CPW series stubs. Two different geometries of CPW series stubs (straight and bent stubs) are compared with respect to resonant frequency and radiation loss. In addition, the encountered radiation loss due to different CPW shunt stubs is evaluated experimentally. The notion of forced radiation simulation is presented, and the results of such a simulation are compared to the actual radiation loss obtained rigorously. It is shown that such a simulation cannot give reliable results concerning radiation loss from printed circuits.

  2. [Laparoscopic versus open surgery for colorectal cancer. A comparative study].

    PubMed

    Arribas-Martin, Antonio; Díaz-Pizarro-Graf, José Ignacio; Muñoz-Hinojosa, Jorge Demetrio; Valdés-Castañeda, Alberto; Cruz-Ramírez, Omar; Bertrand, Martin Marie

    2014-01-01

    Laparoscopic surgery for colorectal cancer is currently accepted and widespread worldwide. However, according tol the surgical experience on this approach, surgical and short-term oncologic results may vary. Studies comparing laparoscopic vs. open surgery in our population are scarce. To determine the superiority of the laparoscopic vs. open technique for colorectal cancer surgery. This retrospective and comparative study collected data from patients operated on for colorectal cancer between 1999 and 2011 at the Angeles Lomas Hospital, Mexico. A total of 82 patients were included in this study; 47 were operated through an open approach and 35 laparoscopically. Mean operative time was significantly lower in the open approach group (p= 0.008). There were no significant difference between both techniques for intraoperative bleeding (p= 0.3980), number of lymph nodes (p= 0.27), time to initiate oral feeding (p= 0.31), hospital stay (p= 0.12), and postoperative pain (p= 0.19). Procedure-related complications rate and type were not significantly different in both groups (p= 0.44). Patients operated laparoscopically required significantly less analgesic drugs (p= 0.04) and less need for epidural postoperative analgesia (p= 0.01). Laparoscopic approach is as safe as the traditional open approach for colorectal cancer. Early oncological and surgical results confirm its suitability according to this indication.

  3. An open multicenter comparative randomized clinical study on chitosan.

    PubMed

    Mo, Xiaohui; Cen, John; Gibson, Elaine; Wang, Robin; Percival, Steven L

    2015-01-01

    Chitosan, a natural polysaccharide derivate from chitin, offers a promising alternative biomaterial for use in wound dressings. In this work, the safety and efficacy of a next-generation KA01 chitosan wound dressing in facilitating the healing of nonhealing chronic wounds was studied. This open multicenter comparative prospective randomized clinical study was conducted at three medical centers in China. A total of 90 patients (45 in test group and 45 in control group) with unhealed chronic wounds including pressure ulcers, vascular ulcers, diabetic foot ulcers, and wounds with minor infections, or at risk of infection, were treated with the next generation chitosan wound dressing as the test article or traditional vaseline gauze as a control. Baseline assessments were undertaken with the primary end point being wound area reduction. The secondary end points included pain reduction (using the NRS11 pain scale) at dressing change, wound exudate levels, wound depth and duration of the treatment. After 4 weeks treatment, the wound area reduction was significantly greater in the test group (65.97 ± 4.48%) than the control group (39.95 ± 4.48%). The average pain level in the test group was 1.12 ± 0.23 and 2.30 ± 0.23 in the control group. The wound depth was also lower in the test group 0.30 ± 0.48 cm than the control group 0.54 ± 0.86 cm. The level of exudate fell and the dressing could be removed integrally in both the test and control groups. The mean duration of the test group was 27.31 ± 5.37 days and control group 27.09 ± 6.44 days. No adverse events were reported in either group. In conclusion this open multicenter comparative prospective randomized clinical study has provided compelling evidence that the next generation chitosan wound dressing can enhance wound progression towards healing by facilitating wound reepithelialization and reducing the patients pain level. Furthermore the dressing was shown to be clinically safe and effective in the management

  4. Comparative Analysis Study of Open Source GIS in Malaysia

    NASA Astrophysics Data System (ADS)

    Rasid, Muhammad Zamir Abdul; Kamis, Naddia; Khuizham Abd Halim, Mohd

    2014-06-01

    Open source origin might appear like a major prospective change which is qualified to deliver in various industries and also competing means in developing countries. The leading purpose of this research study is to basically discover the degree of adopting Open Source Software (OSS) that is connected with Geographic Information System (GIS) application within Malaysia. It was derived based on inadequate awareness with regards to the origin ideas or even on account of techie deficiencies in the open origin instruments. This particular research has been carried out based on two significant stages; the first stage involved a survey questionnaire: to evaluate the awareness and acceptance level based on the comparison feedback regarding OSS and commercial GIS. This particular survey was conducted among three groups of candidates: government servant, university students and lecturers, as well as individual. The approaches of measuring awareness in this research were based on a comprehending signal plus a notion signal for each survey questions. These kinds of signs had been designed throughout the analysis in order to supply a measurable and also a descriptive signal to produce the final result. The second stage involved an interview session with a major organization that carries out available origin internet GIS; the Federal Department of Town and Country Planning Peninsular Malaysia (JPBD). The impact of this preliminary study was to understand the particular viewpoint of different groups of people on the available origin, and also their insufficient awareness with regards to origin ideas as well as likelihood may be significant root of adopting level connected with available origin options.

  5. A Comparative Study of Student Support Services of Allama Iqbal Open University and the Open University of Sri Lanka

    ERIC Educational Resources Information Center

    Gujjar, Aijaz Ahmed; Chaudhry, Bushra Naoreen; Chaudhry, Amtul Hafeez

    2009-01-01

    This paper attempts to compare the availability, quality, similarities and differences in student support services offered by the Allama Iqbal Open University (AIOU) Pakistan and The Open University of Sri Lanka (OUSL). It also aims to identify and report the deficiencies that students of both the institutions face in the student support services.…

  6. A Comparative Study of Student Support Services of Allama Iqbal Open University and the Open University of Sri Lanka

    ERIC Educational Resources Information Center

    Gujjar, Aijaz Ahmed; Chaudhry, Bushra Naoreen; Chaudhry, Amtul Hafeez

    2009-01-01

    This paper attempts to compare the availability, quality, similarities and differences in student support services offered by the Allama Iqbal Open University (AIOU) Pakistan and The Open University of Sri Lanka (OUSL). It also aims to identify and report the deficiencies that students of both the institutions face in the student support services.…

  7. Percutaneous versus open repair of the ruptured Achilles tendon: a comparative study.

    PubMed

    Cretnik, Andrej; Kosanovic, Milos; Smrkolj, Vladimir

    2005-09-01

    Controversy regarding the optimal treatment of the fresh total Achilles tendon rupture remains. To compare the results of percutaneous and open Achilles tendon repair. Cohort study; Level of evidence, 2. The results of 132 consecutive patients with acute complete Achilles tendon rupture who were operated on exclusively with modified percutaneous repair under local anesthesia from 1991 to 1997 and followed up for at least 2 years were compared to the results of 105 consecutive patients who were operated on exclusively with open repair under general or spinal anesthesia in the same period. There were significantly fewer major complications in the group of percutaneous repairs in comparison with the group of open repairs (4.5% vs 12.4%; P = .03), particularly necrosis (0% vs 5.6%; P = .019), and a lower total number of complications (9.7% vs 21%; P = .013). There were slightly more reruptures (3.7% vs 2.8%; P = .680) and sural nerve disturbances (4.5% vs 2.8%; P = .487) in the group of percutaneous repairs, with no statistically significant difference. Functional assessment using the American Orthopaedic Foot and Ankle Society scale and the Holz score showed no statistically significant difference. The results of the study support the choice of (modified) percutaneous suturing under local anesthesia as the method that brings comparable functional results to open repair, with a significantly lower rate of complications.

  8. [A prospective study to compare the efficiency of oocyte vitrification using closed or open devices].

    PubMed

    Sarandi, S; Herbemont, C; Sermondade, N; Benoit, A; Sonigo, C; Poncelet, C; Benard, J; Gronier, H; Boujenah, J; Grynberg, M; Sifer, C

    2016-05-01

    Oocyte vitrification using an open device is thought to be a source of microbiological and chemical contaminations that can be avoided using a closed device. The principal purpose of this study was to compare the two vitrification protocols: closed and open system. The secondary aim was to study the effects of the storage in the vapor phase of nitrogen (VPN) on oocytes vitrified using an open system and to compare it to those of a storage in liquid nitrogen (LN). Forty-four patients have been included in our study between November 2014 and May 2015. Two hundred and fourteen oocytes have been vitrified at germinal vesicle (GV), metaphase I (0PB) and metaphase II (1PB) stages. We vitrified 96 oocytes (59 GV/37 0PB) using a closed vitrification device and 118 oocytes (57 GV/31 0PB/30 1PB) using an open device. The vitrified oocytes were then stored either in LN or in VPN. The main outcome measures were the survival rate after warming (SR), meiosis resumption rate (MRR) and maturation rate (MR). The global post-thaw SR was significantly higher for oocytes vitrified using an open system (93.2%) compared to those vitrified using a closed one (64.5%; P<0.001). On the contrary, there was no significant difference in terms of global MRR and MR (82.1% vs. 87.5% and 60.7% vs. 61.2% using closed and open system respectively). The SR, MRR and the MR were not significantly different when vitrified oocytes were stored in VPN or LN (91.6, 83.8, 64.5% vs. 93.9, 89.8, 59.1% respectively). Taking into account the limits of our protocol, the open vitrification system remains the more efficient system. The use of sterile liquid nitrogen for oocyte vitrification and the subsequent storage in vapor phase of nitrogen could minimize the hypothetical risks of biological and chemical contaminations. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  9. Functional outcomes after open versus arthroscopic Latarjet procedure: A prospective comparative study.

    PubMed

    Nourissat, G; Neyton, L; Metais, P; Clavert, P; Villain, B; Haeni, D; Walch, G; Lafosse, L

    2016-12-01

    The Latarjet procedure provides effective stabilization of chronically unstable shoulders. Since this procedure is mainly performed in a young athletic population, the functional impact is significant. Published data does not shed light on the time needed to recover work-related or sports-related function. Performing this procedure arthroscopically may improve functional recovery. This led us to carry out a prospective, multicenter study to compare the functional recovery after arthroscopic versus open Latarjet procedure. Between June and November 2014, 184 patients were included in a prospective multicenter study: 85 in the open group and 99 in the arthroscopy group. The patients were evaluated preoperatively with the WOSI score. The early postoperative pain was evaluated on D3, D7 and D30. The WOSI score was determined postoperatively at 1, 3, 6 and 12 months of follow-up. The functional scores of the shoulder in both cohorts were identical overall preoperatively. In the immediate postoperative period, the arthroscopy group had statistically lower pain levels on D3 and D7. The postoperative WOSI was improved in both groups at 3 months, then continued to improve until it reached a plateau at 1 year. The WOSI score was better in the arthroscopy group at 3 months, but better in the open group at 6 months. This study found that a Latarjet procedure performed arthroscopically generates less immediately postoperative pain than when it is performed as an open procedure. The Latarjet procedure (whether open or arthroscopic) improves shoulder function, with normal function returning after 1 year. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  10. A Comparative Study of Self-Concept: Open Space Versus Self-Contained Classroom.

    ERIC Educational Resources Information Center

    Heimgartner, Norman Louis

    A determination was made of whether any change occurred in the self-concept of children in the open space environment as compared to the change of self-concept of children in a self-contained environment. A total of 216 children, part from an open space environment school and the others from self-contained classrooms at grade levels with one…

  11. Study Behavior in the Closed-Book and the Open-Book Examination: A Comparative Analysis.

    ERIC Educational Resources Information Center

    Theophilides, Christos; Koutselini, Mary

    2000-01-01

    Investigated the study behavior used by students facing an open-book or closed-book examination. Results for 201 college students in Cyprus indicate that students preparing for a closed-book examination tended to postpone study at the end of the semester, focus on assigned texts, and memorize information. Students preparing for open-book tests…

  12. Dentoalveolar comparative study between removable and fixed cribs, associated to chincup, in anterior open bite treatment

    PubMed Central

    TORRES, Fernando César; de ALMEIDA, Renato Rodrigues; de ALMEIDA-PEDRIN, Renata Rodrigues; PEDRIN, Fernando; PARANHOS, Luiz Renato

    2012-01-01

    Objective The aim of this prospective study was to compare the dentoalveolar effects produced by two types of palatal crib, removable (Rpc+C) and fixed (Fpc+C), combined with chincup in growing patients with anterior open bite. Material and Methods Each group comprised 30 patients, in the mixed dentition phase, with similar cephalometric characteristics and skeletal ages. Group 1 (Rpc+C) presented initial mean age of 8.3 years and mean anterior open bite of 4.0 mm. Group 2 (Fpc+C) presented initial mean age of 8.54 years and mean anterior open bite of 4.3 mm. The evaluation period comprised 12 months between initial (T1) and second lateral radiograph (T2). The T2-T1 changes were compared cephalometrically in the 2 groups using the non-paired t-test. Results Vertical changes in the posterior dentoalveolar region were similar between the groups (about 1 mm) and no significant differences were found in molar mesialization. The Fpc+C group had in average 1.6 mm more improvement of the overbite as a result of greater maxillary incisor extrusion (1.3 mm). Patients in this group also presented less lingual tipping of maxillary incisors and more mandibular incisors uprighting. Conclusions The Fpc+C combination was more efficient in the correction of the negative overbite mainly due to greater extrusion of the maxillary incisors. However, the Rpc+C appliance promoted better upper and lower incisor inclination, resulting in a more adequate overjet. PMID:23138739

  13. Laparoscopic hepatectomy versus open hepatectomy for colorectal cancer liver metastases: comparative study with propensity score matching

    PubMed Central

    Untereiner, Xavier; Cagniet, Audrey; Memeo, Riccardo; Tzedakis, Stylianos; Piardi, Tullio; Severac, François; Mutter, Didier; Kianmanesh, Reza; Marescaux, Jacques; Sommacale, Daniele

    2016-01-01

    Background The objective of this study was to compare the results of laparoscopic hepatectomy with those of open hepatectomy for colorectal cancer liver metastases (CCLM) using a propensity score matching (PSM) in two university hospital settings. Methods A patient in the laparoscopic approach (LA) surgery group was randomly matched with another patient in the open approach (OA) group using a 1:1 allocated ratio with the nearest estimated propensity score. No patients of the LA group were excluded for the matching. Matching criteria included age, gender, body mass index (BMI), American society anesthesiologists score, potential co-morbidities, hepatopathies, synchronous or metachronous lesions, size and number of CCLM, preoperative chemotherapy, minor or major liver resections. Intraoperative, postoperative data, and survival were compared in both groups. Results From January 2012 to January 2015, a total of 242 hepatectomies were consecutively performed, of which 119 for CCLM, namely 101 in the OA group (84.9%) and 18 in the LA group (15.1%). The conversion rate was 5.6% (n=1). The mortality rate was 1% in the OA group and 0% in the LA group. Prior to PSM, there was a statistically significant difference favorable to the LA group regarding operative time, blood loss, length of hospital stay and the rate of medical complications. After PSM, there was no difference regarding operative time or length of hospital stay. However, there was a trend towards less blood loss (P=0.066) and fewer medical complications (44.4% vs.16.7%, P=0.07). The R0 resection rate was 94.4% (n=17) in the two groups. In addition, there was no difference regarding overall survival (P=0.358) and recurrence-free survival [HR =0.99 (0.1–12.7); P=0.99]. Conclusions Laparoscopic liver resections for CCLM seem to yield short- and long-term results, which are similar to open hepatectomies, and could well be considered an alternative to open surgery and become the gold standard in carefully selected

  14. Thermocleavable materials for polymer solar cells with high open circuit voltage-a comparative study.

    PubMed

    Tromholt, Thomas; Gevorgyan, Suren A; Jørgensen, Mikkel; Krebs, Frederik C; Sylvester-Hvid, Kristian O

    2009-12-01

    The search for polymer solar cells giving a high open circuit voltage was conducted through a comparative study of four types of bulk-heterojunction solar cells employing different photoactive layers. As electron donors the thermo-cleavable polymer poly-(3-(2-methylhexyloxycarbonyl)dithiophene) (P3MHOCT) and unsubstituted polythiophene (PT) were used, the latter of which results from thermo cleaving the former at 310 degrees C. As reference, P3HT solar cells were built in parallel. As electron acceptors, either PCBM or bis-[60]PCBM were used. In excess of 300 solar cells were produced under as identical conditions as possible, varying only the material combination of the photo active layer. It was observed that on replacing PCBM with bis[60]PCBM, the open circuit voltage on average increased by 100 mV for P3MHOCT and 200 mV for PT solar cells. Open circuit voltages approaching 1 V were observed for the PT:bis[60]PCBM solar cells and a maximum conversion efficiency of 1.3% was obtained for solar cells with P3MHOCT:PCBM as the photoactive material. For the reference solar cells maximum efficiencies of 2.1 and 2.4% were achieved for P3HT:PCBM and P3HT:bis[60]PCBM, respectively. Despite special measures taken in terms of substrate design and device processing, a substantial spread in the photovoltaic properties was generally observed. This spread could not be correlated with the optical properties of the solar cells, the thickness of the photo active layer or the electrode deposition conditions of the aluminum top electrode.

  15. Clinical evaluation of the centrifugal pump in open heart surgery: a comparative study of different pumps.

    PubMed

    Takarabe, K; Yoshikai, M; Murayama, J; Hamada, M; Ito, T

    1997-07-01

    The centrifugal pump is now widely used in open heart surgery for its clinical benefits related to the blood elements and the coagulation system. The purpose of this study was to compare the clinical performances of and the outcomes offered by 4 types of centrifugal pumps. For each pump, we investigated the effects on the blood elements, coagulation system, complements, and immunoglobulins during open heart surgery. Four types of centrifugal pumps were used: the HPM-15 (Nikkiso Co.), the Capiox (Terumo Co.), the Lifestream (St. Jude Medical Co.), and the BP-80 (Medtronic, BioMedicus Co.). The platelet count, lactate dehydrogenase (LDH), antithrombin III (AT III), thrombin-antithrombin complex (TAT), complements (C3, C4, and CH50), and immunoglobulins (IgG, IgA, and IgM) were measured before and after cardiopulmonary bypass (CPB). The platelet count was decreased more significantly by the HPM-15 than by any of the other pumps. The other parameters showed no difference among the 4 pumps. In clinical use, each of the 4 types of centrifugal pumps was safe.

  16. Efficacy and safety of azithromycin for uncomplicated typhoid fever: an open label non-comparative study.

    PubMed

    Aggarwal, Anju; Ghosh, Apurba; Gomber, Sunil; Mitra, Monjori; Parikh, A O

    2011-07-01

    An open-labelled, non-comparative study was conducted in 117 children aged 2-12 years to evaluate the efficacy and safety of azithromycin (20mg/ kg/day for 6 days) for the treatment of uncomplicated typhoid fever. Of the patients enrolled based on a clinical definition of typhoid fever, 109 (93.1%) completed the study.Mean (SD) of duration of fever at presentation was 9.1(4.5) days. Clinical cure was seen in 102 (93.5%) subjects, while 7 were withdrawn from the study because of clinical deterioration. Mean day of response was 3.45±1.97. BACTEC blood culture was positive for Salmonella typhi in 17/109 (15.5%) and all achieved bacteriological cure. No serious adverse event was observed. Global well being assessed by the investigator and subjects was good in 95% cases which was done at the end of the treatment. Azithromycin was found to be safe and efficacious for the management of uncomplicated typhoid fever.

  17. Use of a splint following open carpal tunnel release: a comparative study.

    PubMed

    Cebesoy, Oguz; Kose, Kamil Cagri; Kuru, Ilhami; Altinel, Levent; Gul, Rauf; Demirtas, Mehmet

    2007-01-01

    This study was undertaken to compare the clinical effectiveness and costs of postoperative splintage and late rehabilitation with a bulky bandage dressing versus early rehabilitation after carpal tunnel release. In this comparative study, 46 patients were randomly divided into 2 groups. In each group, 3 patients were excluded because of improper follow-up, leaving a total of 40 patients. Group 1 used a splint (exercises given 3 wk postoperatively) and group 2 was given a bulky bandage (exercises provided immediately) after open release. Patients were assessed preoperatively and at the first and third postoperative months with the Questionnaire of Levine for Clinical Assessment of Carpal Tunnel Syndrome. The 2 groups were similar in terms of preoperative functional status scores and in controls at the first and third months (P=.549, P=.326, P=.190). When both groups were compared, no statistical significance was found regarding symptom severity scale scores preoperatively and at the first postoperative month (P=.632 vs P=.353). At the third month, scores were lower in favor of group 2 (P=.023). Additionally, 16 of 20 patients (80%) in group 1 reported a heavy feeling and discomfort caused by the splint. This problem was not reported by the patients in group 2. The cheapest splint on the market was 9 times more expensive than a bulky dressing. The investigators concluded that postoperative immobilization with a splint has no detectable benefits. Use of bulky dressings and abandonment of the use of postoperative splints may prevent unnecessary expenditures without sacrificing patient comfort or compromising the course of healing in carpal tunnel surgery.

  18. Who Are the Open Learners? A Comparative Study Profiling Non-Formal Users of Open Educational Resources

    ERIC Educational Resources Information Center

    Farrow, Robert; de los Arcos, Beatriz; Pitt, Rebecca; Weller, Martin

    2015-01-01

    Open educational resources (OER) have been identified as having the potential to extend opportunities for learning to non-formal learners. However, little research has been conducted into the impact of OER on non-formal learners. This paper presents the results of a systematic survey of more than 3,000 users of open educational resources (OER).…

  19. Habitat specialization through germination cueing: a comparative study of herbs from forests and open habitats.

    PubMed

    Ten Brink, Dirk-Jan; Hendriksma, Harmen Pieter; Bruun, Hans Henrik

    2013-02-01

    This study examined the adaptive association between seed germination ecology and specialization to either forest or open habitats across a range of evolutionary lineages of seed plants, in order to test the hypotheses that (1) species' specialization to open vs. shaded habitats is consistently accompanied by specialization in their regeneration niche; and (2) species are thereby adapted to utilize different windows of opportunity in time (season) and space (habitat). Seed germination response to temperature, light and stratification was tested for 17 congeneric pairs, each consisting of one forest species and one open-habitat species. A factorial design was used with temperature levels and diurnal temperature variation (10 °C constant, 15-5 °C fluctuating, 20 °C constant, 25-15 °C fluctuating), and two light levels (light and darkness) and a cold stratification treatment. The congeneric species pair design took phylogenetic dependence into account. Species from open habitats germinated better at high temperatures, whereas forest species performed equally well at low and high temperatures. Forest species tended to germinate only after a period of cold stratification that could break dormancy, while species from open habitats generally germinated without cold stratification. The empirically derived germination strategies correspond quite well with establishment opportunities for forest and open-habitat plant species in nature. Annual changes in temperature and light regime in temperate forest delimit windows of opportunity for germination and establishment. Germination strategies of forest plants are adaptations to utilize such narrow windows in time. Conversely, lack of fit between germination ecology and environment may explain why species of open habitats generally fail to establish in forests. Germination strategy should be considered an important mechanism for habitat specialization in temperate herbs to forest habitats. The findings strongly suggest that

  20. Habitat specialization through germination cueing: a comparative study of herbs from forests and open habitats

    PubMed Central

    ten Brink, Dirk-Jan; Hendriksma, Harmen Pieter; Bruun, Hans Henrik

    2013-01-01

    Background and Aims This study examined the adaptive association between seed germination ecology and specialization to either forest or open habitats across a range of evolutionary lineages of seed plants, in order to test the hypotheses that (1) species' specialization to open vs. shaded habitats is consistently accompanied by specialization in their regeneration niche; and (2) species are thereby adapted to utilize different windows of opportunity in time (season) and space (habitat). Methods Seed germination response to temperature, light and stratification was tested for 17 congeneric pairs, each consisting of one forest species and one open-habitat species. A factorial design was used with temperature levels and diurnal temperature variation (10 °C constant, 15–5 °C fluctuating, 20 °C constant, 25–15 °C fluctuating), and two light levels (light and darkness) and a cold stratification treatment. The congeneric species pair design took phylogenetic dependence into account. Key Results Species from open habitats germinated better at high temperatures, whereas forest species performed equally well at low and high temperatures. Forest species tended to germinate only after a period of cold stratification that could break dormancy, while species from open habitats generally germinated without cold stratification. The empirically derived germination strategies correspond quite well with establishment opportunities for forest and open-habitat plant species in nature. Conclusions Annual changes in temperature and light regime in temperate forest delimit windows of opportunity for germination and establishment. Germination strategies of forest plants are adaptations to utilize such narrow windows in time. Conversely, lack of fit between germination ecology and environment may explain why species of open habitats generally fail to establish in forests. Germination strategy should be considered an important mechanism for habitat specialization in temperate herbs

  1. Prospective study comparing laparoscopic and open adenomectomy: Surgical and functional results.

    PubMed

    Garcia-Segui, A; Angulo, J C

    Open adenomectomy (OA) is the surgery of choice for large volume benign prostatic hyperplasia, and laparoscopic adenomectomy (LA) represents a minimally invasive alternative. We present a long-term, prospective study comparing both techniques. The study consecutively included 199 patients with benign prostatic hyperplasia and prostate volumes>80g who were followed for more than 12 months. The patients underwent OA (n=97) or LA (n=102). We recorded and compared demographic and perioperative data, functional results and complications using a descriptive statistical analysis. The mean age was 69.2±7.7 years (range 42-87), and the mean prostate volume (measured by TRUS) was 112.1±32.7mL (range 78-260). There were no baseline differences among the groups in terms of age, ASA scale, prostate volume, PSA levels, Qmax, IPSS, QoL or treatments prior to the surgery. The surgical time (P<.0001) and catheter time (P<.0002) were longer in the LA group. Operative bleeding (P<.0001), transfusion rate (P=.0015) and mean stay (P<.0001) were significantly lower in the LA group. The LA group had a lower rate of complications (P=.04), but there were no significant differences between the groups in terms of major complications (Clavien score≥3) (P=.13) or in the rate of late complications (at one year) (P=.66). There were also no differences between the groups in the functional postoperative results: IPSS (P=.17), QoL (P=.3) and Qmax (P=.17). LA is a reasonable, safe and effective alternative that results in less bleeding, fewer transfusions, shorter hospital stays and lower morbidity than OA. LA has similar functional results to OA, at the expense of longer surgical times and longer catheter times. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Comparative study of laparoscopic vs open gastrectomy in gastric cancer management

    PubMed Central

    Sica, Giuseppe S; Iaculli, Edoardo; Biancone, Livia; Carlo, Sara Di; Scaramuzzo, Rosa; Fiorani, Cristina; Gentileschi, Paolo; Gaspari, Achille L

    2011-01-01

    AIM: To compare long-term results of gastric cancer patients undergoing laparoscopic and open gastrectomy in a single unit. METHODS: From February 2000 to September 2004, all patients with adenocarcinoma of the stomach were assessed to entry in this longitudinal prospective non-randomized trial. Primary endpoint was cancer-related survival and secondary endpoints were overall survival, evaluation of surgical complications and mortality. RESULTS: Fifty-eight patients were enrolled. Forty-seven patients were followed-up (range 11-103, median 38 mo). Four patients were lost at follow up. Twenty-two patients underwent a laparoscopic gastric surgery (LGS) and 25 had a standard open procedure (OGS). No statistical difference was found between the two groups in terms of 5 years cancer-related mortality rate (50% vs 52%, P = 1), and 5 years overall mortality rate (54.5% vs 56%, P = 1). Accordingly, cancer-related and overall survival probability by Kaplan-Meier method showed comparable results (P = 0.81 and P = 0.83, respectively). We found no differences in surgical complications in the 2 groups. There was no conversion to open surgery in this series. CONCLUSION: LGS is as effective as OGS in the management of advanced gastric cancer. However LGS cannot be recommended routinely over OGS for the treatment of advanced gastric cancer. PMID:22147966

  3. An open, randomized, comparative study of oral finasteride and 5% topical minoxidil in male androgenetic alopecia.

    PubMed

    Arca, Ercan; Açikgöz, Gürol; Taştan, Halis Bülent; Köse, Osman; Kurumlu, Zafer

    2004-01-01

    Androgenetic alopecia (AGA) is undoubtedly the most common form of hair loss in males. It is a condition which may cause cosmetic and psychosocial problems in androgen-dependent cases. In this open, randomized and comparative study we evaluated the efficacy of oral finasteride and 5% topical minoxidil treatment for 12 months in 65 male patients with mild to severe AGA. We randomly assigned 40 (61.53%) patients to receive 1 mg/day oral finasteride for 12 months, and 25 (38.47%) patients applied 5% topical minoxidil solution twice daily for 12 months. There were no significant differences between the 2 groups considering age, age of onset of hair loss, family history and type of hair loss (p > 0.05). In the clinical evaluation at the endpoint of treatment, the clinical cure rates (i.e. increased intensity of hair) were 80% (32/40) for the oral finasteride group and 52% (13/25) for the 5% topical minoxidil group. Encountered side effects were all mild, and there was no need to stop the treatment. In the group given oral finasteride, side effects were noted in 7 patients: 6 patients suffered from loss of libido, and 1 patient had an increase in other body hairs; irritation of the scalp was seen in 1 patient in the group administered 5% minoxidil. These adverse events disappeared as soon as the treatment was stopped. The laboratory data on both drug groups did not show any statistically or clinically significant intragroup changes from baseline values to the endpoint (p > 0.05), except the level of serum total testosterone which was increased, and free testosterone and serum prostate-specific antigen in the finasteride group which were statistically decreased from baseline values to the endpoint (p < 0.05). In this comparative study of systemic finasteride and topical minoxidil, it was concluded that both drugs were effective and safe in the treatment of mild to severe AGA, although oral finasteride treatment was more effective (p < 0.05). Adverse events were not

  4. PROSPECTIVE AND COMPARATIVE STUDY ON FUNCTIONAL OUTCOMES AFTER OPEN AND ARTHROSCOPIC REPAIR OF ROTATOR CUFF TEARS

    PubMed Central

    de Castro Veado, Marco Antônio; Castilho, Rodrigo Simões; Maia, Philipe Eduardo Carvalho; Rodrigues, Alessandro Ulhôa

    2015-01-01

    Objective: To prospectively assess the surgical results from patients undergoing repairs to rotator cuff injuries via open and arthroscopic procedures, with regard to functional and clinical features, and by means of ultrasound examinations, and to compare occurrences of renewed tearing. Methods: Sixty patients underwent operations performed by the same surgeon (29 via open surgery and 31 via arthroscopy), to repair complete rotator cuff tears. The procedures were performed at Hospital Governor Israel Pinheiro (HGIP) and Mater Dei Hospital in Belo Horizonte, Minas Gerais, between August 2007 and February 2009. The patients were assessed functionally by means of the UCLA score before and after the operation, and magnetic resonance imaging was done before the operation. All the patients were reassessed at least 12 months after the operation, and an ultrasound examination was also performed at this time. Results: Out of the 29 patients who underwent open surgery, 27 (93.1%) presented good or excellent results, with a mean UCLA score of 32 after the operation. Their mean follow-up was 14 months. Three patients presented renewed tearing on ultrasound, of whom one remained asymptomatic. Out of the 31 patients who underwent arthroscopic procedures, 29 (93.5%) presented good or excellent results, with a mean UCLA score of 33 after the operation. Their mean follow-up was 19 months. Two patients presented renewed tearing, of whom one remained asymptomatic and one evolved with loosening of an anchor, with an unsatisfactory result. Conclusion: The repairs on rotator cuff injuries presented good results by means of both open surgery and arthroscopy, with similar functional results in the two groups and similar rates of renewed tearing. PMID:27027052

  5. [A comparative study of laparoscopic-assisted and open distal gastrectomy for advanced gastric cancer].

    PubMed

    Ye, Min-feng; Tao, Feng; Xu, Guan-gen; Xu, Guo-quan; Jing, Yuan-ming; Lü, Jie-qing; Sun, Ai-jing

    2013-05-01

    To evaluate the safety, feasibility and the long-term outcomes of laparoscopy-assisted gastrectomy (LAG) for advanced gastric cancer (AGC). The clinical and follow-up data of 46 cases after LAG from June 2008 to December 2009 were analyzed, and compared with 85 cases after conventional open gastrectomy (OG) for advanced gastric cancer at the same period at our hospital. The surgical safety, postoperative recovery, complications, radical degree, survival rate were compared. As compared with OG group, operation time was longer in LATG group ((274 ± 78) min vs. ( 217 ± 41) min, t = 4.635, P = 0.000). Estimated blood loss in the LAG group ((254 ± 112) ml) was significantly less than in the OG group (t = 3.942, P = 0.000). Time to ambulation ((63 ± 16) hours), first flatus ((77 ± 20) hours), resumed liquid diet ((88 ± 15) hours), duration of analgesic medication ((53 ± 20) hours) and postoperative hospital stay ((11.1 ± 4.6) days) were significantly shorter in the LAG group (t = 5.549, 6.508, 9.436, 9.464 and 2.980 respectively, all P < 0.01). The distance of the proximal and distal resection margin were (5.7 ± 1.4) cm and (3.9 ± 1.5) cm in LAG group, (5.8 ± 1.1) cm and (4.7 ± 1.5) cm in OG group respectively, but the difference was not significant. The number of lymph node dissections was also similar, (30.5 ± 10.4) in LAG group and (32.6 ± 12.3) in OG group (t = 0.960, P = 0.339). The incidence of postoperative complications and mortality rate in LAG group (8.7% and 0 respectively) were also lower than in the OG group, with no statistically significant difference (P > 0.05). The mean follow-up was 31.0 months (range 6-48 months), and the cumulative survival of the 2 groups was similar (χ(2) = 1.594, P = 0.207). Laparoscopy-assisted gastrectomy for advanced gastric cancer is not significantly different with open surgery in surgical safety, radical degree, and survival rate. It is less traumatic and of fewer complications.

  6. Examining MOOCs: A Comparative Study among Educational Technology Experts in Traditional and Open Universities

    ERIC Educational Resources Information Center

    Cabrera, Nati; Fernández-Ferrer, Maite

    2017-01-01

    The proliferation of Massive Open Online Courses (MOOCs) in recent years has generated much debate. MOOCs have been presented as technology-based educational practices, but many researchers question if this kind of open courses really respects some of the consolidated principles behind the education offered at universities. In light of this…

  7. Randomized Study Comparing the Effect of Carbon Dioxide Insufflation on Veins Using 2 Types of Endoscopic and Open Vein Harvesting.

    PubMed

    Krishnamoorthy, Bhuvaneswari; Critchley, William R; Nair, Janesh; Malagon, Ignacio; Carey, John; Barnard, James B; Waterworth, Paul D; Venkateswaran, Rajamiyer V; Fildes, James E; Caress, Ann L; Yonan, Nizar

    2017-10-09

    The aim of the study was to assess whether the use of carbon dioxide insufflation has any impact on integrity of long saphenous vein comparing 2 types of endoscopic vein harvesting and traditional open vein harvesting. A total of 301 patients were prospectively randomized into 3 groups. Group 1 control arm of open vein harvesting (n = 101), group 2 closed tunnel (carbon dioxide) endoscopic vein harvesting (n = 100) and Group 3 open tunnel (carbon dioxide) endoscopic vein harvesting (open tunnel endoscopic vein harvesting) (n = 100). Each group was assessed to determine the systemic level of partial arterial carbon dioxide, end-tidal carbon dioxide, and pH. Three blood samples were obtained at baseline, 10 minutes after start of endoscopic vein harvesting, and 10 minutes after the vein was retrieved. Vein samples were taken immediately after vein harvesting without further surgical handling to measure the histological level of endothelial damage. A modified validated endothelial scoring system was used to compare the extent of endothelial stretching and detachment. The level of end-tidal carbon dioxide was maintained in the open tunnel endoscopic vein harvesting and open vein harvesting groups but increased significantly in the closed tunnel endoscopic vein harvesting group (P = 0.451, P = 0.385, and P < 0.001). Interestingly, partial arterial carbon dioxide also did not differ over time in the open tunnel endoscopic vein harvesting group (P = 0.241), whereas partial arterial carbon dioxide reduced significantly over time in the open vein harvesting group (P = 0.001). A profound increase in partial arterial carbon dioxide was observed in the closed tunnel endoscopic vein harvesting group (P < 0.001). Consistent with these patterns, only the closed tunnel endoscopic vein harvesting group demonstrated a sudden drop in pH over time (P < 0.001), whereas pH remained stable for both open tunnel endoscopic vein harvesting and open vein harvesting groups (P = 0.105 and P

  8. A Comparative Study of Strength of Two-Way Rectangular Slabs with and without Openings

    NASA Astrophysics Data System (ADS)

    Ravindra, M.; Rakesh, V.; Rambabu, K.

    2016-09-01

    The present work uses yield-line theory to find the strength of uniformly loaded rectangular reinforced concrete slabs with and without rectangular openings. Five positions of openings are considered, i.e. the slab centre, the slab corner, the centre of a short side, the centre of a long side and the opening eccentric to the slab centre. All possible admissible yield line patterns are considered for all given configurations of the slab subjected to uniformly distributed load keeping in view the basic principles of yield line theory. The ratios of the corresponding lengths of the sides of the opening and the slab are different and sizes of opening up to 0.4× the length of the slab sides are considered. Symmetric edge conditions like continuous slab, simply supported, two long sides continuous and two short sides continuous are considered for various sizes of openings in order to plot the design charts for isotropic reinforcement coefficients only. Affine transformation is also performed for slab with openings.

  9. What Multilevel Parallel Programs do when you are not Watching: A Performance Analysis Case Study Comparing MPI/OpenMP, MLP, and Nested OpenMP

    NASA Technical Reports Server (NTRS)

    Jost, Gabriele; Labarta, Jesus; Gimenez, Judit

    2004-01-01

    With the current trend in parallel computer architectures towards clusters of shared memory symmetric multi-processors, parallel programming techniques have evolved that support parallelism beyond a single level. When comparing the performance of applications based on different programming paradigms, it is important to differentiate between the influence of the programming model itself and other factors, such as implementation specific behavior of the operating system (OS) or architectural issues. Rewriting-a large scientific application in order to employ a new programming paradigms is usually a time consuming and error prone task. Before embarking on such an endeavor it is important to determine that there is really a gain that would not be possible with the current implementation. A detailed performance analysis is crucial to clarify these issues. The multilevel programming paradigms considered in this study are hybrid MPI/OpenMP, MLP, and nested OpenMP. The hybrid MPI/OpenMP approach is based on using MPI [7] for the coarse grained parallelization and OpenMP [9] for fine grained loop level parallelism. The MPI programming paradigm assumes a private address space for each process. Data is transferred by explicitly exchanging messages via calls to the MPI library. This model was originally designed for distributed memory architectures but is also suitable for shared memory systems. The second paradigm under consideration is MLP which was developed by Taft. The approach is similar to MPi/OpenMP, using a mix of coarse grain process level parallelization and loop level OpenMP parallelization. As it is the case with MPI, a private address space is assumed for each process. The MLP approach was developed for ccNUMA architectures and explicitly takes advantage of the availability of shared memory. A shared memory arena which is accessible by all processes is required. Communication is done by reading from and writing to the shared memory.

  10. Prospective comparative study of endoscopic via unilateral axillobreast approach versus open conventional total thyroidectomy in patients with papillary thyroid carcinoma.

    PubMed

    Park, Ki Nam; Jung, Chan-Hee; Mok, Ji Oh; Kwak, Jung Ja; Lee, Seung Won

    2016-09-01

    Total thyroidectomy can be accomplished in one of two ways. The first is an open conventional approach, and the other is an endoscopic unilateral axillobreast approach (UABA). However, the two have not been thoroughly compared. In the study described herein, we compare the technical feasibility, safety, and surgical completeness of open versus endoscopic total thyroidectomy procedures. A total of 152 patients who underwent open (n = 102) or endoscopic (n = 50) total thyroidectomy via UABA for papillary microcarcinoma from January to December 2011 were enrolled in this study. Data were collected prospectively after obtaining informed consent. We analyzed the clinical characteristics, pathologic results, postoperative thyroglobulin (Tg) levels, and results of radioactive iodine treatment between the two groups. We conclude that endoscopic thyroidectomy resulted in a younger age, lower body mass index, longer operation time and drain maintenance, and larger drain amount. There were no significant differences with respect to gender, hospital stay, tumor size, time for central compartment neck dissection, number of harvested ipsilateral lymph nodes, or bleeding amount between groups. The proportion of extrathyroidal extension, multifocality, and bilaterality did not differ, and the surgical complication rate was similar. In addition, the postoperative stimulated and non-stimulated Tg levels did not differ significantly, nor did the thyroid bed/brain iodine uptake ratio. Based on our results, endoscopic total thyroidectomy via UABA is technically feasible and has comparable surgical completeness to open total thyroidectomy for papillary microcarcinoma within 1 cm.

  11. Posterior tibial slope changes after opening- and closing-wedge high tibial osteotomy: a comparative prospective multicenter study.

    PubMed

    Ducat, A; Sariali, E; Lebel, B; Mertl, P; Hernigou, P; Flecher, X; Zayni, R; Bonnin, M; Jalil, R; Amzallag, J; Rosset, P; Servien, E; Gaudot, F; Judet, T; Catonné, Y

    2012-02-01

    Valgus high tibial osteotomy is considered to be an effective treatment for unicompartmental medial osteoarthritis. It is generally admitted that tibial slope increases after open-wedge high tibial osteotomy and decreases after closing-wedge high tibial osteotomy. However, the effects on posterior tibial slope of closing- or opening-wedge osteotomies remain controversial. We analyzed the modifications of tibial slope after opening- and closing-wedge high tibial osteotomies and compared the results of these two procedures. We hypothesized that there was no difference in postoperative tibial slope between opening and closing-wedge osteotomies. This prospective consecutive nonrandomized multicenter study was conducted between January 2008 and March 2009 and included 321 patients: 205 men and 116 women. A total of 224 patients underwent an opening-wedge high tibial osteotomy and 97 a closing-wedge osteotomy. The mean age was 52 years ± 9 and the mean body mass index was 28kg/m(2) ± 5. The main etiology was primary arthritis. Posterior tibial slope was measured preoperatively and at the last follow-up on a lateral radiograph in relation to the posterior tibial cortex. In the opening-wedge group, a definite 0.6° increase in tibial slope (P=0.016) was observed. In the closing-wedge group, a definite 0.7° decrease in tibial slope (P=0.02) was found. Fourteen percent of the opening-wedge osteotomies increased tibial slope by 5° or more versus only 2% of the closed-wedge osteotomies (P<0.001). Twelve percent of the closing-wedge high tibial osteotomies led to a decrease of 5° or more of the tibial slope versus 7% of the opening-wedge osteotomies (P<0.02). These results confirm what is generally reported in the literature, i.e., an increase in tibial slope in opening-wedge high tibial osteotomy and a decrease in the slope in closing-wedge osteotomies. These tibial slope changes appear to be very limited in this series, less than 1° on average. However, there was a bias

  12. A Prospective Comparative Study of Arthroscopic Versus Mini-Open Latarjet Procedure With a Minimum 2-Year Follow-up.

    PubMed

    Marion, Blandine; Klouche, Shahnaz; Deranlot, Julien; Bauer, Thomas; Nourissat, Geoffroy; Hardy, Philippe

    2017-02-01

    To compare postoperative pain during the first postoperative week and the position of the coracoid bone block at the anterior aspect of the glenoid after the arthroscopic and the mini-open Latarjet procedure. The secondary purpose was to assess functional results and recurrence after at least 2 years of follow-up. This comparative prospective study included patients who underwent a Latarjet-Bristow procedure for anterior shoulder instability in 2012. The Latarjet procedure was performed by a mini-open approach (G1) in one center and by an arthroscopic approach (G2) in the other. The main evaluation criterion was average shoulder pain during the first postoperative week assessed by the patient on a standard 10-cm visual analog scale (0-10). Secondary criteria were consumption of analgesics during the first week, the position of the coracoid bone block on radiograph and computed tomography scan at the 3-month follow-up and clinical outcomes (Western Ontario Score Index and new surgery) after at least 2 years of follow-up. Fifty-eight patients were included, 22 G1 and 36 G2, 13 women and 45 men, mean age 26.9 ± 7.7 years. The mean follow-up was 29.8 ± 4.4 months. There was significantly less pain in the arthroscopic Latarjet group than in the mini-open group during the first postoperative week (2.5 ± 1.4 vs 1.2 ± 1.2, P = .002) with comparable consumption of analgesics (P > .05). The arthroscopic Latarjet procedure resulted in a more lateral coracoid bone block (P = .04) and a better equatorial position than the mini-open technique (P = .02). Three patients underwent revision surgery (1 recurrence [2.8%], 1 block fracture, 1 screw ablation) in the arthroscopic group, none in the mini-open group (P = .54). At the final follow-up, the Western Ontario Score Index score was good in all patients (G1: 78.5 ± 7.5% vs G2: 82.3 ± 7%, P = .03). This prospective comparative study showed that the arthroscopic Latarjet procedure was significantly less painful than

  13. Reversal of the Hartmann's procedure: A comparative study of laparoscopic versus open surgery

    PubMed Central

    Melkonian, Ernesto; Heine, Claudio; Contreras, David; Rodriguez, Marcelo; Opazo, Patricio; Silva, Andres; Robles, Ignacio; Rebolledo, Rolando

    2017-01-01

    BACKGROUND: The Hartmann's operation, although less frequently performed today, is still used when initial colonic anastomosis is too risky in the short term. However, the subsequent procedure to restore gastrointestinal continuity is associated with significant morbidity and mortality. PATIENTS AND METHODS: The review of an institutional review board (IRB)-approved prospectively maintained database provided data on the Hartmann's reversal procedure performed by either laparoscopic or open technique at our institution. The data collected included: demographic data, operative approach, conversion for laparoscopic cases and perioperative morbidity and mortality. RESULTS: Over a 14-year period from January 1997 to August 2011, 74 Hartmann's reversal procedures were performed (laparoscopic surgery—49, open surgery—25). The average age was 55 years for the laparoscopic and 57 years for the open surgery group, respectively. Male patients represent 61% of both groups. There was no significant difference in operative time between the two groups (149 min vs 151 min; P = 0.95), and there was a tendency to lower morbidity (3/49—7.3% vs 4/25—16%; P = 0.24) in the laparoscopic surgery group. In the laparoscopic group, eight patients (16.3%) were converted to open surgery, mostly due to severe adhesions. The length of hospital stay was significantly shorter for the laparoscopic group (5 days vs 7 days; P = 0.44). CONCLUSIONS: The Hartmann's reversal procedure can be safely performed in the majority of the cases using a laparoscopic approach with a low morbidity rate and achieving a shorter hospital stay. PMID:27251820

  14. Platelet-rich plasma versus open surgical release in chronic tennis elbow: A retrospective comparative study.

    PubMed

    Karaduman, Mert; Okkaoglu, Mustafa Caner; Sesen, Hakan; Taskesen, Anil; Ozdemir, Mahmut; Altay, Murat

    2016-03-01

    To compare short and mid-term results in the treatment of chronic elbow tendinosis with platelet-rich plasma (PRP) or Nirschl surgical technique. A retrospective study was conducted on patients with chronic lateral epicondylitis, treated by Nirschl surgical technique (50 elbows) or PRP (60 elbows). Outcome was evaluated with Visual Analog Score (VAS), Mayo Elbow Scores and grip strength measurements. VAS and Mayo Elbow Scores of the PRP group had improved as a mean of 83% (p = 0.0001), 74% (p = 0.0001) over baseline and 34.2 pounds gain of grip strength. The PRP seems to be better for pain relief and functionality in the short and mid-term periods.

  15. Platelet-rich plasma versus open surgical release in chronic tennis elbow: A retrospective comparative study

    PubMed Central

    Karaduman, Mert; Okkaoglu, Mustafa Caner; Sesen, Hakan; Taskesen, Anil; Ozdemir, Mahmut; Altay, Murat

    2016-01-01

    Purpose To compare short and mid-term results in the treatment of chronic elbow tendinosis with platelet-rich plasma (PRP) or Nirschl surgical technique. Method A retrospective study was conducted on patients with chronic lateral epicondylitis, treated by Nirschl surgical technique (50 elbows) or PRP (60 elbows). Outcome was evaluated with Visual Analog Score (VAS), Mayo Elbow Scores and grip strength measurements. Results VAS and Mayo Elbow Scores of the PRP group had improved as a mean of 83% (p = 0.0001), 74% (p = 0.0001) over baseline and 34.2 pounds gain of grip strength. Conclusion The PRP seems to be better for pain relief and functionality in the short and mid-term periods. PMID:26955228

  16. Access to the parapharyngeal space: an anatomical study comparing the endoscopic and open approaches.

    PubMed

    Van Rompaey, Jason; Suruliraj, Anand; Carrau, Ricardo; Panizza, Benedict; Solares, C Arturo

    2013-10-01

    A subtemporal preauricular approach to the infratemporal fossa and parapharyngeal space has been the traditional path to tumors of this region. The morbidity associated with this procedure has lead to the pursuit of less invasive techniques. Endoscopic access using a minimally invasive transmaxillary/transpterygoid approach potentially may obviate the drawbacks associated with open surgery. The anatomy of the parapharyngeal space is complex and critical; therefore, a comparison of the anatomy exposed by these different approaches could aid in the decision making toward a minimally invasive surgical corridor. Technical Note. The parapharyngeal space was accessed endonasally by removal of the medial and posterior walls of the maxillary sinus. To allow better visualization and increased triangulation of a bimanual dissection technique, a sublabial canine fossa antrostomy was created. The medial and lateral pterygoid plates were removed. Further lateral dissection exposed the relevant anatomy of the parapharyngeal space. A subtemporal preauricular infratemporal approach was also completed. The endoscopic approach provided sufficient access to the superior portion of the parapharyngeal space. The open approach also provided adequate access; however, it required a larger surgical window, causing greater injury. A significant advantage of the subtemporal approach is the improved access to the petrous portion of the internal carotid artery. Conversely, the endonasal approach provided improved access to the anterior and medial portions of the superior parapharyngeal space. Endoscopic endonasal access utilizing a transmaxillary/transpterygoid approach provides a sufficient surgical window for tumor extirpation. Utilization of this approach obviates some of the morbidity associated with an open procedure. 5. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  17. Open comparative randomised study of moclobemide versus amitriptyline in major depressive illness (DSM IIIR) in Nigeria.

    PubMed

    Ononye, F; Sijuola, O A; Chukwuani, C M; Mume, O C; Makanjuola, R O

    2000-01-01

    In a multi-centre study, 60 patients (20 males and 40 females aged 43 +/- 15 and 37 +/- 15 years respectively) with a DSM-IIIR diagnosis of major depressive disorders were randomly assigned to treatment with either Moclobemide (maximum dose 600 mg per day) or Amitriptyline (maximum dose 150 mg per day) for eight weeks. Patients were evaluated pretreatment and over the 8 weeks treatment period using Hamilton Depression Rating Scale (HDRS) and the clinical global impressions (CGI). The Adverse Drug Effects Schedule, clinical, haematological and biochemical status were also evaluated pre, during and post treatment. Of the 60 patients enrolled for the study 54 were found evaluable for efficacy whilst all 60 were evaluated for safety (Adverse Event). On the HDRS and CGI scale there was no significant difference in the therapeutic outcome between the two treatment groups. In the overall clinical assessment rating at the end of treatment 94.1% of patients in the Moclobemide group were rated 'very good to good' and 94.4% with Amitriptyline. Moclobemide appeared to have a slightly better safety profile, the incidence of adverse event was 9.0% compared to 19.0% with Amitriptyline. The drop out rate was 16.7% and 26.7% for moclobemide and amitriptyline respectively. These differences were however not statistically significant. It was therefore concluded that moclobemide is an effective and safe alternative to amitriptyline, with attractive potential for out patients management of depressive illness.

  18. Comparative Study of Prolene Hernia System and Lichtenstein Method for Open Inguinal Hernia Repair

    PubMed Central

    Badkur, Mayank

    2015-01-01

    Background Prolene Hernia System (PHS) is a bi-layered polypropylene mesh with a connector that combines the anterior and posterior inguinal hernia repair, but still not very popular in this part of the country. Hence a prospective & randomized comparative study was undertaken to compare PHS with the already popular Lichtenstein Hernia Repair (LHR) and determine the post-operative outcome. Materials and Methods Total 67 inguinal hernia repairs were randomly assigned to either PHS or LHR method, and data was collected regarding various outcome measures like duration of surgery, post-operative pain, requirement of analgesia, return to normal activity, and early and late complications. Results Mean duration of surgery was significantly higher for PHS group than LHR group (65.4 min vs 51.26 min, p-value <0.0001). Significant difference was noted between the PHS and LHR group in terms of moderate to severe post-operative pain (15.15% vs 41.18%,p-value 0.018), time of requirement of analgesia (3.7 vs 4.6 days, p-value 0.024), and time to return to normal activity (2.7 vs 3.4 days, p-value 0.023), all in favour of the former technique. No intra-operative complication was noted in either of the groups. 5 patients had early complications in PHS group and 6 in LHR group, but this was statistically not significant. The average time of follow-up for the study was 7.8 month, ranging from 1 to 18 months. Chronic inguinal pain was noted in 1 and 2 patients respectively in PHS and LHR group, again statistically not significant. No recurrence was noted in both the groups till the time of follow-up. Conclusion PHS is a safe and better alternative to the time honored Lichtenstein hernia repair with the added advantage of strengthening whole of myopectineal orifice, and virtually eliminating any risk of recurrence. PMID:26266158

  19. Comparative study of voiding and male sexual function following open and laparoscopic total mesorectal excision in patients with rectal cancer.

    PubMed

    Hur, Hyuk; Bae, Sung Uk; Kim, Nam Kyu; Min, Byung Soh; Baik, Seung Hyuk; Lee, Kang Young; Kim, Young Tae; Choi, Young Deuk

    2013-12-01

    This study aimed to compare voiding and male sexual dysfunction between open and laparoscopic rectal cancer surgery. Ninety-seven patients (62 male and 35 female) who underwent open (n = 41) or laparoscopic (n = 56) surgery for rectal cancer were prospectively enrolled. Urine flowmetry, the international prostate symptom score, and the international index of erectile function were assessed preoperatively and postoperatively. Voiding function score increased 1 month after surgery (open: 9.3 ± 4.6 to 14.0 ± 8.2, laparoscopic: 8.3 ± 5.3 to 12.3 ± 5.2; P = 0.002 and P < 0.001). The score was even higher in both groups after 6 months, but the increases were not statistically significant (open: 9.9 ± 4.5, laparoscopic: 9.2 ± 5.6; P = 0.546 and P = 0.280). Male patients who underwent open surgery (n = 22) experienced declining sexual function until 12 months post surgery (before: 55.2 ± 9.8, 12 months: 48.7 ± 15.9, P = 0.031). In laparoscopic group (n = 28), sexual function decreased until 6 months after surgery, but rose again by 12 months (before: 55.4 ± 9.0, 12 months: 52.2 ± 11.7, P = 0.134). Voiding dysfunction recovered after 6 months following both open and laparoscopic surgery. Male sexual function recovered more quickly in laparoscopic group and returned to preoperative levels after 12 months. © 2013 Wiley Periodicals, Inc.

  20. Comparative Theoretical Study of the Ring-Opening Polymerization of Caprolactam vs Caprolactone Using QM/MM Methods

    SciTech Connect

    Elsasser, Brigitta M.; Schoenen, Iris; Fels, Gregor

    2013-06-07

    Candida antarctica lipase B (CALB) efficiently catalyzes the ring-opening polymerization of lactones to high molecular weight products in good yield. In contrast, an efficient enzymatic synthesis of polyamides has so far not been described in the literature. This obvious difference in enzyme catalysis is the subject of our comparative study of the initial steps of a CALB catalyzed ring-opening polymerization of ε- caprolactone and ε-caprolactam. We have applied docking tools to generate the reactant state complex and performed quantum mechanical/molecular mechanical (QM/MM) calculations at the density functional theory (DFT) PBE0 level of theory to simulate the acylation of Ser105 by the lactone and the lactam, respectively, via the corresponding first tetrahedral intermediates. We could identify a decisive difference in the accessibility of the two substrates in the ring-opening to the respective acyl enzyme complex as the attack of ε-caprolactam is hindered because of an energetically disfavored proton transfer during this part of the catalytic reaction while ε-caprolactone is perfectly processed along the widely accepted pathway using the catalytic triade of Ser105, His224, and Asp187. Since the generation of an acylated Ser105 species is the crucial step of the polymerization procedure, our results give an explanation for the unsatisfactory enzymatic polyamide formation and opens up new possibilities for targeted rational catalyst redesign in hope of an experimentally useful CALB catalyzed polyamide synthesis.

  1. Comparing open and minimally invasive surgical procedures for oesophagectomy in the treatment of cancer: the ROMIO (Randomised Oesophagectomy: Minimally Invasive or Open) feasibility study and pilot trial.

    PubMed Central

    Metcalfe, Chris; Avery, Kerry; Berrisford, Richard; Barham, Paul; Noble, Sian M; Fernandez, Aida Moure; Hanna, George; Goldin, Robert; Elliott, Jackie; Wheatley, Timothy; Sanders, Grant; Hollowood, Andrew; Falk, Stephen; Titcomb, Dan; Streets, Christopher; Donovan, Jenny L; Blazeby, Jane M

    2016-01-01

    BACKGROUND Localised oesophageal cancer can be curatively treated with surgery (oesophagectomy) but the procedure is complex with a risk of complications, negative effects on quality of life and a recovery period of 6-9 months. Minimal-access surgery may accelerate recovery. OBJECTIVES The ROMIO (Randomised Oesophagectomy: Minimally Invasive or Open) study aimed to establish the feasibility of, and methodology for, a definitive trial comparing minimally invasive and open surgery for oesophagectomy. Objectives were to quantify the number of eligible patients in a pilot trial; develop surgical manuals as the basis for quality assurance; standardise pathological processing; establish a method to blind patients to their allocation in the first week post surgery; identify measures of postsurgical outcome of importance to patients and clinicians; and establish the main cost differences between the surgical approaches. DESIGN Pilot parallel three-arm randomised controlled trial nested within feasibility work. SETTING Two UK NHS departments of upper gastrointestinal surgery. PARTICIPANTS Patients aged ≥ 18 years with histopathological evidence of oesophageal or oesophagogastric junctional adenocarcinoma, squamous cell cancer or high-grade dysplasia, referred for oesophagectomy or oesophagectomy following neoadjuvant chemo(radio)therapy. INTERVENTIONS Oesophagectomy, with patients randomised to open surgery, a hybrid open chest and minimally invasive abdomen or totally minimally invasive access. MAIN OUTCOME MEASURE The primary outcome measure for the pilot trial was the number of patients recruited per month, with the main trial considered feasible if at least 2.5 patients per month were recruited. RESULTS During 21 months of recruitment, 263 patients were assessed for eligibility; of these, 135 (51%) were found to be eligible and 104 (77%) agreed to participate, an average of five patients per month. In total, 41 patients were allocated to open surgery, 43 to the

  2. Comparative study of final visual outcome between open- and closed-globe injuries following surgical treatment of traumatic cataract.

    PubMed

    Shah, Mehul Ashvin; Shah, Shreya Mehul; Shah, Shashank B; Patel, Chintan G; Patel, Utsav A; Appleware, Adway; Gupta, Ashish

    2011-12-01

    The objective of this work is to compare final visual outcomes in cases of surgically treated traumatic cataract between open-globe and closed-globe groups, as classified by the Birmingham Eye Trauma Terminology system. Observational cohort study. Tertiary eye-care center at the trijunction of Gujarat, Madhya Pradesh, and Rajasthan states in central western India. We enrolled patients meeting specific inclusion criteria, examined their eyes to review any co-morbidities due to trauma, performed surgery for traumatic cataracts, and implanted lenses. The patients were re-examined 6 weeks postoperatively. We classified the cases of traumatic cataract as either open-globe (group 1) or closed-globe (group 2), according to the Birmingham Eye Trauma Terminology (BETT) system, and compared visual acuity. Visual Acuity. Our cohort of 687 eyes with traumatic cataracts included 496 eyes in group 1 and 191 in group 2. Six weeks postoperatively, the visual acuity was >20/60 in 298 (58%) and 75 (39.1%) operated eyes in groups 1 and 2, respectively (p < 0.001, ANOVA). At follow-up, >20/60 vision was significantly higher in group 1 than in group 2 (OR = 1.61; 95% CI, 0.85-3.02). Overall, 373 eyes (54.3%) regained final visual acuity >20/60. Open-globe injury has a more favorable prognosis for satisfactory (>20/60) visual recovery after management of traumatic cataracts.

  3. Physical and Visual Accessibilities in Intensive Care Units: A Comparative Study of Open-Plan and Racetrack Units.

    PubMed

    Rashid, Mahbub; Khan, Nayma; Jones, Belinda

    2016-01-01

    This study compared physical and visual accessibilities and their associations with staff perception and interaction behaviors in 2 intensive care units (ICUs) with open-plan and racetrack layouts. For the study, physical and visual accessibilities were measured using the spatial analysis techniques of Space Syntax. Data on staff perception were collected from 81 clinicians using a questionnaire survey. The locations of 2233 interactions, and the location and length of another 339 interactions in these units were collected using systematic field observation techniques. According to the study, physical and visual accessibilities were different in the 2 ICUs, and clinicians' primary workspaces were physically and visually more accessible in the open-plan ICU. Physical and visual accessibilities affected how well clinicians' knew their peers and where their peers were located in these units. Physical and visual accessibilities also affected clinicians' perception of interaction and communication and of teamwork and collaboration in these units. Additionally, physical and visual accessibilities showed significant positive associations with interaction behaviors in these units, with the open-plan ICU showing stronger associations. However, physical accessibilities were less important than visual accessibilities in relation to interaction behaviors in these ICUs. The implications of these findings for ICU design are discussed.

  4. A comparative study of the decomposition of pig carcasses in a methyl methacrylate box and open air conditions.

    PubMed

    Li, Liangliang; Wang, Jiangfeng; Wang, Yu

    2016-08-01

    Analysis of the process of decomposition is essential in establishing the postmortem interval. However, despite the fact that insects are important players in body decomposition, their exact function within the decay process is still unclear. There is also limited knowledge as to how the decomposition process occurs in the absence of insects. In the present study, we compared the decomposition of a pig carcass in open air with that of one placed in a methyl methacrylate box to prevent insect contact. The pig carcass in the methyl methacrylate box was in the fresh stage for 1 day, the bloated stage from 2 d to 11 d, and underwent deflated decay from 12 d. In contrast, the pig carcass in open air went through the fresh, bloated, active decay and post-decay stages; and 22.3 h (0.93 d), 62.47 h (2.60 d), 123.63 h (5.15 d) and 246.5 h (10.27 d) following the start of the experiment respectively, prior to entering the skeletonization stage. A large amount of soft tissue were remained on the pig carcass in the methyl methacrylate box on 26 d, while only scattered bones remained on the pig carcass in open air. The results indicate that insects greatly accelerate the decomposition process.

  5. Open lateral patellar retinacular lengthening versus open retinacular release in lateral patellar hypercompression syndrome: a prospective double-blinded comparative study on complications and outcome.

    PubMed

    Pagenstert, Geert; Wolf, Nicole; Bachmann, Martin; Gravius, Sascha; Barg, Alexej; Hintermann, Beat; Wirtz, Dieter C; Valderrabano, Victor; Leumann, André G

    2012-06-01

    To compare complication rates and outcome of open lateral retinacular (LR) lengthening and open LR release in the treatment of lateral patellar hypercompression syndrome (LPHS). In a prospective double-blinded study, 28 patients (mean age, 48 years; 21 women and 7 men) received either LR release (14 patients) or LR lengthening (14 patients) in alternating fashion over the same lateral parapatellar skin incision for LPHS (blinding of patients to surgical procedure [i.e., single blinding]). Strict inclusion criteria (retinacular pain, tight retinaculum, decreased patellar mobility) were used to exclude other reasons for anterior knee pain (patellar instability, leg malalignment or maltorsion, trochlear dysplasia, patella alta). The surgeon and postsurgical rehabilitation were the same. Preoperatively and at 3, 6, 12, and 24 months postoperatively, complications, muscle atrophy, and Kujala patellofemoral outcome score were documented by examiners blinded to the surgical procedure (double blinding). All patients completed 2 years of follow-up. The results of 2 years of follow-up showed that recurrence of LPHS, as indicated by the patellar tilt test and decreased medial patellar glide test, developed in 2 cases after LR release and 1 case after LR lengthening (P > .999). Medial patellar subluxation, as indicated by the gravitation-subluxation test and increased medial patellar glide test, developed in 5 cases after LR release and no case after LR lengthening (P = .041). Quadriceps atrophy, as indicated by the mean circumference difference compared with the healthy contralateral side, was significantly higher (P = .001) in the LR release group (1.8 cm) than in the LR lengthening group (0.2 cm). The mean Kujala score was significantly lower (P = .035) in the LR release group (77.2 points) than in the LR lengthening group (88.4 points). In this prospective double-blinded study, retinacular lengthening showed less medial instability, less quadriceps atrophy, and a better

  6. Mixed method approaches in open-ended, qualitative, exploratory research involving people with intellectual disabilities: a comparative methods study.

    PubMed

    Ottmann, Goetz; Crosbie, Jenny

    2013-09-01

    People with intellectual disabilities and their families are increasingly being asked to provide input into the services they receive. Under the aegis of the United Nation Convention of the Rights of Persons with Disabilities, support plans crucially depend on a participant's articulation of his or her preferences and life goals. Yet, research highlighting the strengths and weaknesses of different methodological approaches has not been published. This study compared the results of a suite of qualitative methods (questionnaire, focus group, semi-structured interview, "case in point" ethnographic observation, photographic images, and carer proxy response) by identifying the advantages and disadvantages of each method employed. It also foregrounds an effective mix of methods that is likely to produce an adequate representation of the views of people with disabilities within the context of open-ended exploratory questions.

  7. Effects of quetiapine and olanzapine in patients with psychosis and violent behavior: a pilot randomized, open-label, comparative study

    PubMed Central

    Gobbi, Gabriella; Comai, Stefano; Debonnel, Guy

    2014-01-01

    Objective Patients suffering from psychosis are more likely than the general population to commit aggressive acts, but the therapeutics of aggressive behavior are still a matter of debate. Methods This pilot randomized, open-label study compared the efficacy of quetiapine versus olanzapine in reducing impulsive and aggressive behaviors (primary endpoints) and psychotic symptoms (secondary endpoints) from baseline to days 1, 7, 14, 28, 42, 56, and 70, in 15 violent schizophrenic patients hospitalized in a maximum-security psychiatric hospital. Results Quetiapine (525±45 mg) and olanzapine (18.5±4.8 mg) were both efficacious in reducing Impulsivity Rating Scale from baseline to day 70. In addition, both treatments reduced the Brief Psychiatric Rating Scale, Positive and Negative Syndrome Scale, and Clinical Global Impression Scale scores at day 70 compared to baseline, and no differences were observed between treatments. Moreover, quetiapine, but not olanzapine, yielded an improvement of depressive symptoms in the items “depression” in Brief Psychiatric Rating Scale and “blunted affect” in Positive and Negative Syndrome Scale. Modified Overt Aggression Scale scores were also decreased from baseline to the endpoint, but due to the limited number of patients, it was not possible to detect a significant difference. Conclusion In this pilot study, quetiapine and olanzapine equally decreased impulsive and psychotic symptoms after 8 weeks of treatment. Double-blind, large studies are needed to confirm the validity of these two treatments in highly aggressive and violent schizophrenic patients. PMID:24855361

  8. Antidepressant monotherapy compared with combinations of antidepressants in the treatment of resistant depressive patients: a randomized, open-label study.

    PubMed

    Bares, Martin; Novak, Tomas; Kopecek, Miloslav; Stopkova, Pavla; Cermak, Jan; Kozeny, Jiri; Höschl, Cyril

    2013-02-01

    This randomized, 6-week, open-label study compared efficacy of CAD and antidepressant monotherapies (ADM) that had been chosen according to clinical judgment of the attending psychiatrist. A total of 60 inpatients (intent-to-treat analysis) with depressive disorder (≥ 1 unsuccessful antidepressant treatment) were randomly assigned to the interventions. The responders who completed the acute phase of study, were evaluated for relapse within 2 months of follow-up treatment. The primary outcome measure was change in the Montgomery-Åsberg Depression Rating Scale (MADRS) and response was defined as a ≥ 50% reduction of MADRS score. Mean changes in total MADRS score from baseline to week 6 for patients in both treatment modalities were not different (ADM = 13.2 ± 8.6 points; CAD = 14.5 ± 9.5 points; P = 0.58). The analysis of covariance performed for significantly higher value of imipramine equivalent dose in CAD group showed only a non-significant between-group difference for total MADRS change (P = 0.17). There were also no differences between groups in response rate (ADM = 48%; CAD = 58%) and number of drop-outs in acute treatment as well as proportion of responders' relapses in the follow-up. Both treatment modalities produced clinically relevant reduction of depressive symptomatology in acute treatment of patients with resistant depression and their effect was comparable.

  9. easyGWAS: A Cloud-Based Platform for Comparing the Results of Genome-Wide Association Studies[OPEN

    PubMed Central

    Roqueiro, Damian; Salomé, Patrice A.; Kleeberger, Stefan; Zhu, Wangsheng; Lippert, Christoph; Stegle, Oliver; Schölkopf, Bernhard

    2017-01-01

    The ever-growing availability of high-quality genotypes for a multitude of species has enabled researchers to explore the underlying genetic architecture of complex phenotypes at an unprecedented level of detail using genome-wide association studies (GWAS). The systematic comparison of results obtained from GWAS of different traits opens up new possibilities, including the analysis of pleiotropic effects. Other advantages that result from the integration of multiple GWAS are the ability to replicate GWAS signals and to increase statistical power to detect such signals through meta-analyses. In order to facilitate the simple comparison of GWAS results, we present easyGWAS, a powerful, species-independent online resource for computing, storing, sharing, annotating, and comparing GWAS. The easyGWAS tool supports multiple species, the uploading of private genotype data and summary statistics of existing GWAS, as well as advanced methods for comparing GWAS results across different experiments and data sets in an interactive and user-friendly interface. easyGWAS is also a public data repository for GWAS data and summary statistics and already includes published data and results from several major GWAS. We demonstrate the potential of easyGWAS with a case study of the model organism Arabidopsis thaliana, using flowering and growth-related traits. PMID:27986896

  10. Open-Label Study of Craving in Smokers With Schizophrenia Using Nicotine Nasal Spray Compared to Nicotine Patch

    PubMed Central

    Williams, Jill M.; Gandhi, Kunal K.; Karavidas, Maria Katsamanis; Steinberg, Marc L.; Lu, Shou-En; Foulds, Jonathan

    2009-01-01

    Rationale: Nicotine nasal spray (NNS) may be better for relieving acute cigarette cravings than other nicotine replacement and it may help smokers with schizophrenia because of its rapid onset of action. Objectives: We tested whether NNS was more effective than a nicotine patch (NP; 21 mg) in reducing cue-induced craving during a 3-day abstinence. Methods: Twenty-five smokers with schizophrenia or schizoaffective disorder (SA) were randomized to open-label NNS or NP treatment after baseline measures of craving were assessed. NNS users were instructed to dose at a minimum of 1/hour and up to a maximum of 40/day. Averages from a 4-item visual analogue scale (need, urge, want to smoke, crave a cigarette) measured craving. Results: Five subjects who smoked (4 NP, 1 NNS) were excluded, leaving 21 (11 NP, 10 NNS) for analyses. No differences were detected between groups on baseline craving. On day 3, NNS users reported significantly less craving in response to smoking cues compared to NP users (mean craving scores: NNS, 7.0; NP, 20.3; p = .014). A repeated measure ANCOVA demonstrated significantly reduced craving in the NNS group compared to the NP group from baseline to day 3 (F = 5.09; p = .037). NNS users took an average of 20 doses/day, and NNS was rated as being as easy to use as NP. Conclusions: The potential utility of NNS in smokers with schizophrenia supports the need for placebo-controlled studies. PMID:19763279

  11. A 7 year prospective comparative study of three topical beta blockers in the management of primary open angle glaucoma.

    PubMed

    Watson, P G; Barnett, M F; Parker, V; Haybittle, J

    2001-08-01

    To determine the long term efficacy of monotherapy with topically applied beta blocking agents and to determine whether selective beta blockers were able to preserve the visual field more effectively than non-selective agents. A prospective randomised, open, comparative study of three topically applied beta blockers-timolol, betaxolol, and carteolol-was carried out on 153 patients (280 eyes) with newly diagnosed open angle glaucoma. Those patients who were not withdrawn were followed by the same observers for a minimum of 2 years and a maximum of 7 years, with clinical observations, Goldmann tonometry and 24.2 Humphrey visual field analysis. All three drugs lowered the IOP significantly from untreated levels but betaxolol took up to 12 months in some instances to reach the maximum pressure reduction. After 7 years only 43% of the eyes begun on timolol, 34% of those started on carteolol, and 29% of those on betaxolol were still being treated with these medications alone. Visual fields were analysed throughout the trial by CPSD and MD and at the end by linear regression analysis (PROGRESSOR). The visual fields remained the same without apparent improvement or deterioration throughout the period of follow up. Eight patients (11 eyes) were withdrawn because of continuing field loss in spite of reduction in IOP (six using carteolol and five using betaxolol). Analysis shows that less than half the eyes initially treated with topical beta blockers might be expected to still be being treated with their original medication after 5 years. The rest required either additional medication or trabeculectomy. There was no statistically significant improvement or deterioration in the visual fields over a 7 year period. On the evidence of this trial there are no particular advantages in using selective beta blockers.

  12. A Randomised, Open-label, Comparative Study of Tranexamic Acid Microinjections and Tranexamic Acid with Microneedling in Patients with Melasma

    PubMed Central

    Budamakuntla, Leelavathy; Loganathan, Eswari; Suresh, Deepak Hurkudli; Shanmugam, Sharavana; Suryanarayan, Shwetha; Dongare, Aparna; Venkataramiah, Lakshmi Dammaningala; Prabhu, Namitha

    2013-01-01

    Background: Melasma is a common cause of facial hyperpigmentation with significant cosmetic deformity. Although several treatment modalities are available, none is satisfactory. Aim: To compare the therapeutic efficacy and safety of tranexamic acid (TA) microinjections versus tranexamic acid with microneedling in melasma. Materials and Methods: This is a prospective, randomised, open-label study with a sample size of 60; 30 in each treatment arms. Thirty patients were administered with localised microinjections of TA in one arm, and other 30 with TA with microneedling. The procedure was done at monthly intervals (0, 4 and 8 weeks) and followed up for three consecutive months. Clinical images were taken at each visit including modified Melasma Area Severity Index MASI scoring, patient global assessment and physician global assessment to assess the clinical response. Results: In the microinjection group, there was 35.72% improvement in the MASI score compared to 44.41% in the microneedling group, at the end of third follow-up visit. Six patients (26.09%) in the microinjections group, as compared to 12 patients (41.38%) in the microneedling group, showed more than 50% improvement. However, there were no major adverse events observed in both the treatment groups. Conclusions: On the basis of these results, TA can be used as potentially a new, effective, safe and promising therapeutic agent in melasma. The medication is easily available and affordable. Better therapeutic response to treatment in the microneedling group could be attributed to the deeper and uniform delivery of the medication through microchannels created by microneedling. PMID:24163529

  13. Arthroscopic Versus Open Latarjet in the Treatment of Recurrent Anterior Shoulder Dislocation With Marked Glenoid Bone Loss: A Prospective Comparative Study.

    PubMed

    Zhu, Yiming; Jiang, Chunyan; Song, Guanyang

    2017-06-01

    Very few studies have compared open Latarjet versus arthroscopic Latarjet procedures. To compare the clinical and computed tomographic outcomes between open and arthroscopic Latarjet procedures. Cohort study; Level of evidence, 3. A prospective, comparative study was performed. The open Latarjet group included 44 patients, and the arthroscopic Latarjet group included 46 patients. All patients had more than 2 years of clinical follow-up (range of motion, American Shoulder and Elbow Surgeons [ASES] score, Constant-Murley score, and Rowe score). The position of the transferred coracoid, the screw orientation, and graft resorption were evaluated on computed tomography (CT) scan. The surgery time for the open group was significantly shorter than that for the arthroscopic group ( P = .003). No recurrent dislocation occurred in either group. The apprehension test was negative in all patients in both groups. At the final follow-up, no significant difference was detected between the open group and the arthroscopic group regarding any of the clinical outcome measurements. The transferred coracoid graft was level with the glenoid in all patients in both groups. The open group had better position in the superior-inferior direction compared with the arthroscopic group ( P < .001). No significant difference was found in screw orientation between the 2 groups ( P = .102). At 1 year after surgery, patients in the arthroscopic group had significantly less resorption compared with patients in the open group ( P = .044). Both procedures are effective for the treatment of recurrent anterior shoulder dislocation with marked glenoid bone loss. The open group had better position in the superior-inferior direction compared with the arthroscopic group. At 1 year after surgery, patients in the arthroscopic Latarjet group showed notably less graft resorption compared with patients in the open Latarjet group.

  14. A New Viscous Cysteamine Eye Drops Treatment for Ophthalmic Cystinosis: An Open-Label Randomized Comparative Phase III Pivotal Study.

    PubMed

    Liang, Hong; Labbé, Antoine; Le Mouhaër, Jeannie; Plisson, Céline; Baudouin, Christophe

    2017-04-01

    The purpose of this study was to evaluate the efficacy of new viscous cysteamine hydrochloride (CH) eye drops (vCH 0.55%) compared with standard CH 0.10% drops treatment. This was an open-label, phase III, randomized, two-arm multicenter trial conducted at two centers in France. Cystinosis patients ≥2 years old were randomized 1:1 to receive eye drops, four times per day for 90 days in both eyes. We compared the superiority in reducing corneal cystine crystal density as assessed by in vivo confocal microscopy (IVCM). We also evaluated photophobia, corneal cystine crystal scores (CCCSs), and cystine crystal depth measured by optical coherence tomography. Safety objectives were to assess adverse events (AEs), local adverse drug reactions, and ocular safety parameters. We included 15 patients with vCH 0.55% and 16 patients with CH 0.10% drops for 90 days. The mean absolute change in IVCM total score at day 90 in the vCH 0.55% drops group (-4.6 ± 3.1) was significantly greater than and superior to the mean absolute change in the CH 0.10% drops group (-0.46 ± 3.38; P < 0.0001). Photophobia, CCCS, and corneal cystine crystal depth were significantly more improved in the vCH 0.55% drops group than in the CH 0.10% group. The most frequent local adverse drug reactions in both groups were stinging, burning, redness, and blurred vision. vCH 0.55% was effective in reducing corneal cystine crystal density and superior to treatment with CH 0.10% drops, which offer advantages over hospital pharmacy formulations and is a more preferable and convenient treatment option.

  15. A prospective, open, comparative study of 5% potassium hydroxide solution versus cryotherapy in the treatment of genital warts in men*

    PubMed Central

    Camargo, Caio Lamunier de Abreu; Belda, Walter; Fagundes, Luiz Jorge; Romiti, Ricardo

    2014-01-01

    BACKGROUND Genital warts are caused by human papillomavirus infection and represent one of the most common sexually transmitted diseases. Many infections are transient but the virus may recur, persist, or become latent. To date, there is no effective antiviral treatment to eliminate HPV infection and most therapies are aimed at the destruction of visible lesions. Potassium hydroxide is a strong alkali that has been shown to be safe and effective for the treatment of genital warts and molluscum contagiosum. Cryotherapy is considered one of the most established treatments for genital warts. No comparative trials have been reported to date on the use of potassium hydroxide for genital warts. OBJECTIVE A prospective, open-label, randomized clinical trial was conducted to compare topical potassium hydroxide versus cryotherapy in the treatment of genital warts affecting immunocompetent, sexually active men. METHODS Over a period of 10 months, 48 patients were enrolled. They were randomly divided into two groups and selected on an alternative basis for either potassium hydroxide therapy or cryotherapy. While response to therapy did not differ substantially between both treatment modalities, side effects such as local pain and post-treatment hypopigmentation were considerably more prevalent in the groups treated using cryotherapy. RESULT In our study, potassium hydroxide therapy proved to be at least as effective as cryotherapy and offered the benefit of a better safety profile. CONCLUSION Topical 5% potassium hydroxide presents an effective, safe, and low-cost treatment modality for genital warts in men and should be included in the spectrum of therapies for genital warts. PMID:24770498

  16. A comparative study of efficacy and safety of azithromycin and ofloxacin in uncomplicated typhoid Fever: a randomised, open labelled study.

    PubMed

    Chandey, Manish; Multani, A S

    2012-12-01

    To compare the efficacy and safety of azithromycin with ofloxacin in patients with uncomplicated typhoid fever. Forty adult patients with bacteriologically or serologically diagnosed, uncomplicated typhoid fever were included from Medicine out-patient department at Government medical college, Amritsar, India. They were randomized into 2 groups of 20 patients each. Group I: patients received ofloxacin 200mg orally twice daily for 7 days. Group II: Patients received Azithromycin orally 1 gm on day 1 and then 500 mg daily from day 2 to day 6. The following parameters were noted a) fever clearance time b) cure rate c) adverse drug reaction d) recurrence of symptoms, if any, during 4 weeks follow up. Nineteen out of 20 patients from group I were cured with mean fever clearance time of 3.68 days while all 20 patients from group II were cured with mean fever clearance time of 3.65 days. No significant side effects were noted in any of the patients. No relapse was recorded in the present study in a follow up period of 4 weeks in both study groups. Both ofloxacin and Azithromycin are almost equally efficacious and safe in treatment of typhoid fever with no major adverse effect. Azithromycin is an effective alternative in conditions where ofloxacin is contraindicated i.e., children, pregnant women and quinolone resistant cases of typhoid fever.

  17. Open randomised prospective comparative multi-centre intervention study of patients with cystic fibrosis and early diagnosed diabetes mellitus

    PubMed Central

    2014-01-01

    Background Diabetes mellitus may be present in patients with cystic fibrosis starting in the second decade of life. The prevalence increases rapidly with increasing age. As life-expectancy increases in cystic fibrosis, cystic fibrosis related diabetes will be diagnosed more frequently in the future. Up to date, no data are available to answer the question if cystic fibrosis related diabetes should always initially be treated by insulin therapy. Missing data regarding oral antidiabetic treatment of newly diagnosed cystic fibrosis related diabetes are an important reason to recommend insulin treatment. Several centres report the successful management of cystic fibrosis related diabetes using oral anti-diabetic drugs at least for some years. Oral therapies would be less invasive for a patient group which is highly traumatized by a very demanding therapy. Based on an initiative of the German Mukoviszidosis-Foundation, the present study tries to answer the question, whether oral therapy with repaglinide is as effective as insulin therapy in cystic fibrosis patients with early diagnosed diabetes mellitus. Methods/Design In all cystic fibrosis patients with an age of 10 years or older, an oral glucose tolerance test is recommended. The result of this test is classified according to the WHO cut off values. It is required to have two diabetes positive oral glucose tolerance tests for the diagnosis of diabetes mellitus. This study is a multi-national, multicentre, open labelled, randomized and prospective controlled parallel group’s trial, with 24 months treatment. The primary objective of this trial is to compare the glycaemic control of oral therapy with Repaglinide with insulin injections in patients with cystic fibrosis related diabetes after 2 years of treatment. The trial should include 74 subjects showing cystic fibrosis related diabetes newly diagnosed by oral glucose tolerance test during annual screening for cystic fibrosis related diabetes. Patients are

  18. Open-label, randomized, comparative, phase III study on effects of reducing steroid use in combination with Palonosetron

    PubMed Central

    Komatsu, Yoshito; Okita, Kenji; Yuki, Satoshi; Furuhata, Tomohisa; Fukushima, Hiraku; Masuko, Hiroyuki; Kawamoto, Yasuyuki; Isobe, Hiroshi; Miyagishima, Takuto; Sasaki, Kazuaki; Nakamura, Michio; Ohsaki, Yoshinobu; Nakajima, Junta; Tateyama, Miki; Eto, Kazunori; Minami, Shinya; Yokoyama, Ryoji; Iwanaga, Ichiro; Shibuya, Hitoshi; Kudo, Mineo; Oba, Koji; Takahashi, Yasuo

    2015-01-01

    The purpose of this study is to compare the efficacy of a single administration of dexamethasone (DEX) on day 1 against DEX administration on days 1–3 in combination with palonosetron (PALO), a second-generation 5-HT3 receptor antagonist, for chemotherapy-induced nausea and vomiting (CINV) in non-anthracycline and cyclophosphamide (AC) moderately-emetogenic chemotherapy (MEC). This phase III trial was conducted with a multi-center, randomized, open-label, non-inferiority design. Patients who received non-AC MEC as an initial chemotherapy were randomly assigned to either a group administered PALO (0.75 mg, i.v.) and DEX (9.9 mg, i.v.) prior to chemotherapy (study treatment group), or a group administered additional DEX (8 mg, i.v. or p.o.) on days 2–3 (control group). The primary endpoint was complete response (CR) rate. The CR rate difference was estimated by logistic regression with allocation factors as covariates. The non-inferiority margin was set at −15% (study treatment group − control group). From April 2011 to March 2013, 305 patients who received non-AC MEC were randomly allocated to one of two study groups. Overall, the CR rate was 66.2% in the study treatment group (N = 151) and 63.6% in the control group (N = 154). PALO plus DEX day 1 was non-inferior to PALO plus DEX days 1–3 (difference, 2.5%; 95% confidence interval [CI]: −7.8%–12.8%; P-value for non-inferiority test = 0.0004). There were no differences between the two groups in terms of complete control rate (64.9 vs 61.7%) and total control rate (49.7% vs 47.4%). Anti-emetic DEX administration on days 2–3 may be eliminated when used in combination with PALO in patients receiving non-AC MEC. PMID:25872578

  19. Electron-beam generation in a wide-aperture open gas discharge: A comparative study for different inert gases

    SciTech Connect

    Bokhan, P. A.; Zakrevsky, Dm. E.

    2010-08-30

    In the present study, electron-beam generation by open discharges was examined. The study was performed at gas pressures up to 20 Torr, and covered all inert gases. At voltages up to 8 kV, electron-beam currents up to 1600 A with current density {approx}130 A/cm{sup 2} and a beam generation efficiency in excess of 93% were obtained. The production of electrons from cold cathode was concluded to be of photoemissive nature, enabling the production of high-intensity electron beams in any noble gas or in a mixture of a noble gas with molecular gases irrespective of cathode material.

  20. [Who Hits the Mark? A Comparative Study of the Free Geocoding Services of Google and OpenStreetMap].

    PubMed

    Lemke, D; Mattauch, V; Heidinger, O; Hense, H W

    2015-09-01

    Geocoding, the process of converting textual information (addresses) into geographic coordinates is increasingly used in public health/epidemiological research and practice. To date, little attention has been paid to geocoding quality and its impact on different types of spatially-related health studies. The primary aim of this study was to compare 2 freely available geocoding services (Google and OpenStreetMap) with regard to matching rate (percentage of address records capable of being geocoded) and positional accuracy (distance between geocodes and the ground truth locations). Residential addresses were geocoded by the NRW state office for information and technology and were considered as reference data (gold standard). The gold standard included the coordinates, the quality of the addresses (4 categories), and a binary urbanity indicator based on the CORINE land cover data. 2 500 addresses were randomly sampled after stratification for address quality and urbanity indicator (approximately 20 000 addresses). These address samples were geocoded using the geocoding services from Google and OSM. In general, both geocoding services showed a decrease in the matching rate with decreasing address quality and urbanity. Google showed consistently a higher completeness than OSM (>93 vs. >82%). Also, the cartographic confounding between urban and rural regions was less distinct with Google's geocoding API. Regarding the positional accuracy of the geo-coordinates, Google also showed the smallest deviations from the reference coordinates, with a median of <9 vs. <175.8 m. The cumulative density function derived from the positional accuracy showed for Google that nearly 95% and for OSM 50% of the addresses were geocoded within <50 m of their reference coordinates. The geocoding API from Google is superior to OSM regarding completeness and positional accuracy of the geocoded addresses. On the other hand, Google has several restrictions, such as the limitation of the

  1. Volume Computation of a Stockpile - a Study Case Comparing GPS and Uav Measurements in AN Open Pit Quarry

    NASA Astrophysics Data System (ADS)

    Raeva, P. L.; Filipova, S. L.; Filipov, D. G.

    2016-06-01

    The following paper aims to test and evaluate the accuracy of UAV data for volumetric measurements to the conventional GNSS techniques. For this purpose, an appropriate open pit quarry has been chosen. Two sets of measurements were performed. Firstly, a stockpile was measured by GNSS technologies and later other terrestrial GNSS measurements for modelling the berms of the quarry were taken. Secondly, the area of the whole quarry including the stockpile site was mapped by a UAV flight. Having considered how dynamic our world is, new techniques and methods should be presented in numerous fields. For instance, the management of an open pit quarry requires gaining, processing and storing a large amount of information which is constantly changing with time. Fast and precise acquisition of measurements regarding the process taking place in a quarry is the key to an effective and stable maintenance. In other words, this means getting an objective evaluations of the processes, using up-to-date technologies and reliable accuracy of the results. Often legislations concerning mine engineering state that the volumetric calculations are to present ±3% accuracy of the whole amount. On one hand, extremely precise measurements could be performed by GNSS technologies, however, it could be really time consuming. On the other hand, UAV photogrammetry presents a fast, accurate method for mapping large areas and calculating stockpiles volumes. The study case was performed as a part of a master thesis.

  2. Comparative study on anesthetic potency of dental local anesthetics assessed by the jaw-opening reflex in rabbits.

    PubMed Central

    Miyoshi, T.; Aida, H.; Kaneko, Y.

    2000-01-01

    The potency of 4 local anesthetics to dental pulp was compared. Drugs were 4% articaine with 12 microgram/mL epinephrine (A12), 4% articaine with 6 microgram/mL epinephrine (A6), 2% lidocaine with 12.5 microgram/mL epinephrine (L), and 3% propitocaine with 0.03 IU/mL felypressin (P). Local anesthetics were injected into the dental root of the mandibular incisor. Electromyogram (EMG) of the digastric muscle was measured during the jaw-opening reflex induced by electrical stimulation. The disappearance of the EMG wave was judged as positive evidence of anesthesia. The determination of ED50 of the anesthetic was made by probit analysis. The ED50 of the A12 was minimal in all the tested anesthetics throughout the entire course. The potency in the A6 was 2.8 times that of the L. The potency of the A12 at the 15-minute measurement was 3.8 times that of the A6. The ED50 of the P was higher compared with those of the other 3 groups. It was concluded that articaine showed quicker onset than lidocaine and propitocaine and that there was a need to increase the dosage to attain a quick onset or to extend the duration. PMID:11881694

  3. The Efficacy of Final Examinations: A Comparative Study of Closed-Book, Invigilated Exams and Open-Book, Open-Web Exams

    ERIC Educational Resources Information Center

    Williams, Jeremy B.; Wong, Amy

    2009-01-01

    Educators have long debated the usefulness (or otherwise) of final examinations; a debate that has typically revolved around the relative merits of closed-book exams, open-book exams, take-home exams or their substitution by some other assessment format (e.g., project work). This paper adds a new dimension to the debate by considering how the…

  4. Comparative study of open and arthroscopic coracoid transfer for shoulder anterior instability (Latarjet)-clinical results at short term follow-up.

    PubMed

    Kordasiewicz, Bartłomiej; Małachowski, Konrad; Kicinski, Maciej; Chaberek, Sławomir; Pomianowski, Stanisław

    2017-05-01

    The aim of this study was to compare early clinical results after open and arthroscopic Latarjet stabilisation in anterior shoulder instability. Our hypothesis was the results of arthroscopic stabilisation were comparable with the results of open procedure. The clinical results of the patients after primary Latarjet procedure were analysed. Patients operated on between 2006 and 2011 using an open technique composed the OPEN group and patients operated on arthroscopically between 2011 and 2013 composed the ARTHRO group; 48 out of 55 shoulders (87%) in OPEN and 62 out of 64 shoulders (97%) in ARTHRO were available to follow-up. The average age at surgery was 28 years in OPEN and 26 years in ARTHRO. The mean follow-up was 54.2 months in OPEN and 23.4 months in ARTHRO. Intra-operative data were analysed regarding time of surgery, concomitant lesions and complications. Patient results were assessed with Walch-Duplay, Rowe, VAS scores and subjective self-evaluation of satisfaction and shoulder function. Computed tomography scan evaluation was used to assess the graft healing. Average time of surgery was significantly shorter in ARTHRO than OPEN: respectively 110 and 120 minutes. The number of intra-operative complications was six (12.5%) in OPEN and five (8.1%) in ARTHRO. The results were comparable in both groups, with no significant difference between OPEN and ARTHRO group: satisfaction rate - 96.8% and 91.9%, shoulder function - 92.2% and 90%, Walch-Duplay score - 83.9 and 76.7 respecively. A significant difference was reported in Rowe score: 87.8 in OPEN and 78.9 in ARTHRO. Another significant difference was found in the presence of "subjective apprehension"-a term referring to the subjective perception of instability with no signs of instability at clinical examination - 28.7% in OPEN and 50% in ARTHRO. Range of motion in both groups were comparable, however patients in OPEN had significantly lower loss of external rotation in adduction to the side comparing to the

  5. Comparative study of various pixel photodiodes for digital radiography: Junction structure, corner shape and noble window opening

    NASA Astrophysics Data System (ADS)

    Kang, Dong-Uk; Cho, Minsik; Lee, Dae Hee; Yoo, Hyunjun; Kim, Myung Soo; Bae, Jun Hyung; Kim, Hyoungtaek; Kim, Jongyul; Kim, Hyunduk; Cho, Gyuseong

    2012-05-01

    Recently, large-size 3-transistors (3-Tr) active pixel complementary metal-oxide silicon (CMOS) image sensors have been being used for medium-size digital X-ray radiography, such as dental computed tomography (CT), mammography and nondestructive testing (NDT) for consumer products. We designed and fabricated 50 µm × 50 µm 3-Tr test pixels having a pixel photodiode with various structures and shapes by using the TSMC 0.25-m standard CMOS process to compare their optical characteristics. The pixel photodiode output was continuously sampled while a test pixel was continuously illuminated by using 550-nm light at a constant intensity. The measurement was repeated 300 times for each test pixel to obtain reliable results on the mean and the variance of the pixel output at each sampling time. The sampling rate was 50 kHz, and the reset period was 200 msec. To estimate the conversion gain, we used the mean-variance method. From the measured results, the n-well/p-substrate photodiode, among 3 photodiode structures available in a standard CMOS process, showed the best performance at a low illumination equivalent to the typical X-ray signal range. The quantum efficiencies of the n+/p-well, n-well/p-substrate, and n+/p-substrate photodiodes were 18.5%, 62.1%, and 51.5%, respectively. From a comparison of pixels with rounded and rectangular corners, we found that a rounded corner structure could reduce the dark current in large-size pixels. A pixel with four rounded corners showed a reduced dark current of about 200fA compared to a pixel with four rectangular corners in our pixel sample size. Photodiodes with round p-implant openings showed about 5% higher dark current, but about 34% higher sensitivities, than the conventional photodiodes.

  6. Randomized, open-label phase 2 study comparing frontline dovitinib versus sorafenib in patients with advanced hepatocellular carcinoma.

    PubMed

    Cheng, Ann-Lii; Thongprasert, Sumitra; Lim, Ho Yeong; Sukeepaisarnjaroen, Wattana; Yang, Tsai-Shen; Wu, Cheng-Chung; Chao, Yee; Chan, Stephen L; Kudo, Masatoshi; Ikeda, Masafumi; Kang, Yoon-Koo; Pan, Hongming; Numata, Kazushi; Han, Guohong; Balsara, Binaifer; Zhang, Yong; Rodriguez, Ana-Marie; Zhang, Yi; Wang, Yongyu; Poon, Ronnie T P

    2016-09-01

    Angiogenesis inhibition by the vascular endothelial growth factor receptor (VEGFR) and platelet-derived growth factor receptor (PDGFR) inhibitor sorafenib provides survival benefit in hepatocellular carcinoma (HCC); however, angiogenic escape from sorafenib may occur due to angiogenesis-associated fibroblast growth factor receptor (FGFR) pathway activation. In addition to VEGFR and PDGFR, dovitinib inhibits FGFR. Frontline oral dovitinib (500 mg/day, 5 days on, 2 days off; n = 82) versus sorafenib (400 mg twice daily; n = 83) was evaluated in an open-label, randomized phase 2 study of Asian-Pacific patients with advanced HCC. The primary and key secondary endpoints were overall survival (OS) and time to tumor progression (TTP) as determined by a local investigator, respectively. Patients included in the study were ineligible for surgical and/or locoregional therapies or had disease progression after receiving these therapies. The median OS (95% confidence interval [CI]) was 8.0 (6.6-9.1) months for dovitinib and 8.4 (5.4-11.3) months for sorafenib. The median TTP (95% CI) per investigator assessment was 4.1 (2.8-4.2) months and 4.1 (2.8-4.3) months for dovitinib and sorafenib, respectively. Common any-cause adverse events included diarrhea (62%), decreased appetite (43%), nausea (41%), vomiting (41%), fatigue (35%), rash (34%), and pyrexia (30%) for dovitinib and palmar-plantar erythrodysesthesia syndrome (66%) and decreased appetite (31%) for sorafenib. Subgroup analysis revealed a significantly higher median OS for patients in the dovitinib arm who had baseline plasma soluble VEGFR1 (sVEGFR1) and hepatocyte growth factor (HGF) below median levels versus at or above the median levels (median OS [95% CI]: sVEGFR1, 11.2 [9.0-13.8] and 5.7 [4.3-7.0] months, respectively [P = .0002]; HGF, 11.2 [8.9-13.8] and 5.9 [5.0-7.6] months, respectively [P = 0.0002]). Dovitinib was well tolerated, but activity was not greater than sorafenib as a frontline systemic therapy for

  7. Open, randomized, comparative study of efficacy and safety between Haemopressin and Glypressin in treating acute esophageal varices hemorrhage.

    PubMed

    Hu, Rey-Heng; Lee, Po-Huang

    2008-01-01

    Hemorrhage from esophageal varices is a major consequence of liver cirrhosis. Pharmacological treatment can be started immediately by an internist to arrest acute esophageal variceal hemorrhage (EVH). Terlipressin is easy to administer and effective in treating acute EVH, with or without adjuvant endoscopic sclerotherapy, and in reducing mortality in these patients. Due to these potentials, a phase IV bioequivalence study was conducted to compare a new brand of terlipressin (Haemopressin: contains 1 mg tri-glycyl-lysin-vasopressin acetate) with one that is currently available in the market (Glypressin). All cirrhotic patients with acute EVH were randomized to receive Haemopressin (n = 19) or Glypressin (n = 22) 2mg i.v. immediately followed by 1 mg. i.v. q4h for 5 days. The demographics were similar between H-group and G-group. Successful control of acute bleeding within 24 hours was no different between the 2 groups (18/19 vs. 19/22). Failure to control bleeding within 5 days of drug administration was also no different between the 2 groups (4/19 vs. 6/22). Rebleeding events, the requirement for blood transfusions and rescued treatment were also comparative between the 2 groups. Half of the patients in either group had mild, temporary and self-limited side effects. The study confirms that administration of terlipressin, by either Haemopressin or Glypressin, is generally safe and indeed highly effective in the treatment of acute EVH.

  8. Intralesional Mycobacterium w Vaccine Versus Cryotherapy in Treatment of Refractory Extragenital Warts: A Randomized, Open-Label, Comparative Study.

    PubMed

    Dhakar, Ashok K; Dogra, Sunil; Vinay, Keshavamurthy; Sarangal, Rishu; Kanwar, Amrinder J; Singh, Mini P

    2016-01-01

    Initial reports of immunotherapy using intralesional Mycobacterium w (Mw) vaccine have documented its useful role in treatment of genital and extragenital warts. To compare the efficacy and safety of intralesional Mw vaccine versus cryotherapy in the treatment of refractory extragenital warts. This was a prospective, randomized, comparative study of 66 patients. The outcome was assessed in terms of complete clearance of warts and change in Dermatology Life Quality Index (DLQI) score. Complete clearance of treated warts was seen in 66.7% (20/30) and 65.5% (19/29) of patients in the Mw and cryotherapy groups, respectively (P = .769). Clearance of distant warts was significantly (P = .004) high in the Mw group. Improvement in DLQI was greater in the Mw group. Both treatment modalities were well tolerated, and no major side effects occurred. Mw vaccine and cryotherapy are equally efficacious in treatment of refractory extragenital warts. Mw vaccine has an added advantage of clearance of distant warts. © The Author(s) 2015.

  9. Comparative molecular dynamics studies of heterozygous open reading frames of DNA polymerase eta (η) in pathogenic yeast Candida albicans

    PubMed Central

    Satpati, Suresh; Manohar, Kodavati; Acharya, Narottam; Dixit, Anshuman

    2017-01-01

    Genomic instability in Candida albicans is believed to play a crucial role in fungal pathogenesis. DNA polymerases contribute significantly to stability of any genome. Although Candida Genome database predicts presence of S. cerevisiae DNA polymerase orthologs; functional and structural characterizations of Candida DNA polymerases are still unexplored. DNA polymerase eta (Polη) is unique as it promotes efficient bypass of cyclobutane pyrimidine dimers. Interestingly, C. albicans is heterozygous in carrying two Polη genes and the nucleotide substitutions were found only in the ORFs. As allelic differences often result in functional differences of the encoded proteins, comparative analyses of structural models and molecular dynamic simulations were performed to characterize these orthologs of DNA Polη. Overall structures of both the ORFs remain conserved except subtle differences in the palm and PAD domains. The complementation analysis showed that both the ORFs equally suppressed UV sensitivity of yeast rad30 deletion strain. Our study has predicted two novel molecular interactions, a highly conserved molecular tetrad of salt bridges and a series of π–π interactions spanning from thumb to PAD. This study suggests these ORFs as the homologues of yeast Polη, and due to its heterogeneity in C. albicans they may play a significant role in pathogenicity. PMID:28120914

  10. Comparative molecular dynamics studies of heterozygous open reading frames of DNA polymerase eta (η) in pathogenic yeast Candida albicans

    NASA Astrophysics Data System (ADS)

    Satpati, Suresh; Manohar, Kodavati; Acharya, Narottam; Dixit, Anshuman

    2017-01-01

    Genomic instability in Candida albicans is believed to play a crucial role in fungal pathogenesis. DNA polymerases contribute significantly to stability of any genome. Although Candida Genome database predicts presence of S. cerevisiae DNA polymerase orthologs; functional and structural characterizations of Candida DNA polymerases are still unexplored. DNA polymerase eta (Polη) is unique as it promotes efficient bypass of cyclobutane pyrimidine dimers. Interestingly, C. albicans is heterozygous in carrying two Polη genes and the nucleotide substitutions were found only in the ORFs. As allelic differences often result in functional differences of the encoded proteins, comparative analyses of structural models and molecular dynamic simulations were performed to characterize these orthologs of DNA Polη. Overall structures of both the ORFs remain conserved except subtle differences in the palm and PAD domains. The complementation analysis showed that both the ORFs equally suppressed UV sensitivity of yeast rad30 deletion strain. Our study has predicted two novel molecular interactions, a highly conserved molecular tetrad of salt bridges and a series of π-π interactions spanning from thumb to PAD. This study suggests these ORFs as the homologues of yeast Polη, and due to its heterogeneity in C. albicans they may play a significant role in pathogenicity.

  11. Impact of Obesity on Surgical Treatment for Endometrial Cancer: A Multicenter Study Comparing Laparoscopy vs Open Surgery, with Propensity-Matched Analysis.

    PubMed

    Uccella, Stefano; Bonzini, Matteo; Palomba, Stefano; Fanfani, Francesco; Ceccaroni, Marcello; Seracchioli, Renato; Vizza, Enrico; Ferrero, Annamaria; Roviglione, Giovanni; Casadio, Paolo; Corrado, Giacomo; Scambia, Giovanni; Ghezzi, Fabio

    2016-01-01

    To evaluate the impact of obesity on the outcomes of surgical treatment for endometrial cancer in general and also comparing laparoscopic and open abdominal approach. Retrospective case-control study (Canadian Task Force classification II-1). Obstetrics and Gynecology Department, University of Insubria, Varese, Catholic University of the Sacred Heart, Rome, International School of Surgical Anatomy, Sacred Heart Hospital, Negrar, and Sant'Orsola-Malpighi Hospital, Bologna, Italy. Data of consecutive patients who underwent surgery for endometrial cancer in 4 centers were reviewed. Univariate and multivariable analyses were performed. Adjustment for potential selection bias in surgical approach was made using propensity score (PS) matching. Laparoscopic or open surgical treatment for endometrial cancer. A total of 1266 patients were included, including 764 in the laparoscopy group and 502 in the open surgery group. A total of 391 patients (30.9%) were obese, including 238 (18.8%) with class I obesity, 89 (7%) with class II obesity, and 64 (5.1%) with class III obesity. The total number of complications, risk of wound complications, and venous thromboembolic events were higher in obese women compared with nonobese women. Blood transfusions, incidence/severity of postoperative complications, and postoperative hospital stay were significantly higher in the open surgery group compared with the laparoscopy group, irrespective of obesity. These differences remained significant in both multivariable analysis and PS-matched analysis. The percentage of patients who received lymphadenectomy declined significantly in patients with BMI ≥40 in both the laparoscopy and open surgery groups. Conversions from the initially intended minimally invasive approach to open surgery were 1.1% to 2.2% for women with BMI <40, but increased in those with BMI ≥40 (8.6%; p = .05). PS analysis showed a lower complication rate, shorter hospital stay, and greater likelihood of receiving

  12. Previous open renal surgery increased vascular complications in percutaneous nephrolithotomy (PCNL) compared with primary and secondary PCNL and extracorporeal shock wave lithotripsy patients: a retrospective study.

    PubMed

    Yesil, Suleyman; Ozturk, Ufuk; Goktug, Hasan Nedim Goksel; Tuygun, Can; Nalbant, Ismail; Imamoglu, Muhammet Abdurrahim

    2013-01-01

    To evaluate the vascular complications of percutaneous nephrolithotomy (PCNL) patients who have undergone previous open surgery, PCNL and extracorporeal shock wave lithotripsy (ESWL). 360 patients who underwent a PCNL procedure were included into the study. The patients were divided into 4 groups: group 1: primary PCNL (n = 232); group 2: previous open nephrolithotomy (n = 42); group 3: previous PCNL (n = 33); group 4: previous ESWL (n = 63). The periods of operation and fluoroscopy use of the groups were compared in terms of residual stones, with haematuria, pre-operation and post-operation first-day haemoglobin values. Patients with persistent haematuria were assessed through ultrasonography (US), Doppler US, computed tomography and angiography. Upon comparison of the patients' pre- and post-operative haemoglobin changes, haemoglobin was statistically higher in the previous open operation group than the others (p = 0.02). Permanent and intermittent haematuria were detected in 12 (3%) and 7 patients (1%), respectively. Angiography was done in 7 (1.94%) patients. This rate was 9.5% for group 2 and 3% for group 3. These rates were found to be statistically higher than compared to the other groups. Arteriovenous fistula (AVF) was detected in 4 of these patients and pseudoaneurysm in 1. While 1 of the patients with AVF improved spontaneously, embolisation was applied to 4 patients. Four of the patients had had a previous open operation, while 1 had had a PCNL treatment. Vascular complication is a rare complication of PCNL that can be successfully managed with angioembolisation. Our results indicate that previous open surgery significantly predicted the occurrence of these lesions. Copyright © 2013 S. Karger AG, Basel.

  13. Financial Impact of the Robotic Approach in Liver Surgery: A Comparative Study of Clinical Outcomes and Costs Between the Robotic and Open Technique in a Single Institution

    PubMed Central

    Daskalaki, Despoina; Brown, Marc; Bianco, Francesco M.; Tzvetanov, Ivo; Davis, Myriam; Kim, Jihun; Benedetti, Enrico; Giulianotti, Pier C.

    2017-01-01

    Abstract Background: One of the perceived major drawbacks of minimally invasive techniques has always been its cost. This is especially true for the robotic approach and is one of the main reasons that has prevented its wider acceptance among hospitals and surgeons. The aim of our study was to evaluate the clinical outcomes and economic impact of robotic and open liver surgery in a single institution. Methods: Sixty-eight robotic and 55 open hepatectomies were performed at our institution between January 1, 2009 and December 31, 2013. Demographics, perioperative data, and postoperative outcomes were collected and compared between the two groups. An independent company performed the financial analysis. The economic parameters comprised direct variable costs, direct fixed costs, and indirect costs. Results: Mean estimated blood loss was significantly less in the robotic group (438 versus 727.8 mL; P = .038). Overall morbidity was significantly lower in the robotic group (22% versus 40%; P = .047). Clavien III/IV complications were also lower, with 4.4% in the robotic versus 16.3% in the open group (P = .043). The length of stay in the intensive care unit (ICU) was shorter for patients who underwent a robotic procedure (2.1 versus 3.3 days; P = .004). The average total cost, including readmissions, was $37,518 for robotic surgery and $41,948 for open technique. Conclusions: Robotic liver resections had less overall morbidity, ICU, and hospital stay. This translates into decreased average costs for robotic surgery. These procedures are financially comparable to open resections and do not represent a financial burden to the hospital. PMID:28186429

  14. Comparative study on open system digestion and microwave assisted digestion methods for metal determination in shrimp sludge compost.

    PubMed

    Nemati, Keivan; Abu Bakar, Nor Kartini; Bin Abas, Mhd Radzi; Sobhanzadeh, Elham; Low, Kah Hin

    2010-10-15

    The aim of this work was to evaluate two different digestion methods for the determination of the total concentration of metals (Zn, Cu, Cr, Ni, Pb and Cd) in shrimp sludge compost. The compost made from shrimp aquaculture sludge co-composted with organic materials (peat, crushed bark and manure) was used as an organic growing medium for crop. Open system digestion and microwave assisted digestion procedures were employed in sample preparation. Various combinations and volumes of hydrofluoric, nitric and hydrochloric acids were evaluated for the efficiency of both methods. A certified reference material (CRM 146) was used in the comparison of these two digestion methods. The results revealed a good agreement between both procedures and the certified valued. The best recoveries were found in the range between 95% and 99% for microwave assisted digestion with a mixture of 2 ml of HF, 6 ml of HNO(3) and 2 ml of HCl. This procedure was recommended as the method for digestion the compost herein based on the recovery analysis and time taken.

  15. Oncologic Safety of Robot Thyroid Surgery for Papillary Thyroid Carcinoma: A Comparative Study of Robot versus Open Thyroid Surgery Using Inverse Probability of Treatment Weighting

    PubMed Central

    Sung, Tae-Yon; Yoon, Jong Ho; Han, Minkyu; Lee, Yi Ho; Lee, Yu-mi; Song, Dong Eun; Chung, Ki-Wook; Kim, Won Bae; Shong, Young Kee; Hong, Suck Joon

    2016-01-01

    The aim of this study was to evaluate the oncologic safety of robot thyroid surgery compared to open thyroid surgery for papillary thyroid carcinoma (PTC). We enrolled 722 patients with PTC who underwent a total thyroidectomy with central compartment node dissection (CCND) from January 2009 to December 2010. These patients were classified into open thyroid surgery (n = 610) or robot thyroid surgery (n = 112) groups. We verified the impact of robot thyroid surgery on clinical recurrence and ablation/control-stimulated thyroglobulin (sTg) levels predictive of non-recurrence using weighted logistic regression models with inverse probability of treatment weighting (IPTW). Age, sex, thyroid weight, extent of CCND, and TNM were significantly different between the two groups (p < 0.05); however, there was no significant difference in recurrence between the open and robot groups (1.5% vs. 2.7%; p = 0.608). The proportion of patients with ablation sTg < 10.0 ng/mL and control sTg < 1.0 ng/mL was comparable between the two groups (p > 0.05). Logistic regression with IPTW using the propensity scores estimated by adjusting all of the parameters demonstrated that robot thyroid surgery did not influence the clinical recurrence (OR; 0.784, 95% CI; 0.150–3.403, p = 0.750), ablation sTg (OR; 0.950, 95% CI; 0.361–2.399, p = 0.914), and control sTg levels (OR; 0.498, 95% CI; 0.190–1.189, p = 0.130). Robot thyroid surgery is comparable to open thyroid surgery with regard to oncologic safety in PTC patients. PMID:27285846

  16. A prospective randomized trial comparing open versus laparoscopic appendectomy.

    PubMed Central

    Frazee, R C; Roberts, J W; Symmonds, R E; Snyder, S K; Hendricks, J C; Smith, R W; Custer, M D; Harrison, J B

    1994-01-01

    OBJECTIVE: The authors determined whether there was an advantage to laparoscopic appendectomy when compared with open appendectomy. SUMMARY/BACKGROUND DATA: The advantages of laparoscopic appendectomy versus open appendectomy were questioned because the recovery from open appendectomy is brief. METHODS: From January 15, 1992 through January 15, 1993, 75 patients older than 9 years were entered into a study randomizing the choice of operation to either the open or the laparoscopic technique. Statistical comparisons were performed using the Wilcoxon test. RESULTS: Thirty-seven patients were assigned to the open appendectomy group and 38 patients were assigned to the laparoscopic appendectomy group. Two patients were converted intraoperatively from laparoscopic appendectomies to open procedures. Thirty-one patients (81%) in the open group had acute appendicitis, as did 32 patients (84%) in the laparoscopic group. Mean duration of surgery was 65 minutes for open appendectomy and 87 minutes for laparoscopic appendectomy (p < 0.001). There were no statistically significant differences in length of hospitalization, interval until resumption of a regular diet, or morbidity. Duration of both parenteral and oral analgesic use favored laparoscopic appendectomy (2.0 days versus 1.2 days, and 8.0 days versus 5.4 days, p < 0.05). All patients were instructed to return to full activities by 2 weeks postoperatively. This occurred at an average of 25 days for the open appendectomy group versus 14 days for the laparoscopic appendectomy group (p < 0.001). CONCLUSIONS: Patients who underwent laparoscopic appendectomies have a shorter duration of analgesic use and return to full activities sooner postoperatively when compared with patients who underwent open appendectomies. The authors consider laparoscopic appendectomy to be the procedure of choice in patients with acute appendicitis. PMID:8203983

  17. WIN OVER study: Efficacy and safety of olmesartan in Indian hypertensive patients: Results of an open label, non-comparative, multi-centric, post marketing observational study

    PubMed Central

    Kumbla, D.K.; Kumar, S.; Reddy, Y.V.; Trailokya, A.; Naik, M.

    2014-01-01

    Background Hypertension is a global health problem. Multiple classes of drugs including angiotensin receptor blockers (ARBs) are available for the treatment of hypertension. Olmesartan is a relatively newer ARB used in hypertension management. Objective To assess the efficacy and safety of WIN-BP (Olmesartan 20 mg/40 mg) tablet in Indian patients with hypertension. Material and methods An open label, non-comparative, multi-centric, real world post marketing observational study included Indian adult hypertensive patients who were treated with olmesartan 20 mg/40 mg tablet once daily for six months. The primary outcome was reduction of systolic blood pressure (SBP) to <140 mmHg and diastolic BP (DBP) to <90 mmHg at 3 and 6 months after initiation of treatment with olmesartan. All reported adverse events were recorded. Results A total of 8940 patients were enrolled in this study. Baseline SBP of 164 mmHg was reduced to 153, 145, 134 and 130 mmHg at the end of 15 days, 1, 3 and 6 months respectively. Similarly, baseline DBP of 100 mmHg was reduced to 93, 89, 84 and 82 mmHg at the end of 15 days, 1, 3 and 6 months respectively. The reduction in both systolic and diastolic blood pressure from day 15 to month 6 was statistically significant (p < 0.0001) with olmesartan treatment. The percentage of responders for both systolic and diastolic blood pressure increased consistently from day 15 to month 6. Only 0.08% patients reported the adverse events. No serious adverse event was reported in the study. Conclusion Olmesartan 20 mg/40 mg is effective and well tolerated without any serious adverse events in patients with hypertension. PMID:24973841

  18. WIN OVER study: Efficacy and safety of olmesartan in Indian hypertensive patients: results of an open label, non-comparative, multi-centric, post marketing observational study.

    PubMed

    Kumbla, D K; Kumar, S; Reddy, Y V; Trailokya, A; Naik, M

    2014-01-01

    Hypertension is a global health problem. Multiple classes of drugs including angiotensin receptor blockers (ARBs) are available for the treatment of hypertension. Olmesartan is a relatively newer ARB used in hypertension management. To assess the efficacy and safety of WIN-BP (Olmesartan 20 mg/40 mg) tablet in Indian patients with hypertension. An open label, non-comparative, multi-centric, real world post marketing observational study included Indian adult hypertensive patients who were treated with olmesartan 20 mg/40 mg tablet once daily for six months. The primary outcome was reduction of systolic blood pressure (SBP) to <140 mmHg and diastolic BP (DBP) to <90 mmHg at 3 and 6 months after initiation of treatment with olmesartan. All reported adverse events were recorded. A total of 8940 patients were enrolled in this study. Baseline SBP of 164 mmHg was reduced to 153, 145, 134 and 130 mmHg at the end of 15 days, 1, 3 and 6 months respectively. Similarly, baseline DBP of 100 mmHg was reduced to 93, 89, 84 and 82 mmHg at the end of 15 days, 1, 3 and 6 months respectively. The reduction in both systolic and diastolic blood pressure from day 15 to month 6 was statistically significant (p < 0.0001) with olmesartan treatment. The percentage of responders for both systolic and diastolic blood pressure increased consistently from day 15 to month 6. Only 0.08% patients reported the adverse events. No serious adverse event was reported in the study. Olmesartan 20 mg/40 mg is effective and well tolerated without any serious adverse events in patients with hypertension. Copyright © 2014 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  19. Increased Peritoneal Dialysis Exit Site Infections Using Topical Antiseptic Polyhexamethylene Biguanide Compared to Mupirocin: Results of a Safety Interim Analysis of an Open-Label Prospective Randomized Study

    PubMed Central

    Findlay, Andrew; Serrano, Charelle; Punzalan, Sally

    2013-01-01

    Prophylactic mupirocin for peritoneal catheter exit sites reduces exit site infection (ESI) risk but engenders antibiotic resistance. We present early interim safety analysis of an open-label randomized study comparing polyhexamethylene biguanide (PHMB) and mupirocin. A total of 106 patients randomized to 53 in each group were followed up for a mean of 12.68 months per patient. On safety analysis, the PHMB group had a significantly greater ESI rate than the mupirocin group (odds ratio [OR], 0.26; 95% confidence interval [CI], 0.09 to 0.80), leading to discontinuation of the trial. PMID:23403425

  20. A prospective 1-year comparative study of endoscopic thyroidectomy via a retroauricular approach versus conventional open thyroidectomy at a single institution.

    PubMed

    Chung, Eun-Jae; Park, Min-Woo; Cho, Jae-Gu; Baek, Seung-Kuk; Kwon, Soon-Young; Woo, Jeong-Soo; Jung, Kwang-Yoon

    2015-09-01

    The objective of this study was to evaluate the feasibility and safety of performing an endoscopic thyroidectomy (ETE) via a retroauricular approach. Forty-seven patients who underwent ETE via a retroauricular approach were included, and a total of 47 patients who underwent conventional open thyroid lobectomy in the same period were analyzed as a control group. All patients underwent prospective functional evaluations before the operation and 1 week, and 1, 3, 6, and 12 months postoperatively using a comprehensive battery of functional assessments. The mean total operative time was 152 ± 48 min, with a mean endoscopic procedure time of 58 ± 18 min. One patient developed temporary vocal fold paralysis. Although most of the parameters for the functional outcome were worse in the ETE group, these differences were transient. Subjective worsening on the voice handicap index and dysphagia handicap index normalized by 3 months postoperatively. The average pain score on a visual analog scale at 1 week after surgery was 2.84, representing a tolerable range of discomfort. The mean paresthesia/hyperesthesia score was worse in the ETE group than the open surgery group by postoperative month 6; however, these differences eventually disappeared. Thirty-six of the 47 patients in the ETE group were satisfied or extremely satisfied with the retroauricular incision by 6 months after surgery. ETE via a retroauricular approach is a safe, feasible, and cosmetically desirable treatment option, with outcomes comparable to conventional open thyroidectomy in the longer term.

  1. Minimally invasive decompression versus open laminectomy for central stenosis of the lumbar spine: pragmatic comparative effectiveness study.

    PubMed

    Nerland, Ulf S; Jakola, Asgeir S; Solheim, Ole; Weber, Clemens; Rao, Vidar; Lønne, Greger; Solberg, Tore K; Salvesen, Øyvind; Carlsen, Sven M; Nygaard, Øystein P; Gulati, Sasha

    2015-04-01

    To test the equivalence for clinical effectiveness between microdecompression and laminectomy in patients with central lumbar spinal stenosis. Multicentre observational study. Prospective data from the Norwegian Registry for Spine Surgery. 885 patients with central stenosis of the lumbar spine who underwent surgery at 34 Norwegian orthopaedic or neurosurgical departments. Patients were treated from October 2006 to December 2011. Laminectomy and microdecompression. The primary outcome was change in Oswestry disability index score one year after surgery. Secondary endpoints were quality of life (EuroQol EQ-5D), perioperative complications, and duration of surgical procedures and hospital stays. A blinded biostatistician performed predefined statistical analyses in unmatched and propensity matched cohorts. The study was powered to detect a difference between the groups of eight points on the Oswestry disability index at one year. 721 patients (81%) completed the one year follow-up. Equivalence between microdecompression and laminectomy was shown for the Oswestry disability index (difference 1.3 points, 95% confidence interval -1.36 to 3.92, P<0.001 for equivalence). Equivalence was confirmed in the propensity matched cohort and full information regression analyses. No difference was found between groups in quality of life (EQ-5D) one year after surgery. The number of patients with complications was higher in the laminectomy group (15.0% v 9.8%, P=0.018), but after propensity matching for complications the groups did not differ (P=0.23). The duration of surgery for single level decompression was shorter in the microdecompression group (difference 11.2 minutes, 95% confidence interval 4.9 to 17.5, P<0.001), but after propensity matching the groups did not differ (P=0.15). Patients in the microdecompression group had shorter hospital stays, both for single level decompression (difference 1.5 days, 95% confidence interval 1.7 to 2.6, P<0.001) and two level decompression

  2. [Treatment of community-acquired pneumonia by pristinamycin (Pyostacine 500). Results of a non comparative open study].

    PubMed

    Petitpretz, P; Guerin, J C; Nouvet, G; Poirier, R; Portier, F; Vergeret, J; Fraysse, P; Vercken, J B

    1994-01-01

    Activity of natural streptogramin (NSG) appears well adapted to pathogens responsible for CAP. The goal of this multicenter pilot study was to bring first data about efficacy of NSG in treatment of CAP. PATIENTS METHOD: Ten days of a NSG (1 gr b.i.d. or t.i.d.) regimen was administered to 46 hospitalized adult patients for CAP defined with fever > 38 degrees C, respiratory symptoms and X-ray opacity. Severely ill patients were excluded. A broncho-pulmonar sample (expectoration or trantracheal aspiration or protected distal sample) was performed in all patients. two patients were excluded because of pulmonary embolism (n = 1) or tuberculosis (n = 1) and 44 patients were analyzed. 50% of them had associated disease, 20% had failure of prior antibiotherapy. At inclusion, mean fever was 39.2 +/- 0.7 degrees C, respiratory rate was 22 +/- 5/mn, PaO2 was 74 +/- 10 mmHg, chest X-ray showed bilateral opacity in 16%, unilateral in 84% and pleural fluid level in 6 cases. Etiological diagnosis was determined in 70% of cases. Streptococcus pneumoniae (n = 14), Haemophilus influenzae (n = 5), Legionella pneumophila (n = 2), Mycoplasma pneumoniae (n = 2) and Chlamydia psittaci (n = 1) were the most frequent isolated pathogens. 40 patients (91%) were cured with NSG and delay to obtain apyrexia was 4.4 +/- 3.9 days. NSG was stopped in 4 patients: 1 clinical and bacteriological failure (Klebsiella pneumoniae), 2 clinical failures (1 pneumococcus with purulent pleurisy, 1 pneumococcus with worsening of respiratory status), 1 patient with resistant H. influenzae strain in spite of favourable clinical evolution. NSG was well tolerated in 86% of patients. these data invite to carry on evaluation of first line therapy of CAP with NSG.

  3. Adverse drug reaction monitoring with angiotensin converting enzyme inhibitors: A prospective, randomized, open-label, comparative study.

    PubMed

    Sangole, Nishant V; Dadkar, Vaishali N

    2010-02-01

    Angiotensin converting enzyme inhibitors (ACEIs) are known to possess different chemical structures, and change in structure of a drug can bring about change in its adverse drug reaction (ADR) profile. The study aims to observe the incidence and severity of ADRs between the di-carboxyl group containing ACEIs (d-ACEIs) versus phosphonate group containing ACEIs (p-ACEIs), in patients suffering from essential hypertension. One hundred and twenty patients with essential hypertension were randomized into four groups receiving enalapril, lisinopril, ramipril, and fosinopril. They were followed up for four months, to observe the clinical efficacy along with the associated ADRs. Mild, dry brassy cough (% incidence; 95% CI) was observed with d-ACEIs (6.6%; 0 to 15.6) versus p-ACEI (20%; 5.7 to 34.3), in which the cough observed was moderate-to-severe in intensity and two patients required treatment discontinuation (P < 0.05). No cases of hypotension were observed with the use of d-ACEIs, whereas, two patients on p-ACEI (6.6%; 0 to15.6) had hypotension (P < 0.05). Three patients (10%; 0 to 20.7) on d-ACEIs had nausea, which was not observed with p-ACEI treatment (0%) (P < 0.05). The phosphonate group in p-ACEIs may have a probable relationship with increase in the incidence and severity of ADRs such as dry brassy cough and hypotension. The di-carboxyl group in d-ACEIs may have a probable relationship with increase in the incidence of ADRs like nausea.

  4. Adverse drug reaction monitoring with angiotensin converting enzyme inhibitors: A prospective, randomized, open-label, comparative study

    PubMed Central

    Sangole, Nishant V.; Dadkar, Vaishali N.

    2010-01-01

    Objectives: Angiotensin converting enzyme inhibitors (ACEIs) are known to possess different chemical structures, and change in structure of a drug can bring about change in its adverse drug reaction (ADR) profile. The study aims to observe the incidence and severity of ADRs between the di-carboxyl group containing ACEIs (d-ACEIs) versus phosphonate group containing ACEIs (p-ACEIs), in patients suffering from essential hypertension. Materials and Methods: One hundred and twenty patients with essential hypertension were randomized into four groups receiving enalapril, lisinopril, ramipril, and fosinopril. They were followed up for four months, to observe the clinical efficacy along with the associated ADRs. Results: Mild, dry brassy cough (% incidence; 95% CI) was observed with d-ACEIs (6.6%; 0 to 15.6) versus p-ACEI (20%; 5.7 to 34.3), in which the cough observed was moderate-to-severe in intensity and two patients required treatment discontinuation (P < 0.05). No cases of hypotension were observed with the use of d-ACEIs, whereas, two patients on p-ACEI (6.6%; 0 to15.6) had hypotension (P < 0.05). Three patients (10%; 0 to 20.7) on d-ACEIs had nausea, which was not observed with p-ACEI treatment (0%) (P < 0.05). Conclusions: The phosphonate group in p-ACEIs may have a probable relationship with increase in the incidence and severity of ADRs such as dry brassy cough and hypotension. The di-carboxyl group in d-ACEIs may have a probable relationship with increase in the incidence of ADRs like nausea. PMID:20606833

  5. Direct hospital costs of total laparoscopic hysterectomy compared with fast-track open hysterectomy at a tertiary hospital: a retrospective case-controlled study.

    PubMed

    Rhou, Yoon J J; Pather, Selvan; Loadsman, John A; Campbell, Neil; Philp, Shannon; Carter, Jonathan

    2015-12-01

    To assess the direct intraoperative and postoperative costs in women undergoing total laparoscopic hysterectomy and fast-track open hysterectomy. A retrospective review of the direct hospital-related costs in a matched cohort of women undergoing total laparoscopic hysterectomy (TLH) and fast-track open hysterectomy (FTOH) at a tertiary hospital. All costs were calculated, including the cost of advanced high-energy laparoscopic devices. The effect of the learning curve on cost in laparoscopic hysterectomy was also assessed, as was the hospital case-weighted cost, which was compared with the actual cost. Fifty women were included in each arm of the study. TLH had a higher intraoperative cost, but a lower postoperative cost than FTOH (AUD$3877 vs AUD$2776 P < 0.001, AUD$3965 vs AUD$6233 P < 0.001). The total cost of TLH was not different from FTOH (AUD$7842 vs AUD$9009 P = 0.068) and after a learning curve; TLH cost less than FTOH (AUD$6797 vs AUD$8647, P < 0.001). The use of high-energy devices did not impact on the cost benefit of TLH, and hospital case-weight-based funding correlated poorly with actual cost. Despite the use of fast-track recovery protocols, the cost of TLH is no different to FTOH and after a learning curve is cheaper than open hysterectomy. Judicious use of advanced energy devices does not impact on the cost, and hospital case-weight-based funding model in our hospital is inaccurate when compared to directly calculated hospital costs. © 2013 The Authors ANZJOG © 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  6. Perioperative and long-term results after left pancreatectomy: a single-institution, non-randomized, comparative study between open and laparoscopic approach.

    PubMed

    Butturini, Giovanni; Partelli, Stefano; Crippa, Stefano; Malleo, Giuseppe; Rossini, Roberto; Casetti, Luca; Melotti, Gian Luigi; Piccoli, Micaela; Pederzoli, Paolo; Bassi, Claudio

    2011-09-01

    Laparoscopic left pancreatic resections are being increasingly performed. In this study, we provide a nonrandomized comparison between laparoscopic and open left pancreatectomy (OLP) for benign and borderline tumors, focusing on both perioperative and long-term results. Demographic, pathologic, and perioperative details from patients who underwent laparoscopic and OLP between 1999 and 2006 were retrieved from our database and analyzed. Long-term results, including resume to full-time work, occurrence of incisional hernias, and incidence of exocrine and endocrine insufficiency also were evaluated. A total of 116 patients were included in the analysis; 43 (37.1%) were managed laparoscopically and 73 (62.9%) underwent the open procedure. There were no significant differences regarding clinical and pathological data. All of the resections attempted laparoscopically were completed. The rate of splenic preservation was significantly higher in the laparoscopic group (P = 0.0001). Postoperative outcomes were similar between the two groups. Longitudinal comparison between two time periods (1999-June 2004 vs. July 2004-2006) showed that pancreatic fistula and hospital stay significantly diminished over time in the laparoscopic group (P = 0.04 and P = 0.004, respectively). Median follow-up was 53 months. The incidence of exocrine insufficiency and incisional hernias was significantly higher after open resections (both P = 0.05). After hospital discharge, median time to resume full-time work was 6 weeks in the open group and 3 weeks after laparoscopic resections (P < 0.0001). Laparoscopy also resulted as an independent factor for an early resume to full-time activities in the multivariate analysis (P < 0.0001). Laparoscopic left pancreatectomy is a safe procedure for benign and borderline tumors, with similar perioperative outcomes compared with the open procedure. In the long term, the laparoscopic approach is likely to be superior thanks to a more rapid resume

  7. An open-label, two-period comparative study on pharmacokinetics and safety of a combined ethinylestradiol/gestodene transdermal contraceptive patch

    PubMed Central

    Zhang, Chao; Li, Haiyan; Xiong, Xin; Zhai, Suodi; Wei, Yudong; Zhang, Shuang; Zhang, Yuanyuan; Xu, Lin; Liu, Li

    2017-01-01

    We investigated the pharmacokinetics and safety profiles of a newly developed combined ethinylestradiol (EE)/gestodene (GSD) transdermal contraceptive patch after a single-dose administration and compared with the market available tablet formulation in healthy adult subjects. An open-label, two-period comparative study was conducted in 12 healthy women volunteers. A single dose of the study combined EE/GE transdermal contraceptive patch and oral tablet (Milunet®) were administered. Blood samples at different time points after dose were collected, and concentrations were analyzed. A reliable, highly sensitive and accurate high-performance liquid chromatography coupled with tandem mass spectrometry (HPLC/MS/MS) assay method was developed in this study to determine the plasma concentrations of EE and GSD. Compared to the tablet, the study patch had a significantly decreased maximum plasma concentration (Cmax), extended time to reach the Cmax and half-life, as well as increased clearance and apparent volume of distribution. The half-lives of EE and GSD of the patch were 3.3 and 2.2 times, respectively, than the half-life of the tablet. The areas under the plasma concentration–time curve (AUCs) of EE and GSD of the patch were 8.0 and 16.2 times, respectively, than the AUC of the tablet. No severe adverse event was observed during the whole study, and the general safety was acceptable. In conclusion, compared to the oral tablet Milunet, the study contraceptive patch was well tolerated and showed potent drug exposure, significant extended half-life and stable drug concentrations. PMID:28331292

  8. An open-label, two-period comparative study on pharmacokinetics and safety of a combined ethinylestradiol/gestodene transdermal contraceptive patch.

    PubMed

    Zhang, Chao; Li, Haiyan; Xiong, Xin; Zhai, Suodi; Wei, Yudong; Zhang, Shuang; Zhang, Yuanyuan; Xu, Lin; Liu, Li

    2017-01-01

    We investigated the pharmacokinetics and safety profiles of a newly developed combined ethinylestradiol (EE)/gestodene (GSD) transdermal contraceptive patch after a single-dose administration and compared with the market available tablet formulation in healthy adult subjects. An open-label, two-period comparative study was conducted in 12 healthy women volunteers. A single dose of the study combined EE/GE transdermal contraceptive patch and oral tablet (Milunet(®)) were administered. Blood samples at different time points after dose were collected, and concentrations were analyzed. A reliable, highly sensitive and accurate high-performance liquid chromatography coupled with tandem mass spectrometry (HPLC/MS/MS) assay method was developed in this study to determine the plasma concentrations of EE and GSD. Compared to the tablet, the study patch had a significantly decreased maximum plasma concentration (Cmax), extended time to reach the Cmax and half-life, as well as increased clearance and apparent volume of distribution. The half-lives of EE and GSD of the patch were 3.3 and 2.2 times, respectively, than the half-life of the tablet. The areas under the plasma concentration-time curve (AUCs) of EE and GSD of the patch were 8.0 and 16.2 times, respectively, than the AUC of the tablet. No severe adverse event was observed during the whole study, and the general safety was acceptable. In conclusion, compared to the oral tablet Milunet, the study contraceptive patch was well tolerated and showed potent drug exposure, significant extended half-life and stable drug concentrations.

  9. Comparative study of the retinal nerve fibre layer thickness performed with optical coherence tomography and GDx scanning laser polarimetry in patients with primary open-angle glaucoma.

    PubMed

    Wasyluk, Jaromir T; Jankowska-Lech, Irmina; Terelak-Borys, Barbara; Grabska-Liberek, Iwona

    2012-03-01

    We compared the parameters of retinal nerve fibre layer in patients with advanced glaucoma with the use of different OCT (Optical Coherence Tomograph) devices in relation to analogical measurements performed with GDx VCC (Nerve Fiber Analyzer with Variable Corneal Compensation) scanning laser polarimetry. Study subjects had advanced primary open-angle glaucoma, previously treated conservatively, diagnosed and confirmed by additional examinations (visual field, ophthalmoscopy of optic nerve, gonioscopy), A total of 10 patients were enrolled (9 women and 1 man), aged 18-70 years of age. Nineteen eyes with advanced glaucomatous neuropathy were examined. 1) Performing a threshold perimetry Octopus, G2 strategy and ophthalmoscopy of optic nerve to confirm the presence of advanced primary open-angle glaucoma; 2) performing a GDx VCC scanning laser polarimetry of retinal nerve fibre layer; 3) measuring the retinal nerve fibre layer thickness with 3 different optical coherence tomographs. The parameters of the retinal nerve fibre layer thickness are highly correlated between the GDx and OCT Stratus and 3D OCT-1000 devices in mean retinal nerve fibre layer thickness, retinal nerve fibre layer thickness in the upper sector, and correlation of NFI (GDx) with mean retinal nerve fibre layer thickness in OCT examinations. Absolute values of the retinal nerve fibre layer thickness (measured in µm) differ significantly between GDx and all OCT devices. Examination with OCT devices is a sensitive diagnostic method of glaucoma, with good correlation with the results of GDx scanning laser polarimetry of the patients.

  10. Comparative Study of Aluminum Complexes Bearing N,O- and N,S-Schiff Base in Ring-Opening Polymerization of ε-Caprolactone and L-Lactide.

    PubMed

    Chang, Meng-Chih; Lu, Wei-Yi; Chang, Heng-Yi; Lai, Yi-Chun; Chiang, Michael Y; Chen, Hsing-Yin; Chen, Hsuan-Ying

    2015-12-07

    A series of Al complexes bearing Schiff base and thio-Schiff base ligands were synthesized, and their application for the ring-opening polymerization of ε-caprolactone (CL) and l-lactide (LA) was studied. It was found that steric effects of the ligands caused higher polymerization rate and most importantly the Al complexes with N,S-Schiff base showed significantly higher polymerization rate than Al complexes with N,O-Schiff base (5-12-fold for CL polymerization and 2-7-fold for LA polymerization). The reaction mechanism of CL polymerization was investigated by density functional theory (DFT). The calculations predicted a lower activation energy for a process involved with an Al complex bearing an N,S-Schiff base ligand (17.6 kcal/mol) than for that of an Al complex bearing an N,O-Schiff base ligand (19.0 kcal/mol), and this magnitude of activation energy reduction is comparable to the magnitude of rate enhancement observed in the experiment. The reduction of activation energy was attributed to the catalyst-substrate destabilization effect. Using a sulfur-containing ligand to decrease the activation energy in the ring-opening polymerization process may be a new strategy to design a new Al complex with high catalytic activity.

  11. Comparative Study between Robotic Total Thyroidectomy with Central Lymph Node Dissection via Bilateral Axillo-breast Approach and Conventional Open Procedure for Papillary Thyroid Microcarcinoma

    PubMed Central

    He, Qing-Qing; Zhu, Jian; Zhuang, Da-Yong; Fan, Zi-Yi; Zheng, Lu-Ming; Zhou, Peng; Hou, Lei; Yu, Fang; Li, Yan-Ning; Xiao, Lei; Dong, Xue-Feng; Ni, Gao-Feng

    2016-01-01

    Background: A large proportion of the patients with papillary thyroid microcarcinoma are young women. Therefore, minimally invasive endoscopic thyroidectomy with central neck dissection (CND) emerged and showed well-accepted results with improved cosmetic outcome, accelerated healing, and comforting the patients. This study aimed to evaluate the safety and effectiveness of robotic total thyroidectomy with CND via bilateral axillo-breast approach (BABA), compared with conventional open procedure in papillary thyroid microcarcinoma. Methods: One-hundred patients with papillary thyroid microcarcinoma from March 2014 to January 2015 in Jinan Military General Hospital of People's Liberation Army (PLA) were randomly assigned to robotic group or conventional open approach group (n = 50 in each group). The total operative time, estimated intraoperative blood loss, numbers of lymph node removed, visual analog scale (VAS), postoperative hospital stay time, complications, and numerical scoring system (NSS, used to assess cosmetic effect) were analyzed. Results: The robotic total thyroidectomy with CND via BABA was successfully performed in robotic group. There were no conversion from the robotic surgeries to open or endoscopic surgery. The subclinical central lymph node metastasis rate was 35%. The mean operative time of the robotic group was longer than that of the conventional open approach group (118.8 ± 16.5 min vs. 90.7 ± 10.3 min, P < 0.05). The study showed significant differences between the two groups in terms of the VASs (2.1 ± 1.0 vs. 3.8 ± 1.2, P < 0.05) and NSS (8.9 ± 0.8 vs. 4.8 ± 1.7, P < 0.05). The differences between the two groups in the estimated intraoperative blood loss, postoperative hospital stay time, numbers of lymph node removed, postoperative thyroglobulin levels, and complications were not statistically significant (all P > 0.05). Neither iatrogenic implantation nor metastasis occurred in punctured porous channel or chest wall in both groups

  12. OER Quality and Adaptation in K-12: Comparing Teacher Evaluations of Copyright-Restricted, Open, and Open/Adapted Textbooks

    ERIC Educational Resources Information Center

    Kimmons, Royce

    2015-01-01

    Conducted in conjunction with an institute on open textbook adaptation, this study compares textbook evaluations from practicing K-12 classroom teachers (n = 30) on three different types of textbooks utilized in their contexts: copyright-restricted, open, and open/adapted. Copyright-restricted textbooks consisted of those textbooks already in use…

  13. Laparoscopic versus open nephroureterectomy for the treatment of upper urinary tract urothelial carcinoma: a systematic review and cumulative analysis of comparative studies.

    PubMed

    Ni, Shaobin; Tao, Weiyang; Chen, Qiyin; Liu, Lianxin; Jiang, Hongchi; Hu, Hailong; Han, Ruifa; Wang, Chunyang

    2012-06-01

    Laparoscopic nephroureterectomy (LNU) has increasingly been used as a minimally invasive alternative to open nephroureterectomy (ONU), but studies comparing the efficacy and safety of the two surgical procedures are still limited. Evaluate the oncologic and perioperative outcomes of LNU versus ONU in the treatment of upper urinary tract urothelial carcinoma. A systematic review and cumulative analysis of comparative studies reporting both oncologic and perioperative outcomes of LNU and ONU was performed through a comprehensive search of the Medline, Embase, and the Cochrane Library electronic databases. All analyses were performed using the Review Manager (RevMan) v.5 (Nordic Cochrane Centre, Copenhagen, Denmark) and Meta-analysis In eXcel (MIX) 2.0 Pro (BiostatXL) software packages. Twenty-one eligible studies (1235 cases and 3093 controls) were identified. A significantly higher proportion of pTa/Tis was observed in LNU compared to ONU (27.52% vs 22.59%; p = 0.047), but there were no significant differences in other stages and pathologic grades (all p>0.05). For patients who underwent LNU, the 5-yr cancer-specific survival (CSS) rate was significantly higher, at 9% (p = 0.03), compared to those who underwent ONU, while the overall recurrence rate and bladder recurrence rate were notably lower, at 15% (p = 0.01) and 17% (p = 0.02), respectively. However, there were no statistically significant differences in 2-yr CSS, 5-yr recurrence-free survival (RFS), 5-yr overall survival (OS), 2-yr OS, and metastasis rates between LNU and ONU (all p>0.05). Moreover, there were no significant differences between LNU and ONU in terms of intraoperative complications, postoperative complications, and perioperative mortality (all p>0.05). The results of our study were mainly limited by the retrospective design of most of the individual studies included as well as selection biases based on different management of regional lymph nodes and pathologic characteristics. Our data suggest

  14. Observing Protein & Energy Nutrition (OPEN) Study

    Cancer.gov

    The Observing Protein and Energy Nutrition (OPEN) Study was designed to assess dietary measurement error by comparing results from self-reported dietary intake data with four dietary biomarkers: doubly labeled water and urinary nitrogen, sodium, and potassium.

  15. Comparative study of the retinal nerve fibre layer thickness performed with optical coherence tomography and GDx scanning laser polarimetry in patients with primary open-angle glaucoma

    PubMed Central

    Wasyluk, Jaromir T.; Jankowska-Lech, Irmina; Terelak-Borys, Barbara; Grabska-Liberek, Iwona

    2012-01-01

    Summary Background We compared the parameters of retinal nerve fibre layer in patients with advanced glaucoma with the use of different OCT (Optical Coherence Tomograph) devices in relation to analogical measurements performed with GDx VCC (Nerve Fiber Analyzer with Variable Corneal Compensation) scanning laser polarimetry. Material/Methods Study subjects had advanced primary open-angle glaucoma, previously treated conservatively, diagnosed and confirmed by additional examinations (visual field, ophthalmoscopy of optic nerve, gonioscopy), A total of 10 patients were enrolled (9 women and 1 man), aged 18–70 years of age. Nineteen eyes with advanced glaucomatous neuropathy were examined. 1) Performing a threshold perimetry Octopus, G2 strategy and ophthalmoscopy of optic nerve to confirm the presence of advanced primary open-angle glaucoma; 2) performing a GDx VCC scanning laser polarimetry of retinal nerve fibre layer; 3) measuring the retinal nerve fibre layer thickness with 3 different optical coherence tomographs. Results The parameters of the retinal nerve fibre layer thickness are highly correlated between the GDx and OCT Stratus and 3D OCT-1000 devices in mean retinal nerve fibre layer thickness, retinal nerve fibre layer thickness in the upper sector, and correlation of NFI (GDx) with mean retinal nerve fibre layer thickness in OCT examinations. Absolute values of the retinal nerve fibre layer thickness (measured in μm) differ significantly between GDx and all OCT devices. Conclusions Examination with OCT devices is a sensitive diagnostic method of glaucoma, with good correlation with the results of GDx scanning laser polarimetry of the patients. PMID:22367131

  16. Efficacy and safety of alternating norfloxacin and rifaximin as primary prophylaxis for spontaneous bacterial peritonitis in cirrhotic ascites: a prospective randomized open-label comparative multicenter study.

    PubMed

    Assem, M; Elsabaawy, M; Abdelrashed, M; Elemam, S; Khodeer, S; Hamed, W; Abdelaziz, A; El-Azab, G

    2016-03-01

    Primary prevention of spontaneous bacterial peritonitis (SBP) is an important strategy to reduce morbidity and mortality in cirrhotic patients with ascites. Efficacy and safety of alternating rifaximin and norfloxacin as primary prophylaxis is questionable. Three hundred thirty-four cirrhotic patients with high SAAG (≥1.1) ascites, protein level in ascitic fluid less than 1.5 g/dL with advanced liver disease (Child-Pugh score >9 points with serum bilirubin level >3 mg/dL) or renal impairment (serum creatinine level >1.2 mg/dL, blood urea nitrogen level >25 mg/dL, or serum sodium level <130 mEq/L) were included in an open-label, randomized study aimed at comparing alternating use of norfloxacin and rifaximin vs. norfloxacin or rifaximin alone as primary prophylaxis for SBP. Both intention-to-treat and per-protocol efficacy analyses were done after 6 months of treatment by assessment of ascitic fluid neutrophil count. Safety analysis was done for all intention-to-treat populations. Alternating norfloxacin and rifaximin showed superior prophylaxis by intention-to-treat (74.7 vs. 56.4% vs. 68.3%, p < 0.048). Pairwise analysis showed that alternating regimen had lower probability to develop SBP when compared to a norfloxacin-based regimen in intention-to-treat (p = 0.016) and per protocol analysis (p = 0.039). There was no difference among the studied groups regarding the incidence and severity of adverse events reported. Alternating norfloxacin- and rifaximin-based primary prophylaxis for SBP showed higher efficacy with the same safety profile when compared with monotherapy of norfloxacin.

  17. Comparative clinical study of ultrasound-guided A1 pulley release vs open surgical intervention in the treatment of trigger finger

    PubMed Central

    Nikolaou, Vasileios S; Malahias, Michael-Alexander; Kaseta, Maria-Kyriaki; Sourlas, Ioannis; Babis, George C

    2017-01-01

    AIM To investigate the effectiveness of ultrasound-guided release of the first annular pulley and compare results with the conventional open operative technique. METHODS In this prospective randomized, single-center, clinical study, 32 patients with trigger finger or trigger thumb, grade II-IV according to Green classification system, were recruited. Two groups were formed; Group A (16 patients) was treated with an ultrasound-guided percutaneous release of the affected A1 pulley under local anesthesia. Group B (16 patients) underwent an open surgical release of the A1 pulley, through a 10-15 mm incision. Patients were assessed pre- and postoperatively (follow-up: 2, 4 and 12 wk) by physicians blinded to the procedures. Treatment of triggering (primary variable of interest) was expressed as the “success rate” per digit. The time for taking postoperative pain killers, range of motion recovery, QuickDASH test scores (Greek version), return to normal activities (including work), complications and cosmetic results were assessed. RESULTS The success rate in group A was 93.75% (15/16) and in group B 100% (16/16). Mean times in group A patients were 3.5 d for taking pain killers, 4.1 d for returning to normal activities, and 7.2 and 3.9 d for complete extension and flexion recovery, respectively. Mean QuickDASH scores in group A were 45.5 preoperatively and, 7.5, 0.5 and 0 after 2, 4, and 12 wk postoperatively. Mean times in group B patients were 2.9 d for taking pain killers, 17.8 d for returning to normal activities, and 5.6 and 3 d for complete extension and flexion recovery. Mean QuickDASH scores in group B were 43.2 preoperatively and, 8.2, 1.3 and 0 after 2, 4, and 12 wk postoperatively. The cosmetic results found excellent or good in 87.5% (14/16) of group A patients, while in 56.25% (9/16) of group B patients were evaluated as fair or poor. CONCLUSION Treatment of the trigger finger using ultrasonography resulted in fewer absence of work days, and better

  18. Open Entry/Open Exit Study. Final Report.

    ERIC Educational Resources Information Center

    Berg, Marvin

    Open entry/open exit refers to formats and procedures which allow learners to enter a program whenever they are ready and available, and allows them to leave or complete programs when competencies for job entry are attained. This study sought to provide base data on the concept of open entry/open exit by surveying involved individuals and to…

  19. Laparoscopic Surgery Can Reduce Postoperative Edema Compared with Open Surgery

    PubMed Central

    Guo, Dong; Gong, Jianfeng; Cao, Lei; Wei, Yao; Guo, Zhen

    2016-01-01

    Aim. The study aimed to investigate the impact of laparoscopic surgery and open surgery on postoperative edema in Crohn's disease. Methods. Patients who required enterectomy were divided into open group (Group O) and laparoscopic group (Group L). Edema was measured using bioelectrical impedance analysis preoperatively (PRE) and on postoperative day 3 (POD3) and postoperative day 5 (POD5). The postoperative edema was divided into slight edema and edema by an edema index, defined as the ratio of total extracellular water to total body water. Results. Patients who underwent laparoscopic surgery had better clinical outcomes and lower levels of inflammatory and stress markers. A total of 31 patients (26.05%) developed slight edema and 53 patients (44.54%) developed edema on POD3. More patients developed postoperative edema in Group O than in Group L on POD3 (p = 0.006). The value of the edema index of Group O was higher than that of Group L on POD3 and POD5 (0.402 ± 0.010 versus 0.397 ± 0.008, p = 0.001; 0.401 ± 0.009 versus 0.395 ± 0.007, p = 0.039, resp.). Conclusions. Compared with open surgery, laparoscopic surgery can reduce postoperative edema, which may contribute to the better outcomes of laparoscopic surgery over open surgery. PMID:27777583

  20. Field studies courses open

    NASA Astrophysics Data System (ADS)

    Fourteen month-long courses combining applied academics with training in field research methodology are being offered this summer by the School for Field Studies. The courses, held in eight countries during May, June, July, and August, provide unique opportunities for participants to work as a team under primitive conditions.‘Our courses bind together the academic challenge of the research problem, the physical challenge of the site itself, and the interpersonal challenge of the expedition team in a dynamic way so that both cognitive and affective learning are accelerated,’ according to Jim Elder, the school's director.

  1. Treatment of biotin-responsive basal ganglia disease: Open comparative study between the combination of biotin plus thiamine versus thiamine alone.

    PubMed

    Tabarki, Brahim; Alfadhel, Majid; AlShahwan, Saad; Hundallah, Khaled; AlShafi, Shatha; AlHashem, Amel

    2015-09-01

    To compare the combination of biotin plus thiamine to thiamine alone in treating patients with biotin-responsive basal ganglia disease in an open-label prospective, comparative study. twenty patients with genetically proven biotin-responsive basal ganglia disease were enrolled, and received for at least 30 months a combination of biotin plus thiamine or thiamine alone. The outcome measures included duration of the crisis, number of recurrence/admissions, the last neurological examination, the severity of dystonia using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS), and the brain MRI findings during the crisis and after 30 months of follow-up. Ten children with a mean age of 6 years(1/2) were recruited in the biotin plus thiamine group (group 1) and ten children (6 females and 4 males) with a mean age of 6 years and 2 months were recruited in the thiamine group (group 2). After 2 years of follow-up treatment, 6 of 20 children achieved complete remission, 10 had minimal sequelae in the form of mild dystonia and dysarthria (improvement of the BFMDRS, mean: 80%), and 4 had severe neurologic sequelae. All these 4 patients had delayed diagnosis and management. Regarding outcome measures, both groups have a similar outcome regarding the number of recurrences, the neurologic sequelae (mean BFMDS score between the groups, p = 0.84), and the brain MRI findings. The only difference was the duration of the acute crisis: group 1 had faster recovery (2 days), versus 3 days in group 2 (p = 0.005). Our study suggests that over 30 months of treatment, the combination of biotin plus thiamine is not superior to thiamine alone in the treatment of biotin-responsive basal ganglia disease. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  2. In Vitro Comparative Evaluation of Different Types of Impression Trays and Impression Materials on the Accuracy of Open Tray Implant Impressions: A Pilot Study

    PubMed Central

    Gupta, Sonam; Balakrishnan, Dhanasekar

    2017-01-01

    Purpose. For a precise fit of multiple implant framework, having an accurate definitive cast is imperative. The present study evaluated dimensional accuracy of master casts obtained using different impression trays and materials with open tray impression technique. Materials and Methods. A machined aluminum reference model with four parallel implant analogues was fabricated. Forty implant level impressions were made. Eight groups (n = 5) were tested using impression materials (polyether and vinylsiloxanether) and four types of impression trays, two being custom (self-cure acrylic and light cure acrylic) and two being stock (plastic and metal). The interimplant distances were measured on master casts using a coordinate measuring machine. The collected data was compared with a standard reference model and was statistically analyzed using two-way ANOVA. Results. Statistically significant difference (p < 0.05) was found between the two impression materials. However, the difference seen was small (36 μm) irrespective of the tray type used. No significant difference (p > 0.05) was observed between varied stock and custom trays. Conclusions. The polyether impression material proved to be more accurate than vinylsiloxanether impression material. The rigid nonperforated stock trays, both plastic and metal, could be an alternative for custom trays for multi-implant impressions when used with medium viscosity impression materials. PMID:28348595

  3. In Vitro Comparative Evaluation of Different Types of Impression Trays and Impression Materials on the Accuracy of Open Tray Implant Impressions: A Pilot Study.

    PubMed

    Gupta, Sonam; Narayan, Aparna Ichalangod; Balakrishnan, Dhanasekar

    2017-01-01

    Purpose. For a precise fit of multiple implant framework, having an accurate definitive cast is imperative. The present study evaluated dimensional accuracy of master casts obtained using different impression trays and materials with open tray impression technique. Materials and Methods. A machined aluminum reference model with four parallel implant analogues was fabricated. Forty implant level impressions were made. Eight groups (n = 5) were tested using impression materials (polyether and vinylsiloxanether) and four types of impression trays, two being custom (self-cure acrylic and light cure acrylic) and two being stock (plastic and metal). The interimplant distances were measured on master casts using a coordinate measuring machine. The collected data was compared with a standard reference model and was statistically analyzed using two-way ANOVA. Results. Statistically significant difference (p < 0.05) was found between the two impression materials. However, the difference seen was small (36 μm) irrespective of the tray type used. No significant difference (p > 0.05) was observed between varied stock and custom trays. Conclusions. The polyether impression material proved to be more accurate than vinylsiloxanether impression material. The rigid nonperforated stock trays, both plastic and metal, could be an alternative for custom trays for multi-implant impressions when used with medium viscosity impression materials.

  4. The Outcomes of Minimally Invasive versus Open Posterior Approach Spinal Fusion in Treatment of Lumbar Spondylolisthesis: The Current Evidence from Prospective Comparative Studies

    PubMed Central

    Wu, Ai-Min; Chen, Chun-Hui; Shen, Zhi-Hao; Feng, Zhen-Hua; Weng, Wan-Qing; Li, Shu-Min; Chi, Yong-Long; Yin, Li-Hui

    2017-01-01

    Purpose. To investigate the evidence of minimally invasive (MI) versus open (OP) posterior lumbar fusion in treatment of lumbar spondylolisthesis from current prospective literatures. Methods. The electronic literature database of Pubmed, Embase, and Cochrane library was searched at April 2016. The data of operative time, estimated blood loss and length of hospital stay, visual analog scale (VAS) of both lower back pain and leg pain, Oswestry disability index (ODI), SF-36 PCS (physical component scores) and SF-36 MCS (mental component scores), complications, fusion rate, and secondary surgery were extracted and analyzed by STATA 12.0 software. Results. Five nonrandom prospective comparative studies were included in this meta-analysis. The meta-analysis showed that the MI group had a significantly longer operative time than OP group, less blood loss, and shorter hospital stay. No significant difference was found in back pain, leg pain, ODI, SF-36 PCS, SF-36 MCS, complications, fusion rate, and secondary surgery between MI and OP groups. Conclusion. The prospective evidence suggested that MI posterior fusion for spondylolisthesis had less EBL and hospital stay than OP fusion; however it took more operative time. Both MI and OP fusion had similar results in pain and functional outcomes, complication, fusion rate, and secondary surgery. PMID:28154826

  5. Oral risperidone with lorazepam versus oral zuclopenthixol with lorazepam in the treatment of acute psychosis in emergency psychiatry: a prospective, comparative, open-label study.

    PubMed

    Hovens, J E; Dries, P J T; Melman, C T M; Wapenaar, R J C; Loonen, A J M

    2005-01-01

    Acutely psychotic patients presenting as psychiatric emergencies with aggression or agitation are often administered conventional antipsychotics intramuscularly. However, patients view intramuscular administration as coercive, and conventional antipsychotics are often associated with adverse events. In this open study, consecutive adult patients presenting with an acute exacerbation of schizophrenia or other psychotic disorder were assigned to oral risperidone 2-6 mg/day (n = 48) or oral zuclopenthixol 20-50 mg/day (n = 27) for 7-14 days. Lorazepam (either oral or intramuscular) was administered to both groups as needed. Patients were assessed regularly until day 14 or discharge. Mean Positive And Negative Syndrome Scale (PANSS) aggression scores (sum of item scores on excitement, poor impulse control, hostility and uncooperativeness) decreased steadily and similarly in both groups; the mean changes from baseline were statistically significant at days 10 and 14 and at study end-point. The mean decrease at study end-point in the PANSS component score for hostility was statistically significant in the risperidone group, but not in the zuclopenthixol group. Social Dysfunction and Aggression Scale aggression scores and Clinical Global Impression scores decreased significantly and similarly in both groups. Overall, 18.7% of patients showed minor extrapyramidal symptoms during the study, but only 16.7% of risperidone-treated patients, compared to 59.3% of zuclopenthixol-treated patients, received anti-parkinsonian medication (p < 0.001). Lorazepam was administered to all of the patients assigned to risperidone and to 89% of those assigned to zuclopenthixol. Oral risperidone plus lorazepam is a convenient, effective and well-tolerated alternative to conventional antipsychotics for the treatment of acute psychosis in emergency psychiatry.

  6. A 7 year prospective comparative study of three topical β blockers in the management of primary open angle glaucoma

    PubMed Central

    Watson, P; Barnett, M; Parker, V; Haybittle, J

    2001-01-01

    AIM—To determine the long term efficacy of monotherapy with topically applied β blocking agents and to determine whether selective β blockers were able to preserve the visual field more effectively than non-selective agents.
METHOD—A prospective randomised, open, comparative study of three topically applied β blockers—timolol, betaxolol, and carteolol—was carried out on 153 patients (280 eyes) with newly diagnosed open angle glaucoma. Those patients who were not withdrawn were followed by the same observers for a minimum of 2 years and a maximum of 7 years, with clinical observations, Goldmann tonometry and 24.2 Humphrey visual field analysis.
RESULTS—All three drugs lowered the IOP significantly from untreated levels but betaxolol took up to 12 months in some instances to reach the maximum pressure reduction. After 7 years only 43% of the eyes begun on timolol, 34% of those started on carteolol, and 29% of those on betaxolol were still being treated with these medications alone. Visual fields were analysed throughout the trial by CPSD and MD and at the end by linear regression analysis (PROGRESSOR). The visual fields remained the same without apparent improvement or deterioration throughout the period of follow up. Eight patients (11 eyes) were withdrawn because of continuing field loss in spite of reduction in IOP (six using carteolol and five using betaxolol).
CONCLUSIONS—Analysis shows that less than half the eyes initially treated with topical β blockers might be expected to still be being treated with their original medication after 5 years. The rest required either additional medication or trabeculectomy. There was no statistically significant improvement or deterioration in the visual fields over a 7 year period. On the evidence of this trial there are no particular advantages in using selective β blockers.

 PMID:11466256

  7. Efficacy of azacitidine compared with that of conventional care regimens in the treatment of higher-risk myelodysplastic syndromes: a randomised, open-label, phase III study

    PubMed Central

    Fenaux, Pierre; Mufti, Ghulam J; Hellstrom-Lindberg, Eva; Santini, Valeria; Finelli, Carlo; Giagounidis, Aristoteles; Schoch, Robert; Gattermann, Norbert; Sanz, Guillermo; List, Alan; Gore, Steven D; Seymour, John F; Bennett, John M; Byrd, John; Backstrom, Jay; Zimmerman, Linda; McKenzie, David; Beach, C L; Silverman, Lewis R

    2014-01-01

    Summary Background Drug treatments for patients with high-risk myelodysplastic syndromes provide no survival advantage. In this trial, we aimed to assess the effect of azacitidine on overall survival compared with the three commonest conventional care regimens. Methods In a phase III, international, multicentre, controlled, parallel-group, open-label trial, patients with higher-risk myelodysplastic syndromes were randomly assigned one-to-one to receive azacitidine (75 mg/m² per day for 7 days every 28 days) or conventional care (best supportive care, low-dose cytarabine, or intensive chemotherapy as selected by investigators before randomisation). Patients were stratified by French–American–British and international prognostic scoring system classifications; randomisation was done with a block size of four. The primary endpoint was overall survival. Efficacy analyses were by intention to treat for all patients assigned to receive treatment. This study is registered with ClinicalTrials.gov, number NCT00071799. Findings Between Feb 13, 2004, and Aug 7, 2006, 358 patients were randomly assigned to receive azacitidine (n=179) or conventional care regimens (n=179). Four patients in the azacitidine and 14 in the conventional care groups received no study drugs but were included in the intention-to-treat efficacy analysis. After a median follow-up of 21·1 months (IQR 15·1–26·9), median overall survival was 24·5 months (9·9–not reached) for the azacitidine group versus 15·0 months (5·6–24·1) for the conventional care group (hazard ratio 0·58; 95% CI 0·43–0·77; stratified log-rank p=0·0001). At last follow-up, 82 patients in the azacitidine group had died compared with 113 in the conventional care group. At 2 years, on the basis of Kaplan-Meier estimates, 50·8% (95% CI 42·1–58·8) of patients in the azacitidine group were alive compared with 26·2% (18·7–34·3) in the conventional care group (p<0·0001). Peripheral cytopenias were the most

  8. Use of a cognitive ergonomics approach to compare usability of a multidose dry powder inhaler and a capsule dry powder inhaler: an open-label, randomized, controlled study.

    PubMed

    Franks, Mark; Briggs, Pamela

    2004-11-01

    Usability (ease of use) is an important feature of inhalers to ensure optimal dose delivery The aim of this study was to compare the usability of a multidose dry powder inhaler (mDPI) and a capsule dry powder inhaler (cDPI) in older individuals, using a range of qualitative and quantitative techniques from the field of cognitive ergonomics. Participants aged >50 years were enrolled in this 2-visit, open-label, randomized, controlled, parallel-group study conducted at Northumbria University, Newcastle upon Tyne, United Kingdom. Participants who had used an inhaler or were inhaler naive were randomized to use the mDPI or cDPI. At visit 1, the inhaler procedure was demonstrated twice by the investigator. Participants then repeated the procedure (although they were not expected to inhale because no drug was to be administered) until they made 3 consecutive correct attempts. They also undertook a range of tests to assess their confidence in using the device, manual dexterity, and self-efficacy At visit 2 (2 days later), participants made a single inhaler attempt before receiving any demonstrations from the investigator; this was intended to simulate clinical practice, in which the patient may not use an inhaler for a few days after it is prescribed. Participants then completed the inhaler procedure 10 times while undertaking a concurrent distracter task. The number of critical errors (ie, those having a high impact on dose delivery) was recorded for all attempts. To facilitate subsequent correlation analyses, an overall performance measure was derived from a combination of the results of the single inhaler trial and the 10 trials with a distracter. Eighty individuals (51 women, 29 men; mean [SD] age, 74.1 [7.5] years) participated in the study(40 participants per device). Forty of the participants (50%) had used an inhaler previously; 40 (50%) were inhaler naive. Based on the overall performance measure, participants testing the mDPI made significantly fewer critical

  9. A Comparative Study of the Water Drinking Test in Eyes With Open-Angle Glaucoma and Prior Trabeculectomy or Tube Shunt.

    PubMed

    Martinez, Patricia; Trubnik, Valerie; Leiby, Benjamin E; Hegarty, Sarah E; Razeghinejad, Reza; Savant, Shravan; Myers, Jonathan S

    2017-02-01

    To compare the intraocular pressure (IOP) response after the water drinking test (WDT) in patients who have undergone trabeculectomy or tube shunt surgery. This prospective study examined 40 eyes of 34 open-angle glaucoma subjects who had undergone trabeculectomy (n=20) or tube shunt surgery (n=20). Both groups were matched by IOP range and by number of topical antiglaucoma medications used. After a baseline IOP assessment, subjects drank 10 mL water per kg body weight over 15 minutes. IOP was then measured with a Goldman tonometer every 15 minutes over a 1-hour period. Outcomes measures were IOP peak, fluctuation, mean, and range. No significant differences in baseline demographics, baseline clinical characteristics or IOP changes during the WDT were observed between the 2 surgical procedure groups. Mean baseline IOPs for the tube shunt and trabeculectomy groups were 12.55±4.23 and 12.3±4.28 mm Hg, respectively (P=0.854). In the trabeculectomy and tube shunt groups, respectively, peak IOP was 16.25±5.55 and 16.15±5.36 mm Hg (P=0.954); IOP fluctuation (IOP max-IOP baseline) was 3.95±2.17 and 3.6±2.23 mm Hg (P=0.618), and IOP range was 2.78±1.56 and 2.8±1.47 mm Hg (P=0.959). Statistical analysis of IOP fluctuation associations using multivariable linear regression determined that the use of systemic antihypertensive blood pressure medication was associated with an increase in IOP fluctuation of approximately 2 mm Hg. Subjects who had undergone either trabeculectomy or tube shunt surgery showed a similar IOP response to the WDT. Subjects on systemic antihypertensive medications experienced significantly greater IOP fluctuations during the test.

  10. Characteristics of positive surgical margins in robotic-assisted radical prostatectomy, open retropubic radical prostatectomy, and laparoscopic radical prostatectomy: a comparative histopathologic study from a single academic center.

    PubMed

    Albadine, Roula; Hyndman, Matthew E; Chaux, Alcides; Jeong, J Y; Saab, Shahrazad; Tavora, Fabio; Epstein, Jonathan I; Gonzalgo, Mark L; Pavlovich, Christian P; Netto, George J

    2012-02-01

    Studies detailing differences in positive surgical margin among open retropubic radical prostatectomy, laparoscopic radical prostatectomy, and robotic-assisted laparoscopic radical prostatectomy are lacking. A retrospective review of all prostatectomies with positive surgical margin performed at our center in 2007 disclosed 99 cases, 6 (5%) of which were reinterpreted cases as having negative margins. Ninety-three cases were, therefore, included, corresponding to 37 retropubic radical prostatectomies, 19 laparoscopic radical prostatectomies, and 37 robotic-assisted laparoscopic radical prostatectomies. The relationship of positive surgical margin characteristics to clinicopathologic parameters and biochemical recurrence was assessed. The most commonly found positive surgical margin site was the apex/distal third in all groups (62% retropubic prostatectomies, 79% laparoscopic prostatectomies, 60% robotic-assisted prostatectomies). Total linear length of positive surgical margin sites was significantly correlated with preoperative prostate-specific antigen, preoperative prostate-specific antigen density, pT stage, and tumor volume (P ≤ .001). We found no significant differences among the 3 groups with respect to total linear length, number of foci, laterality, or location of positive surgical margin. The rate of biochemical recurrence was also comparable in the 3 groups. On univariate analyses, biochemical recurrence was significantly associated with preoperative prostate-specific antigen values, preoperative prostate-specific antigen density, Gleason score, number of positive surgical margins, and total linear length of positive surgical margin (P ≤ .02). Only preoperative prostate-specific antigen density and number of positive surgical margin foci were statistically significant (P ≤ .03) independent predictors of biochemical recurrence. We found no significant difference in positive surgical margin characteristics or biochemical recurrence among the 3

  11. Outcomes of Prolonged Laparoscopic Bariatric Operations Compared With Shorter Open Procedures.

    PubMed

    Zettervall, Sara L; Amdur, Richard; Vaziri, Khashayar

    2015-12-01

    Prolonged operative time (ORT) is a drawback of laparoscopic bariatric surgery due to concerns for increased morbidity. This study aims to identify the ORT when open procedures are superior to laparoscopic procedures. Thirty-day outcomes for bariatric procedures in the NSQIP database were analyzed comparing laparoscopic ORT to equal or shorter open ORT. Multivariate regression was utilized to control for patient demographics and comorbidities. Among 48,274 cases, laparoscopic procedures reduced morbidity and mortality compared with open procedures of similar ORT. Laparoscopic procedures ≤3 hours were equal or superior to shorter open procedures. Laparoscopic procedures >6 hours had worse outcomes than open operations <3 hours. Open operations >3 hours had no benefit regardless of ORT. Laparoscopic bariatric operations have less mortality and morbidity compared with open procedures of similar ORT. The advantages of laparoscopic procedures are eliminated when ORT exceeds 6 hours compared with shorter open procedures.

  12. Efficacy and safety of leuprorelin acetate 6-month depot in prostate cancer patients: a Phase III, randomized, open-label, parallel-group, comparative study in Japan.

    PubMed

    Suzuki, Kazuhiro; Namiki, Mikio; Fujimoto, Tsukasa; Takabayashi, Nobuyoshi; Kudou, Kentarou; Akaza, Hideyuki

    2015-12-01

    Leuprorelin acetate (TAP-144-SR) is commonly used worldwide in prostate cancer patients. This study was conducted to assess the non-inferiority of a 6-month depot formulation of TAP-144-SR (TAP-144-SR [6M]) 22.5 mg to a 3-month depot formulation of TAP-144-SR (TAP-144-SR [3M]) 11.25 mg in prostate cancer patients in Japan. This was a 48-week Phase III, open-label, parallel-group comparative study. TAP-144-SR (6M) 22.5 mg (6M group) and TAP-144-SR (3M) 11.25 mg (3M group) were administered to 81 and 79 subjects, respectively. The primary endpoint was the rate of serum testosterone suppression to the castrate level (≤100 ng/dl). Serum testosterone of all subjects excluding one subject in the 3M group was suppressed to the castrate level throughout 48 weeks. The estimated between-group difference (6M group - 3M group) in suppression rate was 1.3% (95% confidence interval: -3.4, 6.8), and its lower confidence interval was more than -10% of the pre-determined allowable limit value to judge the non-inferiority. The prostate-specific antigen concentrations were stable throughout the study in both groups. Progressive disease in the best overall response based on the Response Evaluation Criteria In Solid Tumors was 0.0% for the 6M group and 2.6% for the 3M group. Adverse events occurred in 92.6% in the 6M group and 89.9% in the 3M group. Adverse events leading to discontinuation were reported in 2.5% in the 6M group and 3.8% in the 3M group. TAP-144-SR (6M) was not inferior to TAP-144-SR (3M) for the suppressive effect on serum testosterone level. TAP-144-SR (6M) was also as well tolerated as TAP-144-SR (3M). © The Author 2015. Published by Oxford University Press.

  13. Efficacy and safety of leuprorelin acetate 6-month depot in prostate cancer patients: a Phase III, randomized, open-label, parallel-group, comparative study in Japan

    PubMed Central

    Suzuki, Kazuhiro; Namiki, Mikio; Fujimoto, Tsukasa; Takabayashi, Nobuyoshi; Kudou, Kentarou; Akaza, Hideyuki

    2015-01-01

    Objective Leuprorelin acetate (TAP-144-SR) is commonly used worldwide in prostate cancer patients. This study was conducted to assess the non-inferiority of a 6-month depot formulation of TAP-144-SR (TAP-144-SR [6M]) 22.5 mg to a 3-month depot formulation of TAP-144-SR (TAP-144-SR [3M]) 11.25 mg in prostate cancer patients in Japan. Methods This was a 48-week Phase III, open-label, parallel-group comparative study. TAP-144-SR (6M) 22.5 mg (6M group) and TAP-144-SR (3M) 11.25 mg (3M group) were administered to 81 and 79 subjects, respectively. The primary endpoint was the rate of serum testosterone suppression to the castrate level (≤100 ng/dl). Results Serum testosterone of all subjects excluding one subject in the 3M group was suppressed to the castrate level throughout 48 weeks. The estimated between-group difference (6M group − 3M group) in suppression rate was 1.3% (95% confidence interval: −3.4, 6.8), and its lower confidence interval was more than −10% of the pre-determined allowable limit value to judge the non-inferiority. The prostate-specific antigen concentrations were stable throughout the study in both groups. Progressive disease in the best overall response based on the Response Evaluation Criteria In Solid Tumors was 0.0% for the 6M group and 2.6% for the 3M group. Adverse events occurred in 92.6% in the 6M group and 89.9% in the 3M group. Adverse events leading to discontinuation were reported in 2.5% in the 6M group and 3.8% in the 3M group. Conclusions TAP-144-SR (6M) was not inferior to TAP-144-SR (3M) for the suppressive effect on serum testosterone level. TAP-144-SR (6M) was also as well tolerated as TAP-144-SR (3M). PMID:26486824

  14. Triptorelin 6-month formulation in the management of patients with locally advanced and metastatic prostate cancer: an open-label, non-comparative, multicentre, phase III study.

    PubMed

    Lundström, Eija A; Rencken, Rupert K; van Wyk, Johann H; Coetzee, Lance J E; Bahlmann, Johann C M; Reif, Simon; Strasheim, Erdam A; Bigalke, Martin C; Pontin, Alan R; Goedhals, Louis; Steyn, Douw G; Heyns, Chris F; Aldera, Luigi A; Mackenzie, Thomas M; Purcea, Daniela; Grosgurin, Pierre Y; Porchet, Hervé C

    2009-01-01

    Triptorelin 6-month formulation was developed to offer greater convenience to both patients and physicians by reducing the injection frequency. The efficacy, pharmacokinetics and safety of a new 6-month formulation of triptorelin were investigated over 12 months (48 weeks). The primary objective was to evaluate the formulation in achieving castrate serum testosterone levels (< or = 1.735 nmol/L or < or = 50 ng/dL) on day 29 and in maintaining castration at months 2-12. Absence of luteinizing hormone (LH) stimulation and change in prostate-specific antigen (PSA) level were also assessed. An open-label, non-comparative, phase III study in 120 patients with advanced prostate cancer was conducted from July 2006 to August 2007 in private and public institutions in South Africa. Each patient received two consecutive intramuscular injections of triptorelin embonate (pamoate) 22.5 mg at an interval of 24 weeks. In all patients, testosterone (primary outcome measurement) was measured at baseline and then every 4 weeks; LH was measured before and 2 hours after the two injections. PSA was measured on day 1 and at weeks 12, 24, 36 and 48. Adverse events were recorded at each visit. In the intent-to-treat population, 97.5% (95% CI 92.9, 99.5) of patients achieved castrate serum testosterone levels by day 29, and 93.0% (95% CI 86.8, 97.0) maintained castration at months 2-12. After the second injection, 98.3% of patients showed absence of LH stimulation. The most frequent drug-related adverse events were hot flushes (71.7% of patients). No patient withdrew from the study as a result of an adverse event. The triptorelin 6-month formulation was well tolerated and was able to achieve and maintain castration for the treatment of locally advanced and metastatic prostate cancer. By reducing the frequency of required injections, this new formulation offers a more convenient treatment regimen. (Clinical Trial Registration,NCT00751790 at www.clinicaltrials.gov).

  15. Evaluation of bias in predicted and measured propofol concentrations during target-controlled infusions in obese Japanese patients: an open-label comparative study.

    PubMed

    Tachibana, Nobuko; Niiyama, Yukitoshi; Yamakage, Michiaki

    2014-12-01

    Target-controlled infusions (TCIs) of propofol are commonly used for general anaesthesia. The Marsh model pharmacokinetic parameter set incorporated in TCI devices for propofol could increase bias when used in obese patients. The purpose of this study was to assess the optimal predicted blood concentration (Cp) of 4.0 μg ml of propofol using a correction formula including BMI and to evaluate the influences on propofol concentration in obese patients. An open-label, comparative study. Sapporo Medical University Hospital, Japan, from October 2011 to December 2013. Seventy-five adults scheduled for elective surgery under general anaesthesia with the following exclusion criteria: less than 30 or more than 65 years of age; American Society of Anesthesiologists status 3 to 5; allergy to propofol; the daily use of psychoactive drugs; known or suspected drug or alcohol abuse; and cardiac, hepatic, renal or neurological impairment. Propofol was administered and maintained at a Cp of 4.0 μg ml using a TCI device programmed with the Marsh pharmacokinetic model. Arterial blood samples were collected at 15, 30, 60, 90, 120, 150 and 180 min after the start of the infusion, and the measured propofol concentration (Cm) was determined. After calculation of the adjustment formula using the corrected Cp of 69 patients, we then applied the corrected Cp to five other obese patients. The median performance error (MDPE) and median absolute performance error (MDAPE) were calculated to measure bias at each time point. We analysed 333 samples from the 69 individuals. There was a significant correlation between BMI and Cm, which tended be greater than 4.0 μg ml in obese patients. Our new method improved MDPE and MDAPE from a range of 20 to 40 for both, to ranges of -11.3 to -1.8 and 8.8 to 11.5, respectively. BMI influences blood propofol concentrations, leading to the possibility of overdosage of propofol in obese patients when the Marsh model is used to assess propofol

  16. Comparative fasting bioavailability of 2 bepotastine formulations in healthy male Chinese volunteers: an open-label, randomized, single-dose, 2-way crossover study.

    PubMed

    Shentu, Jianzhong; Zhou, Huili; Hu, Xingjiang; Wu, Guolan; Wu, Lihua; Zhu, Meixiang; Zhai, You; Zheng, Yunliang; Liu, Jian

    2014-04-01

    Bepotastine is a second-generation histamine1 receptor antagonist that is used in the treatment of allergic rhinitis, urticaria, and pruritus associated with skin disease. A new generic formulation of bepotastine has been developed in China, and information concerning bioavailability and pharmacokinetic properties in the Chinese population has not been reported. The aim of the present study was to compare the bioavailability and pharmacokinetic properties of 2 tablet formulations of bepotastine, the 10-mg generic formulation (test) and a branded formulation (reference), in healthy male Chinese volunteers to obtain registration approval of the test formulation. A single-center, open-label, randomized, 2-way crossover study with a 1-week washout period was conducted in 24 healthy male volunteers. Blood samples were collected for 16 hours after a single dose of the 10-mg bepotastine test formulation or the reference formulation. Plasma bepotastine concentrations were determined using a validated LC-MS/MS method. Cmax, Tmax, AUC₀-t, AUC₀-∞, and t½ were determined using noncompartmental analysis. The formulations were considered bioequivalent if the 90% CIs for the log-transformed Cmax and AUC values were within the predetermined interval of 75% to 133% and 80% to 125%, respectively, according to the guidelines of the China Food and Drug Administration. No significant differences were found in mean (SD) pharmacokinetic parameters between the test and reference drugs, including Cmax (74.81 [9.91] ng/mL vs 78.60 [29.58] ng/mL), AUC₀-t (295.55[115.29] ng·h/mL vs 299.17[109.29] ng·h/mL), and AUC0-∞ (305.28 [118.50] ng·h/mL vs 310.90 [112.20] ng·h/mL). The mean (SD) t½ values of the test and reference formulations were 2.53 (0.50) hours and 2.62 (0.41) hours, respectively. The 90% CIs of the treatment ratios for the logarithmic transformed values of Cmax, AUC₀-t, and AUC₀-∞ were 86.96% to 101.80%, 93.22% to 104.13%, and 92.66% to 103.30%, respectively

  17. Open-Label Comparative Clinical Study of Chlorproguanil−Dapsone Fixed Dose Combination (Lapdap™) Alone or with Three Different Doses of Artesunate for Uncomplicated Plasmodium falciparum Malaria

    PubMed Central

    Wootton, Daniel G.; Opara, Hyginus; Biagini, Giancarlo A.; Kanjala, Maxwell K.; Duparc, Stephan; Kirby, Paula L.; Woessner, Mary; Neate, Colin; Nyirenda, Maggie; Blencowe, Hannah; Dube-Mbeye, Queen; Kanyok, Thomas; Ward, Stephen; Molyneux, Malcolm; Dunyo, Sam; Winstanley, Peter A.

    2008-01-01

    The objective of this study was to determine the appropriate dose of artesunate for use in a fixed dose combination therapy with chlorproguanil−dapsone (CPG−DDS) for the treatment of uncomplicated falciparum malaria. Methods Open-label clinical trial comparing CPG−DDS alone or with artesunate 4, 2, or 1 mg/kg at medical centers in Blantyre, Malawi and Farafenni, The Gambia. The trial was conducted between June 2002 and February 2005, including 116 adults (median age 27 years) and 107 children (median age 38 months) with acute uncomplicated Plasmodium falciparum malaria. Subjects were randomized into 4 groups to receive CPG–DDS alone or plus 4, 2 or 1 mg/kg of artesunate once daily for 3 days. Assessments took place on Days 0−3 in hospital and follow-up on Days 7 and 14 as out-patients. Efficacy was evaluated in the Day 3 per-protocol (PP) population using mean time to reduce baseline parasitemia by 90% (PC90). A number of secondary outcomes were also included. Appropriate artesunate dose was determined using a pre-defined decision matrix based on primary and secondary outcomes. Treatment emergent adverse events were recorded from clinical assessments and blood parameters. Safety was evaluated in the intent to treat (ITT) population. Results In the Day 3 PP population for the adult group (N = 85), mean time to PC90 was 19.1 h in the CPG−DDS group, significantly longer than for the +artesunate 1 mg/kg (12.5 h; treatment difference −6.6 h [95%CI −11.8, −1.5]), 2 mg/kg (10.7 h; −8.4 h [95%CI −13.6, −3.2]) and 4 mg/kg (10.3 h; −8.7 h [95%CI −14.1, −3.2]) groups. For children in the Day 3 PP population (N = 92), mean time to PC90 was 21.1 h in the CPG−DDS group, similar to the +artesunate 1 mg/kg group (17.7 h; −3.3 h [95%CI −8.6, 2.0]), though the +artesunate 2 mg/kg and 4 mg/kg groups had significantly shorter mean times to PC90 versus CPG−DDS; 14.4 h (treatment difference −6.4 h [95%CI −11.7, −1.0]) and 12.8 h (−7

  18. An open and randomized study comparing the efficacy of standard danazol and modified triptorelin regimens for postoperative disease management of moderate to severe endometriosis.

    PubMed

    Wong, Alice Yuen Kwan; Tang, Lawrence

    2004-06-01

    To compare the efficacy of danazol and triptorelin (Decapeptyl CR, Ferring, Kiel, Germany) in the management of moderate and severe endometriosis in terms of symptom control and revised American Fertility Society (AFS) score reduction, and to evaluate the hormonal profile of patients treated with triptorelin every 6 weeks. Open and randomized trial. Kwong Wah Hospital, a large public hospital in an urban location (Hong Kong). Forty patients after their first conservative operation for endometriosis, with surgical confirmation of revised AFS stage III or IV endometriosis. Postoperative 6 months' therapy of danazol or triptorelin every 6 weeks, postmedical therapy second-look laparoscopy. Symptom control and patients' tolerance during medical therapy, posttherapy revised AFS score, hormonal profile during triptorelin therapy. Pain control was similar between danazol and triptorelin therapy. There was less breakthrough bleeding with triptorelin. More patients failed to complete the whole course of danazol because of its side effects. The revised AFS score at second-look laparoscopy did not show a significant difference between the two medications. Adequate pituitary suppression was observed with injection of triptorelin every 6 weeks. Lengthening of triptorelin administration intervals from 4 weeks to 6 weeks is effective in maintaining a hypoestrogenic state. Patients were more compliant with triptorelin than danazol. Thus, triptorelin injection every 6 weeks is more cost-effective than conventional regimens.

  19. A comparative study of postoperative pain for open thyroidectomy versus bilateral axillo-breast approach robotic thyroidectomy using a self-reporting application for iPad

    PubMed Central

    Chai, Young Jun; Song, Junho; Kang, Jiyoung; Woo, Jung-Woo; Song, Ra-Yeong; Kwon, Hyungju; Kim, Su-Jin; Choi, June Young

    2016-01-01

    Purpose Postoperative pain for robotic thyroid surgeries including bilateral axillo-breast approach (BABA) has not been well studied. In this study, we have developed a self-reporting application (SRA) for iPad and prospectively collected pain scores from open thyroidectomy (OT) and BABA robotic thyroidectomy (RT) patients. Methods Female patients who underwent total thyroidectomy for papillary thyroid carcinoma were included. Patients recorded pain scores for throat, anterior neck, posterior neck, chest, and back on postoperative days 1, 2, and 3. Once discharged, on postoperative day 14, a survey was also conducted on satisfaction of SRA and cosmesis. Results A total of 54 patients were enrolled (27 BABA RT and 27 OT). There were no significant differences between the 2 groups in clinicopathological characteristics and postoperative complication rates. Postoperative pain scores at days 1, 2, 3, and 14 were not significantly different between the groups for throat, anterior neck, posterior neck, or back. Postoperative analgesic requirements were similar between the 2 groups. Wound satisfaction scores were significantly higher in the BABA RT group (BABA RT 7.4 vs. OT 5.7; P = 0.016). Satisfaction scores for the usefulness of SRA were above 7.2 for all four questionnaire items on the 10-point scale. Conclusion Postoperative pain for BABA RT is equivalent to OT but offers greater cosmetic satisfaction for patients. A mobile device application such as SRA may facilitate proper assessment and management of pain in postoperative patients. PMID:27186567

  20. A comparative study of postoperative pain for open thyroidectomy versus bilateral axillo-breast approach robotic thyroidectomy using a self-reporting application for iPad.

    PubMed

    Chai, Young Jun; Song, Junho; Kang, Jiyoung; Woo, Jung-Woo; Song, Ra-Yeong; Kwon, Hyungju; Kim, Su-Jin; Choi, June Young; Lee, Kyu Eun

    2016-05-01

    Postoperative pain for robotic thyroid surgeries including bilateral axillo-breast approach (BABA) has not been well studied. In this study, we have developed a self-reporting application (SRA) for iPad and prospectively collected pain scores from open thyroidectomy (OT) and BABA robotic thyroidectomy (RT) patients. Female patients who underwent total thyroidectomy for papillary thyroid carcinoma were included. Patients recorded pain scores for throat, anterior neck, posterior neck, chest, and back on postoperative days 1, 2, and 3. Once discharged, on postoperative day 14, a survey was also conducted on satisfaction of SRA and cosmesis. A total of 54 patients were enrolled (27 BABA RT and 27 OT). There were no significant differences between the 2 groups in clinicopathological characteristics and postoperative complication rates. Postoperative pain scores at days 1, 2, 3, and 14 were not significantly different between the groups for throat, anterior neck, posterior neck, or back. Postoperative analgesic requirements were similar between the 2 groups. Wound satisfaction scores were significantly higher in the BABA RT group (BABA RT 7.4 vs. OT 5.7; P = 0.016). Satisfaction scores for the usefulness of SRA were above 7.2 for all four questionnaire items on the 10-point scale. Postoperative pain for BABA RT is equivalent to OT but offers greater cosmetic satisfaction for patients. A mobile device application such as SRA may facilitate proper assessment and management of pain in postoperative patients.

  1. An open, prospective, randomized study comparing the immunogenicity and safety of two inactivated hepatitis A pediatric vaccines in toddlers, children and adolescents in China.

    PubMed

    Li, Rong Cheng; Li, Yanping; Yi, Nong; Huang, Lirong; Wan, Zongju; Zhang, Yanping; Rasuli, Anvar

    2013-02-01

    Vaccines against hepatitis A provide long-lasting protection in both adults and children. The aim of this study was to demonstrate that the inactivated hepatitis A vaccine AVAXIM 80U Pediatric is safe and not inferior in terms of seroprotection rate to HAVRIX 720 vaccine 1 month after booster vaccination. An open, randomized, single-center trial was conducted in China in healthy antihepatitis A virus seronegative individuals from 12 months to 15 years of age. Participants were randomized in a 2:1 ratio to receive either AVAXIM 80U Pediatric or HAVRIX 720, followed by a booster vaccination, using the same vaccine 6 months afterward. A total of 720 individuals were included in the study, 480 in the AVAXIM 80U Pediatric group and 240 in the HAVRIX 720 group, and 686 individuals completed the full vaccination schedule. AVAXIM 80U Pediatric was statistically noninferior to HAVRIX 720 in terms of seroprotection rate for all individuals and in each of 3 age groups: toddlers (12-23 months), children (2-11 years) and adolescents (12-15 years). Antihepatitis A virus geometric mean titers were significantly higher with AVAXIM 80U Pediatric than with HAVRIX 720. Both inactivated hepatitis A vaccines were well-tolerated and had a similar incidence and type of adverse events. AVAXIM 80U Pediatric is safe and immunogenic, with a seroprotection rate that is not inferior to HAVRIX 720 in a pediatric population of healthy individuals.

  2. Consistently lower narcotics consumption after video-assisted thoracoscopic surgery for early stage non-small cell lung cancer when compared to open surgery: a one-year follow-up study.

    PubMed

    Fang, Hsin-Yuan; Chen, Chih-Yi; Wang, Yao-Ching; Wang, Pin-Hui; Shieh, Shwn-Huey; Chien, Chun-Ru

    2013-04-01

    Video-assisted thoracoscopic surgery (VATS) is possibly associated with reduced acute pain and narcotics consumption when compared to open surgery, but little is known about the long-term effect. The goal of our study was to evaluate whether narcotics consumption is consistently lower after VATS for early stage non-small cell lung cancer (NSCLC), as compared to open surgery, during one-year follow-up. This nationwide retrospective cohort study was conducted using data relating to cancer registry and national compulsory comprehensive claims in Taiwan. Our study cases were those newly diagnosed with clinical Stage I NSCLC, who underwent primary lung resection in the year 2007. The date of the admission during which index surgery was performed was used as the index date. We compared the use of narcotics, between the VATS and open surgery groups, over a period of one year following the index date. We defined narcotics as either Level 1 or 2 drugs as regulated in Taiwan. We also used an equiananalgesic dose chart to convert drug consumption into a uniform narcotics equivalent dose. Chi-square and t-tests were used for statistical analysis. We identified 329 cases (114 for VATS and 215 for open surgery). These two groups were balanced for most clinical variables. VATS was associated with lower narcotics consumption during the index admission (mean equivalent dose of intravenous morphine: 54.6 vs 71.4 mg) and this trend extended to the period covering the 2nd to 12th month after index date (73.8 vs 149.5mg). Narcotics consumption is consistently lower after VATS for early stage NSCLC, as compared to open surgery. Further prospective studies would be of great value in validating this finding.

  3. Exploring social and infrastructural factors affecting open burning of municipal solid waste (MSW) in Indian cities: A comparative case study of three neighborhoods of Delhi.

    PubMed

    Ramaswami, Anu; Baidwan, Navneet Kaur; Nagpure, Ajay Singh

    2016-11-01

    Open municipal solid waste (MSW)-burning is a major source of particulate matter emissions in developing world cities. Despite a legal ban, MSW-burning is observed ubiquitously in Indian cities with little being known about the factors shaping it. This study seeks to uncover social and infrastructural factors that affect MSW-burning at the neighborhood level. We couple physical assessments of the infrastructure provision and the MSW-burning incidences in three different neighborhoods of varying socio-economic status in Delhi, with an accompanying study of the social actors (interviews of waste handlers and households) to explore the extent to which, and potential reasons why, MSW-burning occurs. The observed differences in MSW-burning incidences range from 130 km(-2) day(-1) in low-income to 30 km(-2) day(-1) in the high-income areas. However, two high-income areas neighborhoods with functional infrastructure service also showed statistical differences in MSW-burning incidences. Our interviews revealed that, while the waste handlers were aware of the health risks associated with MSW-burning, it was not a high priority in the context of the other difficulties they faced. The awareness of the legal ban on MSW-burning was low among both waste handlers and households. In addition to providing infrastructure for waste pickup, informal restrictions from residents and neighborhood associations can play a significant role in restricting MSW-burning at the neighborhood scale. A more efficient management of MSW requires a combined effort that involves interplay of both social and infrastructural systems. © The Author(s) 2016.

  4. A multicentric, open label, randomised, postmarketing efficacy study comparing multidose of lincomycin hydrochloride capsule 500 mg with multidose cefpodoxime proxetil tablet 200 mg in patients with tonsillitis, sinusitis.

    PubMed

    Kothadiya, Ajay

    2012-08-01

    Tonsillitis causes considerable short and medium term morbidity, and can be recurrent. Sinusitis can be acute (less than 4 weeks), subacute (4-8 weeks) or chronic (8 weeks or more). To study the comparative efficacy and safety of multidose treatments of lincomycin hydrochloride 500 mg capsules against cefpodoxime proxetil 200 mg tablets on its outcome in the Indian scenario are the aims and objective of the study. A total of 41 tonsillitis, sinusitis cases of either gender aged above 18 years were enrolled in the study. The diagnosis of sonsillitis, sinusitis was made based on examination of symptoms and throat swab. A randomised treatment of either lincomycin hydrochloride 500 mg capsules or cefpodoxime proxetil 200 mg tablets twice daily for five days alongwith other concomitant medications depending on related symptoms was given to 40 patients. At the end of study, all patients were re-evaluated and the response rate was assessed. The most common clinical symptoms were body temperature, headache, throat pain, postnasal discharge, mucopus, odynophagia, sinus tenderness, nasal congestion, pharyngeal congestion and tonsillar congestion. The overall response rate of lincomycin hydrochloride in all the symptoms except headache was more effective than cefpodoxime proxetil. Out of 100% (n = 20) patients in each group, 67.89% in lincomycin and 52.27% in cefpodoxime patients achieved complete relief, in all the clinical symptoms. The study suggests that lincomycin hydrochloride capsules, a conventional antibiotic indicates effective treatment for relief from tonsillitis and sinusitis, as compared to new third generation antibiotic.

  5. Open-label pilot study comparing quantitative ultrasound and dual-energy X-ray absorptiometry to assess corticosteroid-induced osteoporosis in patients with chronic kidney disease.

    PubMed

    Grabe, Darren W; Chan, Marcia; Eisele, George

    2006-02-01

    Patients with chronic kidney disease (CKD) might be at high risk for bone disease. Decreased functional kidney mass contributes to renal osteodystrophy, which might be exacerbated by certain drug therapies. Long-term (> or = 6 months) corticosteroid treatment is commonly prescribed in patients with glomerular disease, possibly causing bone loss both indirectly and directly, putting the patient at increased risk for fracture. The dual-energy x-ray absorptiometry (DXA) is the current "gold standard" for measuring osteoporosis-related fractures and works by passing ultrasound waves through bone to determine the structural anisotropy in the heel. This pilot study was designed to determine whether there is a correlation between DXA and quantitative ultrasound (QUS) in detecting corticosteroid-induced osteoporosis. This open-label pilot study was conducted at the Medical Center Nephrology Clinic, Albany Medical College, Albany, New York. Female patients aged > or = 18 years with a diagnosis of CKD and/or a history of kidney transplantation and who were receiving long-term corticosteroid treatment were enrolled. Each patient served as her own control and underwent DXA of the hip and spine (DXA-hip and DXA-spine, respectively) and QUS of the dominant and nondominant heels (QUS-dominant and QUS-nondominant, respectively), within 1 week so that conditions were similar in each patient. Eight patients were included in the study (mean [SD] age, 50.2 [11.2] years). A positive correlation was found between DXA-hip and QUS-nondominant (r2=0.76; P=0.009); however, no correlation was found with DXA-spine. Similarly, a positive correlation was found between DXA-hip and QUS-dominant (r2=0.75; P=0.009), but no correlation with DXA-spine was found (r2=0.22). In this small, selected population, QUS showed a fair correlation with DXA-hip but no correlation with DXA-spine. Further studies are needed to determine the effectiveness in other populations.

  6. The efficacy and safety of cyclosporine reduction in de novo renal allograft patients receiving sirolimus and corticosteroids: results from an open-label comparative study.

    PubMed

    Mühlbacher, Ferdinand; Neumayer, Hans-Helmut; del Castillo, Domingo; Stefoni, Sergio; Zygmunt, Anthony J; Budde, Klemens

    2014-02-01

    This study evaluated the safety and efficacy of a sirolimus, corticosteroid, and cyclosporine reduction regimen in an open-label, 12-month trial of 420 de novo renal allograft recipients at 49 European transplant centers. One month post-transplantation, 357 patients were randomized to receive standard-dose cyclosporine (sCsA, n = 179) or reduced-dose cyclosporine (rCsA, n = 178). All patients also received sirolimus and corticosteroids. The primary end points were the rate of biopsy-confirmed acute rejection (BCAR) and renal function, as measured by serum creatinine. Baseline demographic and donor characteristics were similar between groups. BCAR rates at 12 months were not significantly different: 11.2% for rCsA patients and 16.2% for sCsA patients. Mean serum creatinine (±SEM) was significantly lower (1.75 ± 0.10 vs. 1.97 ± 0.07 mg/dl, P < 0.001), and creatinine clearance (±SEM; Nankivell method) was significantly higher (57.8 ± 1.78 vs. 49.5 ± 2.46 ml/min, P < 0.001) in patients receiving rCsA versus sCsA at 1 year, respectively. Patient and graft survival exceeded 98% in both groups. No significant differences in infection or malignancy were noted between groups. The rCsA with sirolimus and corticosteroid regimen resulted in excellent 12-month patient and graft survival, a low incidence of BCAR, and improved renal function in renal allograft recipients. Sirolimus administered with rCsA and corticosteroids provided adequate immunosuppression while reducing the potential for the nephrotoxic effects of cyclosporine. These findings may help to improve long-term renal allograft outcomes. © 2013 Steunstichting ESOT. Published by John Wiley & Sons Ltd.

  7. Outcomes and financial implications of intra-articular distal radius fractures: a comparative study of open reduction internal fixation (ORIF) with volar locking plates versus nonoperative management.

    PubMed

    Toon, Dong Hao; Premchand, Rex Antony Xavier; Sim, Jane; Vaikunthan, Rajaratnam

    2017-02-02

    To evaluate the functional and radiographic outcomes, as well as the treatment costs, of closed displaced intra-articular distal radius fractures treated with either open reduction internal fixation (ORIF) with volar locking plates or nonoperative treatment with plaster cast immobilisation. A total of 60 patients (32 receiving ORIF, 28 receiving nonoperative treatment) with closed intra-articular distal radius fractures were included. The mean age was 52.1 and 57.4, respectively. Functional and radiographic assessments were carried out at 12 months post-injury. Patients' treatment costs, median salaries and lengths of medical leave were obtained. DASH and MAYO wrist score in the ORIF group did not differ significantly from those in the nonoperative group. Apart from superior ulnar deviation in the ORIF group (p = 0.0096), differences in the range of motion of the injured wrists were not significant. Similarly, there were no significant differences in grip strength and visual analog scale for pain. Volar tilt (p = 0.0399), radial height (p = 0.0087), radial inclination (p = 0.0051) and articular step-off (p = 0.0002) were all significantly superior in the ORIF group. There was a 37-fold difference in mean treatment costs between ORIF (SGD 7951.23) and nonoperative treatment (SGD 230.52). Our study shows no difference in overall functional outcomes at 12 months for closed displaced intra-articular distal radius fractures treated with either ORIF with volar locking plates or plaster cast immobilisation, and this is independent of radiographic outcome. A longer follow-up, nevertheless, is needed to determine whether the development of post-traumatic arthritis will have an effect on function. The vast difference in treatment costs should be taken into consideration when deciding on the treatment option. Level 3.

  8. Team Teaching and the "Active" Classroom. A Comparative Study of the Impact of Self-Contained Classrooms and Open-Space Team Teaching Schools on Classroom "Activity."

    ERIC Educational Resources Information Center

    Lueders-Salmon, Erika

    This investigation assesses the environment of the elementary child experience, rather than his academic achievement or personal adjustment. Subjects included 22 collegiate teams in 11 open space schools, and 11 teachers in 7 self-contained classrooms. In each self-contained classroom, a minimum of 15 observations was made (five each of reading,…

  9. Randomized open-label phase II study comparing oxycodone-naloxone with oxycodone in early return of gastrointestinal function after laparoscopic colorectal surgery.

    PubMed

    Creamer, F; Balfour, A; Nimmo, S; Foo, I; Norrie, J D; Williams, L J; Fearon, K C; Paterson, H M

    2017-01-01

    Combined oral modified-release oxycodone-naloxone may reduce opioid-induced postoperative gut dysfunction. This study examined the feasibility of a randomized trial of oxycodone-naloxone within the context of enhanced recovery for laparoscopic colorectal resection. In a single-centre open-label phase II feasibility study, patients received analgesia based on either oxycodone-naloxone or oxycodone. Primary endpoints were recruitment, retention and protocol compliance. Secondary endpoints included a composite endpoint of gut function (tolerance of solid food, low nausea/vomiting score, passage of flatus or faeces). Eighty-two patients were screened and 62 randomized (76 per cent); the attrition rate was 19 per cent (12 of 62), leaving 50 patients who received the allocated intervention with 100 per cent follow-up and retention (modified intention-to-treat cohort). Protocol compliance was more than 90 per cent. Return of gut function by day 3 was similar in the two groups: 13 (48 per cent) of 27 in the oxycodone-naloxone group and 15 (65 per cent) of 23 in the control group (95 per cent c.i. for difference -10·0 to 40·7 per cent; P = 0·264). However, patients in the oxycodone-naloxone group had a shorter time to first bowel movement (mean(s.d.) 87(38) h versus 111(37) h in the control group; 95 per cent c.i. for difference 2·3 to 45·4 h, P = 0·031) and reduced total (oral plus parenteral) opioid consumption (mean(s.d.) 78(36) versus 94(56) mg respectively; 95 per cent c.i. for difference -10·2 to 42·8 mg, P = 0·222). High participation, retention and protocol compliance confirmed feasibility. Potential benefits of oxycodone-naloxone in reducing time to bowel movement and total opioid consumption could be tested in a randomized trial. Registration number: NCT02109640 (https://www.clinicaltrials.gov/). © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

  10. An open, randomized, prospective, comparative study of topical pimecrolimus 1% cream and topical ketoconazole 2% cream in the treatment of seborrheic dermatitis.

    PubMed

    Koc, Erol; Arca, Ercan; Kose, Osman; Akar, Ahmet

    2009-01-01

    Seborrheic dermatitis (SD) is a chronic inflammatory disorder that mainly affects the seborrheic region. While ketoconazole is often used, pimecrolimus has been used successfully in SD. To compare the efficacy and tolerability of pimecrolimus in comparison with ketoconazole in the treatment of SD. A total of 48 patients with SD were included in the study. Patients were randomized into two groups: 23 and 25 patients in the pimecrolimus and ketoconazole groups, respectively. Clinical measures were assessed by erythema, scaling and infiltration, which were evaluated using a four-point scale (0 to 3) at 2, 6, and 12 weeks. Of these 48 patients, 38 completed the study (18 and 20 patients in the pimecrolimus and ketoconazole groups, respectively). The mean percentage decrease in clinical severity scores from baseline to the last follow-up period was 86.2% and 86.1% in the pimecrolimus and ketoconazole groups, respectively. Both pimecrolimus and ketoconazole were effective in SD. Differences between the two groups were not statistically significant. Side effects were observed more frequently with pimecrolimus than with ketoconazole and this difference was statistically significant. Our study showed that pimecrolimus had a comparable efficacy profile with that of ketoconazole, but side effects appeared more frequently in the pimecrolimus group than in the ketoconazole group.

  11. An open, comparative study of 10% potassium hydroxide solution versus salicylic and lactic acid combination in the treatment of molluscum contagiosum in children.

    PubMed

    Köse, Osman; Özmen, İbrahim; Arca, Ercan

    2013-08-01

    To evaluate and compare the safety and efficacy of 10% potassium hydroxide (KOH) solution and salicylic and lactic acid (SAL + LAC) combination in the treatment of molluscum contagiosum (MC). 26 patients with MC randomized into two treatment groups. 12 patients treated with 10% KOH solution and 14 patients treated with SAL + LAC combination for 6 weeks. Parents of patients were instructed to apply medication once daily only to lesions at study onset. Assessment of response of the treated lesions and side effects was performed at 2, 4 and 6 weeks of the treatment. Newly acquired lesions were not included in the study. At the end of therapy, 83.3% (n = 10) of KOH group demonstrated complete remission and 16.7% (n = 2) of them showed partial remission; four patients (33%) developed new lesions during the study. All the patients in the SAL + LAC combination group (100%) demonstrated complete remission of study entry lesions at the end of 6 weeks with five patients (35%) acquiring new lesions during the study. Minor side effects were observed in two groups. 10% KOH solution and SAL + LAC combination were found to be equally effective in the treatment of MC in children.

  12. Dorsal fracture-dislocation of the proximal interphalangeal joint: a comparative study of percutaneous Kirschner wire fixation versus open reduction and internal fixation.

    PubMed

    Aladin, A; Davis, T R C

    2005-05-01

    Nineteen patients with a dorsal fracture-dislocation of the proximal interphalangeal joint of a finger were treated with either closed reduction and transarticular Kirschner wire fixation (eight cases) or open reduction and internal fixation, using either one or two lag screws (six cases) or a cerclage wire (five cases). At a mean follow-up of 7 (range 6-9) years, most patients reported satisfactory finger function, even though some of the injuries healed with proximal interphalangeal joint incongruency (seven cases) or subluxation (four cases). Those treated by open reduction complained of more "loss of feeling" in the affected finger and those specifically treated by cerclage wire fixation reported more cold intolerance and had a significantly larger fixed flexion deformity (median, 30 degrees : range 18-38 degrees ) and a smaller arc of motion (median, 48 degrees : range 45-60 degrees ) at the proximal interphalangeal joint, despite having the best radiological outcomes. Closed reduction and transarticular Kirschner wire fixation produced satisfactory results, with none of the eight patients experiencing significant persistent symptoms despite a reduced arc of proximal interphalangeal joint flexion (median=75 degrees ; range 60-108 degrees ). The results of this relatively simple treatment appear at least as satisfactory as those obtained by the two techniques of open reduction and internal fixation, both of which were technically demanding.

  13. Reduced Silent Occlusions with a Novel Catheter Infusion Set (BD FlowSmart): Results from Two Open-Label Comparative Studies

    PubMed Central

    Gibney, Michael; Xue, Zhenyi; Swinney, Monica; Bialonczyk, Damian

    2016-01-01

    Abstract Background: Insulin pump users experience periods of unexplained hyperglycemia. In some cases these may be due to insulin flow interruptions termed “silent occlusions,” which occur without activating the pump alarm and may require set replacement. Materials and Methods: In-line pressure profiles of a novel infusion set with a 6-mm, 28-gauge polymer, dual-ported catheter (BD FlowSmart™; Becton Dickinson and Co., Franklin Lakes, NJ) were compared with those of an existing infusion set (Quick-set®; Medtronic MiniMed, Northridge, CA) in two separate studies involving insulin diluent infusions over 2.5–4.5-h periods in healthy adults without diabetes. Study 1, a pilot study (n = 25), compared the occurrence of flow interruption events (silent occlusions and/or occlusion alarms) between the two infusion sets and between manual or device-assisted insertion methods. Study 2 (n = 60) was designed to show ≥50% reduction in flow interruption events with the BD set after manual insertions. (Silent occlusions were defined by a continuous pressure rise for ≥30 min.) Results: In Study 1, significantly fewer silent occlusions were seen with BD FlowSmart versus Quick-set infusion sets for both manual (three of 22 [13.6%] vs. 12 of 24 [50%]; P = 0.012) and mechanical (two of 24 [8.3%] vs. nine of 25 [36%]; P = 0.037) insertions, yielding risk reductions of 73% (95% confidence interval [CI], 25–91%) and 77% (95% CI, 17–94%), respectively. In Study 2, flow interruption events occurred in three of 117 (2.6%) and 12 of 118 (10.2%) BD FlowSmart and Quick-set infusion sets, respectively, yielding a 75% risk reduction (95% CI, 20–92%; P = 0.030). Percentage of time with flow interruption was significantly lower with BD sets in both studies (P < 0.02). Leakage (>0.5 IU or 5 μL) occurred infrequently and did not differ between sets. Conclusions: A novel side-ported insulin infusion set demonstrated significant reductions in flow

  14. Reduced Silent Occlusions with a Novel Catheter Infusion Set (BD FlowSmart): Results from Two Open-Label Comparative Studies.

    PubMed

    Gibney, Michael; Xue, Zhenyi; Swinney, Monica; Bialonczyk, Damian; Hirsch, Laurence

    2016-03-01

    Insulin pump users experience periods of unexplained hyperglycemia. In some cases these may be due to insulin flow interruptions termed "silent occlusions," which occur without activating the pump alarm and may require set replacement. In-line pressure profiles of a novel infusion set with a 6-mm, 28-gauge polymer, dual-ported catheter (BD FlowSmart™; Becton Dickinson and Co., Franklin Lakes, NJ) were compared with those of an existing infusion set (Quick-set®; Medtronic MiniMed, Northridge, CA) in two separate studies involving insulin diluent infusions over 2.5-4.5-h periods in healthy adults without diabetes. Study 1, a pilot study (n = 25), compared the occurrence of flow interruption events (silent occlusions and/or occlusion alarms) between the two infusion sets and between manual or device-assisted insertion methods. Study 2 (n = 60) was designed to show ≥50% reduction in flow interruption events with the BD set after manual insertions. (Silent occlusions were defined by a continuous pressure rise for ≥30 min.) In Study 1, significantly fewer silent occlusions were seen with BD FlowSmart versus Quick-set infusion sets for both manual (three of 22 [13.6%] vs. 12 of 24 [50%]; P = 0.012) and mechanical (two of 24 [8.3%] vs. nine of 25 [36%]; P = 0.037) insertions, yielding risk reductions of 73% (95% confidence interval [CI], 25-91%) and 77% (95% CI, 17-94%), respectively. In Study 2, flow interruption events occurred in three of 117 (2.6%) and 12 of 118 (10.2%) BD FlowSmart and Quick-set infusion sets, respectively, yielding a 75% risk reduction (95% CI, 20-92%; P = 0.030). Percentage of time with flow interruption was significantly lower with BD sets in both studies (P < 0.02). Leakage (>0.5 IU or 5 μL) occurred infrequently and did not differ between sets. A novel side-ported insulin infusion set demonstrated significant reductions in flow interruptions, including silent occlusions, versus a leading marketed set, which may

  15. Open-field study comparing an essential oil-based shampoo with miconazole/chlorhexidine for haircoat disinfection in cats with spontaneous microsporiasis.

    PubMed

    Nardoni, Simona; Costanzo, Angela Grazia; Mugnaini, Linda; Pisseri, Francesca; Rocchigiani, Guido; Papini, Roberto; Mancianti, Francesca

    2017-06-01

    Objectives The goal of the present study was to compare the antifungal efficacy of an essential oil (EO) shampoo proven to be effective against Microsporum canis with miconazole/chlorhexidine for topical haircoat disinfection in cats treated concurrently with oral itraconazole. Methods Cats received treatment with oral itraconazole (Itrafungol) at a dose of 5 mg/kg/day pulse administration for 1 week, every 2 weeks for at least 6 weeks and were washed twice a week with a neutral shampoo with added EOs of Thymus serpyllum (2%), Origanum vulgare and Rosmarinus officinalis (5% each) for the period of systemic treatment. This protocol was compared with a conventional treatment (oral itraconazole + 2% miconazole/2% chlorhexidine shampoo). Results The treatment was well tolerated and adverse effects were not recorded. All cats were clinically negative at week 11. With respect to animals with extensive lesions, the speed of resolution was higher in cats with focal lesions. The animals showing diffuse lesions required more than a course of treatment to achieve a mycological cure. There was no significant difference between the number of weeks to obtain mycological cure for cats treated with EOs and animals treated conventionally. Conclusions and relevance The treatment appeared to be effective and well appreciated by the owners. The use of shampoo with the added EOs of T serpyllum, O vulgare and R officinalis would seem an interesting, natural alternative to conventional topical treatment.

  16. A 12-month, open-label, comparative study of quetiapine and risperidone in the acute and long-term treatment of schizophrenia.

    PubMed

    Perez, Victor; Cañas, Fernando; Tafalla, Monica

    2008-05-01

    This multicentre, observational, prospective, nonrandomized study compared the effectiveness and tolerability of quetiapine and risperidone in the acute and long-term treatment of schizophrenia in a clinical setting. Patients admitted to an acute unit with schizophrenia, schizophreniform or schizoaffective disorder (DSM-IV), who were prescribed quetiapine or risperidone (3 : 1 ratio) within the first week of treatment, according to the physician's usual practice, were recruited. In total, 492 patients (quetiapine: 367; risperidone: 125) were followed up at weeks 1 and 2, discharge and 6 and 12 months thereafter. Mean doses at 12 months were: quetiapine 718.5 mg/day and risperidone 7.0 mg/day. Efficacy measures (Brief Psychiatric Rating Scale, Clinical Global Impression Severity of Illness and Improvement) indicated similar results for both agents. No difference was found in rehospitalization rate with either drug. In terms of tolerability, orthostatic hypotension was more frequent with quetiapine, but extrapyramidal symptoms and male sexual dysfunction were more frequent with risperidone. In conclusion, quetiapine and risperidone had comparable effectiveness, but there were differences between treatments in their side effect profile.

  17. Transdermal Patch of Rotigotine Attenuates Freezing of Gait in Patients with Parkinson's Disease: An Open-Label Comparative Study of Three Non-Ergot Dopamine Receptor Agonists

    PubMed Central

    Ikeda, Ken; Hirayama, Takehisa; Takazawa, Takanori; Kawabe, Kiyokazu; Iwasaki, Yasuo

    2016-01-01

    Objective Parkinson's disease (PD) is characterized by the progressive degeneration of the nigrostriatal dopaminergic neurons. Rotigotine is a non-ergot dopamine receptor agonist (DA). Its transdermal patch maintains the effective concentrations for 24 hours. Freezing of gait (FOG) is a common and devastating symptom in PD patients. Little is known about therapeutic effects of rotigotine on FOG in PD patients. Herein we compared how three non-ergot DAs of rotigotine, pramipexole LA and ropinirole CR influence FOG, besides classical motor deficits in PD patients. Methods Rotigotine (maintenance doses of 9-27 mg/day) was administered in 51 patients, 36 patients received pramipexole LA (1.5-4.5 mg/day) and 35 patients received ropinirole CR (8-16 mg/day). The Unified PD Rating Scale (UPDRS) parts I-IV, FOG questionnaire (16 items) and wearing off time were examined from baseline to 7 months after DA administration. UPDRS parts I-IV were evaluated during on time and FOG was recorded during off time if patients experienced wearing off. Results A total of 111 patients completed the study. UPDRS parts II-III scores and wearing off time were significantly reduced after each DA treatment compared to baseline. FOG was found in 54 patients (49%). Most patients developed FOG during off time only. FOG scores were significantly decreased at 2 months after rotigotine treatment whereas pramipexole LA and ropinirole treatment did not alter FOG scores. Conclusion The present study indicates that transdermal patch of rotigotine attenuated the FOG off time. The similar binding affinities to dopamine receptors between rotigotine and dopamine, and 24 hours steady hemodynamics could contribute to the therapeutic mechanism of rotigotine on FOG in PD patients with wearing off. PMID:27725534

  18. Comparing the Effectiveness and Safety of the Addition of and Switching to Aripiprazole for Resolving Antipsychotic-Induced Hyperprolactinemia: A Multicenter, Open-Label, Prospective Study.

    PubMed

    Yoon, Hui Woo; Lee, Jung Suk; Park, Sang Jin; Lee, Seon-Koo; Choi, Won-Jung; Kim, Tae Yong; Hong, Chang Hyung; Seok, Jeong-Ho; Park, Il-Ho; Son, Sang Joon; Roh, Daeyoung; Kim, Bo-Ra; Lee, Byung Ook

    Hyperprolactinemia is an important but often overlooked adverse effect of antipsychotics. Several studies have shown that switching to or adding aripiprazole normalizes antipsychotic-induced hyperprolactinemia. However, no study has directly compared the effectiveness and safety of the 2 strategies. A total of 52 patients with antipsychotic-induced hyperprolactinemia were recruited. Aripiprazole was administered to patients with mild hyperprolactinemia (serum prolactin level < 50 ng/mL). Patients with severe hyperprolactinemia (serum prolactin level > 50 ng/mL) were randomized to an aripiprazole-addition group (adding aripiprazole to previous antipsychotics) or a switching group (switching previous antipsychotics to aripiprazole). Serum prolactin level, menstrual disturbances, sexual dysfunction, psychopathologies, and quality of life were measured at weeks 0, 1, 2, 4, 6, and 8. Both the addition and switching groups showed significantly reduced serum prolactin level and menstrual disturbances and improved sexual dysfunction. In patients with severe hyperprolactinemia, the numbers of patients with hyperprolactinemia and menstrual disturbance in the switching group were significantly lower than those in the addition group at week 8. Both the addition and switching strategies were effective in resolving antipsychotic-induced hyperprolactinemia and hyperprolactinemia-related adverse events, including menstrual disturbances and sexual dysfunction. In addition, these findings suggest that switching to aripiprazole may be more effective than addition of aripiprazole for normalizing hyperprolactinemia and improving hyperprolactinemia-related adverse events in patients with schizophrenia.

  19. [Dexpanthenol nasal spray in comparison to dexpanthenol nasal ointment. A prospective, randomised, open, cross-over study to compare nasal mucociliary clearance].

    PubMed

    Verse, T; Klöcker, N; Riedel, F; Pirsig, W; Scheithauer, M O

    2004-07-01

    Recent technical developments in metered pump systems allow the production and use of preservative-free nasal products. The aim of the current study is to compare the tolerability of a preservative-free dexpanthenol (5%) nasal spray with that of the established dexpanthenol (5%) nasal ointment, also without preservatives. The main outcome measure was in vivo mucociliary clearance. Mucociliary clearance was assessed by saccharin migration time in 20 volunteers. Wash-out phases were 7 days and the spray or ointment was always applied 20 min before the saccharin test. The study was designed to test for non-inferiority. Saccharin migration time was slightly longer after ointment administration, however, these were not significantly different to nasal spray. The saccharin migration time showed a significant correlation with the age of the volunteers. The upper confidence limit of dexpanthenol nasal spray was markedly less than that of the ointment. Therefore, dexpanthenol nasal spray is at least equal to if not better than dexpanthenol nasal ointment. Due to its ease of administration, preservative-free dexpanthenol nasal spray offers a valuable therapeutic alternative.

  20. Chimney stoves modestly improved indoor air quality measurements compared with traditional open fire stoves: results from a small-scale intervention study in rural Peru.

    PubMed

    Hartinger, S M; Commodore, A A; Hattendorf, J; Lanata, C F; Gil, A I; Verastegui, H; Aguilar-Villalobos, M; Mäusezahl, D; Naeher, L P

    2013-08-01

    Nearly half of the world's population depends on biomass fuels to meet domestic energy needs, producing high levels of pollutants responsible for substantial morbidity and mortality. We compare carbon monoxide (CO) and particulate matter (PM2.5) exposures and kitchen concentrations in households with study-promoted intervention (OPTIMA-improved stoves and control stoves) in San Marcos Province, Cajamarca Region, Peru. We determined 48-h indoor air concentration levels of CO and PM2.5 in 93 kitchen environments and personal exposure, after OPTIMA-improved stoves had been installed for an average of 7 months. PM2.5 and CO measurements did not differ significantly between OPTIMA-improved stoves and control stoves. Although not statistically significant, a post hoc stratification of OPTIMA-improved stoves by level of performance revealed mean PM2.5 and CO levels of fully functional OPTIMA-improved stoves were 28% lower (n = 20, PM2.5, 136 μg/m(3) 95% CI 54-217) and 45% lower (n = 25, CO, 3.2 ppm, 95% CI 1.5-4.9) in the kitchen environment compared with the control stoves (n = 34, PM2.5, 189 μg/m(3), 95% CI 116-261; n = 44, CO, 5.8 ppm, 95% CI 3.3-8.2). Likewise, although not statistically significant, personal exposures for OPTIMA-improved stoves were 43% and 17% lower for PM2.5 (n = 23) and CO (n = 25), respectively. Stove maintenance and functionality level are factors worthy of consideration for future evaluations of stove interventions. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Chimney stoves modestly improved indoor air quality measurements compared with traditional open fire stoves: results from a small-scale intervention study in rural Peru

    PubMed Central

    Hartinger, S.M.; Commodore, A.A.; Hattendorf, J.; Lanata, C.F.; Gil, A.I.; Verastegui, H.; Aguilar-Villalobos, M.; Mäusezahl, D.; Naeher, L.P.

    2015-01-01

    Nearly half of the world’s population depends on biomass fuels to meet domestic energy needs, producing high levels of pollutants responsible for substantial morbidity and mortality. We compare carbon monoxide (CO) and particulate matter (PM2.5) exposures and kitchen concentrations in households with study promoted intervention (OPTIMA-improved) stoves and control stoves in San Marcos Province, Cajamarca Region, Peru. We determined 48hr indoor air concentration levels of CO and PM2.5 in 93 kitchen environments and personal exposure, after OPTIMA-improved stoves had been installed for an average of seven months. PM2.5 and CO measurements did not differ significantly between OPTIMA-improved stoves and control stoves. Although not statistically significant, a post-hoc stratification of OPTIMA-improved stoves by level of performance revealed mean PM2.5 and CO levels of fully functional OPTIMA-improved stoves were 28% lower (n=20, PM2.5, 136μg/m3 95%CI 54–217) and 45% lower (n=25, CO, 3.2ppm, 95%CI 1.5–4.9) in the kitchen environment compared to the control stoves (n=34, PM2.5, 189μg/m3, 95%CI 116–261; n=44, CO, 5.8ppm, 95%CI 3.3–8-2). Likewise, although not statistically significant, personal exposures for OPTIMA-improved stoves were 43% and 167% lower for PM2.5 (n=23) and CO (n=25) respectively. Stove maintenance and functionality level are factors worthy of consideration for future evaluations of stove interventions. PMID:23311877

  2. Efficacy of artemether-lumefantrine in relation to drug exposure in children with and without severe acute malnutrition: an open comparative intervention study in Mali and Niger.

    PubMed

    Denoeud-Ndam, Lise; Dicko, Alassane; Baudin, Elisabeth; Guindo, Ousmane; Grandesso, Francesco; Diawara, Halimatou; Sissoko, Sibiri; Sanogo, Koualy; Traoré, Seydou; Keita, Sekouba; Barry, Amadou; de Smet, Martin; Lasry, Estrella; Smit, Michiel; Wiesner, Lubbe; Barnes, Karen I; Djimde, Abdoulaye A; Guerin, Philippe J; Grais, Rebecca F; Doumbo, Ogobara K; Etard, Jean-François

    2016-10-24

    Severe acute malnutrition (SAM) affects almost all organs and has been associated with reduced intestinal absorption of medicines. However, very limited information is available on the pharmacokinetic properties of antimalarial drugs in this vulnerable population. We assessed artemether-lumefantrine (AL) clinical efficacy in children with SAM compared to those without. Children under 5 years of age with uncomplicated P. falciparum malaria were enrolled between November 2013 and January 2015 in Mali and Niger, one third with uncomplicated SAM and two thirds without. AL was administered under direct observation with a fat intake consisting of ready-to-use therapeutic food (RUTF - Plumpy'Nut®) in SAM children, twice daily during 3 days. Children were followed for 42 days, with PCR-corrected adequate clinical and parasitological response (ACPR) at day 28 as the primary outcome. Lumefantrine concentrations were assessed in a subset of participants at different time points, including systematic measurements on day 7. A total of 399 children (360 in Mali and 39 in Niger) were enrolled. Children with SAM were younger than their non-SAM counterparts (mean 17 vs. 28 months, P < 0.0001). PCR-corrected ACPR was 100 % (95 % CI, 96.8-100 %) in SAM at both day 28 and 42, versus 98.8 % (96.4-99.7 %) at day 28 and 98.3 % (95.6-99.4 %) at day 42 in non-SAM (P = 0.236 and 0.168, respectively). Compared to younger children, children older than 21 months experienced more reinfections and SAM was associated with a greater risk of reinfection until day 28 (adjusted hazard ratio = 2.10 (1.04-4.22), P = 0.038). Day 7 lumefantrine concentrations were significantly lower in SAM than non-SAM (median 251 vs. 365 ng/mL, P = 0.049). This study shows comparable therapeutic efficacy of AL in children without SAM and in those with SAM when given in combination with RUTF, but a higher risk of reinfection in older children suffering from SAM. This could be associated

  3. [Arachnoid cysts of the middle cranial fossa in children. A review of 75 cases, 47 of which have been operated in a comparative study between membranectomy with opening of cisterns and cystoperitoneal shunt].

    PubMed

    Lena, G; Erdincler, P; Van Calenberg, F; Genitori, L; Choux, M

    1996-01-01

    The authors report their experience concerning 75 cases of middle fossa arachnoid cysts observed in children during the period 1975-1993, 47 of which (62.6%) were operated upon. The aim of this study was to study the clinical presentation of these cysts, to discuss the surgical indications and to compare the results of the various techniques used to treat these malformations. Head injury was revealing in 17 cases (22.6%) and among these, 12 patients presented intracranial complications (subdural effusions; 6 cases, subdural hematomas: 4 cases and intracystic hematomas: 2 cases). The most usual signs and symptoms were: intracranial hypertension (25.3%), epilepsy (16%) and temporal bulging (24%). Twenty-one patients (44.7%) underwent a cystoperitoneal shunt; 20 patients (42.5%) were treated by membranectomy with opening of the basal cisterns and removal of intracystic (2 cases) or subdural hematoma (4 cases); 2 patients (4.3%) were treated using membranectomy, opening of the cisterns and cystoperitoneal shunt and 4 patients (8.4%) underwent a subduroperitoneal shunt. The long-term results were good regardless of the surgical procedure; nevertheless, only one patient among 20 cases treated by membranectomy and opening of the cisterns developped complications (5%), while multiple shunt revisions were necessary in 11 children (40.7%) out of 27 where a shunt was inserted. The authors conclude that membranectomy and opening of the basal cisterns is the procedure of choice to treat middle fossa arachnoid cysts in children.

  4. Comparative Packaging Study

    NASA Technical Reports Server (NTRS)

    Perchonok, Michele; Antonini, David

    2008-01-01

    This viewgraph presentation describes a comparative packaging study for use on long duration space missions. The topics include: 1) Purpose; 2) Deliverables; 3) Food Sample Selection; 4) Experimental Design Matrix; 5) Permeation Rate Comparison; and 6) Packaging Material Information.

  5. An open, comparative clinical study on the efficacy and safety of 10% trichloroacetic acid, 25% trichloroacetic acid and cryotherapy for verruca plana.

    PubMed

    Cengiz, Fatma Pelin; Emiroglu, Nazan

    2015-01-01

    Although there are several methods to treat Verruca plana, warts do not respond well to the common therapeutic options. In this study, we compared the safety and efficacy of 10% trichloroacetic acid, 25% trichloroacetic acid, and cryotherapy for the treatment of warts caused by Verruca plana. Ten percent and 25% trichloroacetic acid were applied to warts weekly until all lesions cleared. Cryotherapy was performed by liquid nitrogen spray for 5-10 seconds for each lesion per week until the lesions cleared. The number of Verruca plana lesions and adverse effects were evaluated five times during the treatment (the initial visit, week 2, week 4, week 6, and week 8). The number of lesions decreased through week 8 for all three treatments, and the reductions in the mean numbers of lesions were statistically similar (p > 0.05). Those in the cryotherapy group exhibited more erythema, pain, erosions, bullae, and hyperpigmentation (p < 0.001, p < 0.001, p < 0.001, p < 0.05, and p = 0.001, respectively) than those in either TCA group. Itching was more common among those in the trichloroacetic acid groups than in the cryotherapy group (p < 0.05). Additionally, hyperpigmentation, erythema, pain, and itching were more frequent in the 25% trichloroacetic acid group than in the 10% trichloroacetic acid group (p < 0.001), (p < 0.05), (p < 0.05), (p < 0.05). Ten percent trichloroacetic acid, 25% trichloroacetic acid, and cryotherapy are effective methods to treat Verruca plana. 10% trichloroacetic acid offers a safer and easier treatment than either 25% trichloroacetic acid or cryotherapy.

  6. Comparative study on anesthetic potency depending on concentrations of lidocaine and epinephrine: assessment of dental local anesthetics using the jaw-opening reflex.

    PubMed Central

    Ohkado, S.; Ichinohe, T.; Kaneko, Y.

    2001-01-01

    Anesthetic potency of a local anesthetic on the dental pulp was investigated by increasing or decreasing the concentration of lidocaine and that of epinephrine. An electromyogram of the digastric muscle in Japan White male rabbits was recorded during the jaw-opening reflex induced by electrical stimulation of the dental pulp. Probit analysis was used for the determination of the 50% effective volume (ED50) values of the anesthetic. The anesthetics used were plain 2% lidocaine solution (2Lid-0 group), 2% lidocaine solution with 12.5 microgram/mL of epinephrine (2Lid-1/8 group), 2% lidocaine solution with 6.25 microgram/mL of epinephrine (2Lid-1/16 group), and 4% lidocaine solution with 5 microgram/mL of epinephrine (4Lid-1/20 group). No anesthetic effect was shown in the 2Lid-0 group. The 2Lid-1/8 group indicated adequate anesthetic potency with the smallest dosage at all observation periods. The potency in the 2Lid-1/16 group was 0.3-0.5 times, and that in the 4Lid-1/20 group was 0.3-0.4 times as much as the 2Lid-1/8 group. The decrease in epinephrine concentration produced the decrease in the anesthetic potency on the dental pulp independent of lidocaine concentration. These results suggest that the increase in lidocaine concentration may not compensate the decrease in epinephrine concentration. PMID:11495400

  7. A Study Comparing Vein Integrity and Clinical Outcomes (VICO) in Open Vein Harvesting and Two Types of Endoscopic Vein Harvesting for Coronary Artery Bypass Grafting: The VICO Randomised Clinical Trial.

    PubMed

    Krishnamoorthy, Bhuvaneswari; Critchley, William R; Thompson, Alexander J; Payne, Katherine; Morris, Julie; Venkateswaran, Rajamiyer V; Caress, Ann L; Fildes, James E; Yonan, Nizar

    2017-06-21

    Background -Current consensus statements maintain that endoscopic vein harvesting (EVH) should be standard care in coronary artery bypass surgery (CABG) but vein quality and clinical outcomes have been questioned. The Vein Integrity and Clinical Outcome (VICO) trial was designed to assess the impact of different vein harvesting methods on vessel damage and if this contributes to clinical outcomes following CABG. Methods -A single centre, randomised clinical trial of patients undergoing CABG with an internal mammary artery, and with one to four vein grafts were recruited. All the veins were harvested by a single experienced practitioner. We randomly allocated n=300 patients into: closed tunnel CO2 EVH (CT-EVH) (n=100), open tunnel CO2 EVH (OT-EVH) (n=100) and traditional open vein harvesting (OVH) (n=100) groups. The primary end-point was endothelial integrity and muscular damages of the harvested vein. Secondary end-points included clinical outcomes (major adverse cardiac events, MACE), use of healthcare resources and impact on health status (quality-adjusted life years, QALYs). Results -The OVH group demonstrated marginally better endothelial integrity in random samples (85% vs. 88% vs. 93% for CT-EVH, OT-EVH and OVH, p<0.001). CT-EVH displayed the lowest longitudinal hypertrophy (1% vs. 13.5% vs. 3%, p=0.001). However, no differences in endothelial stretching were observed between groups (37% vs. 37% vs. 31%, p=0.62). Secondary clinical outcomes demonstrated no significant differences in composite MACE scores at each time point up to 48 months. The QALY gain per patient was: 0.11 (p<0.001) for closed tunnel CO2 EVH and 0.07 (p=0.003) for open tunnel CO2 EVH compared with open vein harvesting. The likelihood of being cost-effective, at a pre-defined threshold of £20,000 per QALY gained was: 75% for closed tunnel, 19% for open tunnel and 6% for open vein harvesting. Conclusions -Our study demonstrates that harvesting techniques do impact upon integrity of

  8. Open For Business? An Historical, Comparative Study of Public Access to Information about Two Controversial Coastal Developments in North-East Scotland

    ERIC Educational Resources Information Center

    Baxter, Graeme

    2014-01-01

    Introduction: This paper compares public access to information about two controversial coastal developments in North-east Scotland: the construction of a gas terminal by the British Gas Council and Total in the 1970s, and the current development of "the world's greatest golf course" by the tycoon Donald Trump. Method: Data has been…

  9. An Open, Randomized, Comparative Clinical and Histological Study of Imiquimod 5% Cream Versus 10% Potassium Hydroxide Solution in the Treatment of Molluscum Contagiosum

    PubMed Central

    Seo, Sang-Hee; Chin, Hyun-Woo; Sung, Hyun-Woo

    2010-01-01

    Background Although molluscum contagiosum (MC) resolves spontaneously, there are several reasons to treat this dermatological disorder. Objective To evaluate the safety and efficacy of 5% imiquimod cream versus 10% potassium hydroxide (KOH) solution in treating MC, and to propose the mechanism of cure by observing the histological findings. Methods Imiquimod or KOH were applied by the patient or a parent 3 days per week until all lesions cleared. The number of MC lesions was counted and side effects were evaluated at 5 points during the treatment (the initial visit, week 2, week 4, week 8, and week 12). Histological changes were compared between 2 patients of each group, before and after the 2 weeks of application. Results In both group, the mean lesion counts decreased all through to week 12, and the reduction in number of lesions were statistically significant in both groups (p <0.005). Over 40% of each group developed local side effects, and no systemic side effects were noted in either group. Before treatment, histological findings showed little or no dermal infiltrates. After treatment, specimens showed dense lymphocytic infiltrates, especially T cells, around the lesions which had resolved. Conclusion Both 10% KOH solution and 5% imiquimod cream are effective and safe treatment of MC. PMID:20548905

  10. Comparing lymphadenectomy during radical nephroureterectomy: open versus laparoscopic.

    PubMed

    Busby, J Erik; Brown, Gordon A; Matin, Surena F

    2008-03-01

    Laparoscopic nephroureterectomy (LNU) is an accepted treatment for tumors of the ureter and renal pelvis, although the ability to perform a regional lymphadenectomy has been criticized. We compared the quality of lymphadenectomy with LNU with that involving open nephroureterectomy (ONU) to determine whether oncologic principles are maintained. We searched our institutional database for patients who had undergone ONU from 1990 to 2005. These were compared with a series of patients from January 2003 to April 2007 who underwent LNU. From each patient's medical records, we assessed the number of lymph nodes removed, the number of positive nodes removed, and the density of positive nodes. The differences between groups were analyzed using the Wilcoxon rank sum statistical test. We identified 106 patients who underwent ONU with lymphadenectomy and 28 who underwent LNU with lymphadenectomy. The median number of nodes removed, median number of positive nodes, and median density of positive nodes were, respectively, 3, 0, and 0 for the ONU group; and 6, 0, and 0, for the LNU group. There was a statistically significant difference between groups with respect to the number of nodes removed (P = 0.01) but not with respect to the number of positive nodes removed (P = 0.61) or the lymph node density (P = 0.42). Offsetting the benefits of laparoscopy could be a flawed oncologic technique. We have demonstrated that lymphadenectomy, which is a potentially important component of nephroureterectomy, can be performed as well during LNU as it is with ONU when a dedicated effort is made.

  11. Effects of a New Eyelid Shampoo on Lid Hygiene and Eyelash Length in Patients with Meibomian Gland Dysfunction: A Comparative Open Study.

    PubMed

    Kobayashi, Asuka; Ide, Takeshi; Fukumoto, Teruki; Miki, Emiko; Tsubota, Kazuo; Toda, Ikuko

    2016-01-01

    Purpose. Meibomian gland dysfunction (MGD) can lead to abnormalities in the composition and function of tear film, resulting in dry eye. Eyelid hygiene is a key to management of MGD. We tested a novel eyelid shampoo (Eye Shampoo Long, ESL) for its ability to maintain lid hygiene. This shampoo is nonirritating and can potentially lengthen eyelashes. This study was aimed to evaluate the efficacy of ESL in the treatment of MGD and its effects on eyelash length. Methods. Ten patients with MGD and 10 healthy subjects without MGD applied ESL twice daily for 8 weeks. Patients were examined for lid margin and dry eye before and after the trial. Subjective symptoms were evaluated. Eyelash length was measured at baseline and at the end of the trial. Results. In the MGD group, significant improvements were observed in subjective symptoms obstruction of the meibomian orifice, secretion of meibum, eyelashes contamination, eyelid margin foam, and SPK. Eyelash length became significantly longer. Conclusions. Maintaining eyelid hygiene using ESL improved the eyelid margins and symptoms of dry eye in MGD patients and increased eyelash length. These findings are promising and warrant confirmation in a larger randomized controlled study.

  12. Effects of a New Eyelid Shampoo on Lid Hygiene and Eyelash Length in Patients with Meibomian Gland Dysfunction: A Comparative Open Study

    PubMed Central

    Miki, Emiko

    2016-01-01

    Purpose. Meibomian gland dysfunction (MGD) can lead to abnormalities in the composition and function of tear film, resulting in dry eye. Eyelid hygiene is a key to management of MGD. We tested a novel eyelid shampoo (Eye Shampoo Long, ESL) for its ability to maintain lid hygiene. This shampoo is nonirritating and can potentially lengthen eyelashes. This study was aimed to evaluate the efficacy of ESL in the treatment of MGD and its effects on eyelash length. Methods. Ten patients with MGD and 10 healthy subjects without MGD applied ESL twice daily for 8 weeks. Patients were examined for lid margin and dry eye before and after the trial. Subjective symptoms were evaluated. Eyelash length was measured at baseline and at the end of the trial. Results. In the MGD group, significant improvements were observed in subjective symptoms obstruction of the meibomian orifice, secretion of meibum, eyelashes contamination, eyelid margin foam, and SPK. Eyelash length became significantly longer. Conclusions. Maintaining eyelid hygiene using ESL improved the eyelid margins and symptoms of dry eye in MGD patients and increased eyelash length. These findings are promising and warrant confirmation in a larger randomized controlled study. PMID:28078136

  13. Comparative Evaluation of Continuous Thoracic Paravertebral Block and Thoracic Epidural Analgesia Techniques for Post-operative Pain Relief in Patients Undergoing Open Nephrectomy: A Prospective, Randomized, Single-blind Study.

    PubMed

    Gautam, Sujeet Kumar Singh; Das, Pravin Kumar; Agarwal, Anil; Kumar, Sanjay; Dhiraaj, Sanjay; Keshari, Abhishek; Patro, Abinash

    2017-01-01

    Open surgical procedures are associated with substantial postoperative pain; an alternative method providing adequate pain relief with minimal side effects is very much required. The aim of this study was a comparative evaluation of the efficacy of continuous thoracic paravertebral block (PVB) and thoracic epidural analgesia (EA) for postoperative pain relief in patients undergoing open nephrectomy. Prospective, randomized, and single-blind study. Sixty adult patients undergoing open nephrectomy under general anesthesia were randomized to receive a continuous thoracic epidural infusion (Group E) or continuous thoracic paravertebral infusion (Group P) with bupivacaine 0.1% with 1 μg/ml fentanyl at 7 ml/h; both infusions were started after induction of anesthesia. The primary outcome measures were postoperative pain during rest (static pain), deep inspiration, coughing, and movement (getting up from supine to sitting position); the secondary outcome measures were postoperative nausea and vomiting, requirement of rescue antiemetic, hypotension, sedation, pruritus, motor block, and respiratory depression. These were assessed till the morning of the third postoperative day. Results were analyzed by the one-way ANOVA, Chi-square test, and Mann-Whitney U-test. P < 0.05 was considered significant. Both the groups were similar with regard to demographic factors (P > 0.05). The visual analog scale scores at rest, deep breathing, coughing and movement, and postoperative fentanyl consumption were similar in the two groups (P > 0.05); the incidence of side effects was also similar in the two groups (P > 0.05). Continuous thoracic PVB is as effective as continuous thoracic EA in providing pain relief in patients undergoing open nephrectomy in the postoperative period. The side effect profile of the two techniques was also similar.

  14. Incidence of craving for and abuse of gamma-hydroxybutyric acid (GHB) in different populations of treated alcoholics: an open comparative study.

    PubMed

    Caputo, F; Francini, S; Stoppo, M; Lorenzini, F; Vignoli, T; Del Re, A; Comaschi, C; Leggio, L; Addolorato, G; Zoli, G; Bernardi, M

    2009-11-01

    Gamma-hydroxybutyric acid (GHB) is a drug currently used for the treatment of alcohol dependence. The aim of our study was to investigate the incidence of craving for and abuse of GHB in 47 patients enrolled and divided into four groups: group A (pure alcoholics), group B (alcoholics with a sustained full remission from cocaine dependence), group C (alcoholics with a sustained full remission from heroin dependence) and group D (alcoholics in a methadone maintenance treatment [MMT] programme). All patients were treated with an oral dose of GHB (50 mg/kg of body weight t.i.d.) for three months. Craving for GHB was statistically significant higher in group B than in group A (P < 0.001), C (P = 0.01) and D (P < 0.001), and in group C than in group D (P < 0.05). Abuse of GHB proved to be statistically significant higher in group B than in group A (P < 0.001) and D (P < 0.01), and in group C than in group A (P = 0.01) and D (P < 0.05). Thus, the administration of GHB in alcoholics with a sustained full remission from heroin or cocaine dependence is not recommended; however, this should not discourage physicians from using GHB for the treatment of pure alcoholics or alcohol dependents following a MMT.

  15. Comparative effectiveness of switching antipsychotic drug treatment to aripiprazole or ziprasidone for improving metabolic profile and atherogenic dyslipidemia: a 12-month, prospective, open-label study.

    PubMed

    Chen, Yuejin; Bobo, William V; Watts, Kara; Jayathilake, Karuna; Tang, Tinlai; Meltzer, Herbert Y

    2012-09-01

    We studied the effects of switching antipsychotic drug-treated patients with schizophrenia or bipolar disorder who evidenced adverse metabolic side effects as indicated by a triglyceride/high-density lipoprotein ratio (TG/HDL) ≥ 3.5 to aripiprazole (ARIP; 5-30 mg/day, n = 24) or ziprasidone (ZIP; 40-160 mg/day, n = 28). Anthropometric and metabolic measures, psychopathology, quality of life and motor adverse effects were assessed over a 52-week period with evaluations at baseline, 6, 12, 26 and 52 weeks. There were statistically significant improvements in body weight, body mass index (BMI), TG, HDL and TG/HDL which did not differ between treatments. However, numerous secondary measures including weight and BMI, and the proportion of patients who lost ≥ 7% or who no longer met criteria for obesity, favored ZIP over ARIP. Decreases in total cholesterol and increases in HDL-cholesterol also favored ZIP. On the other hand, decreases in TG/HDL ratio and reduction in HgbA1c favored ARIP. There were no significant time or group × time interaction effects for most psychopathology measures; however, Global Assessment of Functioning Scores favored ARIP at 6 and 12 months. We conclude that switching patients with evidence of metabolic side effects to either ARIP or ZIP may be beneficial for some, but not all metabolic measures, with minimal risk of worsening of psychopathology and possibly some benefit in that regard as well.

  16. Inside Open Learning. Studies in Further Education.

    ERIC Educational Resources Information Center

    Bagley, Bill; Challis, Bob

    A study examined the experience of teachers, students, and college administrators in the following three open learning schemes for adult students in Great Britain: Flexistudy at Abraham Moss Open College, the mathematics and communications workshops at Bradford College, and the Technical Education Council programs at Moston College of Further…

  17. Methods of a large prospective, randomised, open-label, blinded end-point study comparing morning versus evening dosing in hypertensive patients: the Treatment In Morning versus Evening (TIME) study

    PubMed Central

    Rorie, David A; Rogers, Amy; Mackenzie, Isla S; Ford, Ian; Webb, David J; Willams, Bryan; Brown, Morris; Poulter, Neil; Findlay, Evelyn; Saywood, Wendy; MacDonald, Thomas M

    2016-01-01

    Introduction Nocturnal blood pressure (BP) appears to be a better predictor of cardiovascular outcome than daytime BP. The BP lowering effects of most antihypertensive therapies are often greater in the first 12 h compared to the next 12 h. The Treatment In Morning versus Evening (TIME) study aims to establish whether evening dosing is more cardioprotective than morning dosing. Methods and analysis The TIME study uses the prospective, randomised, open-label, blinded end-point (PROBE) design. TIME recruits participants by advertising in the community, from primary and secondary care, and from databases of consented patients in the UK. Participants must be aged over 18 years, prescribed at least one antihypertensive drug taken once a day, and have a valid email address. After the participants have self-enrolled and consented on the secure TIME website (http://www.timestudy.co.uk) they are randomised to take their antihypertensive medication in the morning or the evening. Participant follow-ups are conducted after 1 month and then every 3 months by automated email. The trial is expected to run for 5 years, randomising 10 269 participants, with average participant follow-up being 4 years. The primary end point is hospitalisation for the composite end point of non-fatal myocardial infarction (MI), non-fatal stroke (cerebrovascular accident; CVA) or any vascular death determined by record-linkage. Secondary end points are: each component of the primary end point, hospitalisation for non-fatal stroke, hospitalisation for non-fatal MI, cardiovascular death, all-cause mortality, hospitalisation or death from congestive heart failure. The primary outcome will be a comparison of time to first event comparing morning versus evening dosing using an intention-to-treat analysis. The sample size is calculated for a two-sided test to detect 20% superiority at 80% power. Ethics and dissemination TIME has ethical approval in the UK, and results will be published in a

  18. A long-term, phase 2, multicenter, randomized, open-label, comparative safety study of pomaglumetad methionil (LY2140023 monohydrate) versus atypical antipsychotic standard of care in patients with schizophrenia

    PubMed Central

    2013-01-01

    Background We compared the time to discontinuation due to lack of tolerability over 24 weeks in patients suffering from schizophrenia treated with pomaglumetad methionil (LY2140023 monohydrate, the prodrug of metabotropic glutamate 2/3 receptor agonist, LY404039) or standard of care (SOC: olanzapine, risperidone, or aripiprazole). Methods Study HBBR was a multicenter, randomized, open-label study comparing the long-term safety and tolerability of LY2140023 with SOC for schizophrenia. Patients had moderate symptomatology with prominent negative symptoms and evidence of functional impairment. Those who met entry criteria were randomized to open-label treatment with either LY2140023 (target dose: 40 mg twice daily [BID]; n = 130) or SOC (n = 131). Results There was no statistically significant difference between LY2140023 and SOC for time to discontinuation due to lack of tolerability (primary objective; P = .184). The Kaplan-Meier estimates revealed comparable time to event profiles. Only 27% of LY2140023 and 45% of SOC patients completed the 24-week open-label, active treatment phase. Twenty-seven patients (20.8%) in the LY2140023 group and 15 patients (11.5%) in the SOC group discontinued due to lack of efficacy (P = .044). Twenty-three patients (17.7%) in the LY2140023 group and 19 patients (14.5%) in the SOC group discontinued due to adverse events (physician and subject decision combined, P = .505). The incidence of serious adverse events was comparable between groups. LY2140023-treated patients reported significantly more treatment-emergent adverse events of vomiting, agitation, and dyspepsia, while SOC-treated patients reported significantly more akathisia and weight gain. The incidence of treatment-emergent parkinsonism (P = .011) and akathisia (P = .029) was significantly greater in SOC group. Improvement in PANSS total score over the initial 6 to 8 weeks of treatment was similar between groups, but improvement was

  19. Operations dashboard: comparative study

    NASA Astrophysics Data System (ADS)

    Ramly, Noor Nashriq; Ismail, Ahmad Zuhairi; Aziz, Mohd Haris; Ahmad, Nurul Haszeli

    2011-10-01

    In this present days and age, there are increasing needs for companies to monitor application and infrastructure health. Apart from having proactive measures to secure their application and infrastructure, many see monitoring dashboards as crucial investment in disaster preparedness. As companies struggle to find the best solution to cater for their needs and interest for monitoring their application and infrastructure's health, this paper summarizes the studies made on several known off-the-shelf operations dashboard and in-house developed dashboard. A few criteria of good dashboard are collected from previous studies carried out by several researchers and rank them according to importance and business needs. The finalized criteria that will be discussed in later sections are data visualization, performance indicator, dashboard personalization, audit capability and alert/ notification. Comparative studies between several popular dashboards were then carried out to determine whether they met these criteria that we derived from the first exercise. The findings hopefully can be used to educate and provide an overview of selecting the best IT application and infrastructure operations dashboard that suit business needs, thus become the main contribution of this paper.

  20. Surgeon Experience and Medicare Expenditures for Laparoscopic Compared to Open Colectomy.

    PubMed

    Sheetz, Kyle H; Ibrahim, Andrew M; Regenbogen, Scott E; Dimick, Justin B

    2017-05-25

    To quantify the extent to which payments for laparoscopic and open colectomy are influenced by a surgeon's experience with laparoscopy. Numerous studies suggest that healthcare costs for laparoscopic colectomy are lower than open surgery. None have assessed the importance of surgeon experience on the relative financial benefits of laparoscopy. We conducted a study of 182,852 national Medicare beneficiaries undergoing laparoscopic or open colectomy between 2010 and 2012. Using instrumental variable methods to account for selection bias, we compared Medicare payments for laparoscopic and open colectomy. We stratified our analysis by surgeons' annual experience with laparoscopic colectomy to determine the influence of provider experience on payments. In the fully adjusted analysis, average episode payments per patient were $2640 [95% confidence interval (CI) -$4091 to -$1189] lower with the laparoscopic approach versus open. Surgeons in the highest quartile of laparoscopic experience demonstrated an average payment savings of $5456 per patient (CI -$7918 to -$2994) in their laparoscopic versus open cases. Among surgeons in the lowest quartile of laparoscopic experience, there was, however, no difference between laparoscopic and open cases (difference: $954, 95% CI -$731 to $2639). Differences in payments were explained by differences in complications rates. Both groups had similar rates of complications for open procedures (least experience, 21%, most experience, 21%; P = 0.45), but differed significantly on rates of complications for laparoscopic cases (least experience, 28%, most experience, 15%; P < 0.01). This population-based study demonstrates that differences in payments between laparoscopic and open colectomy are influenced by surgeon experience. The laparoscopic approach does not reduce payments for patients whose surgeons have limited experience with the procedure.

  1. Open and Anonymous Peer Review in a Digital Online Environment Compared in Academic Writing Context

    ERIC Educational Resources Information Center

    Razi, Salim

    2016-01-01

    This study compares the impact of "open" and "anonymous" peer feedback as an adjunct to teacher-mediated feedback in a digital online environment utilising data gathered on an academic writing course at a Turkish university. Students were divided into two groups with similar writing proficiencies. Students peer reviewed papers…

  2. Multinational, multicentre, randomised, open-label study evaluating the impact of a 91-day extended regimen combined oral contraceptive, compared with two 28-day traditional combined oral contraceptives, on haemostatic parameters in healthy women

    PubMed Central

    Paoletti, Anna Maria; Volpe, Annibale; Chiovato, Luca; Howard, Brandon; Weiss, Herman; Ricciotti, Nancy

    2014-01-01

    Objectives To evaluate the impact of a 91-day extended regimen combined oral contraceptive (150 μg levonorgestrel [LNG]/30 μg ethinylestradiol [EE] for 84 days, followed by 10 μg EE for seven days [Treatment 1]) compared with two traditional 21/7 regimens (21 days 150 μg LNG/30 μg EE [Treatment 2] or 150 μg desogestrel [DSG]/30 μg EE [Treatment 3], both with seven days’ hormone free), on several coagulation factors and thrombin formation markers. Methods Randomised, open-label, parallel-group comparative study involving healthy women (18–40 years). The primary endpoint was change from baseline in prothrombin fragment 1 + 2 (F1 + 2) levels over six months. Results A total of 187 subjects were included in the primary analysis. In all groups, mean F1 + 2 values were elevated after six months of treatment. Changes were comparable between Treatments 1 and 2 (least squares mean change: 170 pmol/L and 158 pmol/L, respectively) but noticeably larger after Treatment 3 (least squares mean change: 592 pmol/L). The haemostatic effects of Treatment 1 were comparable to those of Treatment 2 and noninferior to those of Treatment 3 (lower limit of 95% confidence interval [− 18.3 pmol/L] > − 130 pmol/L). Conclusions The LNG/EE regimens had similar effects on F1 + 2. Noninferiority was demonstrated between extended regimen LNG/EE and DSG/EE. PMID:24923685

  3. The Leeds Evaluation of Efficacy of Detoxification Study (LEEDS) project: An open-label pragmatic randomised control trial comparing the efficacy of differing therapeutic agents for primary care detoxification from either street heroin or methadone [ISRCTN07752728

    PubMed Central

    Oldham, Nicola S; Wright, Nat MJ; Adams, Clive E; Sheard, Laura; Tompkins, Charlotte NE

    2004-01-01

    Background Heroin is a synthetic opioid with an extensive illicit market leading to large numbers of people becoming addicted. Heroin users often present to community treatment services requesting detoxification and in the UK various agents are used to control symptoms of withdrawal. Dissatisfaction with methadone detoxification [8] has lead to the use of clonidine, lofexidine, buprenorphine and dihydrocodeine; however, there remains limited evaluative research. In Leeds, a city of 700,000 people in the North of England, dihydrocodeine is the detoxification agent of choice. Sublingual buprenorphine, however, is being introduced. The comparative value of these two drugs for helping people successfully and comfortably withdraw from heroin has never been compared in a randomised trial. Additionally, there is a paucity of research evaluating interventions among drug users in the primary care setting. This study seeks to address this by randomising drug users presenting in primary care to receive either dihydrocodeine or buprenorphine. Methods/design The Leeds Evaluation of Efficacy of Detoxification Study (LEEDS) project is a pragmatic randomised trial which will compare the open use of buprenorphine with dihydrocodeine for illicit opiate detoxification, in the UK primary care setting. The LEEDS project will involve consenting adults and will be run in specialist general practice surgeries throughout Leeds. The primary outcome will be the results of a urine opiate screening at the end of the detoxification regimen. Adverse effects and limited data to three and six months will be acquired. PMID:15117415

  4. Comparative effectiveness of open-door laminoplasty versus French-door laminoplasty in cervical compressive myelopathy.

    PubMed

    Nakashima, Hiroaki; Kato, Fumihiko; Yukawa, Yasutsugu; Imagama, Shiro; Ito, Keigo; Machino, Masaaki; Ishiguro, Naoki

    2014-04-15

    Prospective randomized study. This study aimed to prospectively compare the surgical results of the open- and French-door laminoplasty. Cervical laminoplasty is a common surgical procedure for the treatment of cervical compressive myelopathy. These procedures are primarily classified as either open- or French-door laminoplasties. Only few prospective studies comparing the surgical results of the 2 procedures are available. A total of 92 patients with cervical compressive myelopathy who underwent cervical laminoplasty were prospectively enrolled and randomized into the following 2 groups according to the type of laminoplasty: open-door and French-door groups. A single attending spine surgeon performed all surgical procedures. The following factors were evaluated: surgical duration, blood loss, perioperative complications, neurological assessment using the Japanese Orthopedic Association score, and recovery rate. Radiological evaluations included assessment of the cervical lordotic angle and cervical range of motion. In addition, the ratio of postoperative spinal lamina opening was evaluated by magnetic resonance imaging. There were no differences in perioperative complications and neurological outcomes between the 2 groups. The mean reduction in cervical lordotic angle after surgery was significantly greater in the open-door group than the French-door group (3.0° vs. 5.6°). Postoperative cervical range of motion significantly decreased in the open-door group than in the French-door group (19.3° vs. 26.0°). Postoperative cervical lordotic angle in the extension position significantly diminished in the open-door group than in the French-door group (7.9° vs. 14.1°). The ratio of opening of the spinal lamina after surgery was significantly larger in the open-door group than in the French-door group. The 2 laminoplasty methods showed almost the same neurological recovery as well as perioperative complications. In cases of open-door laminoplasty, postoperative

  5. Comparing INLA and OpenBUGS for hierarchical Poisson modeling in disease mapping.

    PubMed

    Carroll, R; Lawson, A B; Faes, C; Kirby, R S; Aregay, M; Watjou, K

    2015-01-01

    The recently developed R package INLA (Integrated Nested Laplace Approximation) is becoming a more widely used package for Bayesian inference. The INLA software has been promoted as a fast alternative to MCMC for disease mapping applications. Here, we compare the INLA package to the MCMC approach by way of the BRugs package in R, which calls OpenBUGS. We focus on the Poisson data model commonly used for disease mapping. Ultimately, INLA is a computationally efficient way of implementing Bayesian methods and returns nearly identical estimates for fixed parameters in comparison to OpenBUGS, but falls short in recovering the true estimates for the random effects, their precisions, and model goodness of fit measures under the default settings. We assumed default settings for ground truth parameters, and through altering these default settings in our simulation study, we were able to recover estimates comparable to those produced in OpenBUGS under the same assumptions.

  6. Comparing INLA and OpenBUGS for hierarchical Poisson modeling in disease mapping

    PubMed Central

    Carroll, R; Lawson, AB; Faes, C; Kirby, RS; Aregay, M; Watjou, K

    2015-01-01

    The recently developed R package INLA (Integrated Nested Laplace Approximation) is becoming a more widely used package for Bayesian inference. The INLA software has been promoted as a fast alternative to MCMC for disease mapping applications. Here, we compare the INLA package to the MCMC approach by way of the BRugs package in R, which calls OpenBUGS. We focus on the Poisson data model commonly used for disease mapping. Ultimately, INLA is a computationally efficient way of implementing Bayesian methods and returns nearly identical estimates for fixed parameters in comparison to OpenBUGS, but falls short in recovering the true estimates for the random effects, their precisions, and model goodness of fit measures under the default settings. We assumed default settings for ground truth parameters, and through altering these default settings in our simulation study, we were able to recover estimates comparable to those produced in OpenBUGS under the same assumptions. PMID:26530822

  7. Study design and rationale of "a multicenter, open-labeled, randomized controlled trial comparing three 2nd-generation drug-eluting stents in real-world practice" (CHOICE trial).

    PubMed

    Youn, Young Jin; Lee, Jun-Won; Ahn, Sung Gyun; Lee, Seung-Hwan; Choi, Hyun Hee; Choi, Hyunmin; Choi, Cheol Ung; Lee, Jin Bae; Cho, Jang Hyun; Kang, Tae Soo; Cho, Byung Ryul; Cha, Kwang Soo; Kim, Moo Hyun; Hyon, Min Su; Cheong, Sang-Sig; Lim, Do-Sun; Han, Kyoo Rok; Jeong, Myung Ho; Park, Keum Soo; Yoon, Junghan

    2013-08-01

    The second-generation drug-eluting stents (DES) have shown superiority in many studies relating to safety and efficacy when compared with the first-generation DES. However, it is unclear whether there are differences in efficacy and safety among the second-generation DES after long-term follow-up. This multicenter, prospective, randomized, open-labeled trial will directly compare the efficacy and safety among the patients treated with either everolimus-eluting stent (EES), zotarolimus-eluting stent with biolinx polymer (ZES-R), or biolimus-eluting stent (BES) with minimal exclusion criteria. The primary end point is a patient-oriented composite consisted of cardiac death, myocardial infarction not clearly attributable to a nontarget vessel and clinically indicated target lesion revascularization at 24-month clinical follow-up post-index procedure. With the hypothesis that "BES is non-inferior to EES" or "BES is non-inferior to ZES-R" in primary end point, approximately 2,600 patients will be assigned to one of the types of stents using a web-based randomization system. The CHOICE trial will directly compare the efficacy and safety of EES, ZES-R, and BES in everyday clinical practice for long-term follow-up. Copyright © 2013 Mosby, Inc. All rights reserved.

  8. Robotic, laparoscopic and open surgery for gastric cancer compared on surgical, clinical and oncological outcomes: a multi-institutional chart review. A study protocol of the International study group on Minimally Invasive surgery for GASTRIc Cancer—IMIGASTRIC

    PubMed Central

    Desiderio, Jacopo; Jiang, Zhi-Wei; Nguyen, Ninh T; Zhang, Shu; Reim, Daniel; Alimoglu, Orhan; Azagra, Juan-Santiago; Yu, Pei-Wu; Coburn, Natalie G; Qi, Feng; Jackson, Patrick G; Zang, Lu; Brower, Steven T; Kurokawa, Yukinori; Facy, Olivier; Tsujimoto, Hironori; Coratti, Andrea; Annecchiarico, Mario; Bazzocchi, Francesca; Avanzolini, Andrea; Gagniere, Johan; Pezet, Denis; Cianchi, Fabio; Badii, Benedetta; Novotny, Alexander; Eren, Tunc; Leblebici, Metin; Goergen, Martine; Zhang, Ben; Zhao, Yong-Liang; Liu, Tong; Al-Refaie, Waddah; Ma, Junjun; Takiguchi, Shuji; Lequeu, Jean-Baptiste; Trastulli, Stefano; Parisi, Amilcare

    2015-01-01

    Introduction Gastric cancer represents a great challenge for healthcare providers and requires a multidisciplinary treatment approach in which surgery plays a major role. Minimally invasive surgery has been progressively developed, first with the advent of laparoscopy and recently with the spread of robotic surgery, but a number of issues are currently being debated, including the limitations in performing an effective extended lymph node dissection, the real advantages of robotic systems, the role of laparoscopy for Advanced Gastric Cancer, the reproducibility of a total intracorporeal technique and the oncological results achievable during long-term follow-up. Methods and analysis A multi-institutional international database will be established to evaluate the role of robotic, laparoscopic and open approaches in gastric cancer, comprising of information regarding surgical, clinical and oncological features. A chart review will be conducted to enter data of participants with gastric cancer, previously treated at the participating institutions. The database is the first of its kind, through an international electronic submission system and a HIPPA protected real time data repository from high volume gastric cancer centres. Ethics and dissemination This study is conducted in compliance with ethical principles originating from the Helsinki Declaration, within the guidelines of Good Clinical Practice and relevant laws/regulations. A multicentre study with a large number of patients will permit further investigation of the safety and efficacy as well as the long-term outcomes of robotic, laparoscopic and open approaches for the management of gastric cancer. Trial registration number NCT02325453; Pre-results. PMID:26482769

  9. Short-term results after robot-assisted laparoscopic radical prostatectomy compared to open radical prostatectomy.

    PubMed

    Wallerstedt, Anna; Tyritzis, Stavros I; Thorsteinsdottir, Thordis; Carlsson, Stefan; Stranne, Johan; Gustafsson, Ove; Hugosson, Jonas; Bjartell, Anders; Wilderäng, Ulrica; Wiklund, N Peter; Steineck, Gunnar; Haglind, Eva

    2015-04-01

    Robot-assisted laparoscopic radical prostatectomy has become a widespread technique despite a lack of randomised trials showing its superiority over open radical prostatectomy. To compare in-hospital characteristics and patient-reported outcomes at 3 mo between robot-assisted laparoscopic and open retropubic radical prostatectomy. A prospective, controlled trial was performed of all men who underwent radical prostatectomy at 14 participating centres. Validated patient questionnaires were collected at baseline and after 3 mo by independent health-care researchers. The difference in outcome between the two treatment groups were analysed using logistic regression analysis, with adjustment for identified confounders. Questionnaires were received from 2506 (95%) patients. The robot-assisted surgery group had less perioperative bleeding (185 vs 683 ml, p<0.001) and shorter hospital stay (3.3 vs 4.1 d, p<0.001) than the open surgery group. Operating time was shorter with the open technique (103 vs 175 min, p<0.001) compared with the robot-assisted technique. Reoperation during initial hospital stay was more frequent after open surgery after adjusting for tumour characteristics and lymph node dissection (1.6% vs 0.7%, odds ratio [OR] 0.31, 95% confidence interval [CI 95%] 0.11-0.90). Men who underwent open surgery were more likely to seek healthcare (for one or more of 22 specified disorders identified prestudy) compared to men in the robot-assisted surgery group (p=0.03). It was more common to seek healthcare for cardiovascular reasons in the open surgery group than in the robot-assisted surgery group, after adjusting for nontumour and tumour-specific confounders, (7.9% vs 5.8%, OR 0.63, CI 95% 0.42-0.94). The readmittance rate was not statistically different between the groups. A limitation of the study is the lack of a standardised tool for the assessment of the adverse events. This large prospective study confirms previous findings that robot-assisted laparoscopic

  10. Outcome of males with high anorectal malformations treated with laparoscopic-assisted anorectal pull-through: preliminary results of a comparative study with the open approach in a single institution.

    PubMed

    Bailez, Maria M; Cuenca, Estela S; Mauri, Veronica; Solana, Julieta; Di Benedetto, Victor

    2011-03-01

    The aim of this study was to analyze the outcome of males with HARM treated with a laparoscopic-assisted anorectal pull-through compared with the open posterior sagittal approach in a single institution. This study includes 32 patients: 17 (9 with a rectoprostatic fistula [RPF] and 8 with a rectovesical fistula [RVF]) who underwent laparoscopic-assisted anorectal pull-through from October 2001 onward and 15 (8 with an RPF and 7 with an RVF) treated by posterior sagittal approach before that date. Patients were reviewed retrospectively but were operated on by the authors and had longitudinal follow-up. Parameters analyzed included associated anomalies, sacral ratio (SR) index, age at surgery, operative time, complications, presence of voluntary bowel movements, constipation, and soiling. A good outcome was determined by absent or grade 1 soiling and a poor outcome result by soiling grades 2 and 3. Mean age at surgery was 22 and 37.5 months for patients with RPF and RVF, respectively, in the laparoscopic group and 29.2 and 25.7 months in the open group. Operative time was significantly shorter (P < .0036) for the laparoscopic RVF repair compared with the open approach. In patients with RPF, 50% in the laparoscopic (L) and 37.5% in the open (O) approach had an SR below 0.6. Fifty percent of all patients with RVF had an SR below 0.6, making groups comparable in terms of evaluating bowel function. Four patients were excluded in the analysis of functional results. Voluntary bowel movements with previous defecatory sensation were present in 83.l3% (5/6) in L vs 87.5% (7/8) in O patients with RPF and 62.5% (5/8) L vs 50% (3/6) in O patients with RVF. Grade 1 soiling was present in 50% (3/6) vs 62.5% (5/8) of patients with RPF and 37.5% (3/8) vs 16% (1/6) of patients with RVF in the L and O groups, respectively. Soiling grade 2 or 3 was present in 50% (3/6) vs 12.5% (1/8) of patients with RPF and 37.5% (3/8) vs 50% (3/6) of patients with RVF in the L and O groups

  11. Moist Exposed Burn Ointment (MEBO) in partial thickness burns - a randomized, comparative open mono-center study on the efficacy of dermaheal (MEBO) ointment on thermal 2nd degree burns compared to conventional therapy.

    PubMed

    Hirsch, T; Ashkar, W; Schumacher, O; Steinstraesser, L; Ingianni, G; Cedidi, C C

    2008-11-24

    Wound healing in burn wounds presents a challenge in healthcare, and there is still a lack of alternatives in topical burn wound treatments. - The purpose of this study was to evaluate the efficacy of a new therapeutic ointment (MEBO) in the treatment of partial thickness burns. 40 patients received either topical treatment with Moist Exposed Burn Ointment (MEBO) or standard Flammazine treatment. All patients suffered from partial-thickness burn injuries (< 20% TBSA). Wounds were evaluated for 60 up to days regarding wound healing, water loss, inflammation, and pain alleviation. For transepidermal water loss, there was a difference of 2.3 gr/m2/h between MEBO, and Flammazine, favoring MEBO. However, this difference was not statistically significant (p=0.78). For all secondary efficacy parameter results were similar. - This study showed that MEBO ointment for topical treatment of burn injuries presents an attractive alternative for the topical treatment of limited partial thickness thermal burns.

  12. Comparative Kinetic Analysis of Closed-Ended and Open-Ended Porous Sensors

    NASA Astrophysics Data System (ADS)

    Zhao, Yiliang; Gaur, Girija; Mernaugh, Raymond L.; Laibinis, Paul E.; Weiss, Sharon M.

    2016-09-01

    Efficient mass transport through porous networks is essential for achieving rapid response times in sensing applications utilizing porous materials. In this work, we show that open-ended porous membranes can overcome diffusion challenges experienced by closed-ended porous materials in a microfluidic environment. A theoretical model including both transport and reaction kinetics is employed to study the influence of flow velocity, bulk analyte concentration, analyte diffusivity, and adsorption rate on the performance of open-ended and closed-ended porous sensors integrated with flow cells. The analysis shows that open-ended pores enable analyte flow through the pores and greatly reduce the response time and analyte consumption for detecting large molecules with slow diffusivities compared with closed-ended pores for which analytes largely flow over the pores. Experimental confirmation of the results was carried out with open- and closed-ended porous silicon (PSi) microcavities fabricated in flow-through and flow-over sensor configurations, respectively. The adsorption behavior of small analytes onto the inner surfaces of closed-ended and open-ended PSi membrane microcavities was similar. However, for large analytes, PSi membranes in a flow-through scheme showed significant improvement in response times due to more efficient convective transport of analytes. The experimental results and theoretical analysis provide quantitative estimates of the benefits offered by open-ended porous membranes for different analyte systems.

  13. Does Postthyroidectomy Syndrome Really Exist Following Thyroidectomy? Prospective Comparative Analysis of Open vs. Endoscopic Thyroidectomy

    PubMed Central

    Park, Ki Nam; Mok, Ji Oh; Chung, Chan Hee

    2015-01-01

    Objectives This study prospectively evaluated postthyroidectomy syndrome (PTS) through objective and subjective voice changes following thyroidectomy of open vs. endoscopic thyroidectomy. Methods A prospective clinical trial (SCHBC IRB 09 26) was performed from Jan 2008 to Aug 2010 to compare the open thyroidectomy (OPEN group) and endoscopic thyroidectomy (ENDO group). Of the 110 patients, 75 completed the evaluation before and 1 and 6 months after surgery. Subjective parameters included perceptual analysis (GRBAS [grade, roughness, breathiness, asthenia, and strain] scale), stroboscopic or flexible fiberscopic analysis, voice handicap index, and 5-point visual analog scales for vocal fatigue, singing difficulty, difficulty with high-pitch phonation, and neck discomfort. Objective parameters included acoustic, aerodynamic analysis and the electroglottograph. Results For the ENDO group (n=36), the operation time was longer than in the OPEN group (n=39; P<0.01). For the OPEN group, two objective and five subjective parameters were worse 1 month postoperatively; of these, two subjective parameters persisted for 6 months (P<0.05). For the ENDO group, three objective and six subjective parameters were worse 1 month postoperatively, and three of the subjective parameters persisted 6 months postoperatively (P<0.05). Conclusion PTS really exists following simple thyroidectomy and are very common for both OPEN and ENDO groups. Most of the parameters improved gradually over time, but some subjective changes persisted 6 months postoperatively. PMID:25729500

  14. A Prospective, Open-label Study to Compare the Efficacy and the Safety of Topical Loteprednol Etabonate and Topical Flurbiprofen Sodium in Patients with Post-Operative Inflammation after Cataract Extraction

    PubMed Central

    Bannale, Sheshidhar G.; Pundarikaksha, H.P.; Sowbhagya, H.N.

    2012-01-01

    Purpose To study the effect of the topical Non-Steroidal Anti Inflammatory Drug (NSAID), Flurbiprofen 0.03%, as an alternative to the topical steroids for the postoperative control of inflammation in cataract surgeries. Methods The effect of the topical NSAID, flurbiprofen sodium 0.03%, was studied and compared with that of the topical steroid – Loteprednol etabonate 0.5% suspension (as eye drops) in a prospective, open labelled study. Both the groups (20 patients each) were similar in the baseline parameters. The postoperative inflammatory response following the standard, small incision, extra capsular cataract extraction was assessed in both the groups for 28 post-operative days. The parameters which were considered for the study were conjunctival hyperaemia, ciliary congestion, corneal oedema, cells in the anterior chamber, aqueous flare and ocular pain. The severity of the postoperative inflammatory responses for both the drugs was graded on the post-operative days 1, 7, 14, 21 and 28 and it was statistically analyzed. Results The 2 groups did not differ statistically in the effect of the treatment for any of the variables, which included aqueous cells, flare, ciliary congestion and conjunctival congestion (p< 0.001). Both the drugs were well tolerated and no severe adverse Drug Reactions (ADRs) were caused by the topical NSAID and the topical steroid. Conclusion The topical NSAID, Flurbiprofen, is as effective as the topical corticosteroid, Loteprednol and it can be used as an alternative in the routine postoperative treatment following uncomplicated cataract surgeries. PMID:23285440

  15. A perioperative cost analysis comparing single-level minimally invasive and open transforaminal lumbar interbody fusion.

    PubMed

    Singh, Kern; Nandyala, Sreeharsha V; Marquez-Lara, Alejandro; Fineberg, Steven J; Oglesby, Mathew; Pelton, Miguel A; Andersson, Gunnar B; Isayeva, Darya; Jegier, Briana J; Phillips, Frank M

    2014-08-01

    Emerging literature suggests superior clinical short- and long-term outcomes of MIS (minimally invasive surgery) TLIFs (transforaminal lumbar interbody fusion) versus open fusions. Few studies to date have analyzed the cost differences between the two techniques and their relationship to acute clinical outcomes. The purpose of the study was to determine the differences in hospitalization costs and payments for patients treated with primary single-level MIS versus open TLIF. The impact of clinical outcomes and their contribution to financial differences was explored as well. This study was a nonrandomized, nonblinded prospective review. Sixty-six consecutive patients undergoing a single-level TLIF (open/MIS) were analyzed (33 open, 33 MIS). Patients in either cohort (MIS/open) were matched based on race, sex, age, smoking status, medical comorbidities (Charlson Comorbidity index), payer, and diagnosis. Every patient in the study had a diagnosis of either degenerative disc disease or spondylolisthesis and stenosis. Operative time (minutes), length of stay (LOS, days), estimated blood loss (EBL, mL), anesthesia time (minutes), Visual Analog Scale (VAS) scores, and hospital cost/payment amount were assessed. The MIS and open TLIF groups were compared based on clinical outcomes measures and hospital cost/payment data using SPSS version 20.0 for statistical analysis. The two groups were compared using bivariate chi-squared analysis. Mann-Whitney tests were used for non-normal distributed data. Effect size estimate was calculated with the Cohen d statistic and the r statistic with a 95% confidence interval. Average surgical time was shorter for the MIS than the open TLIF group (115.8 minutes vs. 186.0 minutes respectively; p=.001). Length of stay was also reduced for the MIS versus the open group (2.3 days vs. 2.9 days, respectively; p=.018). Average anesthesia time and EBL were also lower in the MIS group (p<.001). VAS scores decreased for both groups, although these

  16. Open-Source Data and the Study of Homicide.

    PubMed

    Parkin, William S; Gruenewald, Jeff

    2015-07-20

    To date, no discussion has taken place in the social sciences as to the appropriateness of using open-source data to augment, or replace, official data sources in homicide research. The purpose of this article is to examine whether open-source data have the potential to be used as a valid and reliable data source in testing theory and studying homicide. Official and open-source homicide data were collected as a case study in a single jurisdiction over a 1-year period. The data sets were compared to determine whether open-sources could recreate the population of homicides and variable responses collected in official data. Open-source data were able to replicate the population of homicides identified in the official data. Also, for every variable measured, the open-sources captured as much, or more, of the information presented in the official data. Also, variables not available in official data, but potentially useful for testing theory, were identified in open-sources. The results of the case study show that open-source data are potentially as effective as official data in identifying individual- and situational-level characteristics, provide access to variables not found in official homicide data, and offer geographic data that can be used to link macro-level characteristics to homicide events. © The Author(s) 2015.

  17. Multicentre open-label randomised controlled trial to compare colistin alone with colistin plus meropenem for the treatment of severe infections caused by carbapenem-resistant Gram-negative infections (AIDA): a study protocol

    PubMed Central

    Dickstein, Yaakov; Leibovici, Leonard; Yahav, Dafna; Eliakim-Raz, Noa; Daikos, George L; Skiada, Anna; Antoniadou, Anastasia; Carmeli, Yehuda; Nutman, Amir; Levi, Inbar; Adler, Amos; Durante-Mangoni, Emanuele; Andini, Roberto; Cavezza, Giusi; Mouton, Johan W; Wijma, Rixt A; Theuretzbacher, Ursula; Friberg, Lena E; Kristoffersson, Anders N; Zusman, Oren; Koppel, Fidi; Dishon Benattar, Yael; Altunin, Sergey; Paul, Mical

    2016-01-01

    Introduction The emergence of antibiotic-resistant bacteria has driven renewed interest in older antibacterials, including colistin. Previous studies have shown that colistin is less effective and more toxic than modern antibiotics. In vitro synergy studies and clinical observational studies suggest a benefit of combining colistin with a carbapenem. A randomised controlled study is necessary for clarification. Methods and analysis This is a multicentre, investigator-initiated, open-label, randomised controlled superiority 1:1 study comparing colistin monotherapy with colistin–meropenem combination therapy for infections caused by carbapenem-resistant Gram-negative bacteria. The study is being conducted in 6 centres in 3 countries (Italy, Greece and Israel). We include patients with hospital-associated and ventilator-associated pneumonia, bloodstream infections and urosepsis. The primary outcome is treatment success at day 14, defined as survival, haemodynamic stability, stable or improved respiratory status for patients with pneumonia, microbiological cure for patients with bacteraemia and stability or improvement of the Sequential Organ Failure Assessment (SOFA) score. Secondary outcomes include 14-day and 28-day mortality as well as other clinical end points and safety outcomes. A sample size of 360 patients was calculated on the basis of an absolute improvement in clinical success of 15% with combination therapy. Outcomes will be assessed by intention to treat. Serum colistin samples are obtained from all patients to obtain population pharmacokinetic models. Microbiological sampling includes weekly surveillance samples with analysis of resistance mechanisms and synergy. An observational trial is evaluating patients who met eligibility requirements but were not randomised in order to assess generalisability of findings. Ethics and dissemination The study was approved by ethics committees at each centre and informed consent will be obtained for all patients. The

  18. Comparative Packaging Study

    NASA Technical Reports Server (NTRS)

    Perchonok, Michele H.; Oziomek, Thomas V.

    2009-01-01

    Future long duration manned space flights beyond low earth orbit will require the food system to remain safe, acceptable and nutritious. Development of high barrier food packaging will enable this requirement by preventing the ingress and egress of gases and moisture. New high barrier food packaging materials have been identified through a trade study. Practical application of this packaging material within a shelf life test will allow for better determination of whether this material will allow the food system to meet given requirements after the package has undergone processing. The reason to conduct shelf life testing, using a variety of packaging materials, stems from the need to preserve food used for mission durations of several years. Chemical reactions that take place during longer durations may decrease food quality to a point where crew physical or psychological well-being is compromised. This can result in a reduction or loss of mission success. The rate of chemical reactions, including oxidative rancidity and staling, can be controlled by limiting the reactants, reducing the amount of energy available to drive the reaction, and minimizing the amount of water available. Water not only acts as a media for microbial growth, but also as a reactant and means by which two reactants may come into contact with each other. The objective of this study is to evaluate three packaging materials for potential use in long duration space exploration missions.

  19. Hydrologic studies in wells open through large intervals

    SciTech Connect

    Not Available

    1992-01-01

    This report describes and summarizes activities, data, and preliminary data interpretation from the INEL Oversight Program R D-1 project titled Hydrologic Studies In Wells Open Through Large Intervals.'' The project is designed to use a straddle-packer system to isolate, hydraulically test, and sample specific intervals of monitoring wells that are open (uncased, unscreened) over large intervals of the Snake River Plain aquifer. The objectives of the project are to determine and compare vertical variations in water quality and aquifer properties that have previously only been determined in an integrated fashion over the entire thickness of the open interval of the observation wells.

  20. A randomized, multicenter, pilot study comparing the efficacy and safety of a bupivacaine-collagen implant (XaraColl(®)) with the ON-Q PainBuster(®) Post-op Pain Relief System following open gynecological surgery.

    PubMed

    Cusack, Susan L; Minkowitz, Harold S; Kuss, Michael; Jaros, Mark; Hemsen, Lisa

    2012-01-01

    XaraColl(®), a collagen-based intraoperative implant that delivers bupivacaine to the site of surgical trauma, is under development for postoperative analgesia. We compared the efficacy and safety of XaraColl for the prevention of postsurgical pain versus a slow postoperative perfusion of bupivacaine to the wound environment via the ON-Q PainBuster(®) Post-op Pain Relief System (ON-Q). We randomized 27 women undergoing open gynecological surgery to receive either three XaraColl implants (each containing 50 mg bupivacaine hydrochloride) or ON-Q (900 mg bupivacaine hydrochloride perfused over 72 hours) in a 1:1 ratio. Following surgery, patients had access to intravenous morphine via a patient-controlled analgesia pump as rescue analgesia for the first 24 hours and to oral opioid medication thereafter. Total use of opioid analgesia was compared through 24, 48, 72, and 96 hours after surgery. Patients also evaluated overall pain control over the 96-hour period using a five-point numeric rating scale. Safety was assessed for 30 days after surgery. XaraColl was non-inferior to ON-Q in total use of opioid analgesia for the first 24, 48, 72, and 96 hours after surgery, with a statistical trend towards reduced opioid use in favor of XaraColl over 24, 48, and 72 hours (P = 0.067, 0.100, and 0.089, respectively). The time to first use of opioid analgesia was also significantly delayed in patients treated with XaraColl (P = 0.024). There was no significant difference between groups in patients' evaluation of pain control or their satisfaction with the treatment in general. Both treatments were considered safe and well tolerated. Despite using only 17% of the ON-Q dose, XaraColl is as effective as ON-Q in providing postoperative analgesia for 4 days after open gynecological surgery. These preliminary findings suggest that XaraColl offers great potential for the management of postoperative pain and warrants further definitive studies.

  1. A randomized, multicenter, pilot study comparing the efficacy and safety of a bupivacaine-collagen implant (XaraColl®) with the ON-Q PainBuster® Post-op Pain Relief System following open gynecological surgery

    PubMed Central

    Cusack, Susan L; Minkowitz, Harold S; Kuss, Michael; Jaros, Mark; Hemsen, Lisa

    2012-01-01

    Background XaraColl®, a collagen-based intraoperative implant that delivers bupivacaine to the site of surgical trauma, is under development for postoperative analgesia. We compared the efficacy and safety of XaraColl for the prevention of postsurgical pain versus a slow postoperative perfusion of bupivacaine to the wound environment via the ON-Q PainBuster® Post-op Pain Relief System (ON-Q). Methods We randomized 27 women undergoing open gynecological surgery to receive either three XaraColl implants (each containing 50 mg bupivacaine hydrochloride) or ON-Q (900 mg bupivacaine hydrochloride perfused over 72 hours) in a 1:1 ratio. Following surgery, patients had access to intravenous morphine via a patient-controlled analgesia pump as rescue analgesia for the first 24 hours and to oral opioid medication thereafter. Total use of opioid analgesia was compared through 24, 48, 72, and 96 hours after surgery. Patients also evaluated overall pain control over the 96-hour period using a five-point numeric rating scale. Safety was assessed for 30 days after surgery. Results XaraColl was non-inferior to ON-Q in total use of opioid analgesia for the first 24, 48, 72, and 96 hours after surgery, with a statistical trend towards reduced opioid use in favor of XaraColl over 24, 48, and 72 hours (P = 0.067, 0.100, and 0.089, respectively). The time to first use of opioid analgesia was also significantly delayed in patients treated with XaraColl (P = 0.024). There was no significant difference between groups in patients’ evaluation of pain control or their satisfaction with the treatment in general. Both treatments were considered safe and well tolerated. Conclusion Despite using only 17% of the ON-Q dose, XaraColl is as effective as ON-Q in providing postoperative analgesia for 4 days after open gynecological surgery. These preliminary findings suggest that XaraColl offers great potential for the management of postoperative pain and warrants further definitive studies. PMID

  2. Comparing the Open University Systems of China and India: Origins, Developments and Prospects

    ERIC Educational Resources Information Center

    Perris, Kirk

    2015-01-01

    The national open universities of China and India are unique adaptations of the open university model that emanated from the UK. These institutions have expanded to become the largest universities in the world as measured by current enrollment of approximately four million each. This article comparatively analyzes how these open universities have…

  3. An Open Label, Randomized, Comparative, Parallel Group, Multicenter, Prospective, Interventional, Clinical Study to Evaluate Efficacy and Safety of “AHPL/AYTOP/0113” in Comparison with “Framycetin Sulphate Cream” in Acute Wounds

    PubMed Central

    Nipanikar, Sanjay U; Gajare, Kamalakar V; Vaidya, Vidyadhar G; Kamthe, Amol B; Upasani, Sachin A; Kumbhar, Vidyadhar S

    2017-01-01

    Objectives: The main objective of the present study was to assess efficacy and safety of AHPL/AYTOP/0113 cream, a polyherbal formulation in comparison with Framycetin sulphate cream in acute wounds. Methodology: It was an open label, randomized, comparative, parallel group and multi-center clinical study. Total 47 subjects were randomly assigned to Group-A (AHPL/AYTOP/0113 cream) and 42 subjects were randomly assigned to Group-B (Framycetin sulphate cream). All the subjects were advised to apply study drug, thrice daily for 21 days or up to complete wound healing (whichever was earlier). All the subjects were called for follow up on days 2, 4, 7, 10, 14, 17 and 21 or up to the day of complete wound healing. Data describing quantitative measures are expressed as mean ± SD. Comparison of variables representing categorical data was performed using Chi-square test. Results: Group-A subjects took significantly less (P < 0.05) i.e., (mean) 7.77 days than (mean) 9.87 days of Group-B subjects for wound healing. At the end of the study, statistically significant better (P < 0.05) results were observed in Group-A than Group-B in mean wound surface area, wound healing parameters and pain associated with wound. Excellent overall efficacy and tolerability was observed in subjects of both the groups. No adverse event or adverse drug reaction was noted in any subject of both the groups. Conclusion: AHPL/AYTOP/0113 cream proved to be superior to Framycetin sulphate cream in healing of acute wounds. PMID:28867855

  4. An open label, comparative study of the effects of a dose-reduced oral contraceptive containing 20 microg ethinyl estradiol and 100 microg levonorgestrel on hemostatic, lipids, and carbohydrate metabolism variables.

    PubMed

    Endrikat, Jan; Klipping, C; Cronin, M; Gerlinger, C; Ruebig, A; Schmidt, W; Düsterberg, B

    2002-03-01

    In this open label, randomized study we compared the influence of a dose-reduced oral contraceptive containing 20 microg ethinyl estradiol (EE) and 100 microg levonorgestrel (20 EE) with a reference preparation containing 30 microg EE and 150 microg levonorgestrel (30 EE) on hemostatic, lipids, and carbohydrate metabolism variables. Data from 48 volunteers were obtained. The direction of the change (increase or decrease) in most of the hemostatic variables were similar in both treatment groups. In particular, prothrombin fragment 1 + 2 increased during treatment, reaching a median percent change of 40% in the 20 EE group and of 17% in the 30 EE group after one year. D-Dimer fibrin split products remained virtually unchanged, with no change at Cycle 13. The median HDL2 cholesterol levels decreased by 26% in the 20 EE group and by 39.8% in 30 EE group (p = 0.0045 for group difference) after one year. The median one year change for LDL cholesterol was 3.23% in the 20 EE group, compared to 25% in the 30 EE group, for VLDL 11.1% compared to 38.8%, respectively, and for total triglycerides 10.0% compared to 37.5%, respectively. The median absolute change for the area under the curve (AUC)(0-3h) for glucose at treatment Cycle 13 was 41.25 mmol/L x min in the 20 EE group and 73.50 mmol/L x min in the 30 EE group. The AUC(0-3h) insulin at treatment Cycle 13 decreased in the 20 EE group by 1635.0 pmolL x min and increased in the 30 EE group by 11797.5 pmolL x min (p = 0.0491 for group difference). Both study treatments were safe and well tolerated by the volunteers. In conclusion, the balanced one-third dose reduction in this new oral contraceptive evoked similar effects on the hemostatic variables, but favorable results for the lipid and carbohydrate profiles.

  5. A Multicenter, Open Labeled, Randomized, Phase III Study Comparing Lopinavir/Ritonavir Plus Atazanavir to Lopinavir/Ritonavir Plus Zidovudine and Lamivudine in Naive HIV-1-Infected Patients: 48-Week Analysis of the LORAN Trial

    PubMed Central

    Ulbricht, K.U; Behrens, G.M; Stoll, M; Salzberger, B; Jessen, H; Jessen, A.B; Kuhlmann, B; Heiken, H; Trein, A; Schmidt, R.E

    2011-01-01

    Objective: The primary aim of the study was to compare the metabolic side effects of a nucleoside analogue-containing regimen with a nucleoside analogue-sparing double protease inhibitor regimen. A secondary goal was to test for efficacy of a double-PI regimen. Design: Multicenter, randomized, open-label, phase III clinical trial. Subjects: Adult HIV-1-infected individuals naïve to antiretroviral therapy with viral load above 400 HIV-RNA copies/ml were randomized (1:1) to either 400 mg lopinavir /100 mg ritonavir (LPV/r) BID plus 150 mg lamivudine/300 mg zidovudine (CBV) BID versus LPV/r BID plus 300 mg atazanavir (ATV) QD. Main outcome measure was the virologic failure in both groups, defined as viral load ≥50 copies/ml at week 48. Results: In the CBV/LPV/r-arm, 29 out of 35 patients [(83%; 95% confidence interval (CI) 66.9-92.2%] and 18 out of 40 patients (45%; 95% CI 29.7-61.5%) in the ATV/LPV/r-arm had a HIV-RNA level <50 copies/ml at week 48. The intent-to-treat analysis revealed inferior virologic response in the ATV/LPV/r arm (Chi-Q and Fisher´s Exact Test p<0.001) and resulted in premature termination of the trial. Eleven patients in the ATV/LPV/r-arm discontinued therapy because of virological failure. These failures mostly presented with low level replication (<1,000 copies/ml). Increases in CD4 cell counts was significantly more rapid in the ATV/LPV/r arm (p=0.02), but comparable at week 48. Conclusions: ATV/LPV/r had less virologic efficacy than the conventional RTI-based regimen and resulted in a high virological failure rate with low level replication. PMID:21643422

  6. Remifentanil-propofol analgo-sedation shortens duration of ventilation and length of ICU stay compared to a conventional regimen: a centre randomised, cross-over, open-label study in the Netherlands.

    PubMed

    Rozendaal, F Willem; Spronk, Peter E; Snellen, Ferdinand F; Schoen, Adri; van Zanten, Arthur R H; Foudraine, Norbert A; Mulder, Paul G H; Bakker, Jan

    2009-02-01

    Compare duration of mechanical ventilation (MV), weaning time, ICU-LOS (ICU-LOS), efficacy and safety of remifentanil-based regimen with conventional sedation and analgesia. Centre randomised, open-label, crossover, 'real-life' study. 15 Dutch hospitals. Adult medical and post-surgical ICU patients with anticipated short-term (2-3 days) MV. Patient cohorts were randomised to remifentanil-based regimen (n = 96) with propofol as required, for a maximum of 10 days, or to conventional regimens (n = 109) of propofol, midazolam or lorazepam combined with fentanyl or morphine. Outcomes were weaning time, duration of MV, ICU-LOS, sedation- and analgesia levels, intensivist/ICU nurse satisfaction, adverse events, mean arterial pressure, heart rate. Median duration of ventilation (MV) was 5.1 days with conventional treatment versus 3.9 days with remifentanil (NS). The remifentanil-based regimen reduced median weaning time by 18.9 h (P = 0.0001). Median ICU-LOS was 7.9 days versus 5.9 days, respectively (NS). However, the treatment effects on duration of MV and ICU stay were time-dependent: patients were almost twice as likely to be extubated (P = 0.018) and discharged from the ICU (P = 0.05) on day 1-3. Propofol doses were reduced by 20% (P = 0.05). Remifentanil also improved sedation-agitation scores (P < 0.0001) and intensivist/ICU nurse satisfaction (P < 0.0001). All other outcomes were comparable. In patients with an expected short-term duration of MV, remifentanil significantly improves sedation and agitation levels and reduces weaning time. This contributes to a shorter duration of MV and ICU-LOS.

  7. Preliminary Comparative Effectiveness of Robotic Versus Open Radical Cystectomy in Elderly Patients.

    PubMed

    Winters, Brian R; Bremjit, Prashoban J; Gore, John L; Lin, Daniel W; Ellis, William J; Dalkin, Bruce L; Porter, Michael P; Harper, Jonathan D; Wright, Jonathan L

    2016-02-01

    Treatment for muscle-invasive bladder cancer (MIBC) remains highly morbid despite improving surgical techniques. As the median age of diagnosis is 73, many patients are elderly at the time of cystectomy. We compare perioperative surgical outcomes in elderly patients undergoing robotic vs open radical cystectomy (RC). Patients >75 years at time of RC were identified. Demographic, clinicopathologic, and perioperative variables were examined. Estimated blood loss (EBL) and length of stay (LOS) data were collected with multivariate linear regression analysis performed to assess whether technique was independently associated with outcomes. Eighty-seven patients >75 years of age underwent cystectomy for MIBC (58 open, 29 robotic). Mean age was 79.6 (±3.2) and 79.2 (±3.5) for open and robotic groups, respectively (p = 0.64). There were no significant differences in baseline comorbidities, clinical or pathologic stage, or use of neoadjuvant chemotherapy. The mean number of lymph nodes removed was similar (p = 0.08). Robotic cystectomy had significantly longer mean OR times (p < 0.001). On multivariate analyses, robotic surgery was associated with -389cc less EBL (95% CI -547 to -230, p < 0.001) and a -1.5-day-shortened LOS (95%CI -2.9 to -0.2, p = 0.02) compared with open surgery. There were no significant differences in surgical complications or 90-day readmission rates between the two groups. Robotic cystectomy is safe and feasible in an elderly population. We observed longer OR times with robotic surgery, but with decreased EBL, shorter hospital stays, and comparable complication and readmission rates with open RC. Larger prospective studies are required to confirm these findings.

  8. Spin Density Distribution in Open-Shell Transition Metal Systems: A Comparative Post-Hartree-Fock, Density Functional Theory, and Quantum Monte Carlo Study of the CuCl2 Molecule.

    PubMed

    Caffarel, Michel; Giner, Emmanuel; Scemama, Anthony; Ramírez-Solís, Alejandro

    2014-12-09

    We present a comparative study of the spatial distribution of the spin density of the ground state of CuCl2 using Density Functional Theory (DFT), quantum Monte Carlo (QMC), and post-Hartree-Fock wave function theory (WFT). A number of studies have shown that an accurate description of the electronic structure of the lowest-lying states of this molecule is particularly challenging due to the interplay between the strong dynamical correlation effects in the 3d shell and the delocalization of the 3d hole over the chlorine atoms. More generally, this problem is representative of the difficulties encountered when studying open-shell metal-containing molecular systems. Here, it is shown that qualitatively different results for the spin density distribution are obtained from the various quantum-mechanical approaches. At the DFT level, the spin density distribution is found to be very dependent on the functional employed. At the QMC level, Fixed-Node Diffusion Monte Carlo (FN-DMC) results are strongly dependent on the nodal structure of the trial wave function. Regarding wave function methods, most approaches not including a very high amount of dynamic correlation effects lead to a much too high localization of the spin density on the copper atom, in sharp contrast with DFT. To shed some light on these conflicting results Full CI-type (FCI) calculations using the 6-31G basis set and based on a selection process of the most important determinants, the so-called CIPSI approach (Configuration Interaction with Perturbative Selection done Iteratively) are performed. Quite remarkably, it is found that for this 63-electron molecule and a full CI space including about 10(18) determinants, the FCI limit can almost be reached. Putting all results together, a natural and coherent picture for the spin distribution is proposed.

  9. Phase II, open-label, randomized, multicenter study comparing the efficacy and safety of olaparib, a poly (ADP-ribose) polymerase inhibitor, and pegylated liposomal doxorubicin in patients with BRCA1 or BRCA2 mutations and recurrent ovarian cancer.

    PubMed

    Kaye, Stan B; Lubinski, Jan; Matulonis, Ursula; Ang, Joo Ern; Gourley, Charlie; Karlan, Beth Y; Amnon, Amit; Bell-McGuinn, Katherine M; Chen, Lee-May; Friedlander, Michael; Safra, Tamar; Vergote, Ignace; Wickens, Mark; Lowe, Elizabeth S; Carmichael, James; Kaufman, Bella

    2012-02-01

    Olaparib (AZD2281), an orally active poly (ADP-ribose) polymerase inhibitor that induces synthetic lethality in BRCA1- or BRCA2-deficient cells, has shown promising clinical efficacy in nonrandomized phase II trials in patients with ovarian cancer with BRCA1 or BRCA2 deficiency. We assessed the comparative efficacy and safety of olaparib and pegylated liposomal doxorubicin (PLD) in this patient population. In this multicenter, open-label, randomized, phase II study, patients with ovarian cancer that recurred within 12 months of prior platinum therapy and with confirmed germline BRCA1 or BRCA2 mutations were enrolled. Patients were assigned in a 1:1:1 ratio to olaparib 200 mg twice per day or 400 mg twice per day continuously or PLD 50 mg/m(2) intravenously every 28 days. The primary efficacy end point was Response Evaluation Criteria in Solid Tumors (RECIST) -assessed progression-free survival (PFS). Secondary end points included objective response rate (ORR) and safety. Ninety-seven patients were randomly assigned. Median PFS was 6.5 months (95% CI, 5.5 to 10.1 months), 8.8 months (95% CI, 5.4 to 9.2 months), and 7.1 months (95% CI, 3.7 to 10.7 months) for the olaparib 200 mg, olaparib 400 mg, and PLD groups, respectively. There was no statistically significant difference in PFS (hazard ratio, 0.88; 95% CI, 0.51 to 1.56; P = .66) for combined olaparib doses versus PLD. RECIST-assessed ORRs were 25%, 31%, and 18% for olaparib 200 mg, olaparib 400 mg, and PLD, respectively; differences were not statistically significant. Tolerability of both treatments was as expected based on previous trials. The efficacy of olaparib was consistent with previous studies. However, the efficacy of PLD was greater than expected. Olaparib 400 mg twice per day is a suitable dose to explore in further studies in this patient population.

  10. An open-label, multicenter, randomized, crossover study comparing sildenafil citrate and tadalafil for treating erectile dysfunction in Chinese men naïve to phosphodiesterase 5 inhibitor therapy.

    PubMed

    Bai, Wen-Jun; Li, Hong-Jun; Dai, Yu-Tian; He, Xue-You; Huang, Yi-Ran; Liu, Ji-Hong; Sorsaburu, Sebastian; Ji, Chen; Jin, Jian-Jun; Wang, Xiao-Feng

    2015-01-01

    The study was to compare treatment preference, efficacy, and tolerability of sildenafil citrate (sildenafil) and tadalafil for treating erectile dysfunction (ED) in Chinese men naοve to phosphodiesterase 5 (PDE5) inhibitor therapies. This multicenter, randomized, open-label, crossover study evaluated whether Chinese men with ED preferred 20-mg tadalafil or 100-mg sildenafil. After a 4 weeks baseline assessment, 383 eligible patients were randomized to sequential 20-mg tadalafil per 100-mg sildenafil or vice versa for 8 weeks respectively and then chose which treatment they preferred to take during the 8 weeks extension. Primary efficacy was measured by Question 1 of the PDE5 Inhibitor Treatment Preference Questionnaire (PITPQ). Secondary efficacy was analyzed by PITPQ Question 2, the International Index of Erectile Function (IIEF) erectile function (EF) domain, sexual encounter profile (SEP) Questions 2 and 3, and the Drug Attributes Questionnaire. Three hundred and fifty men (91%) completed the randomized treatment phase. Two hundred and forty-two per 350 (69.1%) patients preferred 20-mg tadalafil, and 108/350 (30.9%) preferred 100-mg sildenafil (P < 0.001) as their treatment in the 8 weeks extension. Ninety-two per 242 (38%) patients strongly preferred tadalafil and 37/108 (34.3%) strongly the preferred sildenafil. The SEP2 (penetration), SEP3 (successful intercourse), and IIEF-EF domain scores were improved in both tadalafil and sildenafil treatment groups. For patients who preferred tadalafil, getting an erection long after taking the medication was the most reported reason for tadalafil preference. The only treatment-emergent adverse event reported by > 2% of men was headache. After tadalafil and sildenafil treatments, more Chinese men with ED naοve to PDE5 inhibitor preferred tadalafil. Both sildenafil and tadalafil treatments were effective and safe.

  11. Comparing open and closed techniques of frontalis suspension with silicone rod for the treatment congenital blepharoptosis.

    PubMed

    Etezad Razavi, Mohammad; Khalifeh, Mohammad; Yazdani, Ahmad

    2014-04-01

    To compare open and closed methods of the frontalis suspension operation with a silicone rod in the treatment of congenital blepharoptosis. Forty-four cases with unilateral or bilateral congenital ptosis with a poor levator function of < 4 mm were divided randomly into two groups. Each group underwent an eyelid crease incision operation (open) or a supralash stab incision (closed). Ptosis was measured by the difference between the upper eyelid margin reflex distance (MRD) of the affected eyelids of the unilateral and bilateral cases. Frequent follow-up examinations were performed up to 12 months post-surgery. Associated ophthalmologic findings showed that amblyopia, strabismus, wound discharge and knot dehiscence problems were present in 36.6%, 27.3%, 8.5% and 8.5% of the patients, respectively. There was no significant difference between the abovementioned associated ophthalmic findings of the two operative methods studied (P = 0.37). The difference in the surgical methods and MRD 3, 6 and 12 months after operation did not reach statistical significance. Similar results for good MRD (3 < MRD < 5) were found in closed (54.5%, 12/22) and open (54.5%, 12/22) methods, while 40.9% (9/22) and 45.5% (10/22) of cases were attributed to the under correction group in the closed and open methods, respectively. In bilaterally operated cases, MRD was more symmetrical than in unilaterally operated eyes. The symmetry of MRD and the eyelid crease was more prevalent in the open technique group. The frontalis sling operation using a silicone rod exhibited better results, in terms of symmetry, in the open technique in comparison to the closed method.

  12. Multicentre open-label randomised controlled trial to compare colistin alone with colistin plus meropenem for the treatment of severe infections caused by carbapenem-resistant Gram-negative infections (AIDA): a study protocol.

    PubMed

    Dickstein, Yaakov; Leibovici, Leonard; Yahav, Dafna; Eliakim-Raz, Noa; Daikos, George L; Skiada, Anna; Antoniadou, Anastasia; Carmeli, Yehuda; Nutman, Amir; Levi, Inbar; Adler, Amos; Durante-Mangoni, Emanuele; Andini, Roberto; Cavezza, Giusi; Mouton, Johan W; Wijma, Rixt A; Theuretzbacher, Ursula; Friberg, Lena E; Kristoffersson, Anders N; Zusman, Oren; Koppel, Fidi; Dishon Benattar, Yael; Altunin, Sergey; Paul, Mical

    2016-04-20

    The emergence of antibiotic-resistant bacteria has driven renewed interest in older antibacterials, including colistin. Previous studies have shown that colistin is less effective and more toxic than modern antibiotics. In vitro synergy studies and clinical observational studies suggest a benefit of combining colistin with a carbapenem. A randomised controlled study is necessary for clarification. This is a multicentre, investigator-initiated, open-label, randomised controlled superiority 1:1 study comparing colistin monotherapy with colistin-meropenem combination therapy for infections caused by carbapenem-resistant Gram-negative bacteria. The study is being conducted in 6 centres in 3 countries (Italy, Greece and Israel). We include patients with hospital-associated and ventilator-associated pneumonia, bloodstream infections and urosepsis. The primary outcome is treatment success at day 14, defined as survival, haemodynamic stability, stable or improved respiratory status for patients with pneumonia, microbiological cure for patients with bacteraemia and stability or improvement of the Sequential Organ Failure Assessment (SOFA) score. Secondary outcomes include 14-day and 28-day mortality as well as other clinical end points and safety outcomes. A sample size of 360 patients was calculated on the basis of an absolute improvement in clinical success of 15% with combination therapy. Outcomes will be assessed by intention to treat. Serum colistin samples are obtained from all patients to obtain population pharmacokinetic models. Microbiological sampling includes weekly surveillance samples with analysis of resistance mechanisms and synergy. An observational trial is evaluating patients who met eligibility requirements but were not randomised in order to assess generalisability of findings. The study was approved by ethics committees at each centre and informed consent will be obtained for all patients. The trial is being performed under the auspices of an

  13. An open, parallel, randomized, comparative, multicenter study to evaluate the cost-effectiveness, performance, tolerance, and safety of a silver-containing soft silicone foam dressing (intervention) vs silver sulfadiazine cream.

    PubMed

    Silverstein, Paul; Heimbach, David; Meites, Herbert; Latenser, Barbara; Mozingo, David; Mullins, Fred; Garner, Warren; Turkowski, Joseph; Shupp, Jeffrey; Glat, Paul; Purdue, Gary

    2011-01-01

    An open, parallel, randomized, comparative, multicenter study was implemented to evaluate the cost-effectiveness, performance, tolerance, and safety of a silver-containing soft silicone foam dressing (Mepilex Ag) vs silver sulfadiazine cream (control) in the treatment of partial-thickness thermal burns. Individuals aged 5 years and older with partial-thickness thermal burns (2.5-20% BSA) were randomized into two groups and treated with the trial products for 21 days or until healed, whichever occurred first. Data were obtained and analyzed on cost (direct and indirect), healing rates, pain, comfort, ease of product use, and adverse events. A total of 101 subjects were recruited. There were no significant differences in burn area profiles within the groups. The cost of dressing-related analgesia was lower in the intervention group (P = .03) as was the cost of background analgesia (P = .07). The mean total cost of treatment was $309 vs $513 in the control (P < .001). The average cost-effectiveness per treatment regime was $381 lower in the intervention product, producing an incremental cost-effectiveness ratio of $1688 in favor of the soft silicone foam dressing. Mean healing rates were 71.7 vs 60.8% at final visit, and the number of dressing changes were 2.2 vs 12.4 in the treatment and control groups, respectively. Subjects reported significantly less pain at application (P = .02) and during wear (P = .048) of the Mepilex Ag dressing in the acute stages of wound healing. Clinicians reported the intervention dressing was significantly easier to use (P = .03) and flexible (P = .04). Both treatments were well tolerated; however, the total incidence of adverse events was higher in the control group. The silver-containing soft silicone foam dressing was as effective in the treatment of patients as the standard care (silver sulfadiazine). In addition, the group of patients treated with the soft silicone foam dressing demonstrated decreased pain and lower costs associated

  14. Comparative study of the microvascular blood flow in the intestinal wall, wound contraction and fluid evacuation during negative pressure wound therapy in laparostomy using the V.A.C. abdominal dressing and the ABThera open abdomen negative pressure therapy system.

    PubMed

    Lindstedt, Sandra; Malmsjö, Malin; Hlebowicz, Joanna; Ingemansson, Richard

    2015-02-01

    This study aimed to compare the changes in microvascular blood flow in the small intestinal wall, wound contraction and fluid evacuation, using the established V.A.C. abdominal dressing (VAC dressing) and a new abdominal dressing, the ABThera open abdomen negative pressure therapy system (ABThera dressing), in negative pressure wound therapy (NPWT). Midline incisions were made in 12 pigs that were subjected to treatment with NPWT using the VAC or ABThera dressing. The microvascular blood flow in the intestinal wall was measured before and after the application of topical negative pressures of −50, −75 and −125mmHg using laser Doppler velocimetry. Wound contraction and fluid evacuation were also measured. Baseline blood flow was defined as 100% in all settings. The blood flow was significantly reduced to 64·6±6·7% (P <0·05) after the application of −50mmHg using the VAC dressing, and to 65·3±9·6% (P <0·05) after the application of −50mmHg using the ABThera dressing. The blood flow was significantly reduced to 39·6±6·7% (P <0·05) after the application of −125mmHg using VAC and to 40·5±6·2% (P <0·05) after the application of −125mmHg using ABThera. No significant difference in reduction in blood flow could be observed between the two groups. The ABThera system afforded significantly better fluid evacuation from the wound, better drainage of the abdomen and better wound contraction than the VAC dressing.

  15. Iohexol in paediatric myelography. An open non-comparative trial.

    PubMed

    Kendall, B

    1986-01-01

    Iohexol was introduced by lumbar puncture in a series of 148 consecutive children aged between 5 days and 16 years referred for myelography; no patient was excluded. Initially, iohexol 180 mgI/ml was used in dosage proportional to body weight varying between 5 ml and 15 ml. During the later part of the trial concentration of iodine was increased to 240 mg/ml for cases in which the dorsal region was of particular interest (69 patients) and to 300 mg/ml for 8 cervical studies. The total dose ranged up to 4.8 g and varied between 0.03 g and 0.51 gI/kg body weight. In all patients, neurological examinations were performed before and at 24 h and observations for adverse reactions continued over a period of 48 h. The contrast medium was run up to the foramen magnum or basal cisterns in 128 patients and to the upper dorsal region in the other 20. In the first 62 patients vital studies were performed over the period of the myelogram and for 24 h following, and an additional limited neurological examination was made at 6 h, and in the first 26 cases of the series EEG's were done before and at 24 h after the myelogram. Minor variations in pulse rate and blood pressure were observed but these were not of sufficient magnitude to be of clinical significance. In 7 patients there was minor, generally slow wave abnormality on the EEG taken after the procedure, but no spike or epileptogenic activity was observed. There were no unexpected or severe adverse reactions.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. A swirl generator case study for OpenFOAM

    NASA Astrophysics Data System (ADS)

    Petit, O.; Bosioc, A. I.; Nilsson, H.; Muntean, S.; Susan-Resiga, R. F.

    2010-08-01

    This work presents numerical results, using OpenFOAM, of the flow in the swirl flow generator test rig developed at Politehnica University of Timisoara, Romania. The work shows results computed by solving the unsteady Reynolds Averaged Navier Stokes equations. The unsteady method couples the rotating and stationary parts using a sliding grid interface based on a GGI formulation. Turbulence is modeled using the standard k-epsilon model, and block structured wall function ICEM-Hexa meshes are used. The numerical results are validated against experimental LDV results, and against designed velocity profiles. The investigation shows that OpenFOAM gives results that are comparable to the experimental and designed profiles. This case study was presented at the 5th OpenFOAM Workshop, held in Gothenburg, Sweden, as a tutorial on how to treat turbomachinery applications in OpenFOAM.

  17. Laparoscopic Appendectomy Versus Open Appendectomy: A Single Institution Study

    PubMed Central

    Anderson, David G.

    1997-01-01

    Purpose: The purpose of this study was to compare the safety and efficacy of laparoscopic appendectomy versus open appendectomy at Baptist Hospital in Miami, Florida. Methods: A retrospective review was performed on all appendectomies performed at Baptist Hospital from October 1, 1994 to September 30, 1995. There were a total of 244 cases; 137 open appendectomies and 107 laparoscopic appendectomies. The cases were reviewed with regard to pathology, operating time, length of hospital stay and complications. Results: The pathologic findings at surgery were similar for the two groups. Concomitant pathology was more likely to be found laparoscopically than in open surgery. There was a greater percentage of ruptured appendices in surgery done via the open method. Operative time was slightly longer, but complications were less in the laparoscopic group. Length of stay was lower in the laparoscopic appendectomy group. Conclusions: Although very similar, our method of appendectomy favors the laparoscopic technique. PMID:9876696

  18. Randomized, open-label, single-dose, crossover, relative bioavailability study in healthy adults, comparing the pharmacokinetics of rabeprazole granules administered using soft food or infant formula as dosing vehicle versus suspension.

    PubMed

    Thyssen, An; Solanki, Bhavna; Treem, William

    2012-07-01

    A sprinkle capsule formulation containing enteric-coated, delayed-release rabeprazole granules is being developed for the treatment of children with gastrointestinal reflux disease. The granules are designed to be mixed with vehicles that facilitate delivery to children, who may be unable to swallow solid formulations. The primary objective of this study-conducted on the sponsor's initiative-was to compare the bioavailability of rabeprazole granules when mixed with various dosing vehicles (small amount of soft food or infant formula) with that of a rabeprazole suspension with inactive vehicle granules (reference), to determine which dosing vehicle can be used to deliver rabeprazole in children. Tolerability was also assessed. This single-center, single-dose, randomized, open-label, 5-period crossover study was conducted in 35 healthy adult subjects. In a randomized sequence, fasting subjects received a single dose of 10-mg rabeprazole granules per treatment period, mixed with small amounts of 1 of 5 dosing vehicles (a strawberry-flavored suspension of rabeprazole granules with inactive vehicle granules reconstituted with water, yogurt [1 tablespoon], applesauce [1 tablespoon], or infant formula [5 mL], or a suspension of rabeprazole granules with inactive vehicle tablet reconstituted with water). Full plasma pharmacokinetic (PK) profiles of rabeprazole and its thioether metabolite were collected; concentrations were estimated via LC-MS/MS. PK properties were estimated using noncompartmental methods; 90% CIs around least squares mean test-to-reference ratios were calculated for C(max) and AUC values. All treatment-emergent adverse events (TEAEs) were recorded and assessed for severity (mild, moderate, or severe) and relationship to study drug. A total of 35 subjects were enrolled (mean age, 38 years; 54.3% female; 100% white; mean weight, 71.4 kg). Thirty-four subjects completed the study. Rabeprazole and rabeprazole thioether plasma PK properties were comparable

  19. Linkage studies in primary open angle glaucoma

    SciTech Connect

    Avramopoulos, D.; Grigoriadu, M.; Kitsos, G.

    1994-09-01

    Glaucoma is a leading cause of blindness worldwide. The majority of glaucoma is associated with an open, normal appearing anterior chamber angle and is termed primary open angle glaucoma (POAG, MIM 137760). It is characterized by elevated intraocular pressure and onset in middle age or later. A subset of POAG with juvenile onset has recently been linked to chromosome 1q in two families with autosomal dominant inheritance. Eleven pedigrees with autosomal dominant POG (non-juvenile-onset) have been identified in Epirus, Greece. In the present study DNA samples have been collected from 50 individuals from one large pedigree, including 12 affected individuals. Preliminary results of linkage analysis with chromosome 1 microsatellites using the computer program package LINKAGE Version 5.1 showed no linkage with the markers previously linked to juvenile-onset POAG. Further linkage analysis is being pursued, and the results will be presented.

  20. Comparative Analysis of Calcium Silicate-based Root Filling Materials Using an Open Apex Model.

    PubMed

    Tran, Dennis; He, Jianing; Glickman, Gerald N; Woodmansey, Karl F

    2016-04-01

    Many new calcium silicate-based root filling materials have emerged in the market; however, their performance in the orthograde obturation of an open apex has not been evaluated. The purpose of this study was to compare the marginal adaptation of ProRoot MTA (Dentsply Tulsa Dental, Tulsa, OK), NeoMTA Plus (Avalon Biomed Inc, Bradenton, FL), and Endosequence BC RRM-Fast Set Putty (BC RRM-FS; Brasseler USA, Savannah, GA) after orthograde placement in roots with open apices. Palatal roots of maxillary molars were instrumented to create divergent open apices and divided into 4 groups for orthograde obturation: ProRoot MTA, NeoMTA Plus, BC RRM-FS, and BC RRM-FS + BC Sealer. Using a scanning electron microscope, the quality of material adaptation at the anatomic apex was evaluated by 5 blinded examiners; 3 mm of the root end was sectioned, and gap distance was measured at the material-dentin interface. Statistical analyses were performed using the Kruskal-Wallis test. There were no significant differences in marginal adaptation among the 4 groups at the level of the anatomic apex (P = .175). BC RRM-FS + BC Sealer had a significantly smaller gap size after 3-mm root end resection compared with the other 3 groups (P < .01). No differences were observed among the other 3 materials. All materials showed comparable marginal adaptation at the anatomic apex when used for orthograde obturation of open apices. Application of BC Sealer before the delivery of BC RRM-FS Putty enhanced the quality of adaptation coronal to the apex. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  1. Comparing the OpenMP, MPI, and Hybrid Programming Paradigm on an SMP Cluster

    NASA Technical Reports Server (NTRS)

    Jost, Gabriele; Jin, Hao-Qiang; anMey, Dieter; Hatay, Ferhat F.

    2003-01-01

    Clusters of SMP (Symmetric Multi-Processors) nodes provide support for a wide range of parallel programming paradigms. The shared address space within each node is suitable for OpenMP parallelization. Message passing can be employed within and across the nodes of a cluster. Multiple levels of parallelism can be achieved by combining message passing and OpenMP parallelization. Which programming paradigm is the best will depend on the nature of the given problem, the hardware components of the cluster, the network, and the available software. In this study we compare the performance of different implementations of the same CFD benchmark application, using the same numerical algorithm but employing different programming paradigms.

  2. Roxadustat (FG-4592) Versus Epoetin Alfa for Anemia in Patients Receiving Maintenance Hemodialysis: A Phase 2, Randomized, 6- to 19-Week, Open-Label, Active-Comparator, Dose-Ranging, Safety and Exploratory Efficacy Study.

    PubMed

    Provenzano, Robert; Besarab, Anatole; Wright, Steven; Dua, Sohan; Zeig, Steven; Nguyen, Peter; Poole, Lona; Saikali, Khalil G; Saha, Gopal; Hemmerich, Stefan; Szczech, Lynda; Yu, K H Peony; Neff, Thomas B

    2016-06-01

    Roxadustat (FG-4592) is an oral hypoxia-inducible factor prolyl-hydroxylase inhibitor that promotes erythropoiesis through increasing endogenous erythropoietin, improving iron regulation, and reducing hepcidin. Phase 2, randomized (3:1), open-label, active-comparator, safety and efficacy study. Patients with stable end-stage renal disease treated with hemodialysis who previously had hemoglobin (Hb) levels maintained with epoetin alfa. Part 1: 6-week dose-ranging study in 54 individuals of thrice-weekly oral roxadustat doses versus continuation of intravenous epoetin alfa. Part 2: 19-week treatment in 90 individuals in 6 cohorts with various starting doses and adjustment rules (1.0-2.0mg/kg or tiered weight based) in individuals with a range of epoetin alfa responsiveness. Intravenous iron was prohibited. Primary end point was Hb level response, defined as end-of-treatment Hb level change (ΔHb) of -0.5g/dL or greater from baseline (part 1) and as mean Hb level ≥ 11.0g/dL during the last 4 treatment weeks (part 2). Hepcidin, iron parameters, cholesterol, and plasma erythropoietin (the latter in a subset). Baseline epoetin alfa doses were 138.3±51.3 (SD) and 136.3±47.7U/kg/wk in part 1 and 152.8±80.6 and 173.4±83.7U/kg/wk in part 2, in individuals randomly assigned to roxadustat and epoetin alfa, respectively. Hb level responder rates in part 1 were 79% in pooled roxadustat 1.5 to 2.0mg/kg compared to 33% in the epoetin alfa control arm (P=0.03). Hepcidin level reduction was greater at roxadustat 2.0mg/kg versus epoetin alfa (P<0.05). In part 2, the average roxadustat dose requirement for Hb level maintenance was ∼1.7mg/kg. The least-squares-mean ΔHb in roxadustat-treated individuals was comparable to that in epoetin alfa-treated individuals (about -0.5g/dL) and the least-squares-mean difference in ΔHb between both treatment arms was -0.03 (95% CI, -0.39 to 0.33) g/dL (mixed effect model-repeated measure). Roxadustat significantly reduced mean total

  3. A multi-center, open-label trial to compare the efficacy and pharmacokinetics of Artemether-Lumefantrine in children with severe acute malnutrition versus children without severe acute malnutrition: study protocol for the MAL-NUT study.

    PubMed

    Denoeud-Ndam, Lise; Dicko, Alassane; Baudin, Elisabeth; Guindo, Ousmane; Grandesso, Francesco; Sagara, Issaka; Lasry, Estrella; Palma, Pedro Pablo; Parra, Angeles M Lima; Stepniewska, Kasia; Djimde, Abdoulaye A; Barnes, Karen I; Doumbo, Ogobara K; Etard, Jean-François

    2015-06-12

    Malnutrition and malaria frequently coexist in sub-Saharan African countries. Studies on efficacy of antimalarial treatments usually follow the WHO standardized protocol in which severely malnourished children are systematically excluded. Few studies have assessed the efficacy of chloroquine, sulfadoxine-pyrimethamine and quinine in severe acute malnourished children. Overall, efficacy of these treatments appeared to be reduced, attributed to lower immunity and for some antimalarials altered pharmacokinetic profiles and lower drug concentrations. However, similar research on the efficacy and pharmacokinetic profiles of artemisinin-combination therapies (ACTs) and especially artemether-lumefantrine in malnourished children is currently lacking. The main objective of this study is to assess whether artemether-lumefantrine is less efficacious in children suffering from severe acute malnutrition (SAM) compared to non-SAM children, and if so, to what extent this can be attributed to a sub-optimal pharmacokinetic profile. In two sites, Ouelessebougou, Mali and Maradi, Niger, children with uncomplicated microscopically-confirmed P. falciparum malaria aged between 6 and 59 months will be enrolled. Two non-SAM children will be enrolled after the enrolment of each SAM case. Children with severe manifestations of malaria or complications of acute malnutrition needing intensive treatment will be excluded. Treatment intakes will be supervised and children will be followed-up for 42 days, according to WHO guidance for surveillance of antimalarial drug efficacy. Polymerase Chain Reaction genotyping will be used to distinguish recrudescence from re-infection. SAM children will also benefit from the national nutritional rehabilitation program. Outcomes will be compared between the SAM and non-SAM populations. The primary outcome will be adequate clinical and parasitological response at day 28 after PCR correction, estimated by Kaplan-Meier analysis. To assess the pharmacokinetic

  4. Parasitological Clearance Rates and Drug Concentrations of a Fixed Dose Combination of Azithromycin-Chloroquine in Asymptomatic Pregnant Women with Plasmodium Falciparum Parasitemia: An Open-Label, Non-Comparative Study in Sub-Saharan Africa

    PubMed Central

    Phiri, Kamija; Kimani, Joshua; Mtove, George A.; Zhao, Qinying; Rojo, Ricardo; Robbins, Jeffery; Duparc, Stephan; Ayoub, Ayman; Vandenbroucke, Pol

    2016-01-01

    Background Malaria remains one of the most important causes of morbidity and mortality in pregnant women and their newborn babies in sub-Saharan Africa. Intermittent preventive treatment in pregnancy (IPTp) is recommended by the World Health Organization (WHO) to reduce the burden of disease and improve maternal and neonatal survival and general health. Due to the growing resistance to sulfadoxine-pyrimethamine (SP), the current WHO-recommended drug for IPTp, identification of new and effective drugs is an urgent priority. Methods and Findings This was an open-label, non-comparative study (NCT01103713) in 5 countries in East and sub-Saharan Africa (Benin, Kenya, Malawi, Tanzania, and Uganda) to assess parasitological response and drug concentrations of a single, 3-day course of four tablets of a fixed-dose combination of azithromycin-chloroquine (AZCQ) 250/155 mg given during the second or third trimester to women with asymptomatic Plasmodium falciparum parasitemia in their first or second pregnancy. Parasitemia was determined by microscopy and molecular genotyping was performed to characterize parasites relative to the baseline infection. Weekly follow-up visits took place until day 42 after first dose and additional follow-up occurred after delivery. Systemic concentrations of azithromycin (AZ), chloroquine (CQ), and the CQ metabolite, desethyl CQ (DECQ) were evaluated at Day 0 (pre-dose), at Day 2 (pre-dose, 2 and 8 hours) and randomly at Days 7 and 14. Systemic concentrations of CQ and DECQ were also measured randomly at Day 21 and Day 28. In total, 404 women were screened for eligibility and 168 were treated, 155 of whom completed the study. PCR-adjusted parasitological response in the modified intent-to-treat population at day 28 (the primary efficacy endpoint) was estimated by the Kaplan-Meier method as 99.35% (95% confidence interval [CI]: 97.76, 100.00). PCR-adjusted parasitological response remained high at day 42 (95.19%; 95% CI: 91.35, 99.03). In

  5. Comparative pharmacokinetic evaluation of two formulations of bicalutamide 50-mg tablets: an open-label, randomized-sequence, single-dose, two-period crossover study in healthy Korean male volunteers.

    PubMed

    Lee, SeungHwan; Chung, Yong-Ju; Kim, Bo-Hyung; Shim, Jun-Hwa; Yoon, Seo-Hyun; Shin, Sang-Goo; Jang, In-Jin; Yu, Kyung-Sang

    2009-12-01

    Bicalutamide is an oral nonsteroidal antiandrogen drug used during hormone ablation therapy for prostate cancer. A new generic formulation of bicalutamide has been developed. This study was conducted to meet Korean and US regulatory requirements for the marketing of the generic 50-mg tablet formulation of bicalutamide. To this end, the pharmacokinetic properties of the new (test) formulation were compared with those of the currently marketed (reference) formulation. Tolerability was also evaluated. An open-label, randomized-sequence, single-dose, 2-period crossover study was conducted in healthy Korean male volunteers. Subjects received either the test or reference formulation of bicalutamide 50-mg tablets in the first period and crossed over to the alternative formulation in the second period. Serial blood samples for pharmacokinetic analysis were taken over 672 hours after dosing. Plasma concentrations of bicalutamide were measured by HPLC-MS/MS. Pharmacokinetic parameters, including AUC(0-672h), were determined by noncompartmental analysis. Log-transformed C(max) and AUC(0-672h) for the 2 formulations were compared. Tolerability was monitored based on laboratory tests, ECGs, vital signs, and physical examinations. Of the 34 subjects initially enrolled, 33 completed the study. The mean (SD) age, height, and weight of participants were 25.8 (4.1) years, 173.6 (5.7) cm, and 68.9 (7.8) kg, respectively. The median T(max) was 36.0 hours for both formulations. The mean (SD) t(1/2), C(max), and AUC(0-672h) for the reference formulation were 135.4 (28.6) hours, 933.2 (169.2) microg/L, and 215,680.1 (48,753.4) microg x h/L, respectively. Corresponding values for the test formulation were 134.3 (30.7) hours, 946.7 (179.9) microg/L, and 221,708.8 (54,935.1) microg x h/L. The 90% CIs for the mean ratios (test/reference) of log-transformed C(max) and AUC(0-672h) were 0.97 to 1.06 and 0.98 to 1.07, respectively. Twelve adverse events were reported for each formulation, none

  6. Increased incidence of postoperative stiffness after arthroscopic compared with open biceps tenodesis.

    PubMed

    Werner, Brian C; Pehlivan, Hakan C; Hart, Joseph M; Carson, Eric W; Diduch, David R; Miller, Mark D; Brockmeier, Stephen F

    2014-09-01

    To determine the incidence of postoperative stiffness after open and arthroscopic biceps tenodesis, compare the incidence between each method, and determine relevant risk factors for its occurrence. A consecutive series of patients who underwent biceps tenodesis during a 3-year period were retrospectively reviewed. We evaluated 249 patients, which included 143 who underwent open subpectoral tenodesis and 106 who underwent arthroscopic suprapectoral tenodesis. The mean overall follow-up period for the arthroscopic group was 9.9 months (range, 5.1 to 33.5 months). The mean overall follow-up period for the open group was 9.5 months (range, 4.7 to 49.2 months). There was no significant difference in overall follow-up duration between groups (P = .627). A significantly increased incidence of postoperative stiffness was found in the arthroscopic group compared with the open group (17.9% v 5.6%, P = .002). Within the arthroscopic group, patients with postoperative stiffness were more frequently female patients than those without stiffness (63.2% v 33.3%, P = .016) and were more likely to be smokers than those without stiffness (36.8% v 16.1%, P = .040). The tenodesis site was located significantly more proximal in the arthroscopic group of patients with postoperative stiffness compared with patients without postoperative stiffness (32.44 ± 7.8 mm from the top of the humeral head v 50.34 ± 7.8 mm, P < .0001). Our results show a notably increased incidence of postoperative stiffness after arthroscopic suprapectoral biceps tenodesis compared with open subpectoral biceps tenodesis. This appears to occur more commonly in female patients and smokers and may have a relation to the position of the tenodesis, with a more superiorly placed tenodesis site being a potential influencing factor. On the basis of this series, this complication most commonly will improve over time and with symptom-based management. Level III, therapeutic case-control study. Copyright © 2014 Arthroscopy

  7. A prospective, parallel group, open-labeled, comparative, multi-centric, active controlled study to evaluate the safety, tolerability and benefits of fixed dose combination of acarbose and metformin versus metformin alone in type 2 diabetes.

    PubMed

    Jayaram, S; Hariharan, R S; Madhavan, R; Periyandavar, I; Samra, S S

    2010-11-01

    The present study was a prospective, parallel group, open-labeled, comparative, multicentric, active controlled study to evaluate the safety, tolerability and benefits of fixed dose combination of acarbose and metformin versus metformin alone in type 2 diabetic patients. A total of 229 patients with type 2 diabetes were enrolled at 5 medical centers across India. They received either acarbose (50 mg) + metformin (500 mg) bid/tid (n=115) or metformin monotherapy (500 mg) bid/ tid (n=114) for 12 weeks. Primary objective was to evaluate safety and tolerability based on the adverse events reported. Secondary objective was efficacy assessment based on changes in fasting, post prandial blood glucose and HbA1c values. In the acarbose + metformin group 10 patients reported 14 adverse events while in metformin group 9 patients reported 10 adverse events. No patient reported any serious adverse event or was withdraw from study because of adverse events. In the acarbose plus metformin group fasting blood glucose (FBG) decreased from a baseline of 158.85 +/- 18.14 mg/dl to 113.55 +/- 19.38 mg/dl (p < 0.0001) (decrease of 45.30 +/- 15.30 mg/dl) at 12 weeks, while in the metformin group fasting blood glucose decreased from a baseline of 158.31 +/- 26.53 mg/dl to 130.55 +/- 28.31 mg/dl (p < 0.0001) (decrease of 27.76 +/- 22.91 mg/dl) at 12 weeks. In the acarbose plus metformin group postprandial blood glucose (PPBG) decreased from a baseline of 264.65 +/- 34.03 mg/dl to 173.22 +/- 31.40 mg/dl (p < 0.0001) (decrease of 91.43 +/- 28.65 mg/dl) at 12 weeks, while in the metformin group PPBG decreased from a baseline of 253.56 +/- 36.28 mg/dl to 205.36 +/- 39.49 mg/dl (p < 0.0001) (decrease of 48.20 +/- 32.72 mg/dl) at 12 weeks. In the acarbose plus metformin group glycosylated haemoglobin (HbA1c) decreased from a baseline of 9.47 +/- 0.69% to 7.71 +/- 0.85% (p < 0.0001) (% decrease of 1.76 +/- 1.11) at 12 weeks, while in the metformin group HbAlc decreased from a baseline of 9

  8. A Phase 2/3 Multicenter, Randomized, Open-Label Study to Compare the Efficacy and Safety of Lenalidomide Versus Investigator's Choice in Patients with Relapsed or Refractory Diffuse Large B-Cell Lymphoma.

    PubMed

    Czuczman, Myron S; Trněný, Marek; Davies, Andrew; Rule, Simon; Linton, Kim M; Wagner-Johnston, Nina; Gascoyne, Randy D; Slack, Graham W; Brousset, Pierre; Eberhard, David A; Hernandez-Ilizaliturri, Francisco J; Salles, Gilles; Witzig, Thomas E; Zinzani, Pier Luigi; Wright, George W; Staudt, Louis M; Yang, Yandan; Williams, P Mickey; Lih, Chih-Jian; Russo, Jacqueline; Thakurta, Anjan; Hagner, Patrick; Fustier, Pierre; Song, Dale; Lewis, Ian D

    2017-08-01

    Purpose: Randomized, multicenter, open-label, phase 2/3 trial investigating lenalidomide versus investigator's choice (IC) in relapsed/refractory diffuse large B-cell lymphoma (DLBCL).Experimental Design: Patients with DLBCL who received ≥2 prior therapies were stratified by DLBCL subtype [germinal center B-cell (GCB) vs. non-GCB; determined by immunohistochemistry (IHC)] and then randomized 1:1 to lenalidomide (25 mg/day, 21 days of 28-day cycle) or IC (gemcitabine, rituximab, etoposide, or oxaliplatin). Crossover to lenalidomide was permitted for IC-treated patients with radiologically confirmed progressive disease. The primary endpoint was overall response rate (ORR). Progression-free survival (PFS), overall survival, and subtype analysis [GCB vs. activated B-cell (ABC)] using gene expression profiling (GEP) were exploratory endpoints.Results: Stage 1: 102 DLBCL patients (by IHC: non-GCB, n = 54; GCB, n = 48) received ≥1 dose of lenalidomide or IC. Hematologic treatment-emergent adverse events with lenalidomide versus IC included neutropenia (42.6%; 36.4%), anemia (33.3%; 47.3%), thrombocytopenia (24.1%; 43.6%), and leukopenia (5.6%; 12.7%), respectively. Overall, lenalidomide-treated patients had an ORR of 27.5% versus 11.8% in IC (ORRs were similar regardless of IHC-defined DLBCL subtype). Median PFS was increased in patients receiving lenalidomide (13.6 weeks) versus IC (7.9 weeks; P = 0.041), with greater improvements in non-GCB patients (15.1 vs. 7.1 weeks, respectively; P = 0.021) compared with GCB (10.1 vs. 9.0 weeks, respectively; P = 0.550).Conclusions: The clinical benefit of lenalidomide monotherapy in DLBCL patients was more evident in the non-GCB subtype. Exploratory analyses suggest that this preferential benefit was more pronounced in the GEP-defined ABC population, demonstrating a need for additional studies of lenalidomide in DLBCL using GEP subtyping. Clin Cancer Res; 23(15); 4127-37. ©2017 AACR. ©2017 American Association for Cancer

  9. Studies on the corona of open clusters

    NASA Astrophysics Data System (ADS)

    Balaguer-Núñez, L.; Jordi, C.; Muiños, J. L.; Galadí-Enríquez, D.; Masana, E.

    2013-05-01

    High quality proper motions on an extended area of a selection of Open Clusters (OCs) will let us study their coronas with unprecedented accuracy. We are in the process of obtaining astrometry with the Meridian Circles of San Fernando CMASF at El Leoncito (Argentina) and the CTA at La Palma of an area few times the known radius (from Webda) of a selection of OCs. We will make use of Strömgren wide-field photometry to complement their characterization. We have already analysed the old open cluster M67, deriving properties for 2738 stars fainter and, in a wider area, than any previous precise survey in the cluster region. With new data from the CMASF we have covered an area of about 2°×1.4° and down to 17 magnitude in r^'. Proper motions are then used to determine the membership probabilities of stars in the region, applying parametric and non-parametric approaches to cluster/field segregation. Adding photometric criteria, we obtained a preliminary list of 665 probable member stars, up to a distance 0.96° from the cluster centre. These are preliminary results on our work that will lead us to the most complete study of its structure, dynamics and mass segregation up to date. We have already obtained proper motions for NGC 1817, NGC 2264 and NGC 2509 that are now being processed.

  10. Comparative Effectiveness of Cancer Control and Survival after Robot-Assisted versus Open Radical Prostatectomy.

    PubMed

    Hu, Jim C; O'Malley, Padraic; Chughtai, Bilal; Isaacs, Abby; Mao, Jialin; Wright, Jason D; Hershman, Dawn; Sedrakyan, Art

    2017-01-01

    Robot-assisted surgery has been rapidly adopted in the U.S. for prostate cancer. Its adoption has been driven by market forces and patient preference, and debate continues regarding whether it offers improved outcomes to justify the higher cost relative to open surgery. We examined the comparative effectiveness of robot-assisted vs open radical prostatectomy in cancer control and survival in a nationally representative population. This population based observational cohort study of patients with prostate cancer undergoing robot-assisted radical prostatectomy and open radical prostatectomy during 2003 to 2012 used data captured in the SEER (Surveillance, Epidemiology, and End Results)-Medicare linked database. Propensity score matching and time to event analysis were used to compare all cause mortality, prostate cancer specific mortality and use of additional treatment after surgery. A total of 6,430 robot-assisted radical prostatectomies and 9,161 open radical prostatectomies performed during 2003 to 2012 were identified. The use of robot-assisted radical prostatectomy increased from 13.6% in 2003 to 2004 to 72.6% in 2011 to 2012. After a median followup of 6.5 years (IQR 5.2-7.9) robot-assisted radical prostatectomy was associated with an equivalent risk of all cause mortality (HR 0.85, 0.72-1.01) and similar cancer specific mortality (HR 0.85, 0.50-1.43) vs open radical prostatectomy. Robot-assisted radical prostatectomy was also associated with less use of additional treatment (HR 0.78, 0.70-0.86). Robot-assisted radical prostatectomy has comparable intermediate cancer control as evidenced by less use of additional postoperative cancer therapies and equivalent cancer specific and overall survival. Longer term followup is needed to assess for differences in prostate cancer specific survival, which was similar during intermediate followup. Our findings have significant quality and cost implications, and provide reassurance regarding the adoption of more

  11. Development of Fetal Yawn Compared with Non-Yawn Mouth Openings from 24–36 Weeks Gestation

    PubMed Central

    Reissland, Nadja; Francis, Brian; Mason, James

    2012-01-01

    Background Although some research suggests that fetuses yawn, others disagree arguing that is it simple mouth opening. Furthermore there is no developmental account of fetal yawning compared with simple mouth opening. The aim of the present study was to establish in a repeated measures design the development of fetal yawning compared with simple mouth opening. Methodology/Findings Video recordings were made of the fetal face and upper torso visualized by means of 4D full frontal or facial profile ultrasound recordings. Fifteen healthy fetuses were scanned four times at 24, 28, 32 and 36 weeks gestation. Yawning was distinguished from non-yawning in terms of the length of time it took to reach the apex of the mouth stretch, with yawns being defined as more than 50% of the total time observed. To assess changes in frequency, a Poisson mixed effects model was fitted to the count of number of yawn and simple mouth opening events with age and gender as fixed effects, and person as a random effect. For both yawns and simple mouth openings a smooth varying age effect was significant. The number of yawns observed declined with age from 28 weeks gestation, whereas simple mouth openings were less frequent and the decline was observed from 24 weeks. Gender was not significant either for yawn and simple mouth openings. Conclusions/Significance Yawning can be reliably distinguished from other forms of mouth opening with the potential of using yawning as an index of fetal healthy development. PMID:23185638

  12. Development of fetal yawn compared with non-yawn mouth openings from 24-36 weeks gestation.

    PubMed

    Reissland, Nadja; Francis, Brian; Mason, James

    2012-01-01

    Although some research suggests that fetuses yawn, others disagree arguing that is it simple mouth opening. Furthermore there is no developmental account of fetal yawning compared with simple mouth opening. The aim of the present study was to establish in a repeated measures design the development of fetal yawning compared with simple mouth opening. Video recordings were made of the fetal face and upper torso visualized by means of 4D full frontal or facial profile ultrasound recordings. Fifteen healthy fetuses were scanned four times at 24, 28, 32 and 36 weeks gestation. Yawning was distinguished from non-yawning in terms of the length of time it took to reach the apex of the mouth stretch, with yawns being defined as more than 50% of the total time observed. To assess changes in frequency, a Poisson mixed effects model was fitted to the count of number of yawn and simple mouth opening events with age and gender as fixed effects, and person as a random effect. For both yawns and simple mouth openings a smooth varying age effect was significant. The number of yawns observed declined with age from 28 weeks gestation, whereas simple mouth openings were less frequent and the decline was observed from 24 weeks. Gender was not significant either for yawn and simple mouth openings. Yawning can be reliably distinguished from other forms of mouth opening with the potential of using yawning as an index of fetal healthy development.

  13. Bioavailability of three rufinamide oral suspensions compared with the marketed 400-mg tablet formulation: results from a randomized-sequence, open-label, four-period, four-sequence crossover study in healthy subjects.

    PubMed

    Critchley, David John; Aluri, Jagadeesh; Boyd, Peter; Whayman, Matthew; Narurkar, Milind; Delargy, Hugh; Bibbiani, Francesco

    2011-01-01

    Rufinamide is indicated for the adjunctive treatment of seizures associated with Lennox-Gastaut syndrome in patients aged ≥4 years. The primary purpose of this study was to compare the relative bioavailability and other pharmacokinetics of rufinamide administered as a 400-mg tablet formulation (reference) with 10 mL of a newly developed 40-mg/mL suspension (test) manufactured using 3 different homogenization speeds in healthy subjects under fed conditions. The study also explored whether homogenization speed had any effect on rufinamide pharmacokinetics when administered as a suspension formulation. This was a randomized, open-label, crossover, single-dose study in healthy, fed subjects aged 18 to 55 years (inclusive), conducted at a single center in the United Kingdom. Subjects were randomized to 1 of 4 treatment sequences, with each sequence consisting of 4 treatment periods. In each treatment period, subjects received a single dose of either the reference product (400-mg rufinamide tablet) or the test product (10 mL of rufinamide suspension [40 mg/mL] manufactured using 3 different homogenization speeds [1800, 2100, and 3000 revolutions per minute (rpm)]). Serial blood samples were collected for 72 hours after dosing for the measurement of rufinamide in plasma. Primary comparisons between test (suspension) and reference (tablet) formulations focused on AUC from 0 to 72 hours (AUC(0-72 h)) and C(max). The formulations were considered bioequivalent if the ratios of geometric least squares means and associated 90% CIs of AUC(0-72 h) and C(max) were within the predetermined range of 80%-125%, according to the US Food and Drug Administration (FDA) and European Medicines Agency (EMA) requirements. Tolerability was assessed by subject interviews, physical examinations, and laboratory tests. Twenty-four healthy subjects were randomized: 8 were male and 16 were female; 22 white, 1 black, and 1 Asian subjects were enrolled. Mean (SD) age was 29.8 (10.0) years. Mean

  14. The Comparative Harms of Open and Robotic Prostatectomy in Population Based Samples.

    PubMed

    O'Neil, Brock; Koyama, Tatsuki; Alvarez, JoAnn; Conwill, Ralph M; Albertsen, Peter C; Cooperberg, Matthew R; Goodman, Michael; Greenfield, Sheldon; Hamilton, Ann S; Hoffman, Karen E; Hoffman, Richard M; Kaplan, Sherrie H; Stanford, Janet L; Stroup, Antoinette M; Paddock, Lisa E; Wu, Xiao-Cheng; Stephenson, Robert A; Resnick, Matthew J; Barocas, Daniel A; Penson, David F

    2016-02-01

    Robotic assisted radical prostatectomy has largely replaced open radical prostatectomy for the surgical management of prostate cancer despite conflicting evidence of superiority with respect to disease control or functional sequelae. Using population cohort data, in this study we examined sexual and urinary function in men undergoing open radical prostatectomy vs those undergoing robotic assisted radical prostatectomy. Subjects surgically treated for prostate cancer were selected from 2 large population based prospective cohort studies, the Prostate Cancer Outcomes Study (enrolled 1994 to 1995) and the Comparative Effectiveness Analysis of Surgery and Radiation (enrolled 2011 to 2012). Subjects completed baseline, 6-month and 12-month standardized patient reported outcome measures. Main outcomes were between-group differences in functional outcome scores at 6 and 12 months using linear regression, and adjusting for baseline function, sociodemographic and clinical characteristics. Sensitivity analyses were used to evaluate outcomes between patients undergoing open radical prostatectomy and robotic assisted radical prostatectomy within and across CEASAR and PCOS. The combined cohort consisted of 2,438 men, 1,505 of whom underwent open radical prostatectomy and 933 of whom underwent robotic assisted radical prostatectomy. Men treated with robotic assisted radical prostatectomy reported better urinary function at 6 months (mean difference 3.77 points, 95% CI 1.09-6.44) but not at 12 months (1.19, -1.32-3.71). Subjects treated with robotic assisted radical prostatectomy also reported superior sexual function at 6 months (8.31, 6.02-10.56) and at 12 months (7.64, 5.25-10.03). Sensitivity analyses largely supported the sexual function findings with inconsistent support for urinary function results. This population based study reveals that men undergoing robotic assisted radical prostatectomy likely experience less decline in early urinary continence and sexual function

  15. The Comparative Harms of Open and Robotic Prostatectomy in Population Based Samples

    PubMed Central

    O’Neil, Brock; Koyama, Tatsuki; Alvarez, JoAnn; Conwill, Ralph M.; Albertsen, Peter C.; Cooperberg, Matthew R.; Goodman, Michael; Greenfield, Sheldon; Hamilton, Ann S.; Hoffman, Karen E.; Hoffman, Richard M.; Kaplan, Sherrie H.; Stanford, Janet L.; Stroup, Antoinette M.; Paddock, Lisa E.; Wu, Xiao-Cheng; Stephenson, Robert A.; Resnick, Matthew J.; Barocas, Daniel A.; Penson, David F.

    2016-01-01

    Purpose Robotic assisted radical prostatectomy has largely replaced open radical prostatectomy for the surgical management of prostate cancer despite conflicting evidence of superiority with respect to disease control or functional sequelae. Using population cohort data, in this study we examined sexual and urinary function in men undergoing open radical prostatectomy vs those undergoing robotic assisted radical prostatectomy. Materials and Methods Subjects surgically treated for prostate cancer were selected from 2 large population based prospective cohort studies, the Prostate Cancer Outcomes Study (enrolled 1994 to 1995) and the Comparative Effectiveness Analysis of Surgery and Radiation (enrolled 2011 to 2012). Subjects completed baseline, 6-month and 12-month standardized patient reported outcome measures. Main outcomes were between-group differences in functional outcome scores at 6 and 12 months using linear regression, and adjusting for baseline function, sociodemographic and clinical characteristics. Sensitivity analyses were used to evaluate outcomes between patients undergoing open radical prostatectomy and robotic assisted radical prostatectomy within and across CEASAR and PCOS. Results The combined cohort consisted of 2,438 men, 1,505 of whom underwent open radical prostatectomy and 933 of whom underwent robotic assisted radical prostatectomy. Men treated with robotic assisted radical prostatectomy reported better urinary function at 6 months (mean difference 3.77 points, 95% CI 1.09–6.44) but not at 12 months (1.19, −1.32–3.71). Subjects treated with robotic assisted radical prostatectomy also reported superior sexual function at 6 months (8.31, 6.02–10.56) and at 12 months (7.64, 5.25–10.03). Sensitivity analyses largely supported the sexual function findings with inconsistent support for urinary function results. Conclusions This population based study reveals that men undergoing robotic assisted radical prostatectomy likely experience

  16. Comparative analysis of outcome between laparoscopic versus open surgical repair for vesico-vaginal fistula

    PubMed Central

    Ghosh, Bastab; Wats, Varun

    2016-01-01

    Objective Vesicovaginal fistula (VVF) causes detrimental psychosomatic effects on a woman. It is repaired using open abdominal as well as laparoscopic approach. Here we compare a series of open versus laparoscopic VVF repairs done at a single centre. Methods Retrospectively data of patients undergoing VVF repair in our department between January 2011 to December 2014 was analyzed. Patients who had a single, primary, simple VVF following a gynaecological surgery were included in the study. 26 patients met all the criteria. Out of these, thirteen patients had undergone a laparoscopic VVF repair (group 1) while thirteen had undergone an open transabdominal VVF repair (group 2). Results Mean fistula size was 2.14±0.23 cm in group 1 and 2.18±0.30 cm in group 2, which was comparable. Mean blood loss was 58.69±6.48 mL in group 1 and 147.30±19.24 mL in group 2, which is statistically significant (P<0.0001). Mean hospital stay was 4 days in group 1 and 13 days in group 2 which is statistically significant (P<0.0001). The analgesic requirement (diclofenac) was 261.53±29.95 mg in group 1 and 617.30±34.43 mg in group 2, which is statistically significant (P<0.0001). Fistula repair was successful in all the patients in both the groups. Conclusion The present study shows that laparoscopic VVF repair results in reduced patient morbidity and shorter hospital stay without compromising the results. So laparoscopic repair may be a more attractive treatment option for patients with post gynecology surgery VVF. PMID:27896256

  17. Hallux Valgus Correction Comparing Percutaneous Chevron/Akin (PECA) and Open Scarf/Akin Osteotomies.

    PubMed

    Lee, Moses; Walsh, James; Smith, Margaret M; Ling, Jeff; Wines, Andrew; Lam, Peter

    2017-08-01

    Minimally invasive surgery is being used increasingly, including for hallux valgus surgery. Despite the growing interest in minimally invasive procedures, there have been few publications on percutaneous chevron/akin (PECA) procedures, and no studies have been published comparing PECA to open scarf/akin osteotomies (SA). This was a prospective, randomized study of 50 patients undergoing operative correction of hallux valgus using one of 2 techniques (PECA vs open SA). Data were collected preoperatively and on 1 day, 2 weeks, 6 weeks, and 6 months postoperatively. Outcome measures include the American Orthopaedic Foot & Ankle Society Hallux-Metatarsophalangeal-Interphalangeal (AOFAS-HMI) Score, visual analog pain score, hallux valgus angle (HVA), and 1-2 intermetatarsal angle (IMA). Twenty-five patients underwent PECA procedures and 25 patients received SA procedures. Both groups showed significantly improved AOFAS-HMI scores after surgery (PECA group: 61.8 to 88.9, SA group: 57.3 to 84.1, P = .560) with comparable final scores. HVA and IMA also presented similar outcomes at final follow-up ( P = .520 and P = .270, respectively). However, the PECA group showed significantly lower pain level (VAS) in the early postoperative phase (postoperative day 1 to postoperative week 6, P < .001 and P = .004, respectively). No serious complications were observed in either group. Both groups showed comparable good to excellent clinical and radiologic outcomes at final follow-up. However, the PECA group had significantly less pain in the first 6 weeks following surgery. Level of Evidence Level II, prospective comparative study.

  18. The role of visual reafferents during a pointing movement: comparative study between open-loop and closed-loop performances in monkeys before and after unilateral electrolytic lesion of the substantia nigra.

    PubMed

    Viallet, F; Trouche, E; Beaubaton, D; Legallet, E

    1987-01-01

    In order to elucidate the compensatory role of visual feedback during movement, two experiments were designed to compare the motor performances of Papio papio baboons depending on whether the animals were able to visually control the limb trajectory (visual closed-loop condition) or not (visual open-loop condition). The visuomotor task used consisted of making trained pointing movements towards a stationary target. In experiment A, the baboons were successively presented with these two experimental conditions. The abolition of visual control was found to cause no change in either reaction time (RT) or movement time (MT), but brought about extensive pointing errors. It was also associated with a conspicuous increase in the mean velocity and the mean length of the trajectories. In experiment B, two groups of baboons were used. The monkeys in the first group were required to perform under closed loop conditions. The second group performed the pointing movement under open loop conditions. Once criterion was reached by each animal, a unilateral electrolytic lesion of the substantia nigra (SN) was performed. A comparison between the post operative performances of the animals in the two groups showed that suppression of visual cues resulted in a lengthening of the RT and a slowing of the movement speed. Moreover when visual feedback was lacking, the amplitude of the movement decreased and the finger fell short of the target. During the last post operative period, suppression of visual feedback brought about a more rapid return of RTs to their preoperative level and a more durable slowing of movement speed than with normal vision. The discussion deals with the role of visual feed-back in the control of movement preparation and execution, and with the change in mode of motor control caused by lesion of the SN. Partial exclusion of the SN might bring about a shift from the feedforward to a feedback mode relying more heavily on visual cues.

  19. Comparative clinical evaluation of combination anorganic bovine-derived hydroxyapatite matrix (ABM)/cell binding peptide (P-15) and open flap debridement (DEBR) in human periodontal osseous defects: a 6 month pilot study.

    PubMed

    Radhakrishnan, Sujatha; Anusuya, C N

    2004-07-01

    A synthetic cell binding peptide (P-15) combined with anorganic bovine-derived hydroxyapatite bone matrix (ABM) was compared to open flap debridement (DEBR) in human periodontal osseous defects. Following initial preparation procedures, two osseous defects per patient were treated randomly with one of the two procedures after surgical preparation. Appropriate periodontal maintenance schedules were followed, and at 6 months clinical and radiographic assessments for soft tissue and hard tissue were performed for documentation and finalization of treatment. Statistical analysis using Student's paired t-test analyses of patient mean value from 10 patients revealed that the combination ABM/P-15 grafts demonstrated significantly better mean defect fill of 3.4+/-1.7 mm (73.2%) versus a mean defect fill of 0.6 mm (15.8%) for defects treated with DEBR. Soft tissue findings showed significant differences among treatments with ABM/P-15 compared to DEBR. These results suggest that the use of the P-15 synthetic cell-binding peptide combined with ABM yields better clinical results than DEBR.

  20. OpenARC: Extensible OpenACC Compiler Framework for Directive-Based Accelerator Programming Study

    SciTech Connect

    Lee, Seyong; Vetter, Jeffrey S

    2014-01-01

    Directive-based, accelerator programming models such as OpenACC have arisen as an alternative solution to program emerging Scalable Heterogeneous Computing (SHC) platforms. However, the increased complexity in the SHC systems incurs several challenges in terms of portability and productivity. This paper presents an open-sourced OpenACC compiler, called OpenARC, which serves as an extensible research framework to address those issues in the directive-based accelerator programming. This paper explains important design strategies and key compiler transformation techniques needed to implement the reference OpenACC compiler. Moreover, this paper demonstrates the efficacy of OpenARC as a research framework for directive-based programming study, by proposing and implementing OpenACC extensions in the OpenARC framework to 1) support hybrid programming of the unified memory and separate memory and 2) exploit architecture-specific features in an abstract manner. Porting thirteen standard OpenACC programs and three extended OpenACC programs to CUDA GPUs shows that OpenARC performs similarly to a commercial OpenACC compiler, while it serves as a high-level research framework.

  1. NGC 7789: An open cluster case study

    SciTech Connect

    Overbeek, Jamie C.; Friel, Eileen D.; Pilachowski, Catherine A.; Mészáros, Szabolcs; Jacobson, Heather R.; Johnson, Christian I.

    2015-01-01

    We have obtained high-resolution spectra of 32 giants in the open cluster NGC 7789 using the Wisconsin–Indiana–Yale–NOAO Hydra spectrograph. We explore differences in atmospheric parameters and elemental abundances caused by the use of the linelist developed for the Gaia-ESO Survey (GES) compared to one based on Arcturus used in our previous work. [Fe/H] values decrease when using the GES linelist instead of the Arcturus-based linelist; these differences are probably driven by systematically lower (∼−0.1 dex) GES surface gravities. Using the GES linelist we determine abundances for 10 elements—Fe, Mg, Si, Ca, Ti, Na, Ni, Zr, Ba, and La. We find the cluster's average metallicity [Fe/H] = 0.03 ± 0.07 dex, in good agreement with literature values, and a lower [Mg/Fe] abundance than has been reported before for this cluster (0.11 ± 0.05 dex). We also find the neutron-capture element barium to be highly enhanced—[Ba/Fe] = +0.48 ± 0.08—and disparate from cluster measurements of neutron-capture elements La and Zr (−0.08 ± 0.05 and 0.08 ± 0.08, respectively). This is in accordance with recent discoveries of supersolar Ba enhancement in young clusters along with more modest enhancement of other neutron-capture elements formed in similar environments.

  2. NGC 7789: an Open Cluster Case Study

    NASA Astrophysics Data System (ADS)

    Overbeek, Jamie C.; Friel, Eileen D.; Jacobson, Heather R.; Johnson, Christian I.; Pilachowski, Catherine A.; Mészáros, Szabolcs

    2015-01-01

    We have obtained high-resolution spectra of 32 giants in the open cluster NGC 7789 using the Wisconsin-Indiana-Yale-NOAO Hydra spectrograph. We explore differences in atmospheric parameters and elemental abundances caused by the use of the linelist developed for the Gaia-ESO Survey (GES) compared to one based on Arcturus used in our previous work. [Fe/H] values decrease when using the GES linelist instead of the Arcturus-based linelist; these differences are probably driven by systematically lower (˜-0.1 dex) GES surface gravities. Using the GES linelist we determine abundances for 10 elements—Fe, Mg, Si, Ca, Ti, Na, Ni, Zr, Ba, and La. We find the cluster's average metallicity [Fe/H] = 0.03 ± 0.07 dex, in good agreement with literature values, and a lower [Mg/Fe] abundance than has been reported before for this cluster (0.11 ± 0.05 dex). We also find the neutron-capture element barium to be highly enhanced—[Ba/Fe] = +0.48 ± 0.08—and disparate from cluster measurements of neutron-capture elements La and Zr (-0.08 ± 0.05 and 0.08 ± 0.08, respectively). This is in accordance with recent discoveries of supersolar Ba enhancement in young clusters along with more modest enhancement of other neutron-capture elements formed in similar environments.

  3. A comparative concept analysis of centring vs. opening meditation processes in health care.

    PubMed

    Birx, Ellen

    2013-08-01

    To report an analysis and comparison of the concepts centring and opening meditation processes in health care. Centring and opening meditation processes are included in nursing theories and frequently recommended in health care for stress management. These meditation processes are integrated into emerging psychotherapy approaches and there is a rapidly expanding body of neuroscience research distinguishing brain activity associated with different types of meditation. Currently, there is a lack of theoretical and conceptual clarity needed to guide meditation research in health care. A search of healthcare literature between 2006-2011 was conducted using Alt HealthWatch, CINAHL, PsychNET and PubMed databases using the keywords 'centring' and 'opening' alone and in combination with the term 'meditation.' For the concept centring, 10 articles and 11 books and for the concept opening 13 articles and 10 books were included as data sources. Rodgers' evolutionary method of concept analysis was used. Centring and opening are similar in that they both involve awareness in the present moment; both use a gentle, effortless approach; and both have a calming effect. Key differences include centring's focus on the individual's inner experience compared with the non-dual, spacious awareness of opening. Centring and opening are overlapping, yet distinct meditation processes. The term meditation cannot be used in a generic way in health care. The differences between centring and opening have important implications for the further development of unitary-transformative nursing theories. © 2012 Blackwell Publishing Ltd.

  4. Comparative analysis of open and robotic transversus abdominis release for ventral hernia repair.

    PubMed

    Bittner, James G; Alrefai, Sameer; Vy, Michelle; Mabe, Micah; Del Prado, Paul A R; Clingempeel, Natasha L

    2017-07-20

    Transversus abdominis release (TAR) is a safe, effective strategy to repair complex ventral incisional hernia (VIH); however, open TAR (o-TAR) often necessitates prolonged hospitalization. Robot-assisted TAR (r-TAR) may benefit short-term outcomes and shorten convalescence. This study compares 90-day outcomes of o-TAR and r-TAR for VIH repair. A single-center, retrospective review of patients who underwent o-TAR or r-TAR for VIH from 2015 to 2016 was conducted. Patient and hernia characteristics, operative data, and 90-day outcomes were compared. The primary outcome was hospital length of stay, and secondary metrics were morbidity, surgical site events, and readmission. Overall, 102 patients were identified (76 o-TAR and 26 r-TAR). Patients were comparable regarding age, gender, body mass index, and the presence of co-morbidities. Diabetes was more common in the open group (22.3 vs. 0%, P = 0.01). Most VIH defects were midline (89.5 vs. 83%, P = 0.47) and recurrent (52.6 vs. 58.3%, P = 0.65). Hernia characteristics were similar regarding mean defect size (260 ± 209 vs. 235 ± 107 cm(2), P = 0.55), mesh removal, and type/size mesh implanted. Average operative time was longer in the r-TAR cohort (287 ± 121 vs. 365 ± 78 min, P < 0.01) despite most receiving mesh fixation with fibrin sealant alone (18.4 vs. 91.7%, P < 0.01). r-TAR trended toward lower morbidity (39.2 vs. 19.2%, P = 0.09), less severe complications, and similar rates of surgical site events and readmission (6.6 vs. 7.7%, P = 1.00). In addition, r-TAR resulted in a significantly shorter median hospital length of stay compared to o-TAR (6 days, 95% CI 5.9-8.3 vs. 3 days, 95% CI 3.2-4.3). In select patients, the robotic surgical platform facilitates a safe, minimally invasive approach to complex abdominal wall reconstruction, specifically TAR. Robot-assisted TAR for VIH offers the short-term benefits of low morbidity and decreased hospital length of stay compared to open TAR.

  5. Comparing Ksharasutra (Ayurvedic Seton) and open fistulotomy in the management of fistula-in-ano.

    PubMed

    Dutta, Gouranga; Bain, Jayanta; Ray, Ajay Kumar; Dey, Soumedhik; Das, Nandini; Das, Biswanath

    2015-01-01

    Most commonly practiced surgical "lay open" technique to treat fistula-in-ano (a common anorectal pathology) has high rate of recurrence and anal incontinence. Alternatively, a nonsurgical cost efficient treatment with Ksharasutra (cotton Seton coated with Ayurvedic medicines) has minimal complications. In our study, we have tried to compare these two techniques. A prospective randomized control study was designed involving patients referred to the Department of General Surgery in RG Kar Medical College, Kolkata, India, from January 2010 to September 2011. Among 50 patients, 26 were in Ksharasutra and 24 were in fistulotomy group. 86% patients were male and 54% of the patients were in the fourth decade. About 74% fistulas are inter-sphincteric and 26% were of trans-sphincteric variety. Severe postoperative pain was more (7.7% vs. 25%) in fistulotomy group, while wound discharge was more associated with Ksharasutra group (15.3% vs. 8.3%). Wound scarring, bleeding, and infection rate were similar in both groups. Ksharasutra group took more time to heal (mean: 53 vs. 35.7 days, P = 0.002) despite reduced disruption to their routine work (2.7 vs. 15.5 days work off, P <0.001). Interestingly, pain experienced was less in Ksharasutra group, there was no open wound in contrast to fistulotomy and it was significantly cost effective (Rupees 166 vs. 464). Treatment of fistula-in-ano with Ksharasutra is a simple with low complications and minimal cost.

  6. Open Clinical Trial on Using Nifuroxazide Compared to Probiotics in Treating Acute Diarrhoeas in Adults

    PubMed Central

    Begovic, Begler; Ahmedtagic, Sead; Calkic, Lejla; Vehabović, Midhat; Kovacevic, Sanela Bakić; Catic, Tarik; Mehic, Meliha

    2016-01-01

    Background: Nifuroxazide is well known and often used anti-diarrhoeal medicine which has been pushed back from routine practice in recent years and often replaced with probiotics. Even probiotics are accepted and placed in some therapeutic guidelines for diarrhoea treatment, there are no enough evidence for its effectiveness and no comparative efficacy data with nifuroxazide in treatment of acute diarrhea. Patients and Methods: In open, prospective observational study, the efficacy and safety of nifuroxazide were compared with a probiotic containing lactic acid bacteria in the treatment of acute diarrhoea. A total number of 169 adult patients were included in this study, who administered nifuroxazide in the dose of 200 mg/4 times a day, while they took preparation containing lactic acid bacteria (1,2 x 107 live lyophilised lactic-acid bacteria) three times a day for three days. Results: Mean time to last unformed stool (TLUS) in a group which was treated with nifuroxazide was two days, while it took five days for the stool normalisation in the group using probiotic (p=0.0001). Conclusions: Orally administered nifuroxazide has demonstrated better efficiency as compared to probiotic in treating acute diarrhoea, and both medicines have shown the same safety and tolerance in this study. PMID:28144199

  7. Species comparative studies and cognitive development.

    PubMed

    Gómez, Juan-Carlos

    2005-03-01

    The comparative study of infant development and animal cognition brings to cognitive science the promise of insights into the nature and origins of cognitive skills. In this article, I review a recent wave of comparative studies conducted with similar methodologies and similar theoretical frameworks on how two core components of human cognition--object permanence and gaze following--develop in different species. These comparative findings call for an integration of current competing accounts of developmental change. They further suggest that evolution has produced developmental devices capable at the same time of preserving core adaptive components, and opening themselves up to further adaptive change, not only in interaction with the external environment, but also in interaction with other co-developing cognitive systems.

  8. A Study of Clinically Related Open Source Software Projects

    PubMed Central

    Hogarth, Michael A.; Turner, Stuart

    2005-01-01

    Open source software development has recently gained significant interest due to several successful mainstream open source projects. This methodology has been proposed as being similarly viable and beneficial in the clinical application domain as well. However, the clinical software development venue differs significantly from the mainstream software venue. Existing clinical open source projects have not been well characterized nor formally studied so the ‘fit’ of open source in this domain is largely unknown. In order to better understand the open source movement in the clinical application domain, we undertook a study of existing open source clinical projects. In this study we sought to characterize and classify existing clinical open source projects and to determine metrics for their viability. This study revealed several findings which we believe could guide the healthcare community in its quest for successful open source clinical software projects. PMID:16779056

  9. Comparative Study of Student Support Services of AIOU and UKOU

    ERIC Educational Resources Information Center

    Choudhry, Amtul Hafeez; Gujjar, Aijaz Ahmed; Hafeez, Muhammad Rashid

    2008-01-01

    This paper attempts to compare the availability, quality, similarities and differences of student support services in Allama Iqbal Open University (AIOU) and United Kingdom Open University (UKOU) and also to identify and enlist the deficiencies that AIOU students are facing in the student support services. The study found out that student support…

  10. Results of a phase II, open-label, non-comparative study of intralesional PV-10 followed by radiotherapy for the treatment of in-transit or metastatic melanoma.

    PubMed

    Foote, Matthew; Read, Tavis; Thomas, Janine; Wagels, Michael; Burmeister, Bryan; Smithers, B Mark

    2017-06-01

    In-transit and recurrent dermal or subcutaneous melanoma metastases represent a significant burden of advanced disease. Intralesional Rose Bengal can elicit tumor selective ablation and a T-cell mediated abscopal effect in untreated lesions. A subset of patients in a phase II trial setting received external beam radiotherapy to their recurrent lesions with complete or partial response and no significant acute radiation reaction. An open-label, single-arm phase II study was performed to assess the efficacy and safety of PV-10 followed by hypofractionated radiotherapy. Patients had in-transit melanoma metastases suitable for IL therapy and radiotherapy. Fifteen patients were enrolled and thirteen completed both treatment components. The overall response rate was 86.6% and the clinical benefit was 93.3% on an intention to treat analysis (CR 33.3%, PR 53.3%, SD 6.7%). The median follow up duration was 19.25 months. Size of metastases (<10 mm) predicted lesion complete response (74.6%). Treatment was well tolerated with no associated grade 4 or 5 adverse events. The combination of PV-10 and radiotherapy resulted in lesion-specific, normal tissue-sparing, ablation of disease with minimal local or systemic adverse effects. © 2017 Wiley Periodicals, Inc.

  11. The safety of the Harmonic® FOCUS in open thyroidectomy: a prospective, randomized study comparing the Harmonic® FOCUS and traditional suture ligation (knot and tie) technique.

    PubMed

    Zanghì, Antonio; Cavallaro, Andrea; Di Vita, Maria; Cardì, Francesco; Di Mattia, Paolo; Piccolo, Gaetano; Barbera, Giuseppina; Urso, Mario; Cappellani, Alessandro

    2014-01-01

    Since Kocher and Billroth refined an acceptable technique, the thyroidectomy has become one of the most frequent procedures in endocrine surgery and bilateral total thyroidectomy is performed in the majority of thyroid diseases. This work evaluated the use of the Harmonic(®) FOCUS and traditional suture ligation (knot and tie) technique in a prospective, randomized study of open thyroidectomy. Eighty two patients were randomized and divided into two similarly sized groups: the Harmonic(®) FOCUS group (F group) and traditional group (T group). The use of the harmonic FOCUS shows some statistically significant advantages limited to a few intraoperative parameters: surgical time and volume of blood loss. The surgical time was significantly shorter in F group than in the T group (105 ± 27 min vs 143 ± 32 respectively; p < 0.05). Intraoperative volume blood loss was significantly more in the T group than in the F group (36 ± 23 ml vs. 24 ± 18; p < 0.05). The postoperative parameters (volume of drainage fluid, serum calcium at 12 and 48 h, hypocalcemia, wound complication, RLN palsy, postoperative pain and length of hospital stay) showed no statistical difference. The Harmonic Focus may provide a cost-effective option only in high volume centers where reducing operative time may balance the number of daily procedures.

  12. Study of the Open Loop and Closed Loop Oscillator Techniques

    SciTech Connect

    Imel, George R.; Baker, Benjamin; Riley, Tony; Langbehn, Adam; Aryal, Harishchandra; Benzerga, M. Lamine

    2015-04-11

    This report presents the progress and completion of a five-year study undertaken at Idaho State University of the measurement of very small worth reactivity samples comparing open and closed loop oscillator techniques.The study conclusively demonstrated the equivalency of the two techniques with regard to uncertainties in reactivity values, i.e., limited by reactor noise. As those results are thoroughly documented in recent publications, in this report we will concentrate on the support work that was necessary. For example, we describe in some detail the construction and calibration of a pilot rod for the closed loop system. We discuss the campaign to measure the required reactor parameters necessary for inverse-kinetics. Finally, we briefly discuss the transfer of the open loop technique to other reactor systems.

  13. Study of the open loop and closed loop oscillator techniques

    SciTech Connect

    Baker, Benjamin; Riley, Tony; Langbehn, Adam; Imel, George R.; Benzerga, M. Lamine; Aryal, Harishchandra

    2015-07-01

    This paper presents some aspects of a five year study undertaken at Idaho State University of the measurement of very small worth reactivity samples comparing open and closed loop oscillator techniques. The study conclusively demonstrated the equivalency of the two techniques with regard to uncertainties in reactivity values, i.e., limited by reactor noise. As those results are thoroughly documented in recent publications, in this paper we will concentrate on the support work that was necessary. For example, we describe in some detail the construction and calibration of a pilot rod for the closed loop system. We discuss the campaign to measure the required reactor parameters necessary for inverse-kinetics. Finally, we briefly discuss the transfer of the open loop technique to other reactor systems. (authors)

  14. Soil nitrate leaching in silvopastures compared with open pasture and pine plantation.

    PubMed

    Bambo, Susan K; Nowak, Jarek; Blount, Ann R; Long, Alan J; Osiecka, Anna

    2009-01-01

    Wide acceptance of silvopasture as an alternative sustainable agricultural system in the southeastern United States will depend on an improved understanding of the tree-forage interactions and recognition of its environmental benefits. The objective of this study was to evaluate differences in soil nitrate leaching in different land-use systems, in north Florida. An 18-yr-old loblolly pine (Pinus taeda L.) plantation was thinned in the summer of 2002 to create a fifth-row thinned, nontraditional intensive pine plantation (FO), silvopastures (HE = fourth-row conventionally thinned with random tree distribution and DO = double-row sets of trees with 15-m wide alleys), and an open pasture (PA). 'Argentine' bahiagrass (Paspalum notatum Flügge.) was established as understory vegetation in HE, DO, and PA. From 2004 to 2005 soil nitrate leaching was sampled and compared in the DO, HE, PA, and FO systems at 0.3 and 1.2 m depths after fertilizer application. Significant nitrate peaks were observed at 0.3 m depth after N fertilizer application in all systems. At the 1.2 m depth, the maximum nitrate concentrations were 67, 18, and 8 mg L(-1), in the forest plantation, open pasture, and both silvopastures, respectively. In general, reduced nitrate leaching at 1.2 m depth was observed in silvopastures compared with other land-used systems. These results are not intended to have a direct bearing on traditional pine plantation management, but rather support the potential role of silvopasture systems in reducing nitrate losses from the soil.

  15. Multicolor holography: a comparative study

    NASA Astrophysics Data System (ADS)

    Oliveira, Rosa M.; Bernardo, Luis M.; Pinto, Joao L.

    2000-10-01

    A multicolor holography study case will be presented with emphasis on color control in different silver-halide materials. It has been systematized in order to compare the results obtained with Agfa 8E 75HD to those with Slavich PFG-01. Some experiments were made and the emulsion was manipulated before exposure to achieve high quality multicolored white light reflection holograms. This work has therefore been developed in order to obtain the various colors in a very well controlled way.

  16. "Open" Software Design: A Case Study.

    ERIC Educational Resources Information Center

    McMahon, Harry; And Others

    1992-01-01

    Discusses the use of open software, i.e., software which is essentially empty of content and can be customized by users to fit their own context, and describes the development and evaluation of one such program--Bubble Dialog--by the Language Development and Hypermedia Research Group at the University of Ulster. Various applications of the…

  17. Comparative analysis of the safety and tolerability of fixed-dose artesunate/amodiaquine versus artemether/lumefantrine combinations for uncomplicated falciparum malaria in pregnancy: a randomized open label study.

    PubMed

    Iribhogbe, Osede I; Emmanuel, Igue; Odianosen, Marylove

    2017-01-01

    A comparative clinical study was conducted to evaluate the safety and tolerability of two commonly used fixed dose artemisinin-based combinations for the treatment of uncomplicated Plasmodium falciparum malaria in the second and third trimester of pregnancy. To achieve this, a total of 155 participants were recruited for the study. Eighty of these were drawn from pregnant women who came for routine antenatal care while 40 nonpregnant participants were recruited from apparently healthy females in the community. Eighty pregnant participants with uncomplicated P. falciparum malaria were randomized into artesunate/amodiaquine (AA) and artemether/lumefantrine (AL) treatment arms while 40 nonpregnant and 35 nonmalarious pregnant women were used as control. The interventional groups received standard fixed dose combinations of AA (100/270 mg) daily or AL (20/120 mg) twice daily for 3 days. Blood samples were collected on day 4 and patients were followed-up closely to ascertain the safety of the drugs. The study showed a significant (p<0.0001) elevation of alkaline phosphatase in the AA and AL group compared to the nonpregnant control and a significant (p<0.05) elevation of alanine transaminase and aspartate transaminase level in the AL combination group when compared with the AA group. The elevated hepatic enzymes were within the normal range for pregnancy and were not clinically significant. Adverse event rate was higher in the AA group (n=28 [70%]) when compared to the AL group (n=4 [10%]) although the drugs were well-tolerated in both treatment arms. In conclusion, the use of these combinations is safe in the second and third trimester of pregnancy. However, we recommend active pharmacovigilance and spontaneous drug reporting of the agents in order to continuously monitor safety in the vastly heterogeneous population.

  18. Open Education and the Creative Economy: Global Perspectives and Comparative Analysis

    ERIC Educational Resources Information Center

    Liu, Tze-Chang

    2011-01-01

    This dissertation is to deal the issues of open education, creative economies, higher education. It also compares the performances in these aspects among different countries. The conception of the "creative economy" develops within the context of "global neoliberalism" and "knowledge economy." These three notions are…

  19. Open Education and the Creative Economy: Global Perspectives and Comparative Analysis

    ERIC Educational Resources Information Center

    Liu, Tze-Chang

    2011-01-01

    This dissertation is to deal the issues of open education, creative economies, higher education. It also compares the performances in these aspects among different countries. The conception of the "creative economy" develops within the context of "global neoliberalism" and "knowledge economy." These three notions are…

  20. Comparing oncologic outcomes after minimally invasive and open surgery for pediatric neuroblastoma and Wilms tumor.

    PubMed

    Ezekian, Brian; Englum, Brian R; Gulack, Brian C; Rialon, Kristy L; Kim, Jina; Talbot, Lindsay J; Adibe, Obinna O; Routh, Jonathan C; Tracy, Elisabeth T; Rice, Henry E

    2017-08-09

    Minimally invasive surgery (MIS) has been widely adopted for common operations in pediatric surgery; however, its role in childhood tumors is limited by concerns about oncologic outcomes. We compared open and MIS approaches for pediatric neuroblastoma and Wilms tumor (WT) using a national database. The National Cancer Data Base from 2010 to 2012 was queried for cases of neuroblastoma and WT in children ≤21 years old. Children were classified as receiving open or MIS surgery for definitive resection, with clinical outcomes compared using a propensity matching methodology (two open:one MIS). For children with neuroblastoma, 17% (98 of 579) underwent MIS, while only 5% of children with WT (35 of 695) had an MIS approach for tumor resection. After propensity matching, there was no difference between open and MIS surgery for either tumor for 30-day mortality, readmissions, surgical margin status, and 1- and 3-year survival. However, in both tumors, open surgery more often evaluated lymph nodes and had larger lymph node harvest. Our retrospective review suggests that the use of MIS appears to be a safe method of oncologic resection for select children with neuroblastoma and WT. Further research should clarify which children are the optimal candidates for this approach. © 2017 Wiley Periodicals, Inc.

  1. Protocol of the Febuxostat versus Allopurinol Streamlined Trial (FAST): a large prospective, randomised, open, blinded endpoint study comparing the cardiovascular safety of allopurinol and febuxostat in the management of symptomatic hyperuricaemia.

    PubMed

    MacDonald, Thomas M; Ford, Ian; Nuki, George; Mackenzie, Isla S; De Caterina, Raffaele; Findlay, Evelyn; Hallas, Jesper; Hawkey, Christopher J; Ralston, Stuart; Walters, Matthew; Webster, John; McMurray, John; Perez Ruiz, Fernando; Jennings, Claudine G

    2014-07-10

    Gout affects 2.5% of the UK's adult population and is now the most common type of inflammatory arthritis. The long-term management of gout requires reduction of serum urate levels and this is most often achieved with use of xanthine oxidase inhibitors, such as allopurinol. Febuxostat is the first new xanthine oxidase inhibitor since allopurinol and was licensed for use in 2008. The European Medicines Agency requested a postlicensing cardiovascular safety study of febuxostat versus allopurinol, which has been named the Febuxostat versus Allopurinol Streamlined trial (FAST). FAST is a cardiovascular safety study using the prospective, randomised, open, blinded endpoint design. FAST is recruiting in the UK and Denmark. Recruited patients are aged over 60 years, prescribed allopurinol for symptomatic hyperuricaemia and have at least one additional cardiovascular risk factor. After an allopurinol lead-in phase where the dose of allopurinol is optimised to achieve European League against Rheumatism (EULAR) urate targets (serum urate <357 µmol/L), patients are randomised to either continue optimal dose allopurinol or to use febuxostat. Patients are followed-up for an average of 3 years. The primary endpoint is first occurrence of the Anti-Platelet Trialists' Collaboration (APTC) cardiovascular endpoint of non-fatal myocardial infarction, non-fatal stroke or cardiovascular death. Secondary endpoints are all cause mortality and hospitalisations for heart failure, unstable, new or worsening angina, coronary or cerebral revascularisation, transient ischaemic attack, non-fatal cardiac arrest, venous and peripheral arterial vascular thrombotic event and arrhythmia with no evidence of ischaemia. The primary analysis is a non-inferiority analysis with a non-inferiority upper limit for the HR for the primary outcome of 1.3. FAST (ISRCTN72443728) has ethical approval in the UK and Denmark, and results will be published in a peer reviewed journal. FAST is registered in the EU

  2. Protocol of the Febuxostat versus Allopurinol Streamlined Trial (FAST): a large prospective, randomised, open, blinded endpoint study comparing the cardiovascular safety of allopurinol and febuxostat in the management of symptomatic hyperuricaemia

    PubMed Central

    MacDonald, Thomas M; Ford, Ian; Nuki, George; Mackenzie, Isla S; De Caterina, Raffaele; Findlay, Evelyn; Hallas, Jesper; Hawkey, Christopher J; Ralston, Stuart; Walters, Matthew; Webster, John; McMurray, John; Perez Ruiz, Fernando; Jennings, Claudine G

    2014-01-01

    Introduction Gout affects 2.5% of the UK's adult population and is now the most common type of inflammatory arthritis. The long-term management of gout requires reduction of serum urate levels and this is most often achieved with use of xanthine oxidase inhibitors, such as allopurinol. Febuxostat is the first new xanthine oxidase inhibitor since allopurinol and was licensed for use in 2008. The European Medicines Agency requested a postlicensing cardiovascular safety study of febuxostat versus allopurinol, which has been named the Febuxostat versus Allopurinol Streamlined trial (FAST). Methods and analysis FAST is a cardiovascular safety study using the prospective, randomised, open, blinded endpoint design. FAST is recruiting in the UK and Denmark. Recruited patients are aged over 60 years, prescribed allopurinol for symptomatic hyperuricaemia and have at least one additional cardiovascular risk factor. After an allopurinol lead-in phase where the dose of allopurinol is optimised to achieve European League against Rheumatism (EULAR) urate targets (serum urate <357 µmol/L), patients are randomised to either continue optimal dose allopurinol or to use febuxostat. Patients are followed-up for an average of 3 years. The primary endpoint is first occurrence of the Anti-Platelet Trialists’ Collaboration (APTC) cardiovascular endpoint of non-fatal myocardial infarction, non-fatal stroke or cardiovascular death. Secondary endpoints are all cause mortality and hospitalisations for heart failure, unstable, new or worsening angina, coronary or cerebral revascularisation, transient ischaemic attack, non-fatal cardiac arrest, venous and peripheral arterial vascular thrombotic event and arrhythmia with no evidence of ischaemia. The primary analysis is a non-inferiority analysis with a non-inferiority upper limit for the HR for the primary outcome of 1.3. Ethics and dissemination FAST (ISRCTN72443728) has ethical approval in the UK and Denmark, and results will be

  3. [Comparative studies of face recognition].

    PubMed

    Kawai, Nobuyuki

    2012-07-01

    Every human being is proficient in face recognition. However, the reason for and the manner in which humans have attained such an ability remain unknown. These questions can be best answered-through comparative studies of face recognition in non-human animals. Studies in both primates and non-primates show that not only primates, but also non-primates possess the ability to extract information from their conspecifics and from human experimenters. Neural specialization for face recognition is shared with mammals in distant taxa, suggesting that face recognition evolved earlier than the emergence of mammals. A recent study indicated that a social insect, the golden paper wasp, can distinguish their conspecific faces, whereas a closely related species, which has a less complex social lifestyle with just one queen ruling a nest of underlings, did not show strong face recognition for their conspecifics. Social complexity and the need to differentiate between one another likely led humans to evolve their face recognition abilities.

  4. Openings

    PubMed Central

    Selwyn, Peter A.

    2015-01-01

    Reviewing his clinic patient schedule for the day, a physician reflects on the history of a young woman he has been caring for over the past 9 years. What starts out as a routine visit then turns into a unique opening for communication and connection. A chance glimpse out the window of the exam room leads to a deeper meditation on parenthood, survival, and healing, not only for the patient but also for the physician. How many missed opportunities have we all had, without even realizing it, to allow this kind of fleeting but profound opening? PMID:26195687

  5. Open Access on a Zero Budget: A Case Study of "Postcolonial Text": Case Studies in Open Access Publishing. Number Three

    ERIC Educational Resources Information Center

    Willinsky, John; Mendis, Ranjini

    2007-01-01

    Introduction: The founding of a new open access journal is described in terms of its use of the open source software Open Journal Systems, its contribution to a new field of inquiry and its ability to operate on a zero budget in terms of regular expenses. Method: A case study method is deployed describing the circumstances of the journal's…

  6. The endoscope-assisted ventral approach compared with open microscope-assisted surgery for clival chordomas.

    PubMed

    Komotar, Ricardo J; Starke, Robert M; Raper, Daniel M S; Anand, Vijay K; Schwartz, Theodore H

    2011-01-01

    The current management paradigm for clival chordomas includes cytoreductive surgery with adjuvant radiotherapy. Surgical approaches have traditionally utilized the microscope to remove these lesions through approaches that require extensive bone drilling, brain retraction, and mobilization of normal anatomy to create a suitably large corridor. The endoscopic ventral approaches provide a direct route to the tumor using natural orifices. Little data exist comparing these 2 surgical strategies. We conducted a systematic review of case series and case reports in hope of furthering our understanding of the role of endoscopy in the management of these difficult cranial base lesions. We performed a MEDLINE (1950 to 2010) search to identify relevant studies. Statistical analyses of categorical variables such as extent of resection, morbidity, and visual outcome were carried out using chi-square and Fisher exact tests. Thirty-seven studies, involving 766 patients, were included. Compared with the open surgery cohort, the endoscopic cohort had a significantly higher percentage of gross total resection (61.0% vs. 48.1%; P = 0.010), fewer cranial nerve deficits (1.3% vs. 24.2%, P < 0.001), fewer incidences of meningitis (0.9% vs. 5.9%, P = 0.029), less mortality (4.7% vs. 21.6%, P < 0.001), and fewer local recurrences (16.9% vs. 40.0%, P = 0.0001). There was no significant difference in the incidence of postoperative cerebrospinal fluid leak (P = 0.084). Follow-up was longer in the open compared with the endoscopic cohort (59.7 vs. 18.5 months, P < 0.001). Our systematic analysis supports the endoscopic ventral approaches as a safe and effective alternative for the treatment of certain clival chordomas. Although the overall literature supports this technique in carefully selected patients, longer follow-up is needed to more definitively address therapeutic efficacy. Careful patient selection and meticulous multilayer closure are critical to obtaining maximal resection and

  7. Comparative cross-sectional study of empathy among first year and final year medical students in Jimma University, Ethiopia: steady state of the heart and opening of the eyes.

    PubMed

    Dehning, Sandra; Girma, Eshetu; Gasperi, Sarah; Meyer, Sebastian; Tesfaye, Markos; Siebeck, Matthias

    2012-05-24

    There is general consent that empathy is crucial for the physician-patient relationship and thus an important issue in medical education. This comparative study was designed to examine the differences in empathy between first year and final year medical students in Jimma University, Ethiopia. A comparative cross-sectional study among 131 first year and 106 final year medical students was conducted in Jimma University, Ethiopia on academic year 2010/11. The study subjects were selected using simple random sampling technique from the list of the students. Study participation was voluntary. The Balanced Emotional Empathy Scale (BEES) was used for the detection of "heart-reading", i.e. emotional empathy and the Reading the Mind in the Eyes test (RME-R test) to evaluate "mind-reading", i.e. cognitive empathy. We performed t-test to compare the mean difference in empathy and RME-R scores between the two groups of students. A linear regression was computed to identify potential factors influencing the BEES and RME-R. Out of the total 237 students, 207 (87.3%) were males. The mean age of first year and final year students was 19.3 ± 1.1 and 24.0 ± 1.4 years respectively. First year students have scored 40.6 ± 23.8 while final year students scored 41.5 ± 20.8 mean in the BEES measuring emotional empathy score. However, this difference was not statistically significant (t = -0.30, df = 231, P-value >0.05). Final year students had significantly higher mean cognitive empathy score (17.8 ± 4.5) than first year students (14.4 ± 4.8) [β = 2.7, 95%CI (1.20, 4.13)]. Males had scored lower cognitive [β = -2.5, 95%CI (-4.37, -0.66)] and emotional empathy [β = -12.0, 95%CI (-21.66, -5.46)]. Low emotional (BEES) and cognitive empathy sores were found in first year and final year students of Jimma University could have implications on the medical education curricula. Medical education targeted at enhancing emotional empathy and

  8. Comparative cross-sectional study of empathy among first year and final year medical students in Jimma University, Ethiopia: Steady state of the heart and opening of the eyes

    PubMed Central

    2012-01-01

    Background There is general consent that empathy is crucial for the physician-patient relationship and thus an important issue in medical education. This comparative study was designed to examine the differences in empathy between first year and final year medical students in Jimma University, Ethiopia. Methods A comparative cross-sectional study among 131 first year and 106 final year medical students was conducted in Jimma University, Ethiopia on academic year 2010/11. The study subjects were selected using simple random sampling technique from the list of the students. Study participation was voluntary. The Balanced Emotional Empathy Scale (BEES) was used for the detection of “heart-reading”, i.e. emotional empathy and the Reading the Mind in the Eyes test (RME-R test) to evaluate “mind-reading”, i.e. cognitive empathy. We performed t-test to compare the mean difference in empathy and RME-R scores between the two groups of students. A linear regression was computed to identify potential factors influencing the BEES and RME-R. Results Out of the total 237 students, 207 (87.3%) were males. The mean age of first year and final year students was 19.3 ± 1.1 and 24.0 ± 1.4 years respectively. First year students have scored 40.6 ± 23.8 while final year students scored 41.5 ± 20.8 mean in the BEES measuring emotional empathy score. However, this difference was not statistically significant (t = −0.30, df = 231, P-value >0.05). Final year students had significantly higher mean cognitive empathy score (17.8 ± 4.5) than first year students (14.4 ± 4.8) [β = 2.7, 95%CI (1.20, 4.13)]. Males had scored lower cognitive [β = −2.5, 95%CI (−4.37, −0.66)] and emotional empathy [β = −12.0, 95%CI (−21.66, −5.46)]. Conclusions Low emotional (BEES) and cognitive empathy sores were found in first year and final year students of Jimma University could have implications on the medical education curricula

  9. Aortic arch aneurysm: short- and mid-term results comparing open arch surgery and the hybrid procedure†.

    PubMed

    Cazavet, Alexandre; Alacoque, Xavier; Marcheix, Bertrand; Chaufour, Xavier; Rousseau, Herve; Glock, Yves; Leobon, Bertrand

    2016-01-01

    Open arch surgery for aortic arch aneurysm was historically associated with a high risk of postoperative morbi-mortality. Improved operative techniques have now lowered the incidence of these complications but in parallel, hybrid arch procedures have emerged. Nowadays, very little data are available about their mid-term results compared with open surgery. From January 2002 to January 2014, 46 patients had treatment for an exclusive aortic arch aneurysm including 25 open arch surgeries and 21 type I hybrid arch procedures in our institution. All cases involved arch aneurysms involving at least one carotid artery (Zone 0 and Zone 1). Aneurysms of the distal arch and descending aorta were excluded (Zone 2 and beyond). Results from a retrospective database are reported. There were no patients lost to the follow-up. There was no significant difference in preoperative comorbidities between the two groups. The incidence of in-hospital mortality was similar at 20% (5/25) for open surgery and 19% (4/21) for hybrid procedure (P = 0.830). The incidence of permanent cerebral neurological deficit was comparable at 17.4% (4/23) for open surgery and 21.1% (4/19) for hybrid procedure (P = 1). Median survival was 109.5 months for open surgery and 56.3 months for hybrid procedure. Freedom from all-cause mortality was 78, 63, 63 and 57% at 1, 3, 5 and 7 years, respectively in the open surgical group. Freedom from all-cause mortality was 74, 55, 46 and 28% at 1, 3, 5 and 7 years, respectively in the hybrid group. Survival rates and incidence of major adverse cardiac and cerebro-vascular event between open surgery and hybrid procedure were not statistically different (P = 0.530 and P = 0.325, respectively). However, incidence of reintervention was in favour of open surgery [14.5 vs 44.8% at 7 years, P = 0.045; 95% confidence interval: (0.06-0.97)]. The type I hybrid arch procedure fails to demonstrate better results compared with open surgery, regarding morbi-mortality at the short

  10. Comparing Open-Book and Closed-Book Examinations: A Systematic Review.

    PubMed

    Durning, Steven J; Dong, Ting; Ratcliffe, Temple; Schuwirth, Lambert; Artino, Anthony R; Boulet, John R; Eva, Kevin

    2016-04-01

    To compare the relative utility of open-book examinations (OBEs) and closed-book examinations (CBEs) given the rapid expansion and accessibility of knowledge. A systematic review of peer-reviewed articles retrieved from MEDLINE, ERIC, Embase, and PsycINFO (through June 2013). In 2013-2014, articles that met inclusion criteria were reviewed by at least two investigators and coded for six outcome categories: (1) examination preparation, (2) test anxiety, (3) exam performance, (4) psychometrics and logistics, (5) testing effects, and (6) public perception. From 4,192 identified studies, 37 were included. The level of learner and subject studied varied. The frequency of each outcome category was as follows: (1) exam preparation (n = 20; 54%); (2) test anxiety (n = 14; 38%); (3) exam performance (n = 30; 81%); (4) psychometrics and logistics (n = 5; 14%); (5) testing effects (n = 24; 65%); and (6) public perception (n = 5; 14%). Preexamination outcome findings were equivocal, but students may prepare more extensively for CBEs. For during-examination outcomes, examinees appear to take longer to complete OBEs. Studies addressing examination performance favored CBE, particularly when preparation for CBE was greater than for OBE. Postexamination outcomes suggest little difference in testing effects or public perception. Given the data available, there does not appear to be sufficient evidence for exclusively using CBE or OBE. As such, a combined approach could become a more significant part of testing protocols as licensing bodies seek ways to assess competencies other than the maintenance of medical knowledge.

  11. COSMOS - a study comparing peripheral intravenous systems.

    PubMed

    López, Juan Luis González; Del Palacio, Encarnación Ferenández; Marti, Carmen Benedicto; Corral, Javier Olivares; Portal, Pilar Herrera; Vilela, Ana Arribi

    In many areas of the world, safety peripheral intravenous systems have come into widespread use. The Madrid region was the first in Spain to adopt such an approach. These systems, though initially introduced to protect users from sharps injuries, have now evolved to include patient protection features as well. Patient protection, simply stated, means closing the system to pathogen entry. The authors' purpose was to investigate, in a prospective and randomized study, the clinical performance of a closed safe intravenous system versus an open system (COSMOS - Compact Closed System versus Mounted Open System). COSMOS is designed to provide definitive answers, from a nursing perspective, to many topics related to peripheral venous catheterization, which have important implications in intravenous therapy and which have not been validated scientifically. Furthermore, it forms pioneering research in that it is the first clinical trial on medical devices in a legislated environment carried out entirely by nurses and whose promoter and principal investigator is a nurse. The objectives of COSMOS are to compare the effectiveness (as defined by time of survival without complications) and rates of catheter-related complications, such as phlebitis, pain, extravasation, blockage and catheter-related infections. It also looks at rates of catheter colonization, the ease of handling of both systems and overall costs. This article outlines the authors' approach, both in preparing hospital units for such an evaluation as well as in the choice of parameters and their method of study. Further articles will detail the results and findings of the study.

  12. Rationale and design of the HepZero study: a prospective, multicenter, international, open, randomized, controlled clinical study with parallel groups comparing heparin-free dialysis with heparin-coated dialysis membrane (Evodial) versus standard care: study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Anticoagulation for chronic dialysis patients with contraindications to heparin administration is challenging. Current guidelines state that in patients with increased bleeding risks, strategies that can induce systemic anticoagulation should be avoided. Heparin-free dialysis using intermittent saline flushes is widely adopted as the method of choice for patients at risk of bleeding, although on-line blood predilution may also be used. A new dialyzer, Evodial (Gambro, Lund, Sweden), is grafted with unfractionated heparin during the manufacturing process and may allow safe and efficient heparin-free hemodialysis sessions. In the present trial, Evodial was compared to standard care with either saline flushes or blood predilution. Methods The HepZero study is the first international (seven countries), multicenter (10 centers), randomized, controlled, open-label, non-inferiority (and if applicable subsequently, superiority) trial with two parallel groups, comprising 252 end-stage renal disease patients treated by maintenance hemodialysis for at least 3 months and requiring heparin-free dialysis treatments. Patients will be treated during a maximum of three heparin-free dialysis treatments with either saline flushes or blood predilution (control group), or Evodial. The first heparin-free dialysis treatment will be considered successful when there is: no complete occlusion of air traps or dialyzer rendering dialysis impossible; no additional saline flushes to prevent clotting; no change of dialyzer or blood lines because of clotting; and no premature termination (early rinse-back) because of clotting. The primary objectives of the study are to determine the effectiveness of the Evodial dialyzer, compared with standard care in terms of successful treatments during the first heparin-free dialysis. If the non-inferiority of Evodial is demonstrated then the superiority of Evodial over standard care will be tested. The HepZero study results may have major clinical

  13. Comparative study of embedding methods.

    PubMed

    Cellucci, C J; Albano, A M; Rapp, P E

    2003-06-01

    Embedding experimental data is a common first step in many forms of dynamical analysis. The choice of appropriate embedding parameters (dimension and lag) is crucial to the success of the subsequent analysis. We argue here that the optimal embedding of a time series cannot be determined by criteria based solely on the time series itself. Therefore we base our analysis on an examination of systems that have explicit analytic representations. A comparison of analytically obtained results with those obtained by an examination of the corresponding time series provides a means of assessing the comparative success of different embedding criteria. The assessment also includes measures of robustness to noise. The limitations of this study are explicitly delineated. While bearing these limitations in mind, we conclude that for the examples considered here, the best identification of the embedding dimension was achieved with a global false nearest neighbors argument, and the best value of lag was identified by the mutual information function.

  14. Comparing open gastrostomy tube to percutaneous endoscopic gastrostomy tube in heart transplant patients

    PubMed Central

    Ambur, Vishnu; Taghavi, Sharven; Jayarajan, Senthil; Gaughan, John; Toyoda, Yoshiya; Dauer, Elizabeth; Sjoholm, Lars Ola; Pathak, Abhijit; Santora, Thomas; Goldberg, Amy J.

    2016-01-01

    Introduction Impaired wound healing due to immunosuppression has led some surgeons to preferentially use open gastrostomy tube (OGT) over percutaneous gastrostomy tube (PEG) in heart transplant patients when long-term enteral access is deemed necessary. Methods The National Inpatient Sample (NIS) database (2005–2010) was queried for all heart transplant patients. Those receiving OGT were compared to those treated with PEG tube. Results There were 498 patients requiring long-term enteral access treated with a gastrostomy tube, with 424 (85.2%) receiving a PEG and 74 (14.8%) an OGT. The PEG cohort had higher Charlson comorbidity Index (4.1 vs. 2.0, p = 0.002) and a higher incidence of post-operative acute renal failure (31.5 vs. 12.7%, p = 0.001). Post-operative mortality was not different when comparing the two groups (13.8 vs. 6.1%, p = 0.06). On multivariate analysis, while both PEG (OR: 7.87, 95%C.I: 5.88–10.52, p < 0.001) and OGT (OR 5.87, 95%CI: 2.19–15.75, p < 0.001) were independently associated with mortality, PEG conferred a higher mortality risk. Conclusions This is the largest reported study to date comparing outcomes between PEG and OGT in heart transplant patients. PEG does not confer any advantage over OGT in this patient population with respect to morbidity, mortality, and length of stay. PMID:27141303

  15. A multicentre, open-label, randomised phase III study comparing a new levonorgestrel intrauterine contraceptive system (LNG-IUS 8) with combined oral contraception in young women of reproductive age.

    PubMed

    Borgatta, Lynn; Buhling, Kai J; Rybowski, Sarah; Roth, Katrin; Rosen, Kimberly

    2016-10-01

    To compare user satisfaction and adverse events (AEs) with a levonorgestrel intrauterine system (LNG-IUS 8; average levonorgestrel release rate approximately 8 μg/24 h over the first year [total content 13.5 mg]) and a 30 μg ethinyl estradiol/3 mg drospirenone (EE/DRSP) combined oral contraceptive (COC) in a population of young women. Nulliparous and parous women (aged 18-29 years) with regular menstrual cycles (21-35 days) were randomised to LNG-IUS 8 or EE/DRSP for 18 months. The primary endpoint was the overall user satisfaction rate at month 18/end of study visit. Overall, 279 women were randomised to LNG-IUS 8 with attempted placement and 281 women were randomised to EE/DRSP and took ≥1 pill; the mean age was 23.7 and 23.9 years, and 77.4% and 73.3% were nulliparous, respectively. At month 18/end of study, 82.1% and 81.9% of women, respectively, reported being 'very satisfied' or 'satisfied' with their treatment; however, significantly more LNG-IUS 8 users reported a preference to continue their treatment post-study (66.2% vs 48.8%; p = 0.0001). There were two pregnancies (one ectopic pregnancy, one spontaneous abortion) reported in the LNG-IUS 8 group and six (three live births, two spontaneous abortions, one induced abortion) in the EE/DRSP group. LNG-IUS 8 and EE/DRSP were associated with similarly high user satisfaction rates. However, LNG-IUS 8 users were significantly more likely to prefer to continue their contraceptive method post-study, indicating that a levonorgestrel intrauterine system is an appealing contraceptive option for young women.

  16. Multicenter, randomized, open-label Phase II study comparing S-1 alternate-day oral therapy with the standard daily regimen as a first-line treatment in patients with unresectable advanced pancreatic cancer.

    PubMed

    Yamaue, Hiroki; Shimizu, Atsushi; Hagiwara, Yasuhiro; Sho, Masayuki; Yanagimoto, Hiroaki; Nakamori, Shoji; Ueno, Hideki; Ishii, Hiroshi; Kitano, Masayuki; Sugimori, Kazuya; Maguchi, Hiroyuki; Ohkawa, Shinichi; Imaoka, Hiroshi; Hashimoto, Daisuke; Ueda, Kazuki; Nebiki, Hiroko; Nagakawa, Tatsuya; Isayama, Hiroyuki; Yokota, Isao; Ohashi, Yasuo; Shirasaka, Tetsuhiko

    2017-04-01

    Non-inferiority for overall survival (OS) following alternate-day treatment with the oral anticancer drug S-1 compared with standard daily treatment was assessed in Japanese patients with unresectable advanced pancreatic cancer in a multicenter, randomized, phase II study. This trial was registered at the UMIN Clinical Trials Registry (no. 000008604). Chemotherapy-naïve patients with locally advanced or metastatic pancreatic cancer were randomly assigned 2:1 to treatment with alternate-day (twice daily on alternate days from days 1 through 42 of a 42-day cycle) or daily (twice daily on days 1 through 28 of a 42-day cycle) treatment with S-1. The primary endpoint was OS. Secondary endpoints were progression-free survival (PFS), time to treatment failure, response rate, quality of life assessments, and safety. A total of 190 patients were enrolled, of which 185 were included in the final analysis (alternate-day: 121; daily: 64). Median OS was 9.4 for the alternate-day group and 10.4 months for the daily group [hazard ratio (HR), 1.19; 95% credible interval, 0.86 to 1.64], indicating that non-inferiority of alternate-day treatment to daily treatment was not demonstrated. Median PFS was 3.0 for the alternate-day group and 4.2 months for the daily group (HR, 1.65; 95% credible interval, 1.20-2.29). The incidence of anorexia, fatigue, neutrophils, pigmentation, and pneumonitis was lower in alternate-day treatment compared with daily treatment. S-1 for advanced pancreatic cancer should be taken daily as recommended, based on the decreased OS and PFS and marginal improvement in safety observed in the alternate-day group.

  17. Sex work: a comparative study.

    PubMed

    McCarthy, Bill; Benoit, Cecilia; Jansson, Mikael

    2014-10-01

    Explanations of adult involvement in sex work typically adopt one of two approaches. One perspective highlights a variety of negative experiences in childhood and adolescence, including physical and sexual abuse, family instability, poverty, associations with "pimps" and other exploiters, homelessness, and drug use. An alternative account recognizes that some of these factors may be involved, but underscores the contribution of more immediate circumstances, such as current economic needs, human capital, and employment opportunities. Prior research offers a limited assessment of these contrasting claims: most studies have focused exclusively on people working in the sex industry and they have not assessed the independent effects of life course variables central to these two perspectives. We add to this literature with an analysis that drew on insights from life course and life-span development theories and considered the contributions of factors from childhood, adolescence, and adulthood. Our comparative approach examined predictors of employment in sex work relative to two other low-income service or care work occupations: food and beverage serving and barbering and hairstyling. Using data from a study of almost 600 workers from two cities, one in Canada and the other in the United States, we found that both immediate circumstances and negative experiences from early life are related to current sex work involvement: childhood poverty, abuse, and family instability were independently associated with adult sex work, as were limited education and employment experience, adult drug use, and marital status.

  18. Comparing the efficacy and tolerability of a new daily oral vitamin B12 formulation and intermittent intramuscular vitamin B12 in normalizing low cobalamin levels: a randomized, open-label, parallel-group study.

    PubMed

    Castelli, M Cristina; Friedman, Kristen; Sherry, James; Brazzillo, Karen; Genoble, Lise; Bhargava, Prateek; Riley, M Gary I

    2011-03-01

    Vitamin B(12) deficiency is routinely treated with parenteral dosing and less often with high-dose oral vitamin B(12). Oral vitamin B(12) formulations have low bioavailability in patients with malabsorption and are considered less reliable than parenteral treatments. The objective of this study was to compare the efficacy and safety profile of a new proprietary oral vitamin B(12) formulation (oral B(12)) with intramuscular (IM) vitamin B(12) (IM B(12)) in restoring normal serum B(12) concentrations in patients with low cobalamin levels (<350 pg/mL). Patients were recruited from 5 centers and randomly assigned to receive oral B(12) 1000 μg, taken daily for 90 days, or IM B(12) 1000 μg, given on study days 1, 3, 7, 10, 14, 21, 30, 60, and 90. The patients were aged ≥60 years or aged ≥18 years and had gastrointestinal abnormalities or were on a restricted diet. The primary efficacy outcome compared the proportion of patients in each treatment arm in whom cobalamin levels were normalized (≥350 ng/mL) following 60 days of treatment. Secondary objectives included comparing the efficacy of the 2 formulations after 90 days of treatment, assessing time to normalization of B(12) levels, and evaluating the changes in the levels of biomarkers methylmalonic acid (MMA) and homocysteine (HC). The effect on holotranscobalamin II (active B(12)) levels was assessed as an exploratory end point and correlated to serum cobalamin levels in both treatment groups. Blood samples were collected at baseline (day 1) and on days 15, 31, 61, and 91. Fifty patients were recruited. Forty-eight patients (96.0%) completed the study (22 patients [91.7%] in the oral B(12) group and 26 patients [100%] in the IM B(12) group). All patients (100%) in both treatment groups and in both populations had a cobalamin level ≥350 pg/mL on day 61 and maintained it on day 91. The difference between the IM and oral treatment groups did not reach the planned level of statistical significance (P < 0.05) for

  19. Sodium-glucose co-transporter-2 inhibitor use and dietary carbohydrate intake in Japanese individuals with type 2 diabetes: A randomized, open-label, 3-arm parallel comparative, exploratory study.

    PubMed

    Yabe, Daisuke; Iwasaki, Masahiro; Kuwata, Hitoshi; Haraguchi, Takuya; Hamamoto, Yoshiyuki; Kurose, Takeshi; Sumita, Kiminobu; Yamazato, Hitoshi; Kanada, Shigeto; Seino, Yutaka

    2016-12-19

    This study investigated the safety and efficacy of the sodium-glucose co-transporter-2 (SGLT2) inhibitor luseogliflozin with differing carbohydrate intakes in Japanese individuals with type 2 diabetes (T2D). Participants were randomly assigned to 3 carbohydrate-adjusted meals for 14 days (days 1-14; a high carbohydrate [HC; 55% total energy carbohydrate] and high glycaemic index [HGI] meal; an HC [55% total energy carbohydrate] and low glycaemic index [LGI] meal; or a low carbohydrate [LC; 40% total energy carbohydrate] and HGI meal). All participants received luseogliflozin for the last 7 days (days 8-14), continuous glucose monitoring (CGM) before and after luseogliflozin treatment (days 5-8 and days 12-15) and blood tests on days 1, 8 and 15. Luseogliflozin significantly decreased the area under the curve and mean of CGM values in all 3 groups similarly. Fasting plasma glucose, insulin and glucagon were similar at all time points. Ketone bodies on day 15 were significantly higher in the LC-HGI group compared with the HC-HGI and HC-LGI groups. In conclusion, luseogliflozin has similar efficacy and safety in Japanese people with T2D when meals contain 40% to 55% total energy carbohydrate, but a strict LC diet on this class of drug should be avoided to prevent SGLT2 inhibitor-associated diabetic ketoacidosis.

  20. Minimally invasive versus open transforaminal lumbar interbody fusion for degenerative spondylolisthesis: comparative effectiveness and cost-utility analysis.

    PubMed

    Parker, Scott L; Mendenhall, Stephen K; Shau, David N; Zuckerman, Scott L; Godil, Saniya S; Cheng, Joseph S; McGirt, Matthew J

    2014-01-01

    Minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) for lumbar spondylolisthesis allows for the surgical treatment of back/leg pain while minimizing tissue injury and accelerating the patient's recovery. Although previous results have shown shorter hospital stays and decreased intraoperative blood loss for MIS versus open TLIF, short- and long-term outcomes have been similar. Therefore, we performed comparative effectiveness and cost-utility analysis for MIS versus open TLIF. A total of 100 patients (50 MIS, 50 open) undergoing TLIF for lumbar spondylolisthesis were prospectively studied. Back-related medical resource use, missed work, and quality-adjusted life years were assessed. Cost of in-patient care, direct cost (2-year resource use × unit costs based on Medicare national allowable payment amounts), and indirect cost (work-day losses × self-reported gross-of-tax wage rate) were recorded, and the incremental cost-effectiveness ratio was calculated. Length of hospitalization and time to return to work were less for MIS versus open TLIF (P = 0.006 and P = 0.03, respectively). MIS versus open TLIF demonstrated similar improvement in patient-reported outcomes assessed. MIS versus open TLIF was associated with a reduction in mean hospital cost of $1758, indirect cost of $8474, and total 2-year societal cost of $9295 (P = 0.03) but similar 2-year direct health care cost and quality-adjusted life years gained. MIS TLIF resulted in reduced operative blood loss, hospital stay and 2-year cost, and accelerated return to work. Surgical morbidity, hospital readmission, and short- and long-term clinical effectiveness were similar between MIS and open TLIF. MIS TLIF may represent a valuable and cost-saving advancement from a societal and hospital perspective. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Does nasogastric tube decompression get used less often with laparoscopic and hand-assisted compared with open colectomy?

    PubMed

    Shussman, Noam; Brown, Maria R; Johnson, Michael C; Da Silva, Giovanna; Wexner, Steven D; Weiss, Eric G

    2013-12-01

    Laparoscopic surgery is associated with well-known benefits, one of which is earlier return of bowel function. Since the laparoscopic approach to colon resections was introduced in the early 1990s, it has become the standard of care. Hand-assisted laparoscopic surgery (HALS) is a surgical approach in which dissection is facilitated by the surgeon's hand within the abdominal cavity during laparoscopy. The purpose of this study was to compare the incidence of postoperative ileus and the need for nasogastric tube (NGT) decompression in patients undergoing elective colon resections. Following institutional review board approval, we performed a retrospective review of a prospectively collected database. Included were patients who underwent elective left-sided large bowel resections between 2009 and 2012. Exclusion criteria were urgent operation, stoma creation, ASA IV classification, NGT left in place at the end of surgery, and postoperative anastomotic leakage. Patients were divided into three groups: laparoscopic surgery, HALS, and open surgery. We evaluated the incidence of postoperative ileus and the use of nasogastric decompression in each group. A total of 243 patients were included in this study; 73 patients underwent open surgery, 89 patients underwent HALS, and 81 patients underwent laparoscopic surgery. The proportion of patients who needed postoperative nasogastric decompression was significantly reduced in patients undergoing laparoscopic surgery (3.7%) or HALS (4.5%) compared with those who underwent open resection (17.8%). The time from surgery to first flatus and first bowel movement, the time to tolerate solid diet, and the total length of postoperative hospital stay also were all significantly reduced in the laparoscopic and HALS groups compared with the open surgery group. There were no significant differences in any of these measures between the laparoscopic group and the hand-assisted group. Like laparoscopy, HALS is associated with less

  2. Decreased Incidence of Postoperative Delirium in Robot-assisted Thoracoscopic Esophagectomy Compared With Open Transthoracic Esophagectomy.

    PubMed

    Jeong, Dae Myoung; Kim, Jie Ae; Ahn, Hyun Joo; Yang, Mikyung; Heo, Burn Young; Lee, Soo Hee

    2016-12-01

    Postoperative delirium (POD) is one of messy complications related with increased mortality and hospital costs. Patients undergoing esophagectomy are more in danger of delirium than other kinds of surgeries. We investigated the impact of robot-assisted thoracoscopic esophagectomy on the incidence of POD compared with open transthoracic esophagectomy. A retrospective review was completed for the patients who underwent esophagectomy from December 2, 2012 and April 15, 2015 (n=529). POD was assessed using Confusion Assessment Method for the Intensive Care Unit. The comparison of group differences between the robotic esophagectomy group (R group) and the open esophagectomy group (O group) was conducted with and without propensity score (PS) matching method. Univariate model was used for 247 PS-matched patients to calculate the odds ratio of potential risk factors of POD. The incidence rate of POD was significantly lower among R group patients than O group (30% vs. 42%; P=0.035) after PS matching method. The risk of POD in R group was 0.55-fold lower than that of O group. Operative time and intraoperative blood loss were also significantly lower in R group patients. In conclusion, robotic thoracoscopic esophagectomy lowers the incidence of POD 0.55-fold compared with open transthoracic esophagectomy.

  3. Important Questions of Comparative Studies in Asian Countries

    ERIC Educational Resources Information Center

    Pazyura, Natalia

    2015-01-01

    The issue of the "identity" of comparative education as a field of study or a discipline has been discussed for decades. Yet a kind of systematic structure that provides the basic principles for a coherent exposition of the field remains open. "Comparative education" is no longer conceived as an imaginary field's coherence but,…

  4. Important Questions of Comparative Studies in Asian Countries

    ERIC Educational Resources Information Center

    Pazyura, Natalia

    2015-01-01

    The issue of the "identity" of comparative education as a field of study or a discipline has been discussed for decades. Yet a kind of systematic structure that provides the basic principles for a coherent exposition of the field remains open. "Comparative education" is no longer conceived as an imaginary field's coherence but,…

  5. Comparing laser-based open- and closed-path gas analyzers to measure methane fluxes using the eddy covariance method

    USGS Publications Warehouse

    Detto, M.; Verfaillie, J.; Anderson, F.; Xu, L.; Baldocchi, D.

    2011-01-01

    Closed- and open-path methane gas analyzers are used in eddy covariance systems to compare three potential methane emitting ecosystems in the Sacramento-San Joaquin Delta (CA, USA): a rice field, a peatland pasture and a restored wetland. The study points out similarities and differences of the systems in field experiments and data processing. The closed-path system, despite a less intrusive placement with the sonic anemometer, required more care and power. In contrast, the open-path system appears more versatile for a remote and unattended experimental site. Overall, the two systems have comparable minimum detectable limits, but synchronization between wind speed and methane data, air density corrections and spectral losses have different impacts on the computed flux covariances. For the closed-path analyzer, air density effects are less important, but the synchronization and spectral losses may represent a problem when fluxes are small or when an undersized pump is used. For the open-path analyzer air density corrections are greater, due to spectroscopy effects and the classic Webb-Pearman-Leuning correction. Comparison between the 30-min fluxes reveals good agreement in terms of magnitudes between open-path and closed-path flux systems. However, the scatter is large, as consequence of the intensive data processing which both systems require. ?? 2011.

  6. Comparative Effectiveness of Endovascular versus Open Repair of Ruptured Abdominal Aortic Aneurysm in the Medicare Population

    PubMed Central

    Edwards, Samuel T.; Schermerhorn, Marc L.; O’Malley, A. James; Bensley, Rodney P.; Hurks, Rob; Cotterill, Philip; Landon, Bruce E.

    2015-01-01

    Objectives Endovascular abdominal aortic aneurysm repair (EVAR) is increasingly used for emergent treatment of ruptured abdominal aortic aneurysm (rAAA). We sought to compare the perioperative and long-term mortality, procedure-related complications and rates of re-intervention of EVAR versus open aortic repair of rAAA in Medicare beneficiaries. Methods We examined perioperative and long-term mortality and complications after EVAR or open aortic repair performed for rAAA in all traditional Medicare beneficiaries discharged from a US hospital from 2001–2008. Patients were propensity score matched on baseline demographics, coexisting conditions, admission source, and hospital volume of rAAA repair and sensitivity analyses were performed to evaluate the impact of bias that might have resulted from unmeasured confounders Results Of 10,998 patients with repaired rAAA, 1126 underwent EVAR and 9872 underwent open repair. Propensity score matching yielded 1099 patient pairs. The average age was 78 years, and 72.4% were male. Perioperative mortality for EVAR and open repair were 33.8% and 47.7% respectively (p<0.001) and this difference persisted for more than four years. EVAR patients had higher rates of AAA-related reinterventions when compared with open repair patients (endovascular reintervention at 36 months 10.9% vs 1.5%, p<0.001), whereas open patients had more laparotomy related complications (incisional hernia repair at 36 months 1.8% vs. 6.2% p<0.001, all surgical complications at 36 months 4.4% vs. 9.1%, p<0.001). Use of EVAR for rAAA has increased from 6% of cases in 2001 to 31% of cases in 2008, while over the same time period overall 30-day mortality for admission for rAAA regardless of treatment has decreased from 55.8% to 50.9%. Conclusions EVAR for rAAA is associated with lower perioperative and long term mortality in Medicare beneficiaries. Increasing adoption of EVAR for rAAA is associated with an overall decrease in mortality of patients hospitalized

  7. Open and Distance Learning: Case Studies from Industry and Education. Open and Distance Learning Series.

    ERIC Educational Resources Information Center

    Brown, Stephen C., Ed.

    This book contains 14 case studies, written by those involved in the teaching and training initiatives, that illustrate the use of open and distance learning strategies. The case studies, drawn from many parts of the world (but mostly British based), feature efforts in large and small companies in a variety of industries. The first part of the…

  8. Open and Distance Learning: Case Studies from Industry and Education. Open and Distance Learning Series.

    ERIC Educational Resources Information Center

    Brown, Stephen C., Ed.

    This book contains 14 case studies, written by those involved in the teaching and training initiatives, that illustrate the use of open and distance learning strategies. The case studies, drawn from many parts of the world (but mostly British based), feature efforts in large and small companies in a variety of industries. The first part of the…

  9. Opening a New Catholic School: A Series of Case Studies.

    ERIC Educational Resources Information Center

    Kealey, Robert J., Ed.

    During the last 10 years, almost 200 new Catholic schools have opened across the United States. This booklet presents nine case studies that provide ideas about how to open new Catholic schools. The schools include: (1) Diocese of Arlington, Virginia; (2) St. John Neuman Regional Catholic School, Archdiocese of Atlanta, Georgia; (3) Charlotte…

  10. A Case Study of a New Scottish Open Plan School.

    ERIC Educational Resources Information Center

    Hamilton, David

    This report, representing a 12-month case study of a new Scottish primary school, draws together educational issues concerning problems and possibilities of open-plan schooling by locating them in the day-to-day work of a particular open-plan school. During 70 days of field work, the researcher spent time observing classes, interviewing parents,…

  11. Comparing Ksharasutra (Ayurvedic Seton) and open fistulotomy in the management of fistula-in-ano

    PubMed Central

    Dutta, Gouranga; Bain, Jayanta; Ray, Ajay Kumar; Dey, Soumedhik; Das, Nandini; Das, Biswanath

    2015-01-01

    Background: Most commonly practiced surgical “lay open” technique to treat fistula-in-ano (a common anorectal pathology) has high rate of recurrence and anal incontinence. Alternatively, a nonsurgical cost efficient treatment with Ksharasutra (cotton Seton coated with Ayurvedic medicines) has minimal complications. In our study, we have tried to compare these two techniques. Materials and Methods: A prospective randomized control study was designed involving patients referred to the Department of General Surgery in RG Kar Medical College, Kolkata, India, from January 2010 to September 2011. Results: Among 50 patients, 26 were in Ksharasutra and 24 were in fistulotomy group. 86% patients were male and 54% of the patients were in the fourth decade. About 74% fistulas are inter-sphincteric and 26% were of trans-sphincteric variety. Severe postoperative pain was more (7.7% vs. 25%) in fistulotomy group, while wound discharge was more associated with Ksharasutra group (15.3% vs. 8.3%). Wound scarring, bleeding, and infection rate were similar in both groups. Ksharasutra group took more time to heal (mean: 53 vs. 35.7 days, P = 0.002) despite reduced disruption to their routine work (2.7 vs. 15.5 days work off, P <0.001). Interestingly, pain experienced was less in Ksharasutra group, there was no open wound in contrast to fistulotomy and it was significantly cost effective (Rupees 166 vs. 464). Conclusion: Treatment of fistula-in-ano with Ksharasutra is a simple with low complications and minimal cost. PMID:26283840

  12. Laser Hemorrhoidoplasty Procedure vs Open Surgical Hemorrhoidectomy: a Trial Comparing 2 Treatments for Hemorrhoids of Third and Fourth Degree

    PubMed Central

    Maloku, Halit; Gashi, Zaim; Lazovic, Ranko; Islami, Hilmi; Juniku-Shkololli, Argjira

    2014-01-01

    Objective: According to the ‘‘vascular’’ theory, arterial overflow in the superior hemorrhoidal arteries would lead to dilatation of the hemorrhoidal venous plexus. Hemorrhoid laser procedure (LHP) is a new laser procedure for outpatient treatment of hemorrhoids in which hemorrhoidal arterial flow feeding the hemorrhoidal plexus is stopped by laser coagulation. Aim: Our aim was to compare the hemorrhoid laser procedure with open surgical procedure for outpatient treatment of symptomatic hemorrhoids. Material and method: A comparison trial between hemorrhoid laser procedure or open surgical hemorrhoidectomy was made. This study was conducted at Aloka hospital in Kosovo. Patients with symptomatic grade III or grade IV hemorrhoids with minimal or complete mucosal prolapse were eligible for the study: 20 patients treated with the laser hemorrhoidoplasty, and 20 patients–with open surgery hemorrhoidectomy. Operative time and postoperative pain with visual analog scale, were evaluated. Results: A total number of 40 patients (23 men and 17 women, mean age, 46 years) entered the trial. Significant differences between laser hemorrhoidoplasty and open surgical procedure were observed in operative time and early postoperative pain. There was a statistically significant difference between the two groups regarding the early postoperative period: 1 week, 2 weeks, 3 weeks and 1 month after respective procedure (p<0.01). The procedure time for LHP was 15.94 min vs. 26.76 min for open surgery (p<0.01). Conclusion: The laser hemorrhoidoplasty procedure was more effective than open surgical hemorrhoidectomy. Postoperative pain and duration time are only two indicators for this difference between there procedures. PMID:25684841

  13. Integrated spectral study of small angular diameter galactic open clusters

    NASA Astrophysics Data System (ADS)

    Clariá, J. J.; Ahumada, A. V.; Bica, E.; Pavani, D. B.; Parisi, M. C.

    2017-10-01

    This paper presents flux-calibrated integrated spectra obtained at Complejo Astronómico El Leoncito (CASLEO, Argentina) for a sample of 9 Galactic open clusters of small angular diameter. The spectra cover the optical range (3800-6800 Å), with a resolution of ∼14 Å. With one exception (Ruprecht 158), the selected clusters are projected into the fourth Galactic quadrant (282o < l < 345o) near the Galactic plane (∣b∣ ≤ 9o). We performed simultaneous estimates of foreground interstellar reddening and age by comparing the continuum distribution and line strenghts of the cluster spectra with those of template cluster spectra with known parameters. We thus provide spectroscopic information independent from that derived through color-magnitude diagram studies. We found three clusters (Collinder 249, NGC 4463 and Ruprecht 122) younger than ∼40 Myr, four moderately young ones (BH 92, Harvard 5, Hogg 14 and Pismis 23) with ages within 200-400 Myr, and two intermediate-age ones (Ruprecht 158 and ESO 065-SC07) with ages within 1.0-2.2 Gyr. The derived foreground E(B - V) color excesses vary from around 0.0 in Ruprecht 158 to ∼1.1 in Pismis 23. In general terms, the results obtained show good agreement with previous photometric results. In Ruprecht 158 and BH 92, however, some differences are found between the parameters here obtained and previous values in the literature. Individual spectra of some comparatively bright stars located in the fields of 5 out of the 9 clusters here studied, allowed us to evaluate their membership status. The current cluster sample complements that of 46 open clusters previously studied by our group in an effort to gather a spectral library with several clusters per age bin. The cluster spectral library that we have been building is an important tool to tie studies of resolved and unresolved stellar content.

  14. [Vitrum osteomag in prevention of osteoporosis in postmenopausal women: results of the comparative open multicenter trial].

    PubMed

    Benevolenskaia, L I; Toroptsova, N V; Nikitinskaia, O A; Sharapova, E P; Korotkova, T A; Rozhinskaia, L Ia; Marova, E I; Dzeranova, L K; Molitvoslovova, N N; Men'shikova, L V; Grudinina, O V; Lesniak, O M; Evstigneeva, L P; Smetnik, V P; Shestakova, I G; Kuznetsov, S Iu

    2004-01-01

    To investigate efficacy, tolerance and safety of the drug vitrum osteomag one tablet of which contains 600 mg calcium (1500 mg calcium carbonate), 200 IU of cholecalcepherol, 40 mg of magnesium, zinc (7.5 mg), copper (1 mg), manganese (1.8 mg) and boron (250 mcg) in women with osteopenia for prevention of osteoporosis. A multicenter comparative open trial of vitrum osteomag influence on mineral bone density (MBD), change of pain syndrome in bones, index of calcium-phosphorous metabolism covered 334 postmenopausal women with osteopenia. MBD was measured in low-back spine and proximal part of the hip with DEXA method. All the patients were divided into 3 groups: 125 women taking 2 tablets of vitrum osteomag daily for 12 months (group 1); 111 women taking 1500 mg calcium carbonate (group 2); 96 women--control group (only observation). Vitrum osteomag relieved pain in the back and joints, had a positive effect on bone density (+1.5%) and proximal parts of the hip (0.6-0.93%) exceeding the effect of calcium carbonate only which preserves the initial MBD in low back spine but does not prevent bone loss in the hip. MBD dynamics in patients given vitrum osteomag differs essentially from one in the control group (from -1.9 to -2.91%) which demonstrates a reliable preventive anti-osteoporotic effect of this medication. The drug increases the level of general and ionized calcium in blood but does not cause hypercalcemia lowering the level of parathormone in blood. The rate of side effects in group 1 was 14.4% and did not differ much from that in group 2 (16.2%). The results of the study allow to recommend vitrum osteomag for prophylaxis of a rapid loss of bone tissue mineral density.

  15. Comparative assessment of bone pose estimation using Point Cluster Technique and OpenSim.

    PubMed

    Lathrop, Rebecca L; Chaudhari, Ajit M W; Siston, Robert A

    2011-11-01

    Estimating the position of the bones from optical motion capture data is a challenge associated with human movement analysis. Bone pose estimation techniques such as the Point Cluster Technique (PCT) and simulations of movement through software packages such as OpenSim are used to minimize soft tissue artifact and estimate skeletal position; however, using different methods for analysis may produce differing kinematic results which could lead to differences in clinical interpretation such as a misclassification of normal or pathological gait. This study evaluated the differences present in knee joint kinematics as a result of calculating joint angles using various techniques. We calculated knee joint kinematics from experimental gait data using the standard PCT, the least squares approach in OpenSim applied to experimental marker data, and the least squares approach in OpenSim applied to the results of the PCT algorithm. Maximum and resultant RMS differences in knee angles were calculated between all techniques. We observed differences in flexion/extension, varus/valgus, and internal/external rotation angles between all approaches. The largest differences were between the PCT results and all results calculated using OpenSim. The RMS differences averaged nearly 5° for flexion/extension angles with maximum differences exceeding 15°. Average RMS differences were relatively small (< 1.08°) between results calculated within OpenSim, suggesting that the choice of marker weighting is not critical to the results of the least squares inverse kinematics calculations. The largest difference between techniques appeared to be a constant offset between the PCT and all OpenSim results, which may be due to differences in the definition of anatomical reference frames, scaling of musculoskeletal models, and/or placement of virtual markers within OpenSim. Different methods for data analysis can produce largely different kinematic results, which could lead to the misclassification

  16. Comparative Studies in Special Education.

    ERIC Educational Resources Information Center

    Mazurek, Kas, Ed.; Winzer, Margret A., Ed.

    This text presents 26 case studies which examine special education provisions for children in the world today. The reports focus on the current state of special education in selected nations and major issues and controversies in the field of special education within those nations. Each case study addresses the following themes: (1) prevalence of…

  17. An open-label, non-comparative, non-interventional, multi-center, post-authorization safety study on the administration of rabeprazole to adults with gastro-esophageal reflux disease

    PubMed Central

    Zouboulis-Vafiadis, Irini; Paraskevas, Emmanuel; Tzourmakliotis, Dimitrios; Hatzikyriakou, Maria; Mestoussi, Angeliki; Vasdekis, Vassilios; Katsilabros, Nikolaos; Arhimandritis, Athanasios; Papadokostopoulou, Alexandra

    2014-01-01

    Background Rabeprazole produces a profound and long-lasting inhibition of gastric acid secretion. The aim of the study was to monitor the safety and efficacy of rabeprazole administered to patients with erosive or symptomatic non-erosive reflux disease, in real-life healthcare settings. Methods Male and female patients, aged ≥18 years, with endoscopy diagnosed GERD were included; patients received at least 8 weeks treatment with rabeprazole. Changes in severity of symptoms recorded on the Likert scale were analysed using marginal homogeneity tests. Results 186 patients were enrolled across 17 study sites; 127 patients (68.3%) completed the study. Almost 75% of patients had an initial diagnosis of GERD with Grade A or B esophagitis. The most commonly reported adverse events (AEs) were diarrhea, flatulence, dizziness, cough, abdominal pain, upper abdominal pain and somnolence. Over half of AEs were unrelated to study drug; 1 severe AE of diarrhea was possibly related to study drug. No new AEs were reported not included in the current version of Summary of Product Characteristics. Rabeprazole was effective in reducing the symptoms of GERD; the Likert scale scores of symptoms decreased significantly for all patients from 0-4 weeks and 4-8 weeks. Conclusions In our study, rabeprazole was safe and effective in reducing the symptoms of GERD. PMID:24732963

  18. Improved outcomes for laparoscopic appendectomy compared with open appendectomy in the pediatric population.

    PubMed

    Schmelzer, Thomas M; Rana, Ankur R; Walters, K Christian; Norton, H James; Bambini, Daniel A; Heniford, B Todd

    2007-10-01

    The appendectomy is a common emergent surgical procedure in the pediatric population. The aim of this study was to examine our institution's experience and outcomes in the appendectomy in the pediatric population early in our transition from open surgery to a predominantly laparoscopic approach. We retrospectively studied all pediatric patients (age 20 years) that underwent an appendectomy at a tertiary care center over 2 years. The data collected included patient demographics, comorbidities, operative details, outcomes, and complications. Two hundred twenty-three consecutive patients, with a mean age of 9.5 (3.9) years, were included in the study. Forty-four laparoscopic and 179 open appendectomies were performed. Two of the laparoscopic cases were converted to open appendectomies. Significant differences were seen between the two groups, with longer operative times (P < 0.0001) and lower estimated blood loss (P = 0.007) in the laparoscopic group. Operative times improved significantly for the laparoscopic group as the surgeons became more experienced (P = 0.03). The laparoscopic group used intravenous pain medication for a shorter time (0.8 vs. 1.9 days; P = 0.0003) and had a shorter postoperative hospital length of stay (2.2 vs. 3.4 days; P = 0.004). The laparoscopic group had fewer wound infections (2.3% vs. 6.2%; P = 0.3), intra-abdominal abscesses (4.5% vs. 5.6%; P = 0.8), and postoperative ileus (0% vs. 2.2%; P = 0.3), although these differences did not reach statistical significance. The laparoscopic appendectomy procedure is a safe alternative to open appendectomy in pediatric patients and results in shorter hospital stays with less postoperative pain.

  19. Human capital gains associated with robotic assisted laparoscopic pyeloplasty in children compared to open pyeloplasty.

    PubMed

    Behan, James W; Kim, Steve S; Dorey, Frederick; De Filippo, Roger E; Chang, Andy Y; Hardy, Brian E; Koh, Chester J

    2011-10-01

    Robotic assisted laparoscopic pyeloplasty is an emerging, minimally invasive alternative to open pyeloplasty in children for ureteropelvic junction obstruction. The procedure is associated with smaller incisions and shorter hospital stays. To our knowledge previous outcome analyses have not included human capital calculations, especially regarding loss of parental workdays. We compared perioperative factors in patients who underwent robotic assisted laparoscopic and open pyeloplasty at a single institution, especially in regard to human capital changes, in an institutional cost analysis. A total of 44 patients 2 years old or older from a single institution underwent robotic assisted (37) or open (7) pyeloplasty from 2008 to 2010. We retrospectively reviewed the charts to collect demographic and perioperative data. The human capital approach was used to calculate parental productivity losses. Patients who underwent robotic assisted laparoscopic pyeloplasty had a significantly shorter average hospital length of stay (1.6 vs 2.8 days, p <0.05). This correlated with an average savings of lost parental wages of $90.01 and hospitalization expenses of $612.80 per patient when excluding amortized robot costs. However, cost savings were not achieved by varying length of stay when amortized costs were included. Robotic assisted laparoscopic pyeloplasty in children is associated with human capital gains, eg decreased lost parental wages, and lower hospitalization expenses. Future comparative outcome analyses in children should include financial factors such as human capital loss, which can be especially important for families with young children. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  20. Guidance for Identifying, Selecting and Evaluating Open Literature Studies

    EPA Pesticide Factsheets

    This guidance for Office of Pesticide Program staff will assist in their evaluation of open literature studies of pesticides. It also describes how we identify, select, and ensure that data we use in risk assessments is of sufficient scientific quality.

  1. Four open mammillary and catenary compartment models for pharmacokinetics studies.

    PubMed

    de Biasi, J

    1989-11-01

    A mathematical method is proposed to solve a fourth degree equation which gives the eigenvalues of the matrix connected with a four open compartment model used in pharmacokinetic studies. As examples, the method is applied to mammillary and catenary models.

  2. Focus Harmonic Scalpel Compared to Conventional Haemostasis in Open Total Thyroidectomy: A Prospective Randomized Trial

    PubMed Central

    Ferri, Emanuele; Armato, Enrico; Spinato, Giacomo; Spinato, Roberto

    2011-01-01

    The aim of this prospective randomized trial was to compare operative factors, postoperative outcomes and surgical complications of open total thyroidectomy when using the Harmonic Scalpel (HS) versus Conventional Haemostasis (CH). Methods. 100 consecutive patients underwent open total thyroidectomy were randomized into two groups: group CH (Conventional Haemostasis) and group HS (Harmonic Scalpel). We recorded the following: age, sex, pathology, thyroid volume, haemostatic technique, operative time, drainage volume, thyroid weight, postoperative pain, postoperative complications, and hospital stay. The results were analyzed using the Student's t test and χ2 test. Results. No significant difference was found between the two groups concerning mean thyroid weight and mean hospital stay. The mean operative time was significantly shorter in the HS group. The total drainage fluid volume was lower in HS group. Two (4%) transient recurrent laryngeal nerve palsies were observed in CH group and no one (0%) in the HS group. Postoperative transient hypocalcemia occurred more frequently in the CH group. HS group experienced significantly less postoperative pain at 24 and 48 hours. Conclusions. In patients undergoing thyroidectomy, HS is a reliable and safe tool. Comparing with CH techniques, its use reduces operative times, postoperative pain, drainage volume and transient hypocalcemia. PMID:22187563

  3. On the representativeness of coastal aerosol studies to open ocean studies: Mace Head - a case study

    NASA Astrophysics Data System (ADS)

    Rinaldi, M.; Facchini, M. C.; Decesari, S.; Carbone, C.; Finessi, E.; Mircea, M.; Fuzzi, S.; Ceburnis, D.; Ehn, M.; Kulmala, M.; de Leeuw, G.; O'Dowd, C. D.

    2009-12-01

    A unique opportunity arose during the MAP project to compare open ocean aerosol measurements with those undertaken at the Mace Head Global Atmosphere Watch Station, a station used for decades for aerosol process research and long-term monitoring. The objective of the present study is to demonstrate that the key aerosol features and processes observed at Mace Head are characteristic of the open ocean, while acknowledging and allowing for spatial and temporal gradients. Measurements were conducted for a 5-week period at Mace Head and offshore, on the Research Vessel Celtic Explorer, in generally similar marine air masses, albeit not in connected-flow scenarios. The results of the study indicate, in terms of aerosol number size distribution, higher nucleation mode particle concentrations at Mace Head than offshore, pointing to a strong coastal source of new particles that is not representative of the open ocean. The Aitken mode exhibited a large degree of similarity, with no systematic differences between Mace Head and the open ocean, while the accumulation mode showed averagely 35% higher concentrations at Mace Head. The higher accumulation mode concentration can be attributed equally to cloud processing and to a coastal enhancement in concentration. Chemical analysis showed similar or even higher offshore concentrations for dominant species, such as nss-SO4-2, WSOC, WIOC and MSA. Sea salt concentration differences determined a 40% higher supermicron mass at Mace Head, although this difference can be attributed to a higher wind speed at Mace Head during the comparison period. Moreover, the relative chemical composition as a function of size illustrated remarkable similarity. While differences to varying degrees were observed between offshore and coastal measurements, no convincing evidence was found of local coastal effects, apart from nucleation mode aerosol, thus confirming the integrity of previously reported marine aerosol characterisation studies at Mace Head.

  4. The Efficacy and Safety of 17α-Estradiol (Ell-Cranell® alpha 0.025%) Solution on Female Pattern Hair Loss: Single Center, Open-Label, Non-Comparative, Phase IV Study

    PubMed Central

    Kim, Jae-Hong; Lee, Sung Yul; Lee, Hae-Jin; Yoon, Na-Young

    2012-01-01

    Background There are several commercially available agents to treat female pattern hair loss (FPHL), including minoxidil solution, anti-androgen agents and mineral supplements. However, these treatments are not always satisfactory. We report the results of a clinical trial of 17α-estradiol (Ell-Cranell® alpha 0.025%) solution to Korean female patients with FPHL. Objective This study was designed to examine the efficacy and safety of Ell-Cranell® alpha 0.025% solution in Korean female patients with FPHL. Methods A total of 53 women, 18 to 55 years old, applied topical Ell-Cranell® alpha 0.025% solution once daily for 8 months. Efficacy was evaluated by the change of hair counts and diameter, subjective assessment, and photographic assessment by investigators. Results Hair counts and diameter from baseline to 4 and 8 months after treatment increased in treated patients and these changes were statistically significant (p<0.0001). 17α-estradiol (Ell-Cranell® alpha 0.025%) solution showed significant improvement by subjective self-assessment and by investigator photographic assessment. Ell-Cranell® alpha 0.025% solution was well tolerated over 8-months period. Conclusion This study showed that Ell-Cranell® alpha 0.025% solution is a safe and effective agent for Korean women with FPHL. PMID:22879713

  5. The Efficacy and Safety of 17α-Estradiol (Ell-Cranell® alpha 0.025%) Solution on Female Pattern Hair Loss: Single Center, Open-Label, Non-Comparative, Phase IV Study.

    PubMed

    Kim, Jae-Hong; Lee, Sung Yul; Lee, Hae-Jin; Yoon, Na-Young; Lee, Won-Soo

    2012-08-01

    There are several commercially available agents to treat female pattern hair loss (FPHL), including minoxidil solution, anti-androgen agents and mineral supplements. However, these treatments are not always satisfactory. We report the results of a clinical trial of 17α-estradiol (Ell-Cranell® alpha 0.025%) solution to Korean female patients with FPHL. This study was designed to examine the efficacy and safety of Ell-Cranell® alpha 0.025% solution in Korean female patients with FPHL. A total of 53 women, 18 to 55 years old, applied topical Ell-Cranell® alpha 0.025% solution once daily for 8 months. Efficacy was evaluated by the change of hair counts and diameter, subjective assessment, and photographic assessment by investigators. Hair counts and diameter from baseline to 4 and 8 months after treatment increased in treated patients and these changes were statistically significant (p<0.0001). 17α-estradiol (Ell-Cranell® alpha 0.025%) solution showed significant improvement by subjective self-assessment and by investigator photographic assessment. Ell-Cranell® alpha 0.025% solution was well tolerated over 8-months period. This study showed that Ell-Cranell® alpha 0.025% solution is a safe and effective agent for Korean women with FPHL.

  6. Comparative study of silicon detectors

    SciTech Connect

    Allier, C.P.; Valk, H.; Huizenga, J.; Bom, V.R.; Hollander, R.W.; Eijk, C.W.E. van

    1998-06-01

    The authors studied three different types of silicon sensors: PIN diodes, circular drift detectors, both made at the Delft University of Technology (DUT), and Hamamatsu S5345 avalanche photodiodes. Measurements have been carried out in the same optimized experimental setup, both at room temperature and at low temperatures. Comparison is made for direct X-ray detection and CsI(Tl) scintillation light readout.

  7. Comparative Effectiveness of Two Ultrasound-Guided Regional Block Techniques for Surgical Anesthesia in Open Unilateral Inguinal Hernia Repair.

    PubMed

    Steffel, Lauren; Kim, T Edward; Howard, Steven K; Ly, Daphne P; Kou, Alex; King, Robert; Mariano, Edward R

    2016-01-01

    Transversus abdominis plane (TAP) and ilioinguinal/iliohypogastric (II/IH) nerve blocks have been described as analgesic adjuncts for inguinal hernia repair, but the efficacy of these techniques in providing intraoperative anesthesia, either individually or together, is not known. We designed this retrospective cohort study to test the hypothesis that combining TAP and II/IH nerve blocks ("double TAP" technique) results in greater accordance between the preoperative anesthetic plan and actual anesthetic technique provided when compared to TAP alone. Based on this study, double TAP may be preferred for patients undergoing open inguinal hernia repair who wish to avoid general anesthesia.

  8. An open label, randomized, fixed-dose, crossover study comparing efficacy and safety of sildenafil citrate and saffron (Crocus sativus Linn.) for treating erectile dysfunction in men naïve to treatment.

    PubMed

    Safarinejad, M R; Shafiei, N; Safarinejad, S

    2010-01-01

    Saffron (Crocus sativus Linn.) have been perceived by the public as a strong aphrodisiac herbal product. However, studies addressing the potential beneficial effects of saffron on erectile function (EF) in men with ED are lacking. Our aim was to evaluate the efficacy and safety of saffron administration on EF in men with ED. After a 4-week baseline assessment, 346 men with ED (mean age 46.6+/-8.4 years) were randomized to receive on-demand sildenafil for 12 weeks followed by 30 mg saffron twice daily for another 12 weeks or vice versa, separated by a 2-week washout period. To determine the type of ED, penile color duplex Doppler ultrasonography before and after intracavernosal injection with 20 microg prostaglandin E(1), pudendal nerve conduction tests and impaired sensory-evoked potential studies were performed. Subjects were assessed with an International Index of Erectile Function (IIEF) questionnaire, Sexual Encounter Profile (SEP) diary questions, patient and partner versions of the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire and the Global Efficacy Question (GEQ) 'Has the medication you have been taking improved your erections?' No significant improvements were observed with regard to the IIEF sexual function domains, SEP questions and EDITS scores with saffron administration. The mean changes from baseline values in IIEF-EF domain were +87.6% and +9.8% in sildenafil and placebo groups, respectively (P=0.08). We did not observe any improvement in 15 individual IIEF questions in patients while taking saffron. Treatment satisfaction as assessed by partner versions of EDITS was found to be very low in saffron patients (72.4 vs 25.4, P=0.001). Mean per patient 'yes' responses to GEQ was 91.2 and 4.2% for sildenafil and saffron, respectively (P=0.0001). These findings do not support a beneficial effect of saffron administration in men with ED.

  9. Relative bioavailability of tizanidine hydrochloride capsule formulation compared with capsule contents administered in applesauce: a single-dose, open-label, randomized, two-way, crossover study in fasted healthy adult subjects.

    PubMed

    Henney, Herbert R; Fitzpatrick, Anthony; Stewart, Johnston; Runyan, Jacob D

    2008-12-01

    The alpha2-adrenergic agonist tizanidine has been reported to have a narrow therapeutic index. A multiparticulate capsule formulation of tizanidine has been developed in an attempt to improve patient tolerability. This study assessed bioequivalence between a single, intact, 6-mg capsule of tizanidine and the capsule contents sprinkled in applesauce in fasted healthy subjects. Healthy male and female subjects aged 18 to 45 years completed 2 treatment periods: one with a tizanidine 6-mg capsule administered intact and the other with capsule contents sprinkled in applesauce. The 2 treatment periods had a 6-day washout period between administrations. Plasma tizanidine concentrations were determined for blood samples collected over 24 hours after administration. All treatment-emergent adverse events were recorded and graded by intensity and relationship to the study drug (not, improbable, possible, probable, definite) by the attending physician based on his or her clinical impression. A total of 19 men and 9 women (mean age, 26 years) completed the trial. Geometric mean natural logarithm-transformed AUC values (AUC(0-infinity) [AUC to infinity] and AUC(0-t) [AUC to the last measurable time point]) and C(max) ratios were significantly (P

  10. Effectiveness of Tapentadol Prolonged Release (PR) Compared with Oxycodone/Naloxone PR for the Management of Severe Chronic Low Back Pain with a Neuropathic Component: A Randomized, Controlled, Open-Label, Phase 3b/4 Study.

    PubMed

    Baron, Ralf; Likar, Rudolf; Martin-Mola, Emilio; Blanco, Francisco J; Kennes, Lieven; Müller, Matthias; Falke, Dietmar; Steigerwald, Ilona

    2016-06-01

    To evaluate the effectiveness of tapentadol prolonged release (PR) vs. oxycodone/naloxone PR in non-opioid-pretreated patients with severe chronic low back pain with a neuropathic pain component. Eligible patients (average pain intensity [numerical rating scale-3 (NRS-3)] ≥6; painDETECT positive/unclear) were randomized to twice-daily tapentadol PR 50 mg or oxycodone/naloxone PR 10 mg/5 mg. After a 21-day titration (maximum twice-daily doses: tapentadol PR 250 mg, or oxycodone/naloxone PR 40 mg/20 mg plus oxycodone PR 10 mg), target doses were continued for 9 weeks. The primary effectiveness endpoint was the change in NRS-3 from baseline to final evaluation; the exact repeated confidence interval (RCI) for tapentadol PR minus oxycodone/naloxone PR was used to establish noninferiority (upper limit <1.3) and superiority (confirmatory analyses). For the primary effectiveness endpoint, tapentadol PR was noninferior to oxycodone/naloxone PR (97.5% RCI: [-1.820, -0.184]; P < 0.001). This exact RCI also yielded evidence of superiority for tapentadol PR vs. oxycodone/naloxone PR (significantly greater reduction in pain intensity; P = 0.003). Improvements (baseline to final evaluation) in painDETECT and Neuropathic Pain Symptom Inventory scores were significantly greater with tapentadol PR vs. oxycodone/naloxone PR (all P ≤ 0.005). The study was formally shown to be positive and demonstrated, in the primary effectiveness endpoint, the noninferiority for tapentadol PR vs. oxycodone/naloxone PR. The effectiveness of tapentadol PR was superior to that of oxycodone/naloxone PR by means of clinical relevance and statistical significance (confirmatory evidence of superiority). Tapentadol PR was associated with significantly greater improvements in neuropathic pain-related symptoms and global health status than oxycodone/naloxone PR and with a significantly better gastrointestinal tolerability profile. Tapentadol PR may be considered a first-line option for

  11. Outcomes in Pediatric Robot-Assisted Laparoscopic Heminephrectomy Compared with Contemporary Open and Laparoscopic Series

    PubMed Central

    Pariser, Joseph J.; Gundeti, Mohan S.

    2015-01-01

    Abstract Purpose: To compare our renal and clinical outcomes for robot-assisted laparoscopic heminephrectomy (RAL-HN) in the pediatric population with duplicated systems with those of current contemporary open and laparoscopic series. Patients and Methods: Sixteen children underwent RAL-HN from 2009 to 2014. Data were collected via retrospective chart review including demographics, preoperative and postoperative imaging, operative time, estimated blood loss (EBL), length of stay (LOS), complications, and renal outcomes. Results: Mean age at surgery was 37.5±49.2 months. Mean operative time was 135±36 minutes with an EBL of 10±5 mL. Mean LOS was 2±0.8 days, and no major perioperative complications were observed. Mean follow-up was 22.1±17.2 months. Two patients needed secondary ureterectomy for recurrent urinary tract infection in the setting of a refluxing ureteral stump. One of these patients also underwent a ureteral reimplantation of the ipsilateral normal ureter. No patients lost their remaining healthy moiety. Asymptomatic cyst formation was seen in four (25%) patients, and self- limited postoperative urinoma was seen in 2 (13%) patients. Postoperative perinephric abscess did not develop in any patient. Mean change in renal function based on nuclear renography of the duplex kidney was −2.7%±4.6%. Conclusions: Compared with previously published literature evaluating open and laparoscopic heminephrectomy, RAL-HN provides comparable outcomes in regard to complication rate and renal function of the remnant moiety. PMID:25790273

  12. Comparative pyrolysis studies of ethylarsines

    NASA Astrophysics Data System (ADS)

    Li, S. H.; Larsen, C. A.; Stringfellow, G. B.

    1991-01-01

    The pyrolysis of triethylarsine (TEAs), diethylarsine (DEAsH), and monoethylarsine (MEAsH 2) has been studied at atmospheric pressure in a flow tube reactor using mass spectrometry. He and D 2 were selected as the carrier gases to determine ambient effects and to isotopically label the pyrolysis products. For some experiments, supplemental C 2H 5 and CH 3 radicals, produced from pyrolysis of the co-reactants azoethane ((C 2H 5) 2N 2) and azomethane ((CH 3) 2N 2), were added to investigate the roles of C 2H 5 and CH 3 in the reactions. Significant D 2 effects have been observed for pyrolysis of TEAs but not for DEAsH and MEAsH 2. Pyrolysis of the latter could be enhanced by adding C 2H 5 radicals while the TEAs was nearly unaffected. With the presence of supplemental CH 3 radicals, 85% decomposition was induced for each precursor. The products included DEAsD, rather than DEAsH, for TEAs pyrolysis in D 2. However, DEAsH pyrolysis produced TEAs, and MEAsH 2 decomposed to yield DEAsH and arsine, in both ambients. This suggests that a β-elimination reaction is not a major step for any of the ethylarsine precursors. More likely, radical reactions occur. When trimethylgallium (TMGa) was added, the ethylarsine pyrolysis rates were accelerated due to the CH 3 radicals produced from TMGa pyrolysis. In addition, heterogeneous reactions have been observed for pyrolysis of ethylarsines, especially when a GaAs surface was involved.

  13. Treatment of Bankart lesions in traumatic anterior instability of the shoulder: a randomized controlled trial comparing arthroscopy and open techniques.

    PubMed

    Archetti Netto, Nicola; Tamaoki, Marcel Jun Sugawara; Lenza, Mario; dos Santos, João Baptista Gomes; Matsumoto, Marcelo Hide; Faloppa, Flavio; Belloti, João Carlos

    2012-07-01

    The objective of this study was to compare the functional assessments of arthroscopy and open repair for treating Bankart lesion in traumatic anterior shoulder instability. Fifty adult patients, aged less than 40 years, with traumatic anterior shoulder instability and the presence of an isolated Bankart lesion confirmed by diagnostic arthroscopy were included in the study. They were randomly assigned to receive open or arthroscopic treatment of an isolated Bankart lesion. In all cases of both groups, the lesion was repaired with metallic suture anchors. The primary outcomes included the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. After a mean follow-up period of 37.5 months, 42 patients were evaluated. On the DASH scale, there was a statistically significant difference favorable to the patients treated with the arthroscopic technique, but without clinical relevance. There was no difference in the assessments by University of California, Los Angeles and Rowe scales. There was no statistically significant difference regarding complications and failures, as well as range of motion, for the 2 techniques. On the basis of this study, the open and arthroscopic techniques were effective in the treatment of traumatic anterior shoulder instability. The arthroscopic technique showed a lower index of functional limitation of the upper limb, as assessed by the DASH questionnaire; this, however, was not clinically relevant. Copyright © 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  14. Experimental and numerical study of open-air active cooling

    NASA Astrophysics Data System (ADS)

    Al-Fifi, Salman Amsari

    The topic of my thesis is Experimental and Numerical Study of Open Air Active Cooling. The present research is intended to investigate experimentally and Numerically the effectiveness of cooling large open areas like stadiums, shopping malls, national gardens, amusement parks, zoos, transportation facilities and government facilities or even in buildings outdoor gardens and patios. Our cooling systems are simple cooling fans with different diameters and a mist system. This type of cooling systems has been chosen among the others to guarantee less energy consumption, which will make it the most favorable and applicable for cooling such places mentioned above. In the experiments, the main focus is to study the temperature domain as a function of different fan diameters aerodynamically similar in different heights till we come up with an empirical relationship that can determine the temperature domain for different fan diameters and for different heights of these fans. The experimental part has two stages. The first stage is devoted to investigate the maximum range of airspeed and profile for three different fan diameters and for different heights without mist, while the second stage is devoted to investigate the maximum range of temperature and profile for the three different diameter fans and for different heights with mist. The computational study is devoted to built an experimentally verified mathematical model to be used in the design and optimization of water mist cooling systems, and to compare the mathematical results to the experimental results and to get an insight of how to apply such evaporative mist cooling for different places for different conditions. In this study, numerical solution is presented based on experimental conditions, such dry bulb temperature, wet bulb temperature, relative humidity, operating pressure and fan airspeed. In the computational study, all experimental conditions are kept the same for the three fans except the fan airspeed

  15. OpenSimulator Interoperability with DRDC Simulation Tools: Compatibility Study

    DTIC Science & Technology

    2014-09-01

    OpenSimulator has been designed to operate and interface with users, how it incorporates terrain models, and what its capabilities are with regard to...ship design , and SmartPlant 3D for plant design , are two CAD programs used or intended to be used by DND. The 3D CAD models created by these programs...OpenSimulator Interoperability with DRDC Simulation Tools Compatibility Study Mark Swartz Evan Harris CAE Inc. - Integrated

  16. Plasma opening switch studies of an applied Bz ion diode

    NASA Astrophysics Data System (ADS)

    Struckman, C. K.; Kusse, B. R.; Meyerhofer, D. D.; Rondeau, G.

    1989-05-01

    The light ion accelerator (1.5 MV, 4 ohms) at Cornell University is being used to study the characteristics of an applied Bz, or 'barrel', diode. The results of a series of experiments utilizing a plasma opening switch are reported. With a magnetically insulated ion diode load, the peak diode voltage increase from 1.5 to 1.8 MV and the ion power increased from 50 to 80 GW when a plasma opening switch was used.

  17. Developing the urban blue: Comparative health responses to blue and green urban open spaces in Germany.

    PubMed

    Völker, Sebastian; Kistemann, Thomas

    2015-09-01

    Recently, new perspectives upon healthy urban open spaces propose that open spaces can be regarded as urban green or blue spaces. However, there has so far been very little research into blue environments and their benefits for mental well-being. Our article focuses on the effects of water in cities, "urban blue" (as compared to "urban green"), on human health and well-being. To assess the mental well-being of visitors, we conducted qualitative semi-standardised interviews (n=113), asking which differences in well-being occur when visiting urban green and blue spaces in high-density areas of the inner city in Dusseldorf and Cologne, Germany. Although we found many similarities, some health-enhancing effects for users turned out to be prominent for urban blue in the four conceptual therapeutic landscape dimensions: experienced, symbolic, social and activity space. These effects include enhanced contemplation, emotional bonding, participation, and physical activity. The results suggest that urban blue as a health-promoting factor needs more detailed and accurate determination and examination of its general and local health-enhancing effects. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. openSputnik--a database to ESTablish comparative plant genomics using unsaturated sequence collections.

    PubMed

    Rudd, Stephen

    2005-01-01

    The public expressed sequence tag collections are continually being enriched with high-quality sequences that represent an ever-expanding range of taxonomically diverse plant species. While these sequence collections provide biased insight into the populations of expressed genes available within individual species and their associated tissues, the information is conceivably of wider relevance in a comparative context. When we consider the available expressed sequence tag (EST) collections of summer 2004, most of the major plant taxonomic clades are at least superficially represented. Investigation of the five million available plant ESTs provides a wealth of information that has applications in modelling the routes of plant genome evolution and the identification of lineage-specific genes and gene families. Over four million ESTs from over 50 distinct plant species have been collated within an EST analysis pipeline called openSputnik. The ESTs were resolved down into approximately one million unigene sequences. These have been annotated using orthology-based annotation transfer from reference plant genomes and using a variety of contemporary bioinformatics methods to assign peptide, structural and functional attributes. The openSputnik database is available at http://sputnik.btk.fi.

  19. Innovation in Open Systems: A Comparative Study of Banks.

    ERIC Educational Resources Information Center

    Young, Robert L.; And Others

    1981-01-01

    Explains the extent to which the innovativeness of banks (as measured by the adoption of credit cards and computers) is affected by competition, growth, size, and departmentalization. Notes that size and growth are more significantly related to innovation than are departmentalization and competition. (SB)

  20. Comparative analysis of colorimetric staining in skin using open-source software

    PubMed Central

    Billings, Paul C; Sanzari, Jenine K.; Kennedy, Ann R.; Cengel, Keith A.; Seykora, John T.

    2015-01-01

    Colorimetric staining techniques such as immunohistochemistry (IHC), immunofluorescence (IF) and histochemistry (HC) provide useful information regarding the localization and relative amount of a molecule/substance in skin. We have developed a novel, straightforward method to assess colorimetric staining by combining features from two open-source software programs. As a proof of principle, we demonstrate the utility of this approach by analyzing changes in skin melanin deposition during the radiation-induced tanning response of Yucatan mini-pigs. This method includes a visualization step to validate the accuracy of color selection before quantitation to ensure accuracy. The data show that this method is robust and will provide a means to obtain accurate comparative analyses of staining in IHC/IF/HC samples. PMID:25393687

  1. [Comparative characteristics of the open and endovascular methods of treatment for carotid artery stenoses].

    PubMed

    Krotovskiĭ, G S; Uchkin, I G; Shugushev, Z Kh; Zudin, A M; Kagdasarian, A G

    2010-01-01

    The article is dedicated to the problem concerning treatment for stenoses of the extracranial portions of carotid arteries. From March 2004 to November 2009 at the Department of Vascular Surgery No 2 of the N. A. Semashko Central Clinical Hospital No 2 we treated a total of 364 patients presenting with stenotic lesions of the extracranial portion of the carotid arteries. Of these, 176 patients underwent revascularization of the carotid basin: 120 patients endured open carotid endarterectomy (CEAE), 56 patients sustained carotid angioplasty and stenting (CAS), with a total of 128 CEAE and 67 CAS interventions performed. The following conclusion was made: with high skill of surgeons and broad experience in carrying out revascularization of the carotid basin, the CEAE and CAS procedures possess comparable efficacy and safety with CEAE possessing reliable advantage in terms of the parameters of the patient's quality of life.

  2. Comparative analysis of colorimetric staining in skin using open-source software.

    PubMed

    Billings, Paul C; Sanzari, Jenine K; Kennedy, Ann R; Cengel, Keith A; Seykora, John T

    2015-02-01

    Colorimetric staining techniques such as immunohistochemistry (IHC), immunofluorescence (IF) and histochemistry (HC) provide useful information regarding the localization and relative amount of a molecule/substance in skin. We have developed a novel, straightforward method to assess colorimetric staining by combining features from two open-source software programs. As a proof of principle, we demonstrate the utility of this approach by analysing changes in skin melanin deposition during the radiation-induced tanning response of Yucatan mini-pigs. This method includes a visualization step to validate the accuracy of colour selection before quantitation to ensure accuracy. The data show that this method is robust and will provide a means to obtain accurate comparative analyses of staining in IHC/IF/HC samples. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Comparison of inflammatory responses following robotic and open colorectal surgery: a prospective study.

    PubMed

    Zawadzki, Marek; Krzystek-Korpacka, Malgorzata; Gamian, Andrzej; Witkiewicz, Wojciech

    2017-03-01

    Robotic colorectal surgery continues to rise in popularity, but there remains little evidence on the stress response following the procedure. The aim of this study was to evaluate the inflammatory response to robotic colorectal surgery and compare it with the response generated by open colorectal surgery. This was a prospective nonrandomized comparative study involving 61 patients with colorectal cancer. The evaluation of inflammatory response to either robotic or open colorectal surgery was expressed as changes in interleukin-1β, interleukin-1 receptor antagonist, interleukin-6, tumor necrosis factor-α, C-reactive protein, and procalcitonin during the first three postoperative days. Of the 61 patients, 33 underwent robotic colorectal surgery while 28 had open colorectal surgery. Groups were comparable with respect to age, sex, BMI, cancer stage, and type of resection. The relative increase of interleukin-1 receptor antagonist at 8 h postoperative, compared to baseline, was higher in the open group (P = 0.006). The decrease of interleukin-1 receptor antagonist on postoperative days 1 and 3, compared to the maximum at 8 h, was more pronounced in the open group than in the robotic group (P = 0.008, P = 0.006, respectively), and the relative increase of interleukin-6 at 8 h after incision was higher in the open group (P = 0.007). The relative increase of procalcitonin on postoperative days 1 and 3 was higher in the open group than the robotic group (P < 0.001, P = 0.004, respectively). This study shows that when compared with open colorectal surgery, robotic colorectal surgery results in a less pronounced inflammatory response and more pronounced anti-inflammatory action.

  4. Does minimally invasive oesophagectomy provide a benefit in hospital length of stay when compared with open oesophagectomy?

    PubMed

    Rodham, Paul; Batty, Jonathan A; McElnay, Philip J; Immanuel, Arul

    2016-03-01

    A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was: 'in patients undergoing oesophagectomy, does a minimally invasive approach convey a benefit in hospital length of stay (LOS), when compared to an open approach?' A total of 647 papers were identified, using an a priori defined search strategy; 24 papers represented the best evidence to answer the clinical question. The authors, journal, date, country of publication, patient group, study type, relevant outcomes and key results are tabulated. Of the studies identified, data from two randomized controlled trials were available. The first randomized study compared the use of open thoracotomy and laparotomy versus thoracoscopy and laparoscopy. Those undergoing minimally invasive oesophagectomy (MIO) left hospital on average 3 days earlier than those treated with the open oesophagectomy (OO) technique (P = 0.044). The other randomized trial, which compared thoracotomy with thoracoscopy and laparoscopy, demonstrated a reduction of 1.8 days in the LOS when employing the MIO technique (P < 0.001). With the addition of the remaining 22 non-randomized studies, comprising 3 prospective and 19 retrospective cohort studies, which are heterogeneous with regard to their design, study populations and outcomes; data are available representing 3173 MIO and 25 691 OO procedures. In total, 13 studies (including the randomized trials) demonstrate a significant reduction in hospital LOS associated with MIO; 10 suggest no significant difference between techniques; and only 1 suggests a significantly greater length of stay associated with MIO. The only two randomized trials comparing MIO and OO demonstrated a reduction in length of stay in the MIO group, without compromising survival or increasing complication rates. All bar one of the non-randomized studies demonstrated either a significant reduction in length of stay with MIO or no difference. The benefit in reduced

  5. What were the advantages of microendoscopic discectomy for lumbar disc herniation comparing with open discectomy: a meta-analysis?

    PubMed

    Mu, Xiaoping; Wei, Jianxun; Li, Peifeng

    2015-01-01

    The purpose of this study was to compare the safety and efficacy of micro-endoscopic discectomy (MED) and open discectomy (OD) for lubmar disc herniation (LDH). Randomised controlled trials (RCTs) comparing MED with OD for LDH were searched comprehensively in PubMed, EMBASE, the Cochrane Library. Relevant studies retrieved, data extracted and the quality of included studies were independently performed by two authors. RevMan software (Version 5.2.0) was used to analyse and synthesis relevant data of the included studies. Nine RCTs involving 774 patients were obtained and reported the relevant outcome measures. Compared with OD group, there were significant difference in the general operation indicators including operation time, blood loss, site of incision, hospital stay and time of return to work, biochemical indexes including C-reactive protein (CRP) and interleukin-6 (IL-6) in MED group. Meanwhile, there were no difference in effective rate, complication including total complications, dural leaks occurred and recurrence of the disc herniation, compared MED group with OD group. MED had slighter trauma, milder blood loss and shorter healing time than OD. The results demonstrated MED has great efficacy and safety comparable to OD. So we think that MED can be used routinely for LDH patients, especially the patients of old and intolerable major surgery. Meanwhile, it is necessary for surgeon to master indication and contraindication of MED and improve the operative technique.

  6. Study on diesel-DME spray using open-source CFD (OpenFoam)

    NASA Astrophysics Data System (ADS)

    Fajar, Rizqon; Sugiarto, Bambang; Darsono, Dody

    2012-06-01

    In this work, a numerical study has been performed to evaluate the fuel spray of diesel, dimethyl ether (DME) and its mixture using CFD code OpenFoam. This study uses a general method, based on simulating fuel sprays injected into a constant volume vessel. Calculations results are presented as profiles of diameter (MD) and temperature of fuel droplets as function of fuel type. The results have shown that the diameter of fuel droplet decreased as the fraction of DME in the mixture is higher. Fuel properties affected the atomization and evaporation process. The SMD increased with viscosity and the evaporation rate of fuel spray increased with fuel volatility.

  7. Numerical study of compressible magnetoconvection with an open transitional boundary

    SciTech Connect

    Hanami, H.; Tajima, T.

    1990-08-01

    We study by computer simulation nonlinear evolution of magnetoconvection in a system with a dynamical open boundary between the convection region and corona of the sun. We study a model in which the fluid is subject to the vertical gravitation, magnetohydrodynamics (MHD), and high stratification, through an MHD code with the MacCormack-Donner cell hybrid scheme in order to well represent convective phenomena. Initially the vertical fluid flux penetrates from the convectively unstable zone at the bottom into the upper diffuse atmosphere. As the instability develops, the magnetic fields are twisted by the convection motion and the folding magnetic fields is observed. When the magnetic pressure is comparable to the thermal pressure in the upper layer of convective zone, strong flux expulsion from the convective cell interior toward the cell boundary appears. Under appropriate conditions our simulation exhibits no shock formation incurred by the fluid convected to the photosphere, in contrast to earlier works with box boundaries. The magnetic field patterns observed are those of concentrated magnetic flux tubes, accumulation of dynamo flux near the bottom boundary, pinched flux near the downdraft region, and the surface movement of magnetic flux toward the downdraft region. Many of these computationally observed features are reminiscent of solar observations of the fluid and magnetic structures of their motions.

  8. A multicenter, randomized, double-blind dose-ranging study of glycopyrrolate/formoterol fumarate fixed-dose combination metered dose inhaler compared to the monocomponents and open-label tiotropium dry powder inhaler in patients with moderate-to-severe COPD.

    PubMed

    Tashkin, Donald P; Martinez, Fernando J; Rodriguez-Roisin, Roberto; Fogarty, Charles; Gotfried, Mark; Denenberg, Michael; Gottschlich, Gregory; Donohue, James F; Orevillo, Chad; Darken, Patrick; St Rose, Earl; Strom, Shannon; Fischer, Tracy; Golden, Michael; Reisner, Colin

    2016-11-01

    This study formed part of the dose selection for a glycopyrrolate (GP)/formoterol fumarate (FF) fixed-dose combination formulated using novel Co-Suspension™ Delivery Technology and delivered via a metered dose inhaler (GFF MDI). The study aimed to confirm the optimal dose of GP to formulate with FF 9.6 μg in the fixed-dose combination product, GFF MDI. This multicenter, randomized, double-blind, chronic-dosing, balanced incomplete block, crossover study (NCT01587079) compared five doses of GFF MDI (18/9.6, 9/9.6, 4.6/9.6, 2.4/9.6 and 1.2/9.6 μg, twice daily [BID]) with its monocomponents FF MDI 9.6 μg and GP MDI 18 μg (both BID) and open-label tiotropium (18 μg once daily) as the active control. The primary efficacy endpoint was change from baseline in forced expiratory volume in 1 s area under the curve from 0 to 12 h (FEV1 AUC0-12) on Day 7. In total, 159 patients were randomized to treatment and 132 patients (52.2% male, mean age 62.8 years) were included in the intent-to-treat population. All doses of GFF MDI (except 1.2/9.6 μg) resulted in statistically significant improvements in FEV1 AUC0-12 versus monocomponents and open-label tiotropium. GFF MDI 18/9.6 μg consistently showing the greatest improvement over monocomponents and open-label tiotropium. Adverse events for each GFF MDI dose were similar versus GP MDI 18 μg, FF MDI 9.6 μg and open-label tiotropium. These findings further support selection of GP 18 μg as the optimal dose to combine with FF MDI 9.6 μg for advancement into Phase III clinical trials of GFF MDI. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Open source drug discovery in practice: a case study.

    PubMed

    Årdal, Christine; Røttingen, John-Arne

    2012-01-01

    Open source drug discovery offers potential for developing new and inexpensive drugs to combat diseases that disproportionally affect the poor. The concept borrows two principle aspects from open source computing (i.e., collaboration and open access) and applies them to pharmaceutical innovation. By opening a project to external contributors, its research capacity may increase significantly. To date there are only a handful of open source R&D projects focusing on neglected diseases. We wanted to learn from these first movers, their successes and failures, in order to generate a better understanding of how a much-discussed theoretical concept works in practice and may be implemented. A descriptive case study was performed, evaluating two specific R&D projects focused on neglected diseases. CSIR Team India Consortium's Open Source Drug Discovery project (CSIR OSDD) and The Synaptic Leap's Schistosomiasis project (TSLS). Data were gathered from four sources: interviews of participating members (n = 14), a survey of potential members (n = 61), an analysis of the websites and a literature review. Both cases have made significant achievements; however, they have done so in very different ways. CSIR OSDD encourages international collaboration, but its process facilitates contributions from mostly Indian researchers and students. Its processes are formal with each task being reviewed by a mentor (almost always offline) before a result is made public. TSLS, on the other hand, has attracted contributors internationally, albeit significantly fewer than CSIR OSDD. Both have obtained funding used to pay for access to facilities, physical resources and, at times, labor costs. TSLS releases its results into the public domain, whereas CSIR OSDD asserts ownership over its results. Technically TSLS is an open source project, whereas CSIR OSDD is a crowdsourced project. However, both have enabled high quality research at low cost. The critical success factors appear to be clearly

  10. Open Source Drug Discovery in Practice: A Case Study

    PubMed Central

    Årdal, Christine; Røttingen, John-Arne

    2012-01-01

    Background Open source drug discovery offers potential for developing new and inexpensive drugs to combat diseases that disproportionally affect the poor. The concept borrows two principle aspects from open source computing (i.e., collaboration and open access) and applies them to pharmaceutical innovation. By opening a project to external contributors, its research capacity may increase significantly. To date there are only a handful of open source R&D projects focusing on neglected diseases. We wanted to learn from these first movers, their successes and failures, in order to generate a better understanding of how a much-discussed theoretical concept works in practice and may be implemented. Methodology/Principal Findings A descriptive case study was performed, evaluating two specific R&D projects focused on neglected diseases. CSIR Team India Consortium's Open Source Drug Discovery project (CSIR OSDD) and The Synaptic Leap's Schistosomiasis project (TSLS). Data were gathered from four sources: interviews of participating members (n = 14), a survey of potential members (n = 61), an analysis of the websites and a literature review. Both cases have made significant achievements; however, they have done so in very different ways. CSIR OSDD encourages international collaboration, but its process facilitates contributions from mostly Indian researchers and students. Its processes are formal with each task being reviewed by a mentor (almost always offline) before a result is made public. TSLS, on the other hand, has attracted contributors internationally, albeit significantly fewer than CSIR OSDD. Both have obtained funding used to pay for access to facilities, physical resources and, at times, labor costs. TSLS releases its results into the public domain, whereas CSIR OSDD asserts ownership over its results. Conclusions/Significance Technically TSLS is an open source project, whereas CSIR OSDD is a crowdsourced project. However, both have enabled high quality

  11. Hydrologic studies in wells open through large intervals. Annual report, 1992

    SciTech Connect

    Not Available

    1992-12-31

    This report describes and summarizes activities, data, and preliminary data interpretation from the INEL Oversight Program R&D-1 project titled ``Hydrologic Studies In Wells Open Through Large Intervals.`` The project is designed to use a straddle-packer system to isolate, hydraulically test, and sample specific intervals of monitoring wells that are open (uncased, unscreened) over large intervals of the Snake River Plain aquifer. The objectives of the project are to determine and compare vertical variations in water quality and aquifer properties that have previously only been determined in an integrated fashion over the entire thickness of the open interval of the observation wells.

  12. Randomized clinical trial comparing lumbar percutaneous hydrodiscectomy with lumbar open microdiscectomy for the treatment of lumbar disc protrusions and herniations

    PubMed Central

    Cristante, Alexandre Fogaça; Rocha, Ivan Diasda; Marcon, Raphael Martus; de Barros Filho, Tarcísio Eloy Pessoa

    2016-01-01

    OBJECTIVES: Hydrodiscectomy is a new technique used for percutaneous spinal discectomy that employs a high-intensity stream of water for herniated disc ablation and tissue aspiration. No previous clinical study has examined the effects of percutaneous hydrodiscectomy. The aim of this study is to evaluate the outcomes of hydrodiscectomy compared to open microdiscectomy regarding pain, function, satisfaction, complications and recurrence rates. METHODS: In this randomized clinical trial, patients referred to our tertiary hospital for lumbar back pain were recruited and included in the study if they had disc protrusion or small herniation in only one level, without neurological deficits and with no resolution after six weeks of conservative treatment. One group underwent open microdiscectomy, and the other group underwent percutaneous microdiscectomy via hydrosurgery. Function was evaluated using the Oswestry Disability Index and pain was assessed using a visual analog scale. Evaluations were performed preoperatively, and then during the first week and at one, three, six and twelve months postoperatively. Personal satisfaction was verified. Clinicaltrials.gov: NCT01367860. RESULTS: During the study period, 20 patients were included in each arm and 39 completed one-year of follow-up (one patient died of unrelated causes). Both groups exhibited equal improvement on the visual analog scale and Oswestry evaluations after treatment, without any significant differences. The improvement in the lumbar visual analog scale score was not significant in the hydrodiscectomy group (p=0.138). The rates of infection, pain, recurrence and satisfaction were similar between the two groups. CONCLUSION: Percutaneous hydrodiscectomy was demonstrated to be as effective as open microdiscectomy for reducing pain. The rates of complications and recurrence of herniation were similar between groups. Patient satisfaction with the treatment was also similar between groups. PMID:27276397

  13. Open Educational Resources: A Delphi Study of Instructional Design Quality

    ERIC Educational Resources Information Center

    Emerson, Marnice K.

    2013-01-01

    The purpose of this modified Delphi research study was to investigate instructional designers' beliefs about the instructional strategies and activities to be included in a universal framework for designing quality, self-directed, multimedia, open educational resources (OERs). With the rapid growth of availability and use of OERs by a widely…

  14. Comparing the cost and outcomes of laparoscopic versus open appendectomy for perforated appendicitis in children.

    PubMed

    Groves, Leslie B; Ladd, Mitchell R; Gallaher, Jared R; Swanson, John; Becher, Robert D; Pranikoff, Thomas; Neff, Lucas P

    2013-09-01

    Although laparoscopic appendectomy (LA) is accepted treatment for perforated appendicitis (PA) in children, concerns remain whether it has equivalent outcomes with open appendectomy (OA) and increased cost. A retrospective review was conducted of patients younger than age 17 years treated for PA over a 12.5-year period at a tertiary medical center. Patient characteristics, preoperative indices, and postoperative outcomes were analyzed for patients undergoing LA and OA. Of 289 patients meeting inclusion criteria, 86 had LA (29.8%) and 203 OA (70.2%), the two groups having equivalent patient demographics and preoperative indices. Inpatient costs were not significantly different between LA and OA. LA had a lower rate of wound infection (1.2 vs. 8.9%, P = 0.017), total parenteral nutrition use (23.3 vs. 50.7%, P < 0.0001), and length of stay (5.56 ± 2.38 days vs. 7.25 ± 3.77 days, P = 0.0001). There was no significant difference in the rate of postoperative organ space abscess, surgical re-exploration, or rehospitalization. In children with PA, LA had fewer surgical site infections and shorter lengths of hospital stay compared with OA without an increase in inpatient costs.

  15. Comparative Analysis of Hospital Costs of Open and Endovascular Thoracic Aortic Repair

    PubMed Central

    Arnaoutakis, George J.; Hundt, John A.; Shah, Ashish S.; Cameron, Duke E.; Black, James H.

    2011-01-01

    Background Endovascular technologies represent major advancements in treating descending thoracic aortic aneurysms(DTAA). We compared hospital charges of open thoracic aortic replacement(OTAR) with endovascular repair of thoracic aortic aneurysms(TEVAR). Methods Retrospective analysis of hospital charges related to repair of DTAA(2000–2009). Charges were inflation-adjusted for dollars in 2009. Results There were 50 OTAR and 50 TEVAR patients. OTAR charges were $64,531(IQR:49,000–108,515) versus $61,909(IQR:41,307–92,109) for TEVAR(p = 0.4). 10 patients(10%) died before discharge, with zero TEVAR deaths(p<0.05). For OTAR, supply charges($9,167) accounted for 13% of total charges versus 56% for TEVAR($40,468), p <.01. OTAR LOS was 12d(6d ICU stay); bed charges comprised 40% of total charges. TEVAR had lower LOS(5d with 2d ICU stay, p <0.001). Conclusions DTAA repair remains a formidable operation with significant resource utilization. TEVAR does not significantly reduce overall hospital charges due to device costs, but demonstrates improved mortality, ICU and total LOS. PMID:20829240

  16. Open Science Strategies in Research Policies: A Comparative Exploration of Canada, the US and the UK

    ERIC Educational Resources Information Center

    Lasthiotakis, Helen; Kretz, Andrew; Sá, Creso

    2015-01-01

    Several movements have emerged related to the general idea of promoting "openness" in science. Research councils are key institutions in bringing about changes proposed by these movements, as sponsors and facilitators of research. In this paper we identify the approaches used in Canada, the US and the UK to advance open science, as a…

  17. Open Science Strategies in Research Policies: A Comparative Exploration of Canada, the US and the UK

    ERIC Educational Resources Information Center

    Lasthiotakis, Helen; Kretz, Andrew; Sá, Creso

    2015-01-01

    Several movements have emerged related to the general idea of promoting "openness" in science. Research councils are key institutions in bringing about changes proposed by these movements, as sponsors and facilitators of research. In this paper we identify the approaches used in Canada, the US and the UK to advance open science, as a…

  18. Comparing Open and Guided Inquiry Activities in an Informal Physics Program To Promote Agency, Communication, and Reasoning

    NASA Astrophysics Data System (ADS)

    Wulf, Rosemary Philomena

    In this thesis, we investigate an informal after-school science program. We examine two inquiry curricula used in this program; one more guided and the other more open. We have developed new methods to analyze middle school children's scientific notebooks, and we measure how the children exhibit agency, how the children communicate, and the mechanistic reasoning children use. We compare the two curricula and find that the children exhibit more agency in the open curriculum, write and draw more in the open curriculum, demonstrate a wide variety of scientific communication, and use more varied types of mechanistic reasoning in the open curriculum. These aspects can be linked to science identity, and we conclude that the more open curriculum supports the development of positive science identity.

  19. Towards a Comparative Index of Seaport Climate-Risk: Development of Indicators from Open Data

    NASA Astrophysics Data System (ADS)

    McIntosh, R. D.; Becker, A.

    2016-02-01

    Seaports represent an example of coastal infrastructure that is at once critical to global trade, constrained to the land-sea interface, and exposed to weather and climate hazards. Seaports face impacts associated with projected changes in sea level, sedimentation, ocean chemistry, wave dynamics, temperature, precipitation, and storm frequency and intensity. Port decision-makers have the responsibility to enhance resilience against these impacts. At the multi-port (regional or national) scale, policy-makers must prioritize adaptation efforts to maximize the efficiency of limited physical and financial resources. Prioritization requires comparing across seaports, and comparison requires a standardized assessment method, but efforts to date have either been limited in scope to exposure-only assessments or limited in scale to evaluate one port in isolation from a system of ports. In order to better understand the distribution of risk across ports and to inform transportation resilience policy, we are developing a comparative assessment method to measure the relative climate-risk faced by a sample of ports. Our mixed-methods approach combines a quantitative, data-driven, indicator-based assessment with qualitative data collected via expert-elicitation. In this presentation, we identify and synthesize over 120 potential risk indicators from open data sources. Indicators represent exposure, sensitivity, and adaptive capacity for a pilot sample of 20 ports. Our exploratory data analysis, including Principal Component Analysis, uncovered sources of variance between individual ports and between indicators. Next steps include convening an expert panel representing the perspectives of multiple transportation system agencies to find consensus on a suite of robust indicators and metrics for maritime freight node climate risk assessment. The index will be refined based on expert feedback, the sample size expanded, and additional indicators sought from closed data sources

  20. Meta-analysis of the results of randomized controlled trials that compared laparoscopic and open surgery for acute appendicitis.

    PubMed

    Ohtani, Hiroshi; Tamamori, Yutaka; Arimoto, Yuichi; Nishiguchi, Yukio; Maeda, Kiyoshi; Hirakawa, Kosei

    2012-10-01

    We conducted a meta-analysis to evaluate and compare the outcomes of laparoscopic and open surgery for the treatment of patients with acute appendicitis. We searched MEDLINE, EMBASE, Science Citation Index, and the Cochrane Controlled Trial Register for relevant papers published between January 1990 and February 2012. We analyzed 22 outcomes of laparoscopic and open surgery for acute appendicitis. We identified 39 papers reporting results from randomized controlled trials that compared laparoscopic surgery with open surgery for acute appendicitis. Our meta-analysis included 5,896 patients with acute appendicitis; 2,847 had undergone laparoscopic surgery, and 3,049 had undergone open surgery. Compared with open surgery, laparoscopic surgery was associated with longer operative time (by 13.12 min). However, compared with open surgery, laparoscopic surgery for acute appendicitis was associated with earlier resumption of liquid and solid intake; shorter duration of postoperative hospital stay; a reduction in dose numbers of parenteral and oral analgesics; earlier return to normal activity, work, and normal life; decreased occurrence of wound infection; a better cosmesis; and similar hospital charges. Laparoscopic surgery may now be the standard treatment for acute appendicitis.

  1. Open Access Could Transform Drug Discovery: A Case Study of JQ1.

    PubMed

    Arshad, Zeeshaan; Smith, James; Roberts, Mackenna; Lee, Wen Hwa; Davies, Ben; Bure, Kim; Hollander, Georg A; Dopson, Sue; Bountra, Chas; Brindley, David

    2016-01-01

    The cost to develop a new drug from target discovery to market is a staggering $1.8 billion, largely due to the very high attrition rate of drug candidates and the lengthy transition times during development. Open access is an emerging model of open innovation that places no restriction on the use of information and has the potential to accelerate the development of new drugs. To date, no quantitative assessment has yet taken place to determine the effects and viability of open access on the process of drug translation. This need is addressed within this study. The literature and intellectual property landscapes of the drug candidate JQ1, which was made available on an open access basis when discovered, and conventionally developed equivalents that were not are compared using the Web of Science and Thomson Innovation software, respectively. Results demonstrate that openly sharing the JQ1 molecule led to a greater uptake by a wider and more multi-disciplinary research community. A comparative analysis of the patent landscapes for each candidate also found that the broader scientific diaspora of the publically released JQ1 data enhanced innovation, evidenced by a greater number of downstream patents filed in relation to JQ1. The authors' findings counter the notion that open access drug discovery would leak commercial intellectual property. On the contrary, JQ1 serves as a test case to evidence that open access drug discovery can be an economic model that potentially improves efficiency and cost of drug discovery and its subsequent commercialization.

  2. Open-source electronic data capture system offered increased accuracy and cost-effectiveness compared with paper methods in Africa.

    PubMed

    Dillon, David G; Pirie, Fraser; Rice, Stephen; Pomilla, Cristina; Sandhu, Manjinder S; Motala, Ayesha A; Young, Elizabeth H

    2014-12-01

    Existing electronic data capture options are often financially unfeasible in resource-poor settings or difficult to support technically in the field. To help facilitate large-scale multicenter studies in sub-Saharan Africa, the African Partnership for Chronic Disease Research (APCDR) has developed an open-source electronic questionnaire (EQ). To assess its relative validity, we compared the EQ against traditional pen-and-paper methods using 200 randomized interviews conducted in an ongoing type 2 diabetes case-control study in South Africa. During its 3-month validation, the EQ had a lower frequency of errors (EQ, 0.17 errors per 100 questions; paper, 0.73 errors per 100 questions; P-value ≤0.001), and a lower monetary cost per correctly entered question, compared with the pen-and-paper method. We found no marked difference in the average duration of the interview between methods (EQ, 5.4 minutes; paper, 5.6 minutes). This validation study suggests that the EQ may offer increased accuracy, similar interview duration, and increased cost-effectiveness compared with paper-based data collection methods. The APCDR EQ software is freely available (https://github.com/apcdr/questionnaire). Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  3. Comparing willingness-to-pay: bidding game format versus open-ended and payment scale formats.

    PubMed

    Frew, Emma J; Wolstenholme, Jane L; Whynes, David K

    2004-06-01

    The willingness-to-pay technique is being used increasingly in the economic evaluation of new health care technologies. Clinical trials of two methods of screening for colorectal cancer are currently being conducted in the UK and willingness-to-pay for screening has already been estimated by means of a questionnaire survey, using open-ended (OE) and payment scale (PS) formats. This paper addresses the same medical issue, although it elicits willingness-to-pay values by means of a bidding game in an interview setting. Interviews were conducted with 106 subjects in Nottingham. The bidding game format produced considerably higher valuations than had either of the previous questionnaire formats, whilst the significant differences between agreed valuations obtained using different initial bids supported the existence of starting-point bias in the bidding game. As with the questionnaire study, the majority of interview subjects offered relative valuations of tests at variance with their expressed preferences over the same tests. Given the significant difference in valuations generated by different formats, it follows that the economic case for preferring any one technology over others will depend considerably upon whichever format happens to have been used to generate the valuations.

  4. ERA's Open Rotor Studies Including Shielding for Noise Reduction

    NASA Technical Reports Server (NTRS)

    Van Zante, Dale; Thomas, Russell

    2012-01-01

    The Open Rotor is a modern version of the UnDucted Fan (UDF) that was flight tested in the late 1980's through a partnership between NASA and General Electric (GE). Tests were conducted in the 9' x 15' Low Speed Wind Tunnel and the 8' x 6' Supersonic Wind Tunnel starting in late 2009 and completed in early 2012. Aerodynamic and acoustic data were obtained for takeoff, approach and cruise simulations. GE was the primary partner, but other organizations were involved such as Boeing and Airbus who provided additional hardware for fuselage simulations. This test campaign provided the acoustic and performance characteristics for modern open rotor blades designs." NASA and GE conducted joint systems analysis to evaluate how well new blade designs would perform on a B737 class aircraft, and compared the results to an advanced higher bypass ratio turbofan." Acoustic shielding experiments were performed at NASA GRC and Boeing LSAF facilities to provide data for noise estimates of unconventional aircraft configurations with Open Rotor propulsion systems." The work was sponsored by NASA's aeronautics programs, including the Subsonic Fixed Wing (SFW) and the Environmentally Responsible Aviation (ERA) projects."

  5. Comparing long term impact on ovarian reserve between laparoscopic ovarian cystectomy and open laprotomy for ovarian endometrioma

    PubMed Central

    2013-01-01

    Objective To compare the long term impact on ovarian reserve between laparoscopic ovarian cystectomy with bipolar electrocoagulation and laparotomic cystectomy with suturing for ovarian endometrotic cyst. Patient and method(s) 121 patients with benign ovarian endometroitic cysts were randomised to either laparoscopic ovarian cystectomy using bipolar electrocoagulation (61 patients) or laparotomic ovarian cystectomy using sutures (60 patients). Serum follicle-stimulating hormone, Antimullerian hormon, Basal antral follicle Count, mean ovarian diameter, and ovarian stromal blood flow velocity were measured at 6, 12 and 18 months after surgery and compared in both groups. Result(s) A statistically significant increase of serum FSH was found in the laproscopic bipolar group at 6-, 12 and 18-month postoperativly compared to open laparotomy suture group. Also, a statistically significant decrease of the mean AMH value occurred in laproscopic bipolar group at 6-, 12 and 18-month follow- up compared to open laparotomy suture group. Basal antral follicle number, mean ovarian diameter and peak systolic velocity were significantly decreased during the 6-, 12,18 -month follow-up in laproscopic bipolar group compared to open laparotomy suture group. Conclusion(s) After laproscopic ovarian cystecomy for endometrioma all pareameter of ovarian reseve are significantly decreased on long term follow up as compared to open laprotomy. PMID:24180348

  6. [Comparative estimation of the results of open and endoscopic thoracic sympathectomy in the treatment of Raynaud's phenomenon].

    PubMed

    Miminoshvili, O I; Perepelitsa, S V; Shapovalov, I N

    2010-10-01

    Comparative analysis of thoracic sympathectomy efficacy, performed for Raynaud's phenomenon (RP), was accomplished, concerning application either endoscopic or open method. In 62 patients, suffering RP, open or endoscopic thoracic sympathectomy was done in surgical and vascular departments in 1997-2007 yrs. In 32 (51.61%) patients there was performed endoscopic thoracic sympathectomy, in 30 (48.39%)--upper thoracic sympathectomy, using extrapleural supraclavicular access, according to V. N. Klimenko. Immediate results of upper thoracic sympathectomy did not differ trustworthy depending on any method or access. Late follow-up results of upper thoracic sympathectomy were worse than immediate results by 28%--in endoscopic variant and by 43% --in the open one. The positive results rate after endoscopic thoracic sympathectomy have exceeded that after conducting the open one by 15.18%.

  7. Clinical trial: evaluation of gastric acid suppression with three doses of immediate-release esomeprazole in the fixed-dose combination of PN 400 (naproxen/esomeprazole magnesium) compared with naproxen 500 mg and enteric-coated esomeprazole 20 mg: a randomized, open-label, Phase I study in healthy volunteers.

    PubMed

    Miner, P; Plachetka, J; Orlemans, E; Fort, J G; Sostek, M

    2010-08-01

    PN 400 is a fixed-dose combination formulated to provide sequential delivery of immediate-release (IR) esomeprazole and enteric-coated (EC) naproxen. To evaluate gastric acid suppression with three doses of esomeprazole in PN 400 compared with EC esomeprazole 20 mg. In this Phase I, randomized, open-label study, 28 healthy adults received PN 400 b.d. (naproxen 500 mg plus esomeprazole 10, 20 and 30 mg) and non-EC naproxen 500 mg b.d. plus EC esomeprazole 20 mg o.d., each for 9 days in a crossover fashion. The primary endpoint was percentage of time on day 9 that intragastric pH was >4.0; secondary endpoints included pharmacokinetics and safety. Day 9 percentage of time where intragastric pH was >4.0 was 76.5%, 71.4%, 40.9% and 56.9% [corrected] for PN 400 containing 30, 20 and 10 mg esomeprazole, and naproxen plus esomeprazole 20 mg respectively. This was significantly greater for PN 400 containing 30 and 20 mg esomeprazole vs. naproxen plus esomeprazole 20 mg (95% CI: 13.0-26.0 and 7.8-20.7 respectively). The pharmacokinetics of PN 400 were consistent with its formulation. No serious adverse events occurred. PN 400 containing 20 mg esomeprazole was the lowest dose to achieve gastric acid suppression comparable to EC esomeprazole 20 mg and was selected for further evaluation.

  8. Tocotrienol Treatment in Familial Dysautonomia: Open-Label Pilot Study.

    PubMed

    Cheishvili, David; Maayan, Channa; Holzer, Naama; Tsenter, Jeanna; Lax, Elad; Petropoulos, Sophie; Razin, Aharon

    2016-07-01

    Familial dysautonomia (FD) is an autosomal recessive congenital neuropathy, primarily presented in Ashkenazi Jews. The most common mutation in FD patients results from a single base pair substitution of an intronic splice site in the IKBKAP gene which disrupts normal mRNA splicing and leads to tissue-specific reduction of IKBKAP protein (IKAP). To date, treatment of FD patients remains preventative, symptomatic and supportive. Based on previous in vitro evidence that tocotrienols, members of the vitamin E family, upregulate transcription of the IKBKAP gene, we aimed to investigate whether a similar effects was observed in vivo. In the current study, we assessed the effects of tocotrienol treatment on FD patients' symptoms and IKBKAP expression in white blood cells. The initial daily doses of 50 or 100 mg tocotrienol, doubled after 3 months, was administered to 32 FD patients. Twenty-eight FD patients completed the 6-month study. The first 3 months of tocotrienol treatment was associated with a significant increase in IKBKAP expression level in FD patients' blood. Despite doubling the dose after the initial 3 months of treatment, IKBKAP expression level returned to baseline by the end of the 6-month treatment. Clinical improvement was noted in the reported clinical questionnaire (with regard to dizziness, bloching, sweating, number of pneumonia, cough episodes, and walking stability), however, no significant effect was observed in any clinical measurements (weight, height, oxygen saturation, blood pressure, tear production, histamine test, vibration threshold test, nerve conduction, and heart rate variability) following Tocotrienol treatment. In conclusion, tocotrienol treatment appears significantly beneficial by clinical evaluation for some FD patients in a few clinical parameters; however it was not significant by clinical measurements. This open-label study shows the complexity of effect of tocotrienol treatment on FD patients' clinical outcomes and on

  9. Course Evaluation in Open and Distance Learning: A Case Study from Indira Gandhi National Open University

    ERIC Educational Resources Information Center

    Gaba, Ashok K.; Dash, Nirod K.

    2004-01-01

    The success of any open and distance learning course depends on how well it is designed, executed, and evaluated. Evaluation of a course not only demonstrates its strengths, but also points out any inherent shortcomings in the course. This is why course evaluation constitutes an important function in an open and distance learning system. The…

  10. Opening Education: Policies and Practices from Open and Distance Education. Routledge Studies in Distance Education Series.

    ERIC Educational Resources Information Center

    Evans, Terry, Ed.; Nation, Daryl, Ed.

    The overall theme of this book is the relationships between government and organizational policies and the work of practitioners in open and distance learning. The book explores a selection of international examples, many of which concern the use of new technologies for opening education. The contributors, many of whom are recognized experts,…

  11. Course Evaluation in Open and Distance Learning: A Case Study from Indira Gandhi National Open University

    ERIC Educational Resources Information Center

    Gaba, Ashok K.; Dash, Nirod K.

    2004-01-01

    The success of any open and distance learning course depends on how well it is designed, executed, and evaluated. Evaluation of a course not only demonstrates its strengths, but also points out any inherent shortcomings in the course. This is why course evaluation constitutes an important function in an open and distance learning system. The…

  12. Opening Education: Policies and Practices from Open and Distance Education. Routledge Studies in Distance Education Series.

    ERIC Educational Resources Information Center

    Evans, Terry, Ed.; Nation, Daryl, Ed.

    The overall theme of this book is the relationships between government and organizational policies and the work of practitioners in open and distance learning. The book explores a selection of international examples, many of which concern the use of new technologies for opening education. The contributors, many of whom are recognized experts,…

  13. A Comparative Analysis Between Laparoscopic and Open Ventral Hernia Repair at a Tertiary Care Center

    PubMed Central

    DAVIES, STEPHEN W.; TURZA, KRISTIN C.; SAWYER, ROBERT G.; SCHIRMER, BRUCE D.; HALLOWELL, PETER T.

    2012-01-01

    Laparoscopic ventral hernia repair reportedly yields lower postoperative complications than open repair. We hypothesized that patients undergoing laparoscopic repair would have lower postoperative infectious outcomes. Also, certain preoperative patient characteristics and preoperative hernia characteristics are hypothesized to increase complication risk in both groups. All ventral hernia repairs performed at University of Virginia from January 2004 to January 2006 were reviewed. Primary outcomes included wound healing complications and hernia recurrence. Categorical data were analyzed with χ2 and Fisher’s exact tests. Continuous variables were evaluated with independent t tests and Mann-Whitney U tests. Multivariable logistic regression was performed. A total of 268 repairs (110 open, 158 laparoscopic) were evaluated. Patient and hernia characteristics were similar between groups, though the percents of wound contamination (5.4% vs 0.6%; P = 0.02) and simultaneous surgery (7.2% vs 0%; P = 0.001) were greater in the open procedures. Univariate analysis also revealed that open cases had a greater incidence of postoperative superficial surgical site infection (SSI) (30.0% vs 10.7%; P < 0.0001). Multivariable analysis revealed that both diabetes and open repair were associated with an increased risk of superficial SSI (P = 0.019; odds ratio = 3.512; 95% confidence interval = 1.229–10.037 and P = 0.001; odds ratio = 4.6; 95% confidence interval = 1.9–11.2, respectively). Laparoscopic ventral hernia repair yielded lower rates of postoperative superficial SSI than open surgery. Other pre-operative patient characteristics and preoperative hernia characteristics, with the exception of diabetes, were not found to be associated with an increased risk of postoperative complications. PMID:22856497

  14. Study of the radon released from open drill holes

    SciTech Connect

    Pacer, J C

    1981-06-01

    The radon emanating from three open drill holes was measured at a site of known uranium mineralization in the Red Desert of south central Wyoming. The radon flux from the soil and drill holes was measured by the accumulator method with activated charcoal cartridges. The surface soil was found to release radon at an average rate of 0.41 atoms/cm/sup 2//sec; the radon emanating from the holes was more variable than that from the soil. The three holes studied released an average of 47 atoms/cm/sup 2//sec of radon. This average is equivalent to the radon released to the atmosphere by 14.5 ft/sup 2/ of soil. The data indicate that the radon emanated from an open drill hole is not as significant as other possible activities at a drill site (i.e. digging a trench or drilling a hole) or from household activities involving the usage of water.

  15. Anthem simulational studies of the plasma opening switch

    SciTech Connect

    Mason, R.J.

    1992-01-01

    For a deeper understanding of the physical processes governing the Plasma Opening Switch (POS) we use the ANTHEM 2D implicit simulation code to study: (1) ion dynamical effects on electrohydrodynamic (EHD) waves propagating along steep density interfaces in the switch plasmas. At radial interfaces where the density jumps toward the anode, these waves can drive a finger of magnetic field into the plasma toward the load. Ion dynamics can open the rear of such fingers into a wedge-like density gap. Then: (2) we examine ion effects in uniform switch plasmas. These first develop potential hill structures at the drive edge of the cathode from the competition between electron velocity advection and EHD magnetic exclusion waves. Magnetic pressure gradients at the hill periphery and EHD effects then establish a density gap propagating along the cathode with radial electron emission from its tip. Similar results are obtained under both multi-fluid and PIC modeling of the plasma components.

  16. Anthem simulational studies of the plasma opening switch

    SciTech Connect

    Mason, R.J.

    1992-07-01

    For a deeper understanding of the physical processes governing the Plasma Opening Switch (POS) we use the ANTHEM 2D implicit simulation code to study: (1) ion dynamical effects on electrohydrodynamic (EHD) waves propagating along steep density interfaces in the switch plasmas. At radial interfaces where the density jumps toward the anode, these waves can drive a finger of magnetic field into the plasma toward the load. Ion dynamics can open the rear of such fingers into a wedge-like density gap. Then: (2) we examine ion effects in uniform switch plasmas. These first develop potential hill structures at the drive edge of the cathode from the competition between electron velocity advection and EHD magnetic exclusion waves. Magnetic pressure gradients at the hill periphery and EHD effects then establish a density gap propagating along the cathode with radial electron emission from its tip. Similar results are obtained under both multi-fluid and PIC modeling of the plasma components.

  17. Study of Intermediate Age (~10-30 Myr) Open Clusters

    NASA Astrophysics Data System (ADS)

    Olguin, Lorenzo; Michel, Raul; Contreras, Maria; Hernandez, Jesus; Schuster, William; Chavarria-Kleinhenn, Carlos

    2013-07-01

    We present the study of a sample of intermediate age open clusters (age ~ 10-30 Myr) using optical (UBVRI) and infrared photometric data. Optical photometry was obtained as part of the San Pedro Martir Open Clusters Project (SPM-OCP, Schuster et al. 2007; Michel et al. 2013). Infrared photometry was retrieved from 2MASS public data archive and WISE database. Open clusters included in the SPM-OCP were selected from catalogues presented by Dias et al. (2002) and Froebrich, Scholz & Raftery (2007). One of the main goals of the SPM-OCP is to compile a self-consistent and homogeneous set of cluster fundamental parameters such as reddening, distance, age, and metallicity whenever possible. In this work, we have analyzed a set of 25 clusters from the SPM-OCP with estimated ages between 10 and 30 Myr. Derived fundamental parameters for each cluster in the sample as well as an example of typical color-color and color-magnitude diagrams are presented. Kinematic membership was established by using proper motion data taken from the literature. Based on infrared photometry, we have searched for candidate stars to posses a circumstellar disk within each clusters. For those selected candidates a follow-up spectroscpic study is being carried out. This work was partially supported by UNAM-PAPIIT grant IN-109311.

  18. Comparative analysis on flow over cylinder between commercial code and open source algorithm

    NASA Astrophysics Data System (ADS)

    Azri, Zulaikha Asyiqin Nur; Taib, Ishkrizat; Sadikin, Azmahani; Paisal, Muhammad Sufyan Amir; Mohammed, Akmal Nizam; Mohd, Sofian

    2017-04-01

    The understanding of flow over cylinder is crucial especially in aerodynamic study. The present of vortices due to flow separation at the stagnation point of cylinder is differing with the changes of Reynolds number. This study aims to investigate the flow characteristics over cylinder with different Reynolds numbers. Computational modelling is used in predicting the flow characteristic of flow over cylinder. Two different softwares has been used: Code::Blocks as compiler and commercial code as a basis of comparison. Three different Reynolds number imposed in this study are 20, 40 and 100 to compare the accuracy and speed of convergence. Validation has been made with the previous finding to benchmark the accuracy of the result. The parameters used in this study are velocity in x and y direction, Mach numbers, drag coefficient and pressure coefficient. A brief comparison between sequential and optimized configuration which includes multiple processors is also considered. Results show that the drag coefficient and pressure are highly dependent on Reynolds numbers. The commercial code is acknowledged to be providing better results than the applied source code. However, for the optimization issue in the future, the advancement of applied source code will obtain the similar result as compared to commercial code.

  19. Does minimally invasive surgery have a lower risk of surgical site infections compared with open spinal surgery?

    PubMed

    Ee, Wen Wei Gerard; Lau, Wen Liang Joel; Yeo, William; Von Bing, Yap; Yue, Wai Mun

    2014-06-01

    Surgical site infection (SSI) ranges from 1.9% to 5.5% in most large series. Minimally invasive surgery (MIS) has been postulated to reduce SSI rates. (1) Is MIS associated with a lower incidence of SSI compared with open spinal surgery? (2) Are there other independent risk factors associated with SSI? (3) What bacteria are most common in spinal SSI? Medical records of 2299 patients who underwent transforaminal lumbar interbody fusion, laminectomy, or discectomy were analyzed and selected for a nested case-control analysis. Twenty-seven cases with SSI were matched with 162 control subjects without SSI stratified based on procedure performed within 28 days of the case's date of surgery. Patients were identified from an institutional database at a tertiary care hospital. MIS involved spinal procedures performed through a tubular retractor system. Univariate and multivariate analyses were performed. Patients undergoing open spinal surgery were 5.77 times more likely to develop SSI compared with MIS approaches (odds ratio [OR], 5.77; 95% confidence interval [CI], 1.0-32.7; p = 0.048). Also, from the multivariate regression model, diabetes (OR, 4.7; 95% CI, 1.3-17.0; p = 0.018), number of levels operated on (OR, 3.5; 95% CI, 1.6-7.5; p = 0.001), and body mass index (OR, 1.2; 95% CI, 1.0-1.3; p = 0.010) were predictive of an increased risk in SSI. Staphylococcus aureus was most frequently identified, being present in 12 of 21 (52.4%) patients in whom positive cultures were obtained. Four of the 12 patients had methicillin-resistant S aureus infection. In our series, MIS has a lower incidence of SSI. The risk factors predictive of SSI should be further evaluated in well-designed prospective trials. Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

  20. Comparing Learner Community Behavior in Multiple Presentations of a Massive Open Online Course

    ERIC Educational Resources Information Center

    Gallagher, Silvia Elena; Savage, Timothy

    2015-01-01

    Massive Online Open Courses (MOOCs) can create large scale communities of learners who collaborate, interact and discuss learning materials and activities. MOOCs are often delivered multiple times with similar content to different cohorts of learners. However, research into the differences of learner communication, behavior and expectation between…

  1. What Makes a MOOC? Massive Open Online Courses (MOOCSs) Compared to Mainstream Online University Courses

    ERIC Educational Resources Information Center

    Johnston, Timothy C.

    2014-01-01

    A Massive Open Online Course (MOOC) is a model for delivering learning content online to any person who wants to take a course, with no limit on attendance. The MOOC industry is growing rapidly, fueled by students interested in free higher-education learning, and the universities and venture capitalists willing to fund the courses. This paper…

  2. Comparing Learner Community Behavior in Multiple Presentations of a Massive Open Online Course

    ERIC Educational Resources Information Center

    Gallagher, Silvia Elena; Savage, Timothy

    2016-01-01

    Massive Online Open Courses (MOOCs) can create large scale communities of learners who collaborate, interact and discuss learning materials and activities. MOOCs are often delivered multiple times with similar content to different cohorts of learners. However, research into the differences of learner communication, behavior and expectation between…

  3. China's Radio & TV Universities and the British Open University: A Comparative Perspective. ZIFF Papiere 104.

    ERIC Educational Resources Information Center

    Runfang, Wei

    This paper examines the origins, objectives and structures, funding and cost, programs, learners, and teaching and learning of the radio and television universities in China and the British Open University (BOU). It also discusses the nature and role of each of these entities, including growth and development of higher education and the…

  4. Comparing Learner Community Behavior in Multiple Presentations of a Massive Open Online Course

    ERIC Educational Resources Information Center

    Gallagher, Silvia Elena; Savage, Timothy

    2016-01-01

    Massive Online Open Courses (MOOCs) can create large scale communities of learners who collaborate, interact and discuss learning materials and activities. MOOCs are often delivered multiple times with similar content to different cohorts of learners. However, research into the differences of learner communication, behavior and expectation between…

  5. Comparing Assessments of Students' Knowledge by Computerized Open-Ended and Multiple-Choice Tests.

    ERIC Educational Resources Information Center

    Anbar, Michael

    1991-01-01

    Interactive computerized tests accepting unrestricted natural-language input were used to assess knowledge of clinical biophysics at the State University of New York at Buffalo. Comparison of responses to open-ended sequential questions and multiple-choice questions on the same material found the two formats test different aspects of competence.…

  6. Comparative Analysis of Pedagogical Strategies across Disciplines in Open Distance Learning at Unisa

    ERIC Educational Resources Information Center

    Ramdass, Kemlall; Masithulela, Fulufhelo

    2016-01-01

    Re-engineering technological strategies in teaching and learning in an open distance learning (ODL) environment is paramount as the demand for access to quality higher education escalates drastically on a year to year basis. The organisational framework requires change in order to accommodate the increasing number of students. In view of the…

  7. Rate and time to develop first central line-associated bloodstream infections when comparing open and closed infusion containers in a Brazilian Hospital.

    PubMed

    Vilins, Margarete; Blecher, Sergio; Silva, Maria A Maretti da; Rosenthal, Victor Daniel; Barker, Kerry; Salomao, Reinaldo

    2009-10-01

    The objective of the study was to determine the effect of switching from an open (glass or semi-rigid plastic) infusion container to a closed, fully collapsible plastic infusion container (Viaflex) on rate and time to onset of central lineassociated bloodstream infections (CLABSI). An open-label, prospective cohort, active healthcare-associated infection surveillance, sequential study was conducted in three intensive care units in Brazil. The CLABSI rate using open infusion containers was compared to the rate using a closed infusion container. Probability of acquiring CLABSI was assessed over time and compared between open and closed infusion container periods; three-day intervals were examined. A total of 1125 adult ICU patients were enrolled. CLABSI rate was significantly higher during the open compared with the closed infusion container period (6.5 versus 3.2 CLABSI/1000 CL days; RR=0.49, 95%CI=0.26- 0.95, p=0.031). During the closed infusion container period, the probability of acquiring a CLABSI remained relatively constant along the time of central line use (0.8% Days 2-4 to 0.7% Days 11-13) but increased in the open infusion container period (1.5% Days 2-4 to 2.3% Days 11-13). Combined across all time intervals, the chance of a patient acquiring a CLABSI was significantly lower (55%) in the closed infusion container period (Cox proportional hazard ratio 0.45, p= 0.019). CLABSIs can be reduced with the use of full barrier precautions, education, and performance feedback. Our results show that switching from an open to a closed infusion container may further reduce CLABSI rate as well as delay the onset of CLABSIs. Closed infusion containers significantly reduced CLABSI rate and the probability of acquiring CLABSI.

  8. Open source projects in software engineering education: a mapping study

    NASA Astrophysics Data System (ADS)

    Nascimento, Debora M. C.; Almeida Bittencourt, Roberto; Chavez, Christina

    2015-01-01

    Context: It is common practice in academia to have students work with "toy" projects in software engineering (SE) courses. One way to make such courses more realistic and reduce the gap between academic courses and industry needs is getting students involved in open source projects (OSP) with faculty supervision. Objective: This study aims to summarize the literature on how OSP have been used to facilitate students' learning of SE. Method: A systematic mapping study was undertaken by identifying, filtering and classifying primary studies using a predefined strategy. Results: 72 papers were selected and classified. The main results were: (a) most studies focused on comprehensive SE courses, although some dealt with specific areas; (b) the most prevalent approach was the traditional project method; (c) studies' general goals were: learning SE concepts and principles by using OSP, learning open source software or both; (d) most studies tried out ideas in regular courses within the curriculum; (e) in general, students had to work with predefined projects; (f) there was a balance between approaches where instructors had either inside control or no control on the activities performed by students; (g) when learning was assessed, software artefacts, reports and presentations were the main instruments used by teachers, while surveys were widely used for students' self-assessment; (h) most studies were published in the last seven years. Conclusions: The resulting map gives an overview of the existing initiatives in this context and shows gaps where further research can be pursued.

  9. A Study of Innovative Features in Scholarly Open Access Journals

    PubMed Central

    2011-01-01

    Background The emergence of the Internet has triggered tremendous changes in the publication of scientific peer-reviewed journals. Today, journals are usually available in parallel electronic versions, but the way the peer-review process works, the look of articles and journals, and the rigid and slow publication schedules have remained largely unchanged, at least for the vast majority of subscription-based journals. Those publishing firms and scholarly publishers who have chosen the more radical option of open access (OA), in which the content of journals is freely accessible to anybody with Internet connectivity, have had a much bigger degree of freedom to experiment with innovations. Objective The objective was to study how open access journals have experimented with innovations concerning ways of organizing the peer review, the format of journals and articles, new interactive and media formats, and novel publishing revenue models. Methods The features of 24 open access journals were studied. The journals were chosen in a nonrandom manner from the approximately 7000 existing OA journals based on available information about interesting journals and include both representative cases and highly innovative outlier cases. Results Most early OA journals in the 1990s were founded by individual scholars and used a business model based on voluntary work close in spirit to open-source development of software. In the next wave, many long-established journals, in particular society journals and journals from regions such as Latin America, made their articles OA when they started publishing parallel electronic versions. From about 2002 on, newly founded professional OA publishing firms using article-processing charges to fund their operations have emerged. Over the years, there have been several experiments with new forms of peer review, media enhancements, and the inclusion of structured data sets with articles. In recent years, the growth of OA publishing has also been

  10. Comparative Environmental Threat Analysis: Three Case Studies.

    ERIC Educational Resources Information Center

    Latour, J. B.; Reiling, R.

    1994-01-01

    Reviews how carrying capacity for different environmental problems is operationalized. Discusses whether it is possible to compare threats, using the exceeding of carrying capacity as a yardstick. Points out problems in comparative threat analysis using three case studies: threats to European groundwater resources, threats to ecosystems in Europe,…

  11. Comparative Environmental Threat Analysis: Three Case Studies.

    ERIC Educational Resources Information Center

    Latour, J. B.; Reiling, R.

    1994-01-01

    Reviews how carrying capacity for different environmental problems is operationalized. Discusses whether it is possible to compare threats, using the exceeding of carrying capacity as a yardstick. Points out problems in comparative threat analysis using three case studies: threats to European groundwater resources, threats to ecosystems in Europe,…

  12. Effect of obesity on laparoscopy-assisted distal gastrectomy compared with open distal gastrectomy for gastric cancer.

    PubMed

    Makino, Hirochika; Kunisaki, Chikara; Izumisawa, Yusuke; Tokuhisa, Motohiko; Oshima, Takashi; Nagano, Yasuhiko; Fujii, Shoichi; Kimura, Jun; Takagawa, Ryo; Kosaka, Takashi; Ono, Hidetaka A; Akiyama, Hirotoshi; Endo, Itaru

    2010-08-01

    This study compared surgical outcomes between patients undergoing laparoscopy-assisted distal gastrectomy (LADG) and those undergoing open distal gastrectomy (ODG) from the viewpoint of obesity. Between June 2002 and May 2008, 146 patients with preoperatively diagnosed early gastric cancer who underwent LADG (n = 90) or ODG (n = 56) were enrolled in this study and compared in terms of clinicopathological findings and operative outcome. The visceral fat area (VFA) and subcutaneous fat area (SFA) were assessed as identifiers of obesity using FatScan software. The relationship between obesity and operative outcomes after LADG and ODG was evaluated. There were no significant correlations between intraoperative blood loss (IBL) and any obesity-related factors, or between operation time (OT) and any obesity-related factors in the LADG group. There was a significant correlation between IBL and BMI (r = 0.486, P = 0.0001), IBL and VFA (r = 0.456, P = 0.0003), IBL and SFA (r = 0.311, P = 0.0193), OT and BMI (r = 0.406, P = 0.0017), OT and VFA (r = 0.314, P = 0.0178), and between OT and SFA (r = 0.382, P = 0.0034) in the ODG group. LADG may be a useful operative manipulation that is not influenced by obesity, whereas ODG may be influenced by obesity even after reaching the surgical plateau. (c) 2010 Wiley-Liss, Inc.

  13. Comparative Review of Elementary Social Studies Textbooks.

    ERIC Educational Resources Information Center

    Waters, Barbara A.

    Four elementary social studies textbook series are reviewed and compared with particular attention paid to the extent to which the textbooks are globally oriented. The trend of emphasizing global education in the social studies also is discussed. As used in this paper, "global education" includes the study of world geography, world…

  14. Comparing the OpenMP, MPI, and Hybrid Programming Paradigm on an SMP Cluster

    NASA Technical Reports Server (NTRS)

    Jost, Gabriele; Jin, Haoqiang; anMey, Dieter; Hatay, Ferhat F.

    2003-01-01

    With the advent of parallel hardware and software technologies users are faced with the challenge to choose a programming paradigm best suited for the underlying computer architecture. With the current trend in parallel computer architectures towards clusters of shared memory symmetric multi-processors (SMP), parallel programming techniques have evolved to support parallelism beyond a single level. Which programming paradigm is the best will depend on the nature of the given problem, the hardware architecture, and the available software. In this study we will compare different programming paradigms for the parallelization of a selected benchmark application on a cluster of SMP nodes. We compare the timings of different implementations of the same CFD benchmark application employing the same numerical algorithm on a cluster of Sun Fire SMP nodes. The rest of the paper is structured as follows: In section 2 we briefly discuss the programming models under consideration. We describe our compute platform in section 3. The different implementations of our benchmark code are described in section 4 and the performance results are presented in section 5. We conclude our study in section 6.

  15. Investigation of the hemostatic effect of a transdermal patch containing 0.55 mg ethinyl estradiol and 2.1 mg gestodene compared with a monophasic oral contraceptive containing 0.03 mg ethinyl estradiol and 0.15 mg levonorgestrel: an open-label, randomized, crossover study.

    PubMed

    Junge, Wolfgang; Heger-Mahn, Doris; Trummer, Dietmar; Merz, Martin

    2013-09-01

    Transdermal delivery of contraceptives offers several advantages over combined oral contraceptives (COCs), including effective absorption and the provision of relatively constant serum concentrations. Ethinyl estradiol (EE) and the progestin gestodene are well-absorbed through the skin and, therefore, well-suited for use in a transdermal contraceptive patch. The objective of this study was to investigate the impact of a once-weekly transparent, transdermal patch delivering low doses of EE and gestodene equivalent to a COC containing 0.02 mg EE and 0.06 mg gestodene on hemostasis parameters compared with a monophasic COC containing 0.03 mg EE and 0.15 mg levonorgestrel. In this single-center, open-label, randomized, crossover study, 30 women (aged 18-35 years) received three cycles of each treatment, separated by a two-cycle washout period. The primary outcome measure was the absolute change from baseline in prothrombin fragments 1 + 2 and D-dimer. For both treatments, prothrombin fragments 1 + 2 remained stable during the first treatment period, and increased only slightly in the second period (mean absolute change 0.025 and 0.028 nmol/L in the novel Bayer patch and COC groups, respectively). Increases in D-dimer were observed in both periods (mean absolute change 107.0 ± 147.2 ng/L for the novel Bayer patch and 113.7 ± 159.0 ng/L for the COC). There were no statistically significant treatment differences in prothrombin 1 + 2 or D-dimer (p = 0.667 and p = 0.884, respectively) and no statistically significant treatment sequence or period effects. A COC containing 0.03 mg EE and 0.15 mg levonorgestrel and the novel Bayer patch have comparable influence on hemostatic endpoints. Both treatments were well-tolerated by subjects.

  16. Studying Student Motivations in an Astronomy Massive Open Online Class

    NASA Astrophysics Data System (ADS)

    Wenger, Matthew; Impey, Chris David; Buxner, Sanlyn; Formanek, Martin

    2017-01-01

    Massive Open Online Courses (MOOCs) are large-scale, free classes open to anyone around the world and are are part of an educational industry that includes a growing number of universities. Although they resemble formal classes, MOOCs are of interest to instructors and educational researchers because they are unique learning environments where various people--particularly adult learners--learn science. This research project examined learners in an astronomy MOOC in order to better understand the motivations of MOOC learners. Using a well-tested instrument that examines student motivations for learning, we wanted to compare the motivations of MOOC learners to previous results in undergraduate classrooms. Our results show that our MOOC learners scored high in intrinsic motivation, self-efficacy, and self-determination. They differed from learners in traditional formal educational environments by having lower grade and career-related motivations. These results suggest that MOOC learners have characteristics of learners in so called “free-choice” learning environments, similar to other life-long learners.

  17. A Comparative Assessment of Postoperative Analgesic Efficacy of Lornoxicam versus Tramadol after Open Reduction and Internal Fixation of Mandibular Fractures.

    PubMed

    Jain, Ankesh Dilip; Vsm, Ravisankar; Ksn, Siva Bharani; Km, Sudheesh; Tewathia, Nisha

    2017-09-01

    Pain after any surgical procedure is inevitable but can be controlled by administration of analgesics in most cases. Postoperative pain after surgical treatment of mandibular fractures can be treated by nonsteroidal anti-inflammatory drugs (NSAIDs) and opioid analgesics. The purpose of this study is to critically compare the postoperative analgesic efficacy of small doses of intravenous TRAMADOL (opioid analgesic) versus LORNOXICAM (NSAID) in patients with mandibular trauma undergoing open reduction and internal fixation (ORIF) and to assess the presence of any adverse effects due to NSAID or opioid use. Forty adult ASA grade I-II patients with mandibular trauma, scheduled for ORIF under general anesthesia in the Department of Oral and Maxillofacial Surgery, College of Dental Sciences, Davangere, were selected for the study. The patients were randomly assigned into a tramadol group (Group T) and a lornoxicam group (Group L) and were administered intravenous tramadol 50 mg and intravenous lornoxicam 8 mg, respectively, at specific postoperative intervals. Pain intensity was quantitatively assessed at the 2nd, 4th, 6th, 12th, and 24th postoperative hours using a visual analog scale of 10 cm. Adverse effects of the analgesics were also recorded and compared. Both the drugs resulted in a significant decrease in pain intensity from 2nd to 24th postoperative hours, but better pain control was observed in Group L at 24th postoperative hour. Only two patients experienced nausea and vomiting in Group T and one patient experienced gastric acidity in Group L. The comparative results clearly demonstrate that pain control by intravenous lornoxicam is significantly better than by intravenous tramadol at 24th postoperative hour after ORIF of mandibular trauma. Side effects produced by both the drugs were minor and had no apparent effect on the study results.

  18. Topical Adapalene in the Treatment of Plantar Warts; Randomized Comparative Open Trial in Comparison with Cryo-Therapy

    PubMed Central

    Gupta, Ramji; Gupta, Sarthak

    2015-01-01

    Background: Various therapeutic modalities, which are available for treating plantar wart, have not been successful every time. Aims: To evaluate topical adapalene under occlusion in the treatment of plantar warts and compare it with cryo-therapy. Materials and Methods: 50 patients with 424 plantar warts were included in this single center, two arm, prospective, randomized, control, open study. Patients were allocated randomly into two groups consisting of 25 patients each. Group A patients having 299 plantar warts were treated using adapalene gel 0.1% under occlusion while Group B patients having 125 warts were treated using cryo-therapy. All the patients were evaluated weekly till the clearance of all the warts and the results compared. Result: All the warts of 25 patients of Group A that were treated using adapalene gel 0.1% cleared in 36.71 ± 19.24 (55.95-17.47) days except those in one patient. In Group B, warts in all except one treated by cryo-therapy cleared in 52.17 ± 30.06 (82.23-22.11) days. There were no side effects like scar formation, irritation, erythema, or infections with adapalene group while in the cryo group scar was seen in 2 patients, pain in 24, erythema in 10, and infection in 3 patients. Conclusion: Adapalene gel 0.1% under occlusion is an effective, safe and easy to use treatment for plantar warts and may help clear lesions faster than cryo-therapy. PMID:25657417

  19. A computational study of open-chain epothilone analogue

    NASA Astrophysics Data System (ADS)

    Kamel, Karol; Rusinska-Roszak, Danuta

    Molecular mechanics (MM/Ambers) calculations were applied to probe the conformational profile of open-chain epothilone analogue [Org Lett 2006, 8, 685], cytotoxic against some cell lines. Geometries of the most stable conformers were optimized at DFT level using the B3LYP functional and then compared to known both experimental and virtual conformers of epothilone. One of the most stable structures is III (1.47 kcal/mol above global minimum) which represents high similarity to the appropriate fragment of the Taylor's model of epothilone A, but two other conformers: XIV and XX, although they have almost the same conformation as the mother structure, are very unstable (6.7 and 12.4 kcal/mol above the global minimum).0

  20. Comparative efficacy trial of cupping and serkangabin versus conventional therapy of migraine headaches: A randomized, open-label, comparative efficacy trial

    PubMed Central

    Firoozabadi, Mohammad Dehghani; Navabzadeh, Maryam; Roudsari, Mohammad Khodashenas; Zahmatkash, Mohsen

    2014-01-01

    Background: Migraine headaches are the most common acute and recurrent headaches. Current treatment of a migraine headache consists of multiple medications for control and prevention of recurrent attacks. Global emergence of alternative medicine led us to examine the efficacy of cupping therapy plus serkangabin syrup in the treatment of migraine headaches. Materials and Methods: This study was a randomized, controlled, open-label, comparative efficacy trial. We randomly assigned patients with migraine into cupping therapy plus serkangabin group (30 patients) and conventional treatment group (30 patients). An investigator assessed the severity of headache, frequency of attacks in a week and duration of attacks per hour in 5 visits (at the end of 2 weeks, 1, 3 and 6 months). Generalized estimating equations approach was used to analyze repeated measures data to compare outcomes in both groups. Results: Average age for cupping therapy group and conventional treatment group were 31.7 (±7.6) and 32.6 (±12.7) years, respectively (P = 0.45). After treatment for 2 weeks; and 1, 3 and 6 months, severity of headache (P = 0.80), frequency of migraine attacks (P = 0.63) and duration of attacks per hours (P = 0.48) were similar in conventional and cupping groups but these symptoms were decreased in each group during the study (P < 0.001). Conclusion: There was no significant difference between cupping plus serkangabin therapy and conventional treatment in the treatment and prophylaxis of migraine. The alternative therapy may be used in cases of drug intolerance, no medication response, and in primary care. PMID:25709653

  1. Pulse perfusion value predicts eye opening after sevoflurane anaesthesia: an explorative study.

    PubMed

    Enekvist, Bruno; Johansson, Anders

    2015-08-01

    The variables measured in modern pulse oximetry apparatuses include a graphical pulse curve and a specified perfusion value (PV) that could be a sensitive marker for detecting differences in sympathetic activity. We hypothesized that there is a correlation between a reduction of PV and the time to eye opening after general anaesthesia. The objective was to investigate whether PV can predict eye opening after sevoflurane anaesthesia. Prospective, explorative clinical study included 20 patients, ASA physical status 1 or 2, at Skåne University Hospital, Lund, Sweden, from November 2012 to January 2013 scheduled for elective breast tumour surgery. A general anaesthesia was delivered with inhalation of oxygen, nitrous oxide and sevoflurane anaesthesia to a depth of 1.2 minimal alveolar concentration. Sevoflurane inspiratory and expiratory concentrations were measured. Bispectral index monitoring, PV as measured by pulse oximeter, heart rate and carbon dioxide were registered at before anaesthesia, 15 min after induction (at 1.2 minimal alveolar concentration), at end of surgery and at eye opening at the end of anaesthesia. PV values were lower before anaesthesia and at eye opening compared to at 15 min after induction and at end of surgery (P < 0.05). The reduction of PV between end of surgery and eye opening was 0.76. We conclude that the pulse oximeter PV could be a useful variable to assess the timing of recovery, in terms of eye opening after a general anaesthesia.

  2. World Studies through a Comparative Constitutional Prism.

    ERIC Educational Resources Information Center

    Robinson, Donald

    1992-01-01

    Emphasizes the importance of understanding the development of democracy around the world by comparative study of constitutions. Uses the development of the Japanese constitution after World War II as a case study. Describes the work of the team appointed by General Douglas MacArthur and the significance of the clause guaranteeing equal rights for…

  3. A study of institutional spending on open access publication fees in Germany

    PubMed Central

    Tullney, Marco

    2016-01-01

    Publication fees as a revenue source for open access publishing hold a prominent place on the agendas of researchers, policy makers, and academic publishers. This study contributes to the evolving empirical basis for funding these charges and examines how much German universities and research organisations spent on open access publication fees. Using self-reported cost data from the Open APC initiative, the analysis focused on the amount that was being spent on publication fees, and compared these expenditure with data from related Austrian (FWF) and UK (Wellcome Trust, Jisc) initiatives, in terms of both size and the proportion of articles being published in fully and hybrid open access journals. We also investigated how thoroughly self-reported articles were indexed in Crossref, a DOI minting agency for scholarly literature, and analysed how the institutional spending was distributed across publishers and journal titles. According to self-reported data from 30 German universities and research organisations between 2005 and 2015, expenditures on open access publication fees increased over the years in Germany and amounted to € 9,627,537 for 7,417 open access journal articles. The average payment was € 1,298, and the median was € 1,231. A total of 94% of the total article volume included in the study was supported in accordance with the price cap of € 2,000, a limit imposed by the Deutsche Forschungsgemeinschaft (DFG) as part of its funding activities for open access funding at German universities. Expenditures varied considerably at the institutional level. There were also differences in how much the institutions spent per journal and publisher. These differences reflect, at least in part, the varying pricing schemes in place including discounted publication fees. With an indexing coverage of 99%, Crossref thoroughly indexed the open access journals articles included in the study. A comparison with the related openly available cost data from Austria and

  4. A study of institutional spending on open access publication fees in Germany.

    PubMed

    Jahn, Najko; Tullney, Marco

    2016-01-01

    Publication fees as a revenue source for open access publishing hold a prominent place on the agendas of researchers, policy makers, and academic publishers. This study contributes to the evolving empirical basis for funding these charges and examines how much German universities and research organisations spent on open access publication fees. Using self-reported cost data from the Open APC initiative, the analysis focused on the amount that was being spent on publication fees, and compared these expenditure with data from related Austrian (FWF) and UK (Wellcome Trust, Jisc) initiatives, in terms of both size and the proportion of articles being published in fully and hybrid open access journals. We also investigated how thoroughly self-reported articles were indexed in Crossref, a DOI minting agency for scholarly literature, and analysed how the institutional spending was distributed across publishers and journal titles. According to self-reported data from 30 German universities and research organisations between 2005 and 2015, expenditures on open access publication fees increased over the years in Germany and amounted to € 9,627,537 for 7,417 open access journal articles. The average payment was € 1,298, and the median was € 1,231. A total of 94% of the total article volume included in the study was supported in accordance with the price cap of € 2,000, a limit imposed by the Deutsche Forschungsgemeinschaft (DFG) as part of its funding activities for open access funding at German universities. Expenditures varied considerably at the institutional level. There were also differences in how much the institutions spent per journal and publisher. These differences reflect, at least in part, the varying pricing schemes in place including discounted publication fees. With an indexing coverage of 99%, Crossref thoroughly indexed the open access journals articles included in the study. A comparison with the related openly available cost data from Austria and

  5. Fluid lavage of open wounds (FLOW): a multicenter, blinded, factorial pilot trial comparing alternative irrigating solutions and pressures in patients with open fractures.

    PubMed

    Petrisor, Bradley; Sun, Xin; Bhandari, Mohit; Guyatt, Gordon; Jeray, Kyle J; Sprague, Sheila; Tanner, Stephanie; Schemitsch, Emil; Sancheti, Parag; Anglen, Jeff; Tornetta, Paul; Bosse, Michael; Liew, Susan; Walter, Stephen

    2011-09-01

    Open fractures are an important source of morbidity and are associated with delayed union, nonunion, and infection. Preventing infection through meticulous irrigation and debridement is an important goal in management, and different lavage fluids and irrigation techniques (e.g., high- or low-pressure lavage) have been described for this purpose. However, there are a limited number of randomized trials comparing irrigating solutions or irrigating technique. We compared the use of castile soap versus normal saline and high- versus low-pressure pulsatile lavage on the rates of reoperations and complications in patients with open fracture wounds. We conducted a multicenter, blinded, randomized 2 × 2 factorial pilot trial of 111 patients in whom an open fracture wound was treated with either castile soap solution or normal saline and either high- or low-pressure pulsatile lavage. The primary composite outcome of reoperation, measured at 12 months after initial operative procedure, included infection, wound healing problems, and nonunion. Planned reoperations were not included. Secondary outcomes included all infection, all wound healing problems, and nonunion as well as functional outcomes scores (EuroQol-5 dimensions and short form-12). Eighty-nine patients completed the 1-year follow-up. Among all patients, 13 (23%) in the castile soap group and 13 (24%) in the saline group had a primary outcome event (hazard ratio, 0.91, 95% confidence interval: 0.42-2.00, p = 0.52). Sixteen patients (28%) in the high-pressure group and 10 patients (19%) in the low-pressure group had a primary outcome event (hazard ratio 0.55, 95% confidence interval: 0.24-1.27, p = 0.17). Functional outcome scores showed no significant differences at any time point between groups. The fluid lavage of open wounds pilot randomized controlled trial demonstrated the possibility that the use of low pressure may decrease the reoperation rate for infection, wound healing problems, or nonunion. We have

  6. A Case Study of Scholars' Open and Sharing Practices

    ERIC Educational Resources Information Center

    Veletsianos, George

    2015-01-01

    Although the open scholarship movement has successfully captured the attention and interest of higher education stakeholders, researchers currently lack an understanding of the degree to which open scholarship is enacted in institutions that lack institutional support for openness. I help fill this gap in the literature by presenting a descriptive…

  7. Astrometric and Photometric Study of the Open Cluster NGC 2323

    NASA Astrophysics Data System (ADS)

    Amin, M. Y.; Elsanhoury, W. H.

    2017-06-01

    We present a study of the open cluster NGC 2323 using astrometric and photometric data. In our study we used two methods that are able to separate open cluster's stars from those that belong to the stellar background. Our results of calculations by these two methods indicate that: 1) according to the membership probability, NGC 2323 should contain 497 stars, 2) the cluster center should be at 07h 02m 48.02s and -08° 20' 17" 74, 3) the limiting radius of NGC 2323 is 2.31 ± 0.04 pc, the surface number density at this radius is 98.16 stars pc^{-2}, 4) the magnitude function has a maximum at about m_{v} = 14 mag, 5) the total mass of NGC 2323 is estimated dynamically by using astrometric data to be 890 M_{⊙}, and statistically by using photometric data to be 900 M_{⊙}, and 6) the distance and age of the cluster are found to be equal to 900 ± 100 pc, and 140 ± 20 Myr, respectively. Finally the dynamical evolution parameter τ of the cluster is about 436.2.

  8. A comparative direct cost analysis of pediatric urologic robot-assisted laparoscopic surgery versus open surgery: could robot-assisted surgery be less expensive?

    PubMed

    Rowe, Courtney K; Pierce, Michael W; Tecci, Katherine C; Houck, Constance S; Mandell, James; Retik, Alan B; Nguyen, Hiep T

    2012-07-01

    Cost in healthcare is an increasing and justifiable concern that impacts decisions about the introduction of new devices such as the da Vinci(®) surgical robot. Because equipment expenses represent only a portion of overall medical costs, we set out to make more specific cost comparisons between open and robot-assisted laparoscopic surgery. We performed a retrospective, observational, matched cohort study of 146 pediatric patients undergoing either open or robot-assisted laparoscopic urologic surgery from October 2004 to September 2009 at a single institution. Patients were matched based on surgery type, age, and fiscal year. Direct internal costs from the institution were used to compare the two surgery types across several procedures. Robot-assisted surgery direct costs were 11.9% (P=0.03) lower than open surgery. This cost difference was primarily because of the difference in hospital length of stay between patients undergoing open vs robot-assisted surgery (3.8 vs 1.6 days, P<0.001). Maintenance fees and equipment expenses were the primary contributors to robotic surgery costs, while open surgery costs were affected most by room and board expenses. When estimates of the indirect costs of robot purchase and maintenance were included, open surgery had a lower total cost. There were no differences in follow-up times or complication rates. Direct costs for robot-assisted surgery were significantly lower than equivalent open surgery. Factors reducing robot-assisted surgery costs included: A consistent and trained robotic surgery team, an extensive history of performing urologic robotic surgery, selection of patients for robotic surgery who otherwise would have had longer hospital stays after open surgery, and selection of procedures without a laparoscopic alternative. The high indirect costs of robot purchase and maintenance remain major factors, but could be overcome by high surgical volume and reduced prices as competitors enter the market.

  9. CFD study of Jet Impingement Test erosion using Ansys Fluent® and OpenFOAM®

    NASA Astrophysics Data System (ADS)

    López, Alejandro; Nicholls, William; Stickland, Matthew T.; Dempster, William M.

    2015-12-01

    The initial aim of this study was to compare OpenFoam and Ansys Fluent in order to verify OpenFoam's Lagrangian Library and erosion capabilities. However, it was found that previous versions of Fluent have been providing wrong results for the discrete phase and the differences with the latest version (Ansys Fluent 15) are shown. A Submerged Jet Impingement Test is an effective method for studying erosion created by solid particles entrained in a liquid. When considering low particle concentrations a Lagrangian modeling of the particulate phase is a reasonable approach. Proper linkage between OpenFOAM's Lagrangian library and the solver pimpleFoam for incompressible transient flows allows two-phase simulations to be undertaken for comparison with Ansys Fluent with the aim of verifying OpenFoam's accuracy. Steady state convergence for the fluid flow is first accomplished and the results are compared, confirming a good agreement between the two packages. A transient simulation was then set up and spherical particles incorporated into the fluid flow. An assessment of the two codes' discrete phase models was carried out, focusing on the differences between impact angles and velocities yielded at the impingement plate's surface employing a similar strategy to that outlined first by Hattori et al. (2008) and later by Gnanavelu et al. (2009, 2011). In the comparison of OpenFoam with the latest version of Fluent, the main differences between the injection models are highlighted and the coupling possibilities between phases are taken into consideration. Agreement between trends for both impact angles and velocities is satisfactory when the last version of the commercial package is considered and the average discrepancy between numerical values is very low, verifying OpenFoam's Lagrangian library. Two different Jet Impingement Test configurations are also compared and the differences highlighted.

  10. Similar results comparing early and late surgery in open repair of traumatic rotator cuff tears.

    PubMed

    Zhaeentan, Soheila; Von Heijne, Anders; Stark, André; Hagert, Elisabet; Salomonsson, Björn

    2016-12-01

    The purpose was to investigate whether surgical repair earlier or later than 3 months after injury may result in similar outcomes and patient satisfaction. Seventy-three patients (75 shoulders, 58 males, mean age 59) who had undergone surgical intervention for traumatic rotator cuff tears from 1999 to 2011 were assessed by MRI, clinical examination and Western Ontario Rotator Cuff Index (WORC) as a primary outcome measure and Oxford Shoulder score (OSS), Constant-Murley score (CS) and EQ-5D as secondary. The patients treated less than 3 months after injury (n = 39) were compared with patients treated more than 3 months after injury (n = 36). The average follow-up time was 56 months (range 14-149), and the average time from injury to repair for all patients was 16 weeks (range 3-104). A single senior radiologist performed a blinded evaluation of all the MRIs. Rotator cuff integrity, presence of arthritis, fatty degeneration and muscle atrophy were evaluated. No differences were found for any of the assessed outcomes (WORC, OSS, CS and EQ-5D) between the two groups. The mean WORC % was 77 % for both groups. Re-tear frequency was 24 %, nine in both groups. Patients with re-tear reported less satisfaction with their outcome. The surgical treatment of symptomatic traumatic rotator cuff tears repairable later than 3 months after injury yields a good functional outcome, a high level of subjective patient satisfaction, and at the same level for patients receiving earlier treatment. Based on our findings, surgical repair could be encouraged whenever technically possible. Retrospective Comparative Study, Level III.

  11. Geothermal Exploration Case Studies on OpenEI (Presentation)

    SciTech Connect

    Young, K.; Bennett, M.; Atkins, D.

    2014-03-01

    The U.S. Geological Survey (USGS) resource assessment (Williams et al., 2008) outlined a mean 30 GWe of undiscovered hydrothermal resource in the western United States. One goal of the U.S. Department of Energy's (DOE) Geothermal Technology Office (GTO) is to accelerate the development of this undiscovered resource. DOE has focused efforts on helping industry identify hidden geothermal resources to increase geothermal capacity in the near term. Increased exploration activity will produce more prospects, more discoveries, and more readily developable resources. Detailed exploration case studies akin to those found in oil and gas (e.g. Beaumont and Foster, 1990-1992) will give developers central location for information gives models for identifying new geothermal areas, and guide efficient exploration and development of these areas. To support this effort, the National Renewable Energy Laboratory (NREL) has been working with GTO to develop a template for geothermal case studies on the Geothermal Gateway on OpenEI. In 2012, the template was developed and tested with two case studies: Raft River Geothermal Area (http://en.openei.org/wiki/Raft_River_Geothermal_Area) and Coso Geothermal Area (http://en.openei.org/wiki/Coso_Geothermal_Area). In 2013, ten additional case studies were completed, and Semantic MediaWiki features were developed to allow for more data and the direct citations of these data. These case studies are now in the process of external peer review. In 2014, NREL is working with universities and industry partners to populate additional case studies on OpenEI. The goal is to provide a large enough data set to start conducting analyses of exploration programs to identify correlations between successful exploration plans for areas with similar geologic occurrence models.

  12. Sea-Salt Aerosol Forecasts Compared with Wave and Sea-Salt Measurements in the Open Mediterranean Sea

    NASA Astrophysics Data System (ADS)

    Kishcha, P.; Starobinets, B.; Bozzano, R.; Pensieri, S.; Canepa, E.; Nickovie, S.; di Sarra, A.; Udisti, R.; Becagli, S.; Alpert, P.

    2012-03-01

    Sea-salt aerosol (SSA) could influence the Earth's climate acting as cloud condensation nuclei. However, there were no regular measurements of SSA in the open sea. At Tel-Aviv University, the DREAM-Salt prediction system has been producing daily forecasts of 3-D distribution of sea-salt aerosol concentrations over the Mediterranean Sea (http://wind.tau.ac.il/saltina/ salt.html). In order to evaluate the model performance in the open sea, daily modeled concentrations were compared directly with SSA measurements taken at the tiny island of Lampedusa, in the Central Mediterranean. In order to further test the robustness of the model, the model performance over the open sea was indirectly verified by comparing modeled SSA concentrations with wave height measurements collected by the ODAS Italia 1 buoy and the Llobregat buoy. Model-vs.-measurement comparisons show that the model is capable of producing realistic SSA concentrations and their day-today variations over the open sea, in accordance with observed wave height and wind speed.

  13. A systematic review comparing open-book and closed-book examinations: Evaluating effects on development of critical thinking skills.

    PubMed

    Johanns, Beth; Dinkens, Amber; Moore, Jill

    2017-08-19

    The advantages of using traditional closed-book examinations are closely compared to the advantages of using open-book examinations for the development of critical thinking skills in nursing students. The use of critical thinking skills is vital among nurses to assess patient needs and modify standard approaches to individualize care for better patient outcomes. The following areas are compared and contrasted for both closed-book and open-book examinations: examination preparation, rote memorization versus active learning, intellectual engagement, simulation of working environment, higher order thinking skills, anxiety reduction and student satisfaction. During investigation of closed-book examinations and open-book examinations, the use of collaborative testing was unveiled. Collaborative testing combines areas from both closed-book and open-book examinations. Based on the systematic review of literature, the recommendation is to use a mixed method of examination types throughout the course of the nursing program. Each type of examination helps develop different skill sets in the nursing student. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Rodents for comparative aging studies: from mice to beavers

    PubMed Central

    Bozzella, Michael J.; Seluanov, Andrei

    2008-01-01

    After humans, mice are the best-studied mammalian species in terms of their biology and genetics. Gerontological research has used mice and rats extensively to generate short- and long-lived mutants, study caloric restriction and more. Mice and rats are valuable model organisms thanks to their small size, short lifespans and fast reproduction. However, when the goal is to further extend the already long human lifespan, studying fast aging species may not provide all the answers. Remarkably, in addition to the fast-aging species, the order Rodentia contains multiple long-lived species with lifespans exceeding 20 years (naked mole-rat, beavers, porcupines, and some squirrels). This diversity opens great opportunities for comparative aging studies. Here we discuss the evolution of lifespan in rodents, review the biology of slow-aging rodents, and show an example of how the use of a comparative approach revealed that telomerase activity coevolved with body mass in rodents. PMID:19424861

  15. Open access and openly accessible: a study of scientific publications shared via the internet

    PubMed Central

    Wren, Jonathan D

    2005-01-01

    Objectives To determine how often reprints of scientific publications are shared online, whether journal readership level is a predictor, how the amount of file sharing changes with the age of the article, and to what degree open access publications are shared on non-journal websites. Design The internet was searched using an application programming interface to Google, a popular and freely available search engine. Main outcome measures The proportion of reprints of journal articles published between 1994 and 2004 from within 13 subscription based and four open access journals that could be located online at non-journal websites. Results The probability that an article could be found online at a non-journal website correlated with the journal impact factor and the time since initial publication. Papers from higher impact journals and more recent articles were more likely to be located. On average, for the high impact journal articles published in 2003, over a third could be located at non-journal websites. Similar trends were observed for the delayed or full open access publications. Conclusions Decentralised sharing of scientific reprints through the internet creates a degree of de facto open access that, though highly incomplete in its coverage, is none the less biased towards publications of higher popular demand. PMID:15827063

  16. Open access and openly accessible: a study of scientific publications shared via the internet.

    PubMed

    Wren, Jonathan D

    2005-05-14

    To determine how often reprints of scientific publications are shared online, whether journal readership level is a predictor, how the amount of file sharing changes with the age of the article, and to what degree open access publications are shared on non-journal websites. The internet was searched using an application programming interface to Google, a popular and freely available search engine. The proportion of reprints of journal articles published between 1994 and 2004 from within 13 subscription based and four open access journals that could be located online at non-journal websites. The probability that an article could be found online at a non-journal website correlated with the journal impact factor and the time since initial publication. Papers from higher impact journals and more recent articles were more likely to be located. On average, for the high impact journal articles published in 2003, over a third could be located at non-journal websites. Similar trends were observed for the delayed or full open access publications. Decentralised sharing of scientific reprints through the internet creates a degree of de facto open access that, though highly incomplete in its coverage, is none the less biased towards publications of higher popular demand.

  17. Efficacy and safety of leuprorelin acetate 6-month depot, TAP-144-SR (6M), in combination with tamoxifen in postoperative, premenopausal patients with hormone receptor-positive breast cancer: a phase III, randomized, open-label, parallel-group comparative study.

    PubMed

    Kurebayashi, Junichi; Toyama, Tatsuya; Sumino, Shuuji; Miyajima, Eri; Fujimoto, Tsukasa

    2017-01-01

    Leuprorelin acetate, a luteinizing hormone-releasing hormone agonist, is used worldwide in premenopausal women with hormone receptor-positive breast cancer. This study was conducted to assess the non-inferiority of the 6-month depot formulation, TAP-144-SR (6M) 22.5 mg to the 3-month depot formulation, TAP-144-SR (3M) 11.25 mg in postoperative, premenopausal patients with hormone receptor-positive breast cancer. This was a 96-week phase III, randomized, open-label, parallel-group comparative study. All patients concomitantly received oral tamoxifen (20 mg daily). The primary endpoint was the suppression rate of serum estradiol (E2) to the menopausal level (≤30 pg/mL) from Week 4 through Week 48. In total, 167 patients were randomized to receive TAP-144-SR (6M) (n = 83) or TAP-144-SR (3M) (n = 84) and the E2 suppression rate was 97.6 and 96.4 %, respectively. The estimated between-group difference was 1.2 % (95 % confidence interval -5.2 to 7.8). The non-inferiority of TAP-144-SR (6M) to TAP-144-SR (3M) for E2 suppression was confirmed. As for safety, common adverse events were hot flush and injection site reactions including induration, pain, and erythema in both treatment groups, which were of ≤Grade 2 in severity and not serious. No significant between-group differences in safety profiles and tolerability were observed. TAP-144-SR (6M) was not inferior to TAP-144-SR (3M) for its suppressive effect on serum E2. TAP-144-SR (6M) was also as well tolerated as TAP-144-SR (3M).

  18. Open-Source Software in Computational Research: A Case Study

    DOE PAGES

    Syamlal, Madhava; O'Brien, Thomas J.; Benyahia, Sofiane; ...

    2008-01-01

    A case study of open-source (OS) development of the computational research software MFIX, used for multiphase computational fluid dynamics simulations, is presented here. The verification and validation steps required for constructing modern computational software and the advantages of OS development in those steps are discussed. The infrastructure used for enabling the OS development of MFIX is described. The impact of OS development on computational research and education in gas-solids flow, as well as the dissemination of information to other areas such as geophysical and volcanology research, is demonstrated. This study shows that the advantages of OS development were realized inmore » the case of MFIX: verification by many users, which enhances software quality; the use of software as a means for accumulating and exchanging information; the facilitation of peer review of the results of computational research.« less

  19. Open-Source Software in Computational Research: A Case Study

    SciTech Connect

    Syamlal, Madhava; O'Brien, Thomas J.; Benyahia, Sofiane; Gel, Aytekin; Pannala, Sreekanth

    2008-01-01

    A case study of open-source (OS) development of the computational research software MFIX, used for multiphase computational fluid dynamics simulations, is presented here. The verification and validation steps required for constructing modern computational software and the advantages of OS development in those steps are discussed. The infrastructure used for enabling the OS development of MFIX is described. The impact of OS development on computational research and education in gas-solids flow, as well as the dissemination of information to other areas such as geophysical and volcanology research, is demonstrated. This study shows that the advantages of OS development were realized in the case of MFIX: verification by many users, which enhances software quality; the use of software as a means for accumulating and exchanging information; the facilitation of peer review of the results of computational research.

  20. Open -source software in computational research: A case study

    SciTech Connect

    Syamlal, M.; O'Brien, T.; Benyahia, S.; Gel, A.; Pannala, S.

    2008-01-01

    A case study of open-source (OS) development of the computational research software MFIX, used for multiphase computational fluid dynamics simulations, is presented here. The verification and validation steps required for constructing modern computational software and the advantages of OS development in those steps are discussed. The infrastructure used for enabling the OS development of MFIX is described. The impact of OS development on computational research and education in gas-solids flow, as well as the dissemination of information to other areas such as geophysical and volcanology research, is demonstrated. This study shows that the advantages of OS development were realized in the case of MFIX: verification by many users, which enhances software quality; the use of software as a means for accumulating and exchanging information; the facilitation of peer review of the results of computational research.

  1. Rubisco activity in guard cells compared with the solute requirement for stomatal opening. [Pisum sativum

    SciTech Connect

    Reckmann, U.; Scheibe, R.; Raschke, K. )

    1990-01-01

    We investigated whether the reductive pentose phosphate path in guard cells of Pisum sativum had the capacity to contribute significantly to the production of osmotica during stomatal opening in the light. Amounts of ribulose 1,5-bisphophate carboxylase/oxygenase (Rubisco) were determined by the ({sup 14}C) carboxyarabinitol bisphosphate assay. A guard cell contained about 1.2 and a mesophyll cell about 324 picograms of the enzyme; the ratio was 1:270. The specific activities of Rubisco in guard cells and in mesophyll cells were equal; there was no indication of a specific inhibitor of Rubisco in guard cells. Rubisco activity was 115 femtomol per guard-cell protoplast and hour. This value was different from zero with a probability of 0.99. After exposure of guard-cell protoplasts to {sup 14}CO{sub 2} for 2 seconds in the light, about one-half of the radioactivity was in phosphorylated compounds and <10% in malate. Guard cells in epidermal strips produced a different labelling pattern; in the light, <10% of the label was in phosphorylated compounds and about 60% in malate. The rate of solute accumulation in intact guard cells was estimated to have been 900 femto-osmol per cell and hour. If Rubisco operated at full capacity in guard cells, and hexoses were produced as osmotica, solutes could be supplied at a rate of 19femto-osmol per cell and hour, which would constitute 2% of the estimated requirement. The capacity of guard-cell Rubisco to meet the solute requirement for stomatal opening in leaves of Pisum sativum is insignificant.

  2. Rubisco Activity in Guard Cells Compared with the Solute Requirement for Stomatal Opening 1

    PubMed Central

    Reckmann, Udo; Scheibe, Renate; Raschke, Klaus

    1990-01-01

    We investigated whether the reductive pentose phosphate path in guard cells of Pisum sativum had the capacity to contribute significantly to the production of osmotica during stomatal opening in the light. Amounts of ribulose 1,5-bisphophate carboxylase/oxygenase (Rubisco) were determined by the [14C]carboxyarabinitol bisphosphate assay. A guard cell contained about 1.2 and a mesophyll cell about 324 picograms of the enzyme; the ratio was 1:270. The specific activities of Rubisco in guard cells and in mesophyll cells were equal; there was no indication of a specific inhibitor of Rubisco in guard cells. Rubisco activity was 115 femtomol per guard-cell protoplast and hour. This value was different from zero with a probability of 0.99. After exposure of guard-cell protoplasts to 14CO2 for 2 seconds in the light, about one-half of the radioactivity was in phosphorylated compounds and <10% in malate. Guard cells in epidermal strips produced a different labelling pattern; in the light, <10% of the label was in phosphorylated compounds and about 60% in malate. The rate of solute accumulation in intact guard cells was estimated to have been 900 femto-osmol per cell and hour. If Rubisco operated at full capacity in guard cells, and hexoses were produced as osmotica, solutes could be supplied at a rate of 19 femto-osmol per cell and hour, which would constitute 2% of the estimated requirement. The capacity of guard-cell Rubisco to meet the solute requirement for stomatal opening in leaves of Pisum sativum is insignificant. Images Figure 1 PMID:16667255

  3. A study of explosively formed fuse (EFF) opening switch resistance

    SciTech Connect

    Oona, Henn; Goforth, James H; Herrera, Dennis H; Tasker, Douglas G; Torres, D. T.

    2010-12-21

    Many pulsed power experiments need pulse shaping to optimize the power flow from a flux compression generator (FCG) to an experimental load. In a laboratory environment this can be a simple task where the switches are not destroyed. However, in experiments with high explosives, where a large amount of damage occurs, a single use EFF opening switch may be a good choice. In an EFF, explosives are used to thin a current carrying sheet of aluminum as it is forced into a grooved dye. The current is modified by the time dependent changes in resistance as the aluminum is stretched. We will correlate the hydrodynamic effects with resistance. The hydrodynamic profile is determined by Mesa-2D, a well proven hydrodynamics computer code, and MA THEMA TICA is used convert material contours into total resistance using the resistivity as a function of time from various sources. Experimentally, we will determine the actual resistance and compare it with the calculated values. We have used these switches for decades but still do not understand the details of the physics. The resistance change may be due to several processes but in this paper we will concentrate on stretching as the most important contribution. Also, in this paper we will compare the details of the hydrodynamics with the details of experimental and calculated resistance and hopefully generate a predictive model for future designs with other geometries and materials.

  4. Comparative analysis of curative effect of CT-guided stem cell transplantation and open surgical transplantation for sequelae of spinal cord injury.

    PubMed

    Dai, Guanghui; Liu, Xuebin; Zhang, Zan; Wang, Xiaodong; Li, Min; Cheng, Hongbin; Hua, Rongrong; Shi, Jing; Wang, Renzhi; Qin, Chuan; Gao, Jianhua; An, Yihua

    2013-12-20

    This study compared the clinical efficacies, advantages and disadvantages of two transplantation approaches for treating spinal cord injury: open surgical exploration combined with local stem cell transplantation (referred to as open surgical transplantation) and local stem cell transplantation by CT-guided puncture (referred to as CT-guided transplantation). The patients were divided into the following three groups to perform a retrospective controlled study: Group A included nine patients who underwent open surgical transplantation, Group B included nine patients who underwent CT-guided transplantation, and Group C included nine patients who did not receive stem cell transplantation. The Abbreviated Injury Scale (AIS), the American Spinal Injury Association (ASIA) score and the motor evoked potentials (MEP) examination were utilized to compare the differences in the clinical efficacies. The advantages and disadvantages of the two transplantation approaches were also compared, including the surgical risks, the possibility of repeating the operation, the interval between surgery and rehabilitation exercises and the scope of conditions suitable for the operation. Whether evaluated by the AIS grading scale, the ASIA score or the MEP results, there were significant differences in the clinical efficacy among the three patient groups. Group B exhibited the best clinical outcome, followed by Group A, and Group C fared the worst. The CT-guided transplantation had the advantages of lower surgical risk, the potential to repeat the operations within a short time-frame and a short interval between surgery and rehabilitation exercise compared with the open surgical transplantation. The conditions that are suitable for CT-guided transplantation versus the conditions suitable for open surgical transplantation are not identical. The application scopes for the two approaches had their respective strengths. CT-guided stem cell transplantation was confirmed as a safe and effective

  5. Muscular workload of veterinary students during simulated open and laparoscopic surgery: A pilot study.

    PubMed

    Kilkenny, Jessica; Larson, Dennis J; MacCormick, Mathew; Brown, Stephen H M; Singh, Ameet

    2017-08-01

    To compare upper extremity muscle activity and workload between simulated open surgery, multiple port laparoscopic surgery (MLS), and single incision laparoscopic surgery (SLS) techniques in veterinary students. Pilot study. Veterinary students (n = 10) from years 1 to 4. Bipolar skin surface electrodes were fixed bilaterally to the forearm flexor, forearm extensor, biceps brachii, triceps brachii, and upper trapezius muscles. Electromyography data were recorded during one repetition of 2 simulated surgical exercises via open surgery, MLS, and SLS. Participants completed a validated workload survey after each simulated surgical technique. Muscle activity and perceived workload were compared between surgical techniques with 1-way ANOVAs and Fisher's LSD post hoc tests. Muscle activity during peg transfer was higher with MLS and SLS compared to simulated open surgery in the right and left forearm extensors (both P < .0001), right (P < .0001) and left biceps (P = .0005), right triceps (P = .0004), and right upper trapezius muscles (P = .0211). Similar results were found for the right and left forearm extensors (both P < .0001), right (P = .0381) and left (P = .0147) forearm flexors, right biceps (P < .0001), and right triceps (P = .0004) during a simulated suture task. Participants found laparoscopic techniques more mentally demanding, physically demanding, complex, and stressful compared to a simulated open surgical technique. In veterinary students, average muscle activity and perceived workload were highest using MLS and SLS compared to an open surgical technique when performing simulated surgical exercises in a laparoscopic box trainer. © 2017 The American College of Veterinary Surgeons.

  6. The Student Teaching Experience: A Comparative Study.

    ERIC Educational Resources Information Center

    Butler, Judy D.

    This paper describes a 1996 study that compared the student teaching experiences of a traditional and a nontraditional student to ascertain what differences in their experiences might imply about teacher preparation. The two students kept journals that could be written in at any time of the day. They recorded their impressions of their situation…

  7. Development and validation of an open source quantification tool for DSC-MRI studies.

    PubMed

    Gordaliza, P M; Mateos-Pérez, J M; Montesinos, P; Guzmán-de-Villoria, J A; Desco, M; Vaquero, J J

    2015-03-01

    This work presents the development of an open source tool for the quantification of dynamic susceptibility-weighted contrast-enhanced (DSC) perfusion studies. The development of this tool is motivated by the lack of open source tools implemented on open platforms to allow external developers to implement their own quantification methods easily and without the need of paying for a development license. This quantification tool was developed as a plugin for the ImageJ image analysis platform using the Java programming language. A modular approach was used in the implementation of the components, in such a way that the addition of new methods can be done without breaking any of the existing functionalities. For the validation process, images from seven patients with brain tumors were acquired and quantified with the presented tool and with a widely used clinical software package. The resulting perfusion parameters were then compared. Perfusion parameters and the corresponding parametric images were obtained. When no gamma-fitting is used, an excellent agreement with the tool used as a gold-standard was obtained (R(2)>0.8 and values are within 95% CI limits in Bland-Altman plots). An open source tool that performs quantification of perfusion studies using magnetic resonance imaging has been developed and validated using a clinical software package. It works as an ImageJ plugin and the source code has been published with an open source license. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Radiological outcomes in a randomized trial comparing opening wedge and closing wedge techniques of high tibial osteotomy.

    PubMed

    Nerhus, Tor Kjetil; Ekeland, Arne; Solberg, Geir; Sivertsen, Einar Andreas; Madsen, Jan Erik; Heir, Stig

    2017-03-01

    The aim of the present study was to examine changes in radiological variables in a prospective randomized study comparing opening wedge (OW) and closing wedge (CW) techniques of high tibial osteotomy (HTO). Our hypothesis was that there would be no differences in joint line angles or correction accuracy between the two groups, that patellar height would increase after CW HTO and decrease after OW HTO, and that leg length and posterior tibial slope would decrease after CW HTO and increase after OW HTO. Radiological data were collected from 70 patients participating in an ongoing prospective randomized clinical trial comparing OW and CW HTOs. Digital standing hip-knee-ankle (HKA) radiographs as well as lateral radiographs in 30° of flexion were obtained preoperatively and at 6 months for each patient. Joint line angles, HKA angle, leg length, Insall-Salvati index, Miura-Kawamura index and posterior tibial slope were measured using medical planning software. The complete preoperative radiological examinations of the first 50 patients were used in a study of intra- and inter-rater reliability of the measurements. The mean posterior slope was reduced by 2.5° in CW HTO, whereas it remained unchanged in OW HTO (p < 0.001). Mean leg length decreased 5.7 mm in CW HTO and increased 3.1 mm in OW HTO (p < 0.001). Changes in joint line angles, patellar height indexes and the correction accuracy showed no significant differences comparing the two techniques. Frontal plane reliability measurement intra- and inter-rater intraclass correlation coefficient (ICC) varied from 0.81 to 0.99. Sagittal plane intra- and inter-rater ICC varied from 0.60 to 0.87. Posterior tibial slope intra- and inter-rater ICC showed the lowest values (0.70 and 0.60, respectively) corresponding to a smallest real difference of 4.5° and 5.5°, respectively. Posterior tibial slope and leg length changes were significantly different in CW compared to OW HTOs. We recommend that possible alterations

  9. Comparative Study of Student Support Services of UKOU and SLOU

    ERIC Educational Resources Information Center

    Gujjar, Aijaz Ahmed; Choudhry, Bushra Naoreen; Choudhry, Amtul Hafeez

    2008-01-01

    This paper attempts to compare the availability, quality, similarities and differences of students' support services in United Kingdom Open University (UKOU) and Sri Lanka Open University (SLOU) and also to identify and enlist the deficiencies that SLOU students are facing in the student support services. To get the desired end four hundred…

  10. Comparative Proteomics Analysis of Phloem Exudates Collected during the Induction of Systemic Acquired Resistance1[OPEN

    PubMed Central

    Wilson, Daniel C.; Dey, Sanjukta; Hauck, Stefanie M.; Vlot, A. Corina; Cameron, Robin K.

    2016-01-01

    Systemic acquired resistance (SAR) is a plant defense response that provides long-lasting, broad-spectrum pathogen resistance to uninfected systemic leaves following an initial localized infection. In Arabidopsis (Arabidopsis thaliana), local infection with virulent or avirulent strains of Pseudomonas syringae pv tomato generates long-distance SAR signals that travel from locally infected to distant leaves through the phloem to establish SAR. In this study, a proteomics approach was used to identify proteins that accumulate in phloem exudates in response to the induction of SAR. To accomplish this, phloem exudates collected from mock-inoculated or SAR-induced leaves of wild-type Columbia-0 plants were subjected to label-free quantitative liquid chromatography-tandem mass spectrometry proteomics. Comparing mock- and SAR-induced phloem exudate proteomes, 16 proteins were enriched in phloem exudates collected from SAR-induced plants, while 46 proteins were suppressed. SAR-related proteins THIOREDOXIN h3, ACYL-COENZYME A-BINDING PROTEIN6, and PATHOGENESIS-RELATED1 were enriched in phloem exudates of SAR-induced plants, demonstrating the strength of this approach and suggesting a role for these proteins in the phloem during SAR. To identify novel components of SAR, transfer DNA mutants of differentially abundant phloem proteins were assayed for SAR competence. This analysis identified a number of new proteins (m-type thioredoxins, major latex protein-like protein, ULTRAVIOLET-B RESISTANCE8 photoreceptor) that contribute to the SAR response. The Arabidopsis SAR phloem proteome is a valuable resource for understanding SAR long-distance signaling and the dynamic nature of the phloem during plant-pathogen interactions. PMID:27208255

  11. A prospective randomized comparative trial between open subinguinal and loupe assisted subinguinal varicocelectome: A single center experience

    PubMed Central

    Vyas, Hari Gopal; Bhandari, Vimal; Kumar, Anup; Nanda, Biswajit; Singh, Harbinder; Bhowmick, Subroto

    2017-01-01

    Introduction: In our study, we reviewed efficacy and complication rates of open subinguinal varicocelectomy (OSV) and loupe assisted subinguinal varicocelectomy (LASV) using seminal and hormonal parameters in a prospective randomized study. Materials and Methods: We prospectively studied 60 males with Grade 2 and Grade 3 varicocele. Thirty patients underwent OSV and the other 30 patients underwent LASV. Intra-operative and post-operative complications along with pre-operative and post-operative seminal, hormonal parameters and testicular volume were compared between the groups. Results: Sperm count, motility and morphology increased significantly in both groups, but the improvement was significantly better in LASV group. (Group A – improvement in sperm count, motility and morphology by 25%, 8.5%, 10.3%, respectively and in Group B – improvement in sperm count, motility and morphology by 110%, 68.59%, 71.1%, respectively. Decrease in serum follicular stimulating hormone (FSH), luteinizing hormone (LH) and increase in serum testosterone were significant in both groups, but the improvement was significantly better in LASV group. (Group A – serum FSH and LH decreased by 17.2%, 23%, respectively and serum testosterone increased by 13.7% and in Group B – serum FSH and LH decreased by 56.9%, 56.65%, respectively and serum testosterone increased by 95.9%). The recurrence (OSV = 13.2% and LASV = 0, P = 0.01) and complication rates were significantly lower in LASV group. Conclusion: Our study shows that LASV is significantly better than OSV regarding efficacy and complication rates. PMID:28216922

  12. Effects on agitation with rivastigmine patch monotherapy and combination therapy with memantine in mild to moderate Alzheimer's disease: a multicenter 24-week prospective randomized open-label study (the Korean EXelon Patch and combination with mEmantine Comparative Trial study).

    PubMed

    Yoon, Soo J; Choi, Seong H; Na, Hae R; Park, Kyung-Won; Kim, Eun-Joo; Han, Hyun J; Lee, Jae-Hong; Shim, Young S; Na, Duk L

    2017-03-01

    Memantine is known to be effective in the treatment of the behavioral symptoms of dementia, especially agitation in moderate to severe Alzheimer's disease (AD). However, memantine and rivastigmine patch combination therapy has not been well studied in determining treatment effectiveness with mild to moderate AD patients. This was a multicenter, 24-week, prospective, randomized, open-label study design. A total 147 AD patients with Mini-Mental State Examination scores from 10 to 20 were randomly assigned to rivastigmine patch monotherapy and combination therapy with memantine groups. Agitation symptoms, using the Korean Version of the Cohen Mansfield Agitation Inventory were evaluated at baseline and at study end. Suppression and emergence of agitation symptoms were also evaluated. We carried out factor analyses to evaluate the interrelationship of agitation symptoms and to investigate treatment response in these symptoms. Factor analyses showed two symptom clusters: factor A - aggressive agitated behaviors - versus factor B - non-aggressive agitated behaviors. The rivastigmine patch monotherapy group showed significantly decreased factor B scores and had a tendency of decreased Korean Version of the Cohen Mansfield Agitation Inventory total scores and factor A scores. Conversely, the combination therapy group showed significantly increased Korean Version of the Cohen Mansfield Agitation Inventory total scores and factor B scores. Neither monotherapy nor combination therapy reduced the emergence of new agitation symptoms. In this trial of mild to moderate AD patients, the rivastigmine patch monotherapy group experienced a reduction of non-aggressive agitated behaviors. However, combination therapy with memantine did not show any benefit on the agitation associated with mild to moderate AD. Geriatr Gerontol Int 2017; 17: 494-499. © 2016 Japan Geriatrics Society.

  13. A comparative analysis between laparoscopy and open colectomy: assessment of perioperative and oncological outcomes.

    PubMed

    Farinetti, Alberto; Bonetti, Luca Reggiani; Migaldi, Mario; Mattioli, Anna Vittoria; Pennella, Sonia; Muratori, Simone; Rossi, Aldo

    2015-01-01

    Il presente studio raffronta due gruppi di pazienti affetti da adenocarcinoma dolo-rettale, sottoposti rispettivamente a colectomia con tecnica open e a videolaparoscopia, mettendone in luce benefici e svantaggi. Si tratta di un’analisi retrospettiva: dal gennaio 2003 e il dicembre 2006 sono stati reclutati 54 pazienti; di questi 26 operati in laparotomia e 28 in laparoscopia. Per la chirurgia laparotomica la durata media dell’intervento è stata di 177.9 minuti (tempo chirurgico) e di 280.4 minuti (tempo di sala operatoria con un minimo di 110 ed un massimo di 360 minuti, con significative differenze in rapporto al tipo di chirurgia effettuata e la storia clinica del paziente. Per la chirurgia laparoscopica la durata media è stata di 293 minuti (range 135-520), con significative differenze dipendenti dalla porzione di intestino asportata. Il raffronto delle due tecniche chirurgiche, laparotomica versus lapsroscopica, ha rivelato alcune differenze. La durata della resezione è stata maggiore per la laparoscopia se confrontata con la tecnica tradizionale. Entrambi gli approcci rappresentano tecniche convenienti, sicure ed oncologicamente corrette. La laparoscopia mostra maggiori vantaggi in termini di controllo del dolore, assenza di estese cicatrici, riscontro di laparoceli e di degenza post operatoria comparata con la tecnica laparotomica.

  14. A Descriptive Study of Open Fractures Contaminated by Seawater: Infection, Pathogens, and Antibiotic Resistance.

    PubMed

    Zhu, Hongyi; Li, Xingwei; Zheng, Xianyou

    2017-01-01

    Aims. In this work, the main objectives were to investigate the clinical characteristics and bacterial spectrum present in open fractures contaminated by seawater. Methods. We conducted a retrospective cohort study and included all patients with open fractures from 1st January, 2012, to 31st December, 2015, in our hospital. Patients were grouped based on the presence of seawater contamination in wounds. We compared the infection rate, bacterial spectrum, and antibiotic resistance between the two groups. Results. We totally included 1337 cases of open fracture. Wounds from 107 cases (8.0%) were contaminated by seawater. The wound infection rate of seawater-contaminated group was significantly higher in patients with Gustilo-Anderson Type II and Type III open fractures. The bacterial spectrum from seawater-contaminated wounds was remarkably different from that of the remaining. Antibiotic sensitivity tests revealed that more than 90% of infecting pathogens in seawater-contaminated wounds were sensitive to levofloxacin and ciprofloxacin. Conclusion. Cephalosporin in combination with quinolone was recommended in the early-stage management of open fractures contaminated by seawater.

  15. A Descriptive Study of Open Fractures Contaminated by Seawater: Infection, Pathogens, and Antibiotic Resistance

    PubMed Central

    Zhu, Hongyi

    2017-01-01

    Aims. In this work, the main objectives were to investigate the clinical characteristics and bacterial spectrum present in open fractures contaminated by seawater. Methods. We conducted a retrospective cohort study and included all patients with open fractures from 1st January, 2012, to 31st December, 2015, in our hospital. Patients were grouped based on the presence of seawater contamination in wounds. We compared the infection rate, bacterial spectrum, and antibiotic resistance between the two groups. Results. We totally included 1337 cases of open fracture. Wounds from 107 cases (8.0%) were contaminated by seawater. The wound infection rate of seawater-contaminated group was significantly higher in patients with Gustilo-Anderson Type II and Type III open fractures. The bacterial spectrum from seawater-contaminated wounds was remarkably different from that of the remaining. Antibiotic sensitivity tests revealed that more than 90% of infecting pathogens in seawater-contaminated wounds were sensitive to levofloxacin and ciprofloxacin. Conclusion. Cephalosporin in combination with quinolone was recommended in the early-stage management of open fractures contaminated by seawater. PMID:28303249

  16. Open surgery versus retroperitoneal laparoscopic nephrectomy for renal tuberculosis: a retrospective study of 120 patients

    PubMed Central

    Wang, Cheng; Xiong, Hu; Fu, Sheng-Jun

    2016-01-01

    Background Laparoscopic renal surgery has been widely used in the treatment of renal diseases. However, there is still little research about its application in addressing renal tuberculosis. The purpose of this study is to retrospectively investigate the surgical results of laparoscopic and open surgery for nonfunctional tuberculous kidneys. Methods Between May 2011 and June 2016, 120 nephrectomies were performed in patients with a nonfunctional tuberculous kidney. Of these, 69 patients underwent retroperitoneal laparoscopic nephrectomy, and 51 patients underwent open nephrectomy. Data about the patients’ characteristics and surgical outcomes were collected from their electronic medical records. Outcomes were compared between these two groups. Results Our results showed that a number of renal tuberculosis patients presented no significant symptoms during their disease. Lower urinary tract symptoms (LUTS) were the most common at a rate of 73/120, followed by flank pain or accidently discovery (66/120), urine abnormality (30/120) and fever (27/120). Patients who underwent open surgery were similar to laparoscopic patients with regard to sex, BMI, location, previous tuberculous history, grade, anemia, adhesion, hypertension, diabetes and preoperative serum creatinine level, but were generally older than laparoscopic patients. There were no significant differences between open and laparoscopic surgery in estimated blood loss, transfusion, postoperative hospital days and perioperative complication rate. However, the median operation time of laparoscopic operation was much longer than open surgery (180 [150–225] vs 135 [120–165] minutes, P < 0.01). Seven of the 69 laparoscopic operations were converted to open surgery because of severe adhesions. Conclusion Laparoscopic nephrectomy is as an effective treatment as open surgery for a nonfunctional tuberculous kidney, although it requires more time during the surgical procedure. No significant differences in other

  17. A systematic review and meta-analysis on the treatment of liver hydatid cyst: Comparing laparoscopic and open surgeries.

    PubMed

    Sokouti, Massoud; Sadeghi, Ramin; Pashazadeh, Saeid; Abadi, Saeed Eslami Hasan; Sokouti, Mohsen; Rezaei-Hachesu, Peyman; Ghojazadeh, Morteza; Sokouti, Babak

    2017-10-04

    There is an academic debate regarding surgical interventions for liver hydatid cyst disease. The purpose of the current systematic review and meta-analysis study was to analyse the pros and cons of open surgery and laparoscopic techniques, considering the outcomes of liver hydatid cysts. Descriptive Boolean queries were used to search PubMed and Scopus for articles published between January 2000 and December 2016 to evaluate the outcomes of liver hydatid cyst in terms of mortality, post-operative complications, cure rate and recurrences. The data related to the four outcomes of liver hydatid cyst were extracted, assessed and then used as their corresponding effect sizes in the meta-analysis process. Six studies totally consisting of 1028 patients [open surgery group=816 (+7 converted to lap) and laparoscopic group=212] were analysed. In this meta-analysis study, random effects models of outcomes (i.e. post-operative complications, mortalities, recurrences and cure rate) of the two procedures were OR=0.852, LL=0.469, UL=1.546, Z=-0.526, p=0.599 (for post-operative complications); OR=0.849, LL=0.141, UL=5.105, Z=-0.179, p=0.858 (for mortality); OR=0.903, LL=0.166, UL=4.906, Z=-0.119, p=0.906 (for recurrence); and OR=0.459, LL=0.129, UL=1.637, Z=-1.201, p=0.230 (for cure rate). Meta-analysis and illustrated forest plots showed that there are no superiorities between the two approaches. The results of heterogeneity tests of the above mentioned outcomes were Q=8.083, df=5, p=0.152, I(2)=38.142% for post-operative complications; Q=0.127, df=2, p=0.938, I(2)=0% for mortality; Q=4.984, df=2, p=0.083, I(2)=59.874% for recurrence; and Q=10.639, df=5, p=0.059, I(2)=53.001% for cure rate. The results of regression tests based on Egger's, smoothed variance based on Egger (SVE) and smoothed variance based on Thomson (SVT) showed that the p values are not significant, and there are neither significant statistical differences nor publication bias between the outcomes of the two

  18. Biphasic shocks compared with monophasic damped sine wave shocks for direct ventricular defibrillation during open heart surgery.

    PubMed

    Schwarz, Birgit; Bowdle, T Andrew; Jett, G Kimble; Mair, Peter; Lindner, Karl H; Aldea, Gabriel S; Lazzara, Robert G; O'Grady, Sharon G; Schmitt, Paul W; Walker, Robert G; Chapman, Fred W; Tacker, Willis A

    2003-05-01

    Biphasic waveform shocks are more effective than monophasic shocks for transchest ventricular defibrillation, atrial cardioversion, and defibrillation with implantable defibrillators but have not been studied for open chest, intraoperative defibrillation. This prospective, blinded, randomized clinical study compares biphasic and monophasic shock effectiveness and establishes intraoperative energy dose-response curves. Patients undergoing cardiothoracic surgery with bypass cardioplegia were randomly assigned to the monophasic or biphasic shock group. Ventricular fibrillation occurring after aortic clamp removal was treated with escalating energies of 2, 5, 7, 10, and 20 J until defibrillation occurred. If ventricular fibrillation persisted, a 20-J crossover shock of the other waveform was used. Cumulative defibrillation success at 5 J, the primary end point of the study, was higher in the biphasic group than in the monophasic group (25 of 50 vs. 9 of 41 defibrillated; P = 0.011). In addition, the biphasic group required lower threshold energy (6.8 vs. 11.0 J; P = 0.003), less cumulative energy (12.6 vs. 23.4 J; P = 0.002), and fewer shocks (2.5 vs. 3.5; P = 0.002). Crossover-shock effectiveness did not differ between groups. Dose-response curves show biphasic shocks to have higher cumulative success rates at all energies tested. Biphasic shocks are substantially more effective than monophasic shocks for direct defibrillation. The dose-response curve guides selection of first-shock energy for traditional step-up protocols. Starting at 5 J optimizes for lowest threshold and cumulative energy, whereas 10 or 20 J optimizes for more rapid defibrillation and fewer shocks.

  19. Open Source Course Management Systems: A Case Study

    ERIC Educational Resources Information Center

    Remy, Eric

    2005-01-01

    In Fall 2003, Randolph-Macon Woman's College rolled out Claroline, an Open Source course management system for all the classes on campus. This document will cover some background on both Open Source in general and course management systems in specific, discuss technical challenges in the introduction and integration of the system and give some…

  20. Evaluation of normal range of mouth opening using three finger index: South India perspective study.

    PubMed

    Agrawal, Jayshree; Shenai, Prashanth K; Chatra, Laxmikanth; Kumar, Pavan Y

    2015-01-01

    The frequency, with which restricted mouth opening is encountered in the clinical practice, makes it essential to establish what constitutes the normal range. This study was undertaken to evaluate the normal range of mouth opening in adult population in south India. randomized clinical study conducted on dentate adult patients to evaluate the normal range of mouth openin. 500 healthy patients aged between 18-59 were randomly selected and divided into four groups according to their age ranges. The maximum inter-incisal distance and width of right and left three fingers at the first distal inter-phalanges were measured using vernier calipers. ANOVA test, student t test and pearsons correlation test. The mean value and range of maximum mouth opening of 50.3 mm ± 6.26 mm for males and 49.9 mm ± 6.74 mm for females was recorded. These values were significant and correlated with the width of three fingers. It was found that the greatest mean maximum mouth opening was recorded in youngest age group and lowest was recorded in older age group in both genders. The mean mouth opening value decreases with age and is lesser in females as compared to males of same age. This study demonstrated that individuals in all the four groups were able to vertically align their right and left three fingers between the upper and lower central incisors upto the first distal interphalangeal folds thus suggesting that, width of three fingers can be used as 'tool' to distinguish 'normal' from 'restricted' mouth opening.

  1. Laparoscopic versus open peritoneal dialysis catheter insertion, the LOCI-trial: a study protocol

    PubMed Central

    2011-01-01

    Background Peritoneal dialysis (PD) is an effective treatment for end-stage renal disease. It allows patients more freedom to perform daily activities compared to haemodialysis. Key to successful PD is the presence of a well-functioning dialysis catheter. Several complications, such as in- and outflow obstruction, peritonitis, exit-site infections, leakage and migration, can lead to catheter removal and loss of peritoneal access. Currently, different surgical techniques are in practice for PD-catheter placement. The type of insertion technique used may greatly influence the occurrence of complications. In the literature, up to 35% catheter failure has been described when using the open technique and only 13% for the laparoscopic technique. However, a well-designed randomized controlled trial is lacking. Methods/Design The LOCI-trial is a multi-center randomized controlled, single-blind trial (pilot). The study compares the laparoscopic with the open technique for PD catheter insertion. The primary objective is to determine the optimum placement technique in order to minimize the incidence of catheter malfunction at 6 weeks postoperatively. Secondary objectives are to determine the best approach to optimize catheter function and to study the quality of life at 6 months postoperatively comparing the two operative techniques. Discussion This study will generate evidence on any benefits of laparoscopic versus open PD catheter insertion. Trial registration Dutch Trial Register NTR2878 PMID:22185091

  2. How to Study Thermal Applications of Open-Cell Metal Foam: Experiments and Computational Fluid Dynamics

    PubMed Central

    De Schampheleire, Sven; De Jaeger, Peter; De Kerpel, Kathleen; Ameel, Bernd; Huisseune, Henk; De Paepe, Michel

    2016-01-01

    This paper reviews the available methods to study thermal applications with open-cell metal foam. Both experimental and numerical work are discussed. For experimental research, the focus of this review is on the repeatability of the results. This is a major concern, as most studies only report the dependence of thermal properties on porosity and a number of pores per linear inch (PPI-value). A different approach, which is studied in this paper, is to characterize the foam using micro tomography scans with small voxel sizes. The results of these scans are compared to correlations from the open literature. Large differences are observed. For the numerical work, the focus is on studies using computational fluid dynamics. A novel way of determining the closure terms is proposed in this work. This is done through a numerical foam model based on micro tomography scan data. With this foam model, the closure terms are determined numerically. PMID:28787894

  3. Utilizing Free and Open Source Software to access, view and compare in situ observations, EO products and model output data

    NASA Astrophysics Data System (ADS)

    Vines, Aleksander; Hamre, Torill; Lygre, Kjetil

    2014-05-01

    The GreenSeas project (Development of global plankton data base and model system for eco-climate early warning) aims to advance the knowledge and predictive capacities of how marine ecosystems will respond to global change. A main task has been to set up a data delivery and monitoring core service following the open and free data access policy implemented in the Global Monitoring for the Environment and Security (GMES) programme. The aim is to ensure open and free access to historical plankton data, new data (EO products and in situ measurements), model data (including estimates of simulation error) and biological, environmental and climatic indicators to a range of stakeholders, such as scientists, policy makers and environmental managers. To this end, we have developed a geo-spatial database of both historical and new in situ physical, biological and chemical parameters for the Southern Ocean, Atlantic, Nordic Seas and the Arctic, and organized related satellite-derived quantities and model forecasts in a joint geo-spatial repository. For easy access to these data, we have implemented a web-based GIS (Geographical Information Systems) where observed, derived and forcasted parameters can be searched, displayed, compared and exported. Model forecasts can also be uploaded dynamically to the system, to allow modelers to quickly compare their results with available in situ and satellite observations. We have implemented the web-based GIS(Geographical Information Systems) system based on free and open source technologies: Thredds Data Server, ncWMS, GeoServer, OpenLayers, PostGIS, Liferay, Apache Tomcat, PRTree, NetCDF-Java, json-simple, Geotoolkit, Highcharts, GeoExt, MapFish, FileSaver, jQuery, jstree and qUnit. We also wanted to used open standards to communicate between the different services and we use WMS, WFS, netCDF, GML, OPeNDAP, JSON, and SLD. The main advantage we got from using FOSS was that we did not have to invent the wheel all over again, but could use

  4. Safety and Efficacy of Totally Percutaneous Access Compared With Open Femoral Exposure for Endovascular Aneurysm Repair: A Meta-analysis.

    PubMed

    Cao, Zhanjiang; Wu, Weiwei; Zhao, Keqiang; Zhao, Junlai; Yang, Yu; Jiang, Chao; Zhu, Rongrong

    2017-04-01

    To compare the safety and efficacy of percutaneous (PEVAR) vs open femoral access (OFA) techniques for endovascular aneurysm repair (EVAR). A systematic review of English-language articles (Medline, EMBASE, and Cochrane databases) between January 1999 and August 2016 returned 11 studies including 1650 patients with 2500 groin accesses eligible for the meta-analysis. Data extracted from each study were synthesized to evaluate technical success rates, procedure time, and complications for the 2 access approaches. Data are presented as the odds ratio (OR) or mean difference (MD) with 95% confidence intervals (CI). The quality of individual studies was evaluated based on the Newcastle-Ottawa scale. The mean technical success rate in the PEVAR group was 94.5% (785/831). The overall OR was 0.38 (95% CI 0.12 to 1.18, p=0.09), indicating no significant difference between the methods. The procedure time in PEVAR was shorter than OFA (mean difference -24.52, 95% CI -46.45 to -22.60, p<0.001). Overall, the total complication rate was 15.3% in the OFA group vs 7.8% in the PEVAR group (OR 0.52, 95% CI 0.37 to 0.73, p<0.001). The meta-analysis identified significant differences between groups for all complications (p<0.001) and the following individual adverse events: wound infection (OR 0.28, 95% CI 0.10 to 0.81, p=0.02), pseudoaneurysm (OR 8.07, 95% CI 1.54 to 42.32, p=0.01), seroma (OR 0.10, 95% CI 0.02 to 0.55, p=0.008), and lymphocele or lymph leak (OR 0.19, 95% CI 0.04 to 0.92, p=0.04). PEVAR had a similar technical success rate, shorter procedure time, and lower complication rate compared with OFA. Thus, percutaneous access appears to be the preferential approach for EVAR. However, larger and randomized studies are needed to draw definitive conclusions.

  5. The cost-utility of open prostatectomy compared with active surveillance in early localised prostate cancer

    PubMed Central

    2014-01-01

    Background There is an on-going debate about whether to perform surgery on early stage localised prostate cancer and risk the common long term side effects such as urinary incontinence and erectile dysfunction. Alternatively these patients could be closely monitored and treated only in case of disease progression (active surveillance). The aim of this paper is to develop a decision-analytic model comparing the cost-utility of active surveillance (AS) and radical prostatectomy (PE) for a cohort of 65 year old men with newly diagnosed low risk prostate cancer. Methods A Markov model comparing PE and AS over a lifetime horizon was programmed in TreeAge from a German societal perspective. Comparative disease specific mortality was obtained from the Scandinavian Prostate Cancer Group trial. Direct costs were identified via national treatment guidelines and expert interviews covering in-patient, out-patient, medication, aids and remedies as well as out of pocket payments. Utility values were used as factor weights for age specific quality of life values of the German population. Uncertainty was assessed deterministically and probabilistically. Results With quality adjustment, AS was the dominant strategy compared with initial treatment. In the base case, it was associated with an additional 0.04 quality adjusted life years (7.60 QALYs vs. 7.56 QALYs) and a cost reduction of €6,883 per patient (2011 prices). Considering only life-years gained, PE was more effective with an incremental cost-effectiveness ratio of €96,420/life year gained. Sensitivity analysis showed that the probability of developing metastases under AS and utility weights under AS are a major sources of uncertainty. A Monte Carlo simulation revealed that AS was more likely to be cost-effective even under very high willingness to pay thresholds. Conclusion AS is likely to be a cost-saving treatment strategy for some patients with early stage localised prostate cancer. However, cost-effectiveness is

  6. A Randomized Controlled Trial Comparing Endoscopic-Assisted Versus Open Neck Tissue Expander Placement in Reconstruction of Post-Burn Facial Scar Deformities.

    PubMed

    As'adi, Kamran; Emami, Seyed Abolhassan; Salehi, Seyed Hamid; Shoar, Saeed

    2016-08-01

    Tissue expansion has evolved reconstruction surgery by providing a great source of additional tissue for large skin defects. Nevertheless, wide application of tissue expander reconstruction is challenging due to high complication rates and uncertainty about final outcomes. Recently, endoscopy has shown promise in reconstructive surgeries using tissue expander placement. This study aimed to compare outcomes between open and endoscopic-assisted neck tissue expander placement in reconstruction of post-burn facial scar deformities. Through a randomized clinical trial, 63 patients with facial burn scars were assigned to an open group or endoscopic group for placement of 81 tissue expanders. The complication rate, operative time, length of hospital stay, and time to full expansion were compared between the two groups. Thirty-one patients were assigned to the open group and 32 patients to the endoscopic group. The average operative time was significantly reduced in the endoscopic group compared with the open group (42.2 ± 3.6, 56.5 ± 4.5 min, p < 0.05). The complication rate was significantly lower in the endoscopic group than the open group (6 vs. 16, p < 0.05). Hospital stay was also significantly diminished from 26.3 ± 7.7 h in open group to 7.4 ± 4.5 h in endoscopic group (p < 0.0001). There was a significant reduction in time to full expansion in the endoscopic group as compared with the open group (93.5 ± 10.2 vs. 112.1 ± 14.2 days, p = 0.002). Endoscopic neck tissue expander placement significantly reduced operative time, the postoperative complication rate, length of hospital stay, and time to achieve full expansion and allowed early initiation of expansion and remote placement of the port in relation to the expander pocket. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to

  7. Open market customer: Volume 2 -- Case study assessments. Final report

    SciTech Connect

    Kotowski, J.; Wikler, G.; Milward, R.; Gudger, K.

    1998-06-01

    This second volume of the Open Market Customer (OMC) contains the case study assessments that illustrate the discussions in Volume 1 and the supporting framework. There are two types of assessments in this volume: actual case studies and prototype case studies. The first, the actual case studies are full OMC assessments of four different types of existing large commercial/industrial facilities. They are, in order of their appearance in this volume: Logan International Airport, Boston, MA--Airport; Washington University, St. Louis, MO--Four-Year University; Cook County Hospital, Chicago, IL--Hospital; and Sierra Pine Ltd., Rocklin, CA--Wood Products Manufacturing. The second type of assessments are the prototype case studies. They were performed on four different types of facilities falling under two market segments. These facilities` models were developed using assumed characteristics, such as floor areas and energy sources. They are, in order of appearance in this volume: Retail Building--small commercial; Sit-Down Restaurant--small commercial; Primary School--small commercial; and Planned Residential Community--residential. For each facility, the characteristics or assumptions are described in detail. Using these characteristics or assumptions a framework for each energy type used on-site was developed. Each framework describes the annual consumption of that energy type as well as the infrastructure supporting it. For example, a facility`s electricity framework shows the estimated annual electricity consumption and expenditures within each of the nine functional areas at that facility. Further, the framework shows the estimated capital associated with each functional area, such as substations, electric distribution lines, and motors. Appendices at the end of this volume contain the frameworks for each case study.

  8. Evaluating synteny for improved comparative studies

    PubMed Central

    Ghiurcuta, Cristina G.; Moret, Bernard M. E.

    2014-01-01

    Motivation: Comparative genomics aims to understand the structure and function of genomes by translating knowledge gained about some genomes to the object of study. Early approaches used pairwise comparisons, but today researchers are attempting to leverage the larger potential of multi-way comparisons. Comparative genomics relies on the structuring of genomes into syntenic blocks: blocks of sequence that exhibit conserved features across the genomes. Syntenic blocs are required for complex computations to scale to the billions of nucleotides present in many genomes; they enable comparisons across broad ranges of genomes because they filter out much of the individual variability; they highlight candidate regions for in-depth studies; and they facilitate whole-genome comparisons through visualization tools. However, the concept of syntenic block remains loosely defined. Tools for the identification of syntenic blocks yield quite different results, thereby preventing a systematic assessment of the next steps in an analysis. Current tools do not include measurable quality objectives and thus cannot be benchmarked against themselves. Comparisons among tools have also been neglected—what few results are given use superficial measures unrelated to quality or consistency. Results: We present a theoretical model as well as an experimental basis for comparing syntenic blocks and thus also for improving or designing tools for the identification of syntenic blocks. We illustrate the application of the model and the measures by applying them to syntenic blocks produced by three different contemporary tools (DRIMM-Synteny, i-ADHoRe and Cyntenator) on a dataset of eight yeast genomes. Our findings highlight the need for a well founded, systematic approach to the decomposition of genomes into syntenic blocks. Our experiments demonstrate widely divergent results among these tools, throwing into question the robustness of the basic approach in comparative genomics. We have taken

  9. Planned Curriculum Change: A Comparative Case Study.

    ERIC Educational Resources Information Center

    Barzansky, Barbara; And Others

    As traditional medical school curricula began to be criticized in the 1950s, various alternatives were proposed, including the organ-system based curriculum (organized around the organ systems of the body) and the problem-based curriculum (organized around clinical problems). From an open systems perspective, any such medical school curriculum…

  10. Postoperative pain after arthroscopic versus open rotator cuff repair. A prospective study.

    PubMed

    Pham, T T; Bayle Iniguez, X; Mansat, P; Maubisson, L; Bonnevialle, N

    2016-02-01

    Although the arthroscopic technique is becoming the gold standard for rotator cuff tendon repair, there is no proof that this technique results in less postoperative pain compared to open repair. The aim of this study was to prospectively compare the postoperative pain level after arthroscopic or open rotator cuff repair and to define factors that could influence its course. Between January 2012 and January 2013, 95 patients were operated for a rotator cuff tear: 45 using an arthroscopic technique and 50 an open technique. Daily analgesic use and self-evaluation of pain level using a visual analogic scale were recorded preoperatively and twice a day postoperatively during the first 6 weeks. These data were compared between the two groups and analyzed according to patients' demographic data and preoperative evaluation of the tear. The preoperative pain level was equivalent in the two groups (P=0.22). Postoperatively, level-2 analgesic medication use was greater in the arthroscopic group after the 4th week (P=0.01). A pain-free shoulder was obtained before the 6th week in 75% and 66% of the patients after arthroscopic or open repair, respectively (P=0.34). There was a positive correlation between the preoperative and postoperative pain level (r=0.25; P=0.02). Work compensation patients experienced more pain postoperatively (P=0.08). Level-III analgesic medication use was greater for patients with massive rotator cuff tear (P=0.001). No evidence was found on the superiority of arthroscopy versus open repair of rotator cuff tear concerning the postoperative pain level. The choice of the surgical technique should not be based on this argument. II. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  11. A numerical study on manoeuvrability of wind turbine installation vessel using OpenFOAM

    NASA Astrophysics Data System (ADS)

    Lee, Sungwook; Kim, Booki

    2015-05-01

    In this study, a numerical prediction method on manoeuvrability of Wind Turbine Installation Vessel (WTIV) is presented. Planar Motion Mechanism (PMM) captive test for the bare hull of WTIV is carried out in the model basin and compared with the numerical results using RANS simulation based on Open-source Field Operation And Manipulation (OpenFOAM) calculation to validate the developed method. The manoeuvrability of WTIV with skeg and/or without skeg is investigated using the numerical approach along with the captive model test. In the numerical calculations, the dynamic stability index which indicates the course keeping ability is evaluated and compared for three different hull configurations i.e. bare hull and other two hulls with center skeg and twin skeg. This paper proves that the numerical approach using RANS simulation can be readily applied to estimate the manoeuvrability of WTIV at the initial design stage.

  12. A numerical study on manoeuvrability of wind turbine installation vessel using OpenFOAM

    NASA Astrophysics Data System (ADS)

    Lee, Sungwook; Kim, Booki

    2015-09-01

    In this study, a numerical prediction method on manoeuvrability of Wind Turbine Installation Vessel (WTIV) is presented. Planar Motion Mechanism (PMM) captive test for the bare hull of WTIV is carried out in the model basin and compared with the numerical results using RANS simulation based on Open-source Field Operation And Manipulation (OpenFOAM) calculation to validate the developed method. The manoeuvrability of WTIV with skeg and/or without skeg is investigated using the numerical approach along with the captive model test. In the numerical calculations, the dynamic stability index which indicates the course keeping ability is evaluated and compared for three different hull configurations i.e. bare hull and other two hulls with center skeg and twin skeg. This paper proves that the numerical approach using RANS simulation can be readily applied to estimate the manoeuvrability of WTIV at the initial design stage.

  13. An Osteologic Study of Cranial Opening of Optic Canal in Gujarat Region

    PubMed Central

    Singh, Praveen R

    2016-01-01

    Introduction Optic canal is a bony canal situated in between the roots of lesser wings of sphenoid, lateral to body of sphenoid. It transmits optic nerve and ophthalmic artery, surrounded by meninges. Various authors have studied variations in skull foramina and correlated clinically, as variants in the body structures have been found to be associated with many inherited or acquired diseases. Aim The present study aimed to examine morphologic and morphometric variations in cranial openings of optic canals. Materials and Methods The study was undertaken in total 150 dry adult human skulls. The variations in size, shape, presence or absence and duplication or multiplication if any, in optic canal were observed bilaterally. Unusual features such as recess, fissure and notch were also observed bilaterally. Student’s t-test was applied to compare size of cranial openings of optic canal on both sides. Similarly, morphologic features related with the canal were studied by calculating frequency and proportions of various parameters. Results Optic canal was present in all 150 skulls studied bilaterally. The mean maximum dimension of the canal at cranial opening was 5.03±0.72 mm on right side and 5.02±0.76 mm on left side. The shape of the canal was ovoid at cranial opening in all the skulls studied. Duplication of optic canal was present in one skull on left side. Recess was found in 105(35%) sides of total skulls observed. Fissure was found in 20(6.67%) sides and notch was observed in 30(10%) sides of total skulls. Conclusion The optic canal showed variability in various parameters. Knowledge regarding variations in size, shape and unusual features on cranial opening of optic canal can be helpful to clinicians while approaching optic canal for various invasive procedures such as optic nerve decompression. PMID:28050353

  14. 2MASS analytical study of four open cluster candidates

    NASA Astrophysics Data System (ADS)

    Bisht, D.; Yadav, R. K. S.; Durgapal, A. K.

    2017-04-01

    The astrophysical parameters of four poorly studied open star clusters namely Teutsch 126, Teutsch 54, Teutsch 61 and Czernik 3, have been estimated using the Two Micron All Sky Survey (2MASS) database. The stellar density distributions and color-magnitude diagrams are used to determine their structural parameters (cluster center, cluster radius, core radius, tidal radius, Galactocenteric coordinates and the distance from the Galactic plane). We have also derived age, color excesses, total mass, relaxation time, luminosity and mass function for each clusters. The mass function slopes for these clusters are derived as 1.59 ± 0.62, 1.31 ± 0.60, 1.22 ± 0.75 and 1.62 ± 0.56 for Teutsch 126, Teutsch 54, Teutsch 61 and Czernik 3 respectively. These values are very close with the Salpeter value (x = 1.35) within the errors. The effect of mass-segregation are observed in the clusters Teutsch 126 and Teutsch 61. Estimated values of dynamical relaxation time are less than age of the clusters under study. This concludes that these objects are dynamically relaxed. The possible reason for relaxation may be due to the dynamical evolution or imprint of star formation or both.

  15. BVI Photometric Study of the Old Open Cluster Ruprecht 6

    NASA Astrophysics Data System (ADS)

    Kim, Sang Chul; Kyeong, Jaemann; Park, Hong Soo; Han, Ilseung; Lee, Joon Hyeop; Moon, Dae-Sik; Lee, Youngdae; Kim, Seongjae

    2017-06-01

    We present a BVI optical photometric study of the old open cluster Ruprecht 6 using the data obtained with the SMARTS 1.0 m telescope at the CTIO, Chile. Its color-magnitude diagrams show the clear existence of the main-sequence stars, whose turn-off point is located around V ≈ 18.45 mag and B-V ≈ 0.85 mag. Three red clump (RC) stars are identified at V = 16.00 mag, I = 14.41 mag and B-V = 1.35 mag. From the mean K_s-band magnitude of RC stars (K_s=12.39 ± 0.21 mag) in Ruprecht 6 from 2MASS photometry and the known absolute magnitudes of the RC stars (M_{K_S} = -1.595 ± 0.025 mag), we obtain the distance modulus to Ruprecht 6 of (m-M)_0 = 13.84 ± 0.21 mag (d=5.86 ± 0.60 kpc). From the (J-K_s) and (B-V) colors of the RC stars, comparison of the (B-V) and (V-I) colors of the bright stars in Ruprecht 6 with those of the intrinsic colors of dwarf and giant stars, and the PARSEC isochrone fittings, we derive the reddening values of E(B-V) = 0.42 mag and E(V-I) = 0.60 mag. Using the PARSEC isochrone fittings onto the color-magnitude diagrams, we estimate the age and metallicity to be: log(t)=9.50 ± 0.10 (t=3.16 ± 0.82 Gyr) and [Fe/H] = -0.42 ± 0.04 dex. We present the Galactocentric radial metallicity gradient analysis for old (age > 1 Gyr) open clusters of the Dias et al. catalog, which likely follow a single relation of [Fe/H] =(-0.034±0.007) R_{GC} + (0.190±0.080) (rms = 0.201) for the whole radial range or a dual relation of [Fe/H] =(-0.077±0.017) R_{GC} + (0.609±0.161) (rms = 0.152) and constant ([Fe/H] ˜ -0.3 dex) value, inside and outside of R_{GC} ˜ 12 kpc, respectively. The metallicity and Galactocentric radius (13.28± 0.54 kpc) of Ruprecht 6 obtained in this study seem to be consistent with both of the relations.

  16. A study on comparative efficacyof hypolipidemic drugs.

    PubMed

    Sher, A; Ullah, A; Mateen, A

    1995-01-01

    A study was carried out on the comparative efficacy of Lopid, Mevacor, Bezalip and Lasona in sixteen hyperlipidemic subjects. All the subjects were on Lopid at least for the last 15 days. Lopid therapy was discontinued after determining blood lipid profile of the subjects on day zero (day of 1st contact). The subjects were divided into three groups and after a washout period of 15 days, they were given three different drugs for the next 15 days. Subjects in group a (6), b (5) and c (5) received Mevacor, Bezalip and lasona respectively. In the present study mevacor was found to be the most potent hypolipidemic drug in lowering blood cholesterol and Low density lipoprotein (LDL) while lopid was most effective in keeping blood Triglycerides (TG) and High density lipoproteins (HDL) level within the desired limits. Bezalip and Lasona were also sufficiently effective in changing blood lipid profile, but lasona showed a negligible effect on HDL rise as compared with Bezalip or any other drug used in this study.

  17. Comparative study of INPIStron and spark gap

    NASA Technical Reports Server (NTRS)

    Han, Kwang S.; Lee, Ja H.

    1993-01-01

    An inverse pinch plasma switch, INPIStron, was studied in comparison to a conventional spark gap. The INPIStron is under development for high power switching applications. The INPIStron has an inverse pinch dynamics, opposed to Z-pinch dynamics in the spark gap. The electrical, plasma dynamics and radiative properties of the closing plasmas have been studied. Recently the high-voltage pulse transfer capabilities or both the INPIStron and the spark gap were also compared. The INPIStron with a low impedance Z = 9 ohms transfers 87 percent of an input pulse with a halfwidth of 2 mu s. For the same input pulse the spark gap of Z = 100 ohms transfers 68 percent. Fast framing and streak photography, taken with an TRW image converter camera, was used to observe the discharge uniformity and closing plasma speed in both switches. In order to assess the effects of closing plasmas on erosion of electrode material, emission spectra of two switches were studied with a spectrometer-optical multi channel analyzer (OMA) system. The typical emission spectra of the closing plasmas in the INPIStron and the spark gap showed that there were comparatively weak carbon line emission in 658.7 nm and copper (electrode material) line emissions in the INPIStron, indicating low erosion of materials in the INPIStron.

  18. The Economics of Comparative Effectiveness Studies

    PubMed Central

    Meltzer, David; Basu, Anirban; Conti, Rena

    2013-01-01

    Comparative effectiveness research (CER) can provide valuable information for patients, providers and payers. These stakeholders differ in their incentives to invest in CER. To maximize benefits from public investments in CER, it is important to understand the value of CER from the perspectives of these stakeholders and how that affects their incentives to invest in CER. This article provides a conceptual framework for valuing CER, and illustrates the potential benefits of such studies from a number of perspectives using several case studies. We examine cases in which CER provides value by identifying when one treatment is consistently better than others, when different treatments are preferred for different subgroups, and when differences are small enough that decisions can be made based on price. We illustrate these findings using value-of-information techniques to assess the value of research, and by examining changes in pharmaceutical prices following publication of a comparative effectiveness study. Our results suggest that CER may have high societal value but limited private return to providers or payers. This suggests the importance of public efforts to promote the production of CER. We also conclude that value-of-information tools may help inform policy decisions about how much public funds to invest in CER and how to prioritize the use of available public funds for CER, in particular targeting public CER spending to areas where private incentives are low relative to social benefits. PMID:20831292

  19. Open Rotor Development

    NASA Technical Reports Server (NTRS)

    Van Zante, Dale E.; Rizzi, Stephen A.

    2016-01-01

    The ERA project executed a comprehensive test program for Open Rotor aerodynamic and acoustic performance. System studies used the data to estimate the fuel burn savings and acoustic margin for an aircraft system with open rotor propulsion. The acoustic measurements were used to produce an auralization that compares the legacy blades to the current generation of open rotor designs.

  20. Surgical Site Infections in Patients With Type 3 Open Fractures: Comparing Antibiotic Prophylaxis With Cefazolin Plus Gentamicin Versus Piperacillin/Tazobactam.

    PubMed

    Redfern, Jenessa; Wasilko, Scott M; Groth, Meghan E; McMillian, Wesley D; Bartlett, Craig S

    2016-08-01

    The purpose of this study was to compare rates of surgical site infection (SSI) in patients with type 3 open fractures who had received cefazolin plus gentamicin versus piperacillin/tazobactam for antibiotic prophylaxis. Retrospective cohort study. Level 1 trauma center. Seven hundred sixty-six patients admitted between January 1, 2004, and December 31, 2012, with open fractures were identified using the National Trauma Data Bank by searching International Classification of Diseases, Ninth Revision (ICD-9) codes. Electronic medical record review revealed 134 patients with type 3 open fractures, of which 72 were included in the final analysis. Administration of cefazolin plus gentamicin or piperacillin/tazobactam for type 3 open fracture antibiotic prophylaxis. SSI, nonunion, death, and rehospitalization rates at 1 year. Surgical site infection at 1 year occurred in 12 of 37 patients (32.4%) in the cefazolin plus gentamicin group and 11 of 35 patients (31.4%) in the piperacillin/tazobactam group (P = 1.000). Nonunion, death, and rehospitalization rates at 1 year were similar between the 2 groups. Although there was no statistically significant difference in SSI at 30 days between groups, the rate was higher in the cefazolin plus gentamicin group (21.6% vs. 11.4%; P = 0.246). At our institution, use of piperacillin/tazobactam as compared with cefazolin plus gentamicin for antibiotic prophylaxis in patients with type 3 open fractures showed similar rates of SSI, nonunion, mortality, and rehospitalization at 1 year after injury. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

  1. Comparative study of hydrogenated and lithiated superhalogens

    NASA Astrophysics Data System (ADS)

    Xu, Li-Na; Li, Ying; Liu, Jia-Yuan; Wu, Di; Sun, Yan-Bo; Li, Zhi-Ru

    2016-09-01

    The structural features, properties and stability of two kinds of representative superhalogen compounds, namely hydrogenated superhalogens and lithiated superhalogens, are theoretically studied in detail, providing further insight into the behavior of superhalogens. According to topological analysis of the electron localization function, most of superhalogen clusters as a whole combine with Li atom through ionic bond(s). In contrast, the H atom tends to bind with superhalogen by covalent bond although a portion of superhalogens are broken upon hydrogenation. In addition, the electric properties of these superhalogen compounds are also obtained and compared with those of traditional acid and salt molecules.

  2. EFQPSK Versus CERN: A Comparative Study

    NASA Technical Reports Server (NTRS)

    Borah, Deva K.; Horan, Stephen

    2001-01-01

    This report presents a comparative study on Enhanced Feher's Quadrature Phase Shift Keying (EFQPSK) and Constrained Envelope Root Nyquist (CERN) techniques. These two techniques have been developed in recent times to provide high spectral and power efficiencies under nonlinear amplifier environment. The purpose of this study is to gain insights into these techniques and to help system planners and designers with an appropriate set of guidelines for using these techniques. The comparative study presented in this report relies on effective simulation models and procedures. Therefore, a significant part of this report is devoted to understanding the mathematical and simulation models of the techniques and their set-up procedures. In particular, mathematical models of EFQPSK and CERN, effects of the sampling rate in discrete time signal representation, and modeling of nonlinear amplifiers and predistorters have been considered in detail. The results of this study show that both EFQPSK and CERN signals provide spectrally efficient communications compared to filtered conventional linear modulation techniques when a nonlinear power amplifier is used. However, there are important differences. The spectral efficiency of CERN signals, with a small amount of input backoff, is significantly better than that of EFQPSK signals if the nonlinear amplifier is an ideal clipper. However, to achieve such spectral efficiencies with a practical nonlinear amplifier, CERN processing requires a predistorter which effectively translates the amplifier's characteristics close to those of an ideal clipper. Thus, the spectral performance of CERN signals strongly depends on the predistorter. EFQPSK signals, on the other hand, do not need such predistorters since their spectra are almost unaffected by the nonlinear amplifier, Ibis report discusses several receiver structures for EFQPSK signals. It is observed that optimal receiver structures can be realized for both coded and uncoded EFQPSK

  3. Comparative Study of Vented vs. Unvented Crawlspaces

    SciTech Connect

    Biswas, Kaushik; Christian, Jeffrey E; Gehl, Anthony C

    2011-10-01

    There has been a significant amount of research in the area of building energy efficiency and durability. However, well-documented quantitative information on the impact of crawlspaces on the performance of residential structures is lacking. The objective of this study was to evaluate and compare the effects of two crawlspace strategies on the whole-house performance of a pair of houses in a mixed humid climate. These houses were built with advanced envelope systems to provide energy savings of 50% or more compared to traditional 2010 new construction. One crawlspace contains insulated walls and is sealed and semi-conditioned. The other is a traditional vented crawlspace with insulation in the crawlspace ceiling. The vented (traditional) crawlspace contains fiberglass batts installed in the floor chase cavities above the crawl, while the sealed and insulated crawlspace contains foil-faced polyisocyanurate foam insulation on the interior side of the masonry walls. Various sensors to measure temperatures, heat flux through crawlspace walls and ceiling, and relative humidity were installed in the two crawlspaces. Data from these sensors have been analyzed to compare the performance of the two crawlspace designs. The analysis results indicated that the sealed and insulated crawlspace design is better than the traditional vented crawlspace in the mixed humid climate.

  4. A Comparative Study of Mammalian Diversification Pattern

    PubMed Central

    Yu, Wenhua; Xu, Junxiao; Wu, Yi; Yang, Guang

    2012-01-01

    Although mammals have long been regarded as a successful radiation, the diversification pattern among the clades is still poorly known. Higher-level phylogenies are conflicting and comprehensive comparative analyses are still lacking. Using a recently published supermatrix encompassing nearly all extant mammalian families and a novel comparative likelihood approach (MEDUSA), the diversification pattern of mammalian groups was examined. Both order- and family-level phylogenetic analyses revealed the rapid radiation of Boreoeutheria and Euaustralidelphia in the early mammalian history. The observation of a diversification burst within Boreoeutheria at approximately 100 My supports the Long Fuse model in elucidating placental diversification progress, and the rapid radiation of Euaustralidelphia suggests an important role of biogeographic dispersal events in triggering early Australian marsupial rapid radiation. Diversification analyses based on family-level diversity tree revealed seven additional clades with exceptional diversification rate shifts, six of which represent accelerations in net diversification rate as compared to the background pattern. The shifts gave origin to the clades Muridae+Cricetidae, Bovidae+Moschidae+Cervidae, Simiiformes, Echimyidae, Odontoceti (excluding Physeteridae+Kogiidae+Platanistidae), Macropodidae, and Vespertilionidae. Moderate to high extinction rates from background and boreoeutherian diversification patterns indicate the important role of turnovers in shaping the heterogeneous taxonomic richness observed among extant mammalian groups. Furthermore, the present results emphasize the key role of extinction on erasing unusual diversification signals, and suggest that further studies are needed to clarify the historical radiation of some mammalian groups for which MEDUSA did not detect exceptional diversification rates. PMID:22457604

  5. WIYN Open Cluster Study: UBVRI Photometry of NGC 2158

    NASA Astrophysics Data System (ADS)

    Taverne, Luke T.; Steinhauer, Aaron J.; Deliyannis, Constantine P.

    2015-01-01

    We present WIYN 0.9m HDI UBVRI photometry of NGC 2158, a very rich, intermediate-aged, open cluster located near the galactic anti-center. We report derived values for the cluster age, distance, reddening.

  6. Spectroscopic and Photometric Study of Open Cluster Trumpler 27

    NASA Astrophysics Data System (ADS)

    Obonyo, W. O.; Baki, P.

    2016-12-01

    Open clusters are essential laboratories for understanding stellar evolution, as they allow constraints to be placed on stellar ages and luminosities. As distance indicators, they are important tracers of star formation in the Milky Way. One such cluster is Trumpler 27. Spectroscopic and photometric data of Trumpler 27 was used to estimate its distance, radial velocity, age, membership and reddening. The Spectroscopic data collected from SAAO's 1.9m telescope and photometric ones from catalogues were used to estimate reddening, identify cluster stars and approximate cluster distance. Classification of spectra was done by comparing them to spectral templates. The result from this work suggests that Trumpler 27 is made up of ∼55 stars which are at different stages of evolution. The stars include main sequence stars, blue supergiants, two cool supergiants and maybe the two WR stars. The cluster's age and distance were found to be 10Myrs old and 2.6 ± 0.2 kpc away from the Sun respectively suggesting that it is located on the outer part of Scutum Centaurus arm of the Galaxy. Its reddening, E(B - V) varies substantially across the field with the average value being 1.3±0.2. It has a radial velocity of -15.3±3km/s, as approximated from some of its cool supergiants. There is a likelihood of a younger population of OB stars located at 3.5 kpc away from the sun, that is right behind Trumpler 27 interpreted as either a cluster or background stars that mimic a cluster.

  7. Short-term and middle-term evaluation of laparoscopic hepatectomies compared with open hepatectomies: A propensity score matching analysis.

    PubMed

    Untereiner, Xavier; Cagnet, Audrey; Memeo, Riccardo; De Blasi, Vito; Tzedakis, Stylianos; Piardi, Tullio; Severac, Francois; Mutter, Didier; Kianmanesh, Reza; Marescaux, Jacques; Sommacale, Daniele; Pessaux, Patrick

    2016-09-27

    To compare short-term results between laparoscopic hepatectomy and open hepatectomy using a propensity score matching. A patient in the laparoscopic liver resection (LLR) group was randomly matched with another patient in the open liver resection (OLR) group using a 1:1 allocated ratio with the nearest estimated propensity score. Patients of the LLR group without matches were excluded. Matching criteria included age, gender, body mass index, American Society of Anesthesiologists score, potential co-morbidities, hepatopathies, size and number of nodules, preoperative chemotherapy, minor or major liver resections. Intraoperative and postoperative data were compared in both groups. From January 2012 to January 2015, a total of 241 hepatectomies were consecutively performed, of which 169 in the OLR group (70.1%) and 72 in the LLR group (29.9%). The conversion rate was 9.7% (n = 7). The mortality rate was 4.2% in the OLR group and 0% in the LLR group. Prior to and after propensity score matching, there was a statistically significant difference favorable to the LLR group regarding shorter operative times (185 min vs 247.5 min; P = 0.002), less blood loss (100 mL vs 300 mL; P = 0.002), a shorter hospital stay (7 d vs 9 d; P = 0.004), and a significantly lower rate of medical complications (4.3% vs 26.4%; P < 0.001). Laparoscopic liver resections seem to yield better short-term and mid-term results as compared to open hepatectomies and could well be considered a privileged approach and become the gold standard in carefully selected patients.

  8. Short-term and middle-term evaluation of laparoscopic hepatectomies compared with open hepatectomies: A propensity score matching analysis

    PubMed Central

    Untereiner, Xavier; Cagnet, Audrey; Memeo, Riccardo; De Blasi, Vito; Tzedakis, Stylianos; Piardi, Tullio; Severac, Francois; Mutter, Didier; Kianmanesh, Reza; Marescaux, Jacques; Sommacale, Daniele; Pessaux, Patrick

    2016-01-01

    AIM To compare short-term results between laparoscopic hepatectomy and open hepatectomy using a propensity score matching. METHODS A patient in the laparoscopic liver resection (LLR) group was randomly matched with another patient in the open liver resection (OLR) group using a 1:1 allocated ratio with the nearest estimated propensity score. Patients of the LLR group without matches were excluded. Matching criteria included age, gender, body mass index, American Society of Anesthesiologists score, potential co-morbidities, hepatopathies, size and number of nodules, preoperative chemotherapy, minor or major liver resections. Intraoperative and postoperative data were compared in both groups. RESULTS From January 2012 to January 2015, a total of 241 hepatectomies were consecutively performed, of which 169 in the OLR group (70.1%) and 72 in the LLR group (29.9%). The conversion rate was 9.7% (n = 7). The mortality rate was 4.2% in the OLR group and 0% in the LLR group. Prior to and after propensity score matching, there was a statistically significant difference favorable to the LLR group regarding shorter operative times (185 min vs 247.5 min; P = 0.002), less blood loss (100 mL vs 300 mL; P = 0.002), a shorter hospital stay (7 d vs 9 d; P = 0.004), and a significantly lower rate of medical complications (4.3% vs 26.4%; P < 0.001). CONCLUSION Laparoscopic liver resections seem to yield better short-term and mid-term results as compared to open hepatectomies and could well be considered a privileged approach and become the gold standard in carefully selected patients. PMID:27721928

  9. Five-year extension of a clinical trial comparing the EX-PRESS glaucoma filtration device and trabeculectomy in primary open-angle glaucoma.

    PubMed

    de Jong, Leo; Lafuma, Antoine; Aguadé, Anne-Sophie; Berdeaux, Gilles

    2011-01-01

    This study compared the efficacy of the EX-PRESS(®) glaucoma filtration device and trabeculectomy in primary open-angle glaucoma up to five years after surgery. Patients from a previously reported randomized, open-label, parallel-arm clinical trial in which 78 patients received either the EX-PRESS glaucoma filtration device or underwent a trabeculectomy were followed for up to an additional four years (five total) beyond the original study (39 eyes per treatment group). Risk-benefit data were obtained for up to five years after glaucoma surgery. Outcome variables were intraocular pressures and intraocular pressure medications. Complete success was denoted by intraocular pressure values ≤ 18 mmHg without medication. The EX-PRESS glaucoma filtration device controlled intraocular pressure more effectively without medication for more patients from year 1 (86.8% versus 61.5%, P = 0.01) to year 3 (66.7% versus 41.0%, P = 0.02) than trabeculectomy. At year 1, only 12.8% of patients required intraocular pressure medication after EX-PRESS implantation, compared with 35.9% after trabeculectomy. The proportions became closer at year 5 (41% versus 53.9%). The responder rate was higher with EX-PRESS and time to failure was longer. In addition, surgical interventions for complications were fewer after EX-PRESS implantation. This five-year analysis confirmed and extended the results reported after one year. Compared with trabeculectomy, EX-PRESS provided better intraocular pressure control in the first three years, and patients required fewer intraocular pressure medications and fewer surgical interventions during the five-year study period. For patients with primary open-angle glaucoma, the EX-PRESS glaucoma filtration device, implanted under a superficial scleral flap, produced significantly higher success rates than trabeculectomy. EX-PRESS is an effective device for long-term treatment of primary open-angle glaucoma.

  10. Major complications, mortality, and resource utilization after open abdominal surgery: 0.9% saline compared to Plasma-Lyte.

    PubMed

    Shaw, Andrew D; Bagshaw, Sean M; Goldstein, Stuart L; Scherer, Lynette A; Duan, Michael; Schermer, Carol R; Kellum, John A

    2012-05-01

    To assess the association of 0.9% saline use versus a calcium-free physiologically balanced crystalloid solution with major morbidity and clinical resource use after abdominal surgery. 0.9% saline, which results in a hyperchloremic acidosis after infusion, is frequently used to replace volume losses after major surgery. An observational study using the Premier Perspective Comparative Database was performed to evaluate adult patients undergoing major open abdominal surgery who received either 0.9% saline (30,994 patients) or a balanced crystalloid solution (926 patients) on the day of surgery. The primary outcome was major morbidity and secondary outcomes included minor complications and acidosis-related interventions. Outcomes were evaluated using multivariable logistic regression and propensity scoring models. For the entire cohort, the in-hospital mortality was 5.6% in the saline group and 2.9% in the balanced group (P < 0.001). One or more major complications occurred in 33.7% of the saline group and 23% of the balanced group (P < 0.001). In the 3:1 propensity-matched sample, treatment with balanced fluid was associated with fewer complications (odds ratio 0.79; 95% confidence interval 0.66-0.97). Postoperative infection (P = 0.006), renal failure requiring dialysis (P < 0.001), blood transfusion (P < 0.001), electrolyte disturbance (P = 0.046), acidosis investigation (P < 0.001), and intervention (P = 0.02) were all more frequent in patients receiving 0.9% saline. Among hospitals in the Premier Perspective Database, the use of a calcium-free balanced crystalloid for replacement of fluid losses on the day of major surgery was associated with less postoperative morbidity than 0.9% saline.

  11. Comparative study of methods for WHPA delineation.

    PubMed

    Paradis, Daniel; Martel, Richard; Karanta, Gilbert; Lefebvre, René; Michaud, Yves; Therrien, René; Nastev, Miroslav

    2007-01-01

    Human activities, whether agricultural, industrial, commercial, or domestic, can contribute to ground water quality deterioration. In order to protect the ground water exploited by a production well, it is essential to develop a good knowledge of the flow system and to adequately delineate the area surrounding the well within which potential contamination sources should be managed. Many methods have been developed to delineate such a wellhead protection area (WHPA). The integration of more information on the geologic and hydrogeologic characteristics of the study area increases the precision of any given WHPA delineation method. From a practical point of view, the WHPA delineation methods allowing the simplest and least expensive integration of the available information should be favored. This paper presents a comparative study in which nine different WHPA delineation methods were applied to a well and a spring in an unconfined granular aquifer and to a well in a confined highly fractured rock aquifer. These methods range from simple approaches to complex computer models. Hydrogeological mapping and numerical modeling with MODFLOW-MODPATH were used as reference methods to respectively compare the delineation of the zone of contribution and the zone of travel obtained from the various WHPA methods. Although applied to simple ground water flow systems, these methods provided a relatively wide range of results. To allow a realistic delineation of the WHPA in aquifers of variable geometry, a WHPA delineation method should ensure a water balance and include observed or calculated regional flow characteristics.

  12. A spectroscopic study of the open cluster NGC 6250

    NASA Astrophysics Data System (ADS)

    Martin, A. J.; Stift, M. J.; Fossati, L.; Bagnulo, S.; Scalia, C.; Leone, F.; Smalley, B.

    2017-04-01

    We present the chemical abundance analysis of 19 upper main-sequence stars of the young open cluster NGC 6250 (log t ∼ 7.42 yr). This work is part of a project aimed at setting observational constraints on the theory of atomic diffusion in stellar photospheres, by means of a systematic study of the abundances of the chemical elements of early F-, A- and late B-type stars of well-determined age. Our data set consists of low-, medium- and high-resolution spectra obtained with the Fibre Large Array Multi Element Spectrograph (FLAMES) instrument of the ESO Very Large Telescope (VLT). To perform our analysis, we have developed a new suite of software tools for the chemical abundance analysis of stellar photospheres in local thermodynamical equilibrium. Together with the chemical composition of the stellar photospheres, we have provided new estimates of the cluster mean radial velocity, proper motion, refined the cluster membership, and we have given the stellar parameters including masses and fractional age. We find no evidence of statistically significant correlation between any of the parameters, including abundance and cluster age, except perhaps for an increase in Ba abundance with cluster age. We have proven that our new software tool may be successfully used for the chemical abundance analysis of large data sets of stellar spectra.

  13. Metabolome-Wide Association Study of Primary Open Angle Glaucoma

    PubMed Central

    Burgess, L. Goodwin; Uppal, Karan; Walker, Douglas I.; Roberson, Rache