Rotor Position Sensorless Control and Its Parameter Sensitivity of Permanent Magnet Motor Based on Model Reference Adaptive System

NASA Astrophysics Data System (ADS)

Ohara, Masaki; Noguchi, Toshihiko

This paper describes a new method for a rotor position sensorless control of a surface permanent magnet synchronous motor based on a model reference adaptive system (MRAS). This method features the MRAS in a current control loop to estimate a rotor speed and position by using only current sensors. This method as well as almost all the conventional methods incorporates a mathematical model of the motor, which consists of parameters such as winding resistances, inductances, and an induced voltage constant. Hence, the important thing is to investigate how the deviation of these parameters affects the estimated rotor position. First, this paper proposes a structure of the sensorless control applied in the current control loop. Next, it proves the stability of the proposed method when motor parameters deviate from the nominal values, and derives the relationship between the estimated position and the deviation of the parameters in a steady state. Finally, some experimental results are presented to show performance and effectiveness of the proposed method.

Type-2 fuzzy logic control based MRAS speed estimator for speed sensorless direct torque and flux control of an induction motor drive.

PubMed

Ramesh, Tejavathu; Kumar Panda, Anup; Shiva Kumar, S

2015-07-01

In this research study, a model reference adaptive system (MRAS) speed estimator for speed sensorless direct torque and flux control (DTFC) of an induction motor drive (IMD) using two adaptation mechanism schemes are proposed to replace the conventional proportional integral controller (PIC). The first adaptation mechanism scheme is based on Type-1 fuzzy logic controller (T1FLC), which is used to achieve high performance sensorless drive in both transient as well as steady state conditions. However, the Type-1 fuzzy sets are certain and unable to work effectively when higher degree of uncertainties presents in the system which can be caused by sudden change in speed or different load disturbances, process noise etc. Therefore, a new Type-2 fuzzy logic controller (T2FLC) based adaptation mechanism scheme is proposed to better handle the higher degree of uncertainties and improves the performance and also robust to various load torque and sudden change in speed conditions, respectively. The detailed performances of various adaptation mechanism schemes are carried out in a MATLAB/Simulink environment with a speed sensor and speed sensorless modes of operation when an IMD is operating under different operating conditions, such as, no-load, load and sudden change in speed, respectively. To validate the different control approaches, the system also implemented on real-time system and adequate results are reported for its validation. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

An Enhanced Three-Level Voltage Switching State Scheme for Direct Torque Controlled Open End Winding Induction Motor

NASA Astrophysics Data System (ADS)

Kunisetti, V. Praveen Kumar; Thippiripati, Vinay Kumar

2018-01-01

Open End Winding Induction Motors (OEWIM) are popular for electric vehicles, ship propulsion applications due to less DC link voltage. Electric vehicles, ship propulsions require ripple free torque. In this article, an enhanced three-level voltage switching state scheme for direct torque controlled OEWIM drive is implemented to reduce torque and flux ripples. The limitations of conventional Direct Torque Control (DTC) are: possible problems during low speeds and starting, it operates with variable switching frequency due to hysteresis controllers and produces higher torque and flux ripple. The proposed DTC scheme can abate the problems of conventional DTC with an enhanced voltage switching state scheme. The three-level inversion was obtained by operating inverters with equal DC-link voltages and it produces 18 voltage space vectors. These 18 vectors are divided into low and high frequencies of operation based on rotor speed. The hardware results prove the validity of proposed DTC scheme during steady-state and transients. From simulation and experimental results, proposed DTC scheme gives less torque and flux ripples on comparison to two-level DTC. The proposed DTC is implemented using dSPACE DS-1104 control board interface with MATLAB/SIMULINK-RTI model.

An Enhanced Three-Level Voltage Switching State Scheme for Direct Torque Controlled Open End Winding Induction Motor

NASA Astrophysics Data System (ADS)

Kunisetti, V. Praveen Kumar; Thippiripati, Vinay Kumar

2018-06-01

Open End Winding Induction Motors (OEWIM) are popular for electric vehicles, ship propulsion applications due to less DC link voltage. Electric vehicles, ship propulsions require ripple free torque. In this article, an enhanced three-level voltage switching state scheme for direct torque controlled OEWIM drive is implemented to reduce torque and flux ripples. The limitations of conventional Direct Torque Control (DTC) are: possible problems during low speeds and starting, it operates with variable switching frequency due to hysteresis controllers and produces higher torque and flux ripple. The proposed DTC scheme can abate the problems of conventional DTC with an enhanced voltage switching state scheme. The three-level inversion was obtained by operating inverters with equal DC-link voltages and it produces 18 voltage space vectors. These 18 vectors are divided into low and high frequencies of operation based on rotor speed. The hardware results prove the validity of proposed DTC scheme during steady-state and transients. From simulation and experimental results, proposed DTC scheme gives less torque and flux ripples on comparison to two-level DTC. The proposed DTC is implemented using dSPACE DS-1104 control board interface with MATLAB/SIMULINK-RTI model.

Awareness and uptake of direct-to-consumer genetic testing among cancer cases, their relatives, and controls: the Northwest Cancer Genetics Network.

PubMed

Hall, Taryn O; Renz, Anne D; Snapinn, Katherine W; Bowen, Deborah J; Edwards, Karen L

2012-07-01

To determine if awareness of, interest in, and use of direct-to-consumer (DTC) genetic testing is greater in a sample of high-risk individuals (cancer cases and their relatives), compared to controls. Participants were recruited from the Northwest Cancer Genetics Network. A follow-up survey was mailed to participants to assess DTC genetic testing awareness, interest, and use. One thousand two hundred sixty-seven participants responded to the survey. Forty-nine percent of respondents were aware of DTC genetic testing. Of those aware, 19% indicated interest in obtaining and <1% reported having used DTC genetic testing. Additional information supplied by respondents who reported use of DTC genetic tests indicated that 55% of these respondents likely engaged in clinical genetic testing, rather than DTC genetic testing. Awareness of DTC genetic testing was greater in our sample of high-risk individuals than in controls and population-based studies. Although interest in and use of these tests among cases in our sample were equivalent to other population-based studies, interest in testing was higher among relatives and people who self-referred for a registry focused on cancer than among cases and controls. Additionally, our results suggest that there may be some confusion about what constitutes DTC genetic testing.

A new technique to control brushless motor for blood pump application.

PubMed

Fonseca, Jeison; Andrade, Aron; Nicolosi, Denys E C; Biscegli, José F; Legendre, Daniel; Bock, Eduardo; Lucchi, Júlio César

2008-04-01

This article presents a back-electromotive force (BEMF)-based technique of detection for sensorless brushless direct current motor (BLDCM) drivers. The BLDCM has been chosen as the energy converter in rotary or pulsatile blood pumps that use electrical motors for pumping. However, in order to operate properly, the BLDCM driver needs to know the shaft position. Usually, that information is obtained through a set of Hall sensors assembled close to the rotor and connected to the electronic controller by wires. Sometimes, a large distance between the motor and controller makes the system susceptible to interference on the sensor signal because of winding current switching. Thus, the goal of the sensorless technique presented in this study is to avoid this problem. First, the operation of BLDCM was evaluated on the electronic simulator PSpice. Then, a BEMF detector circuitry was assembled in our laboratories. For the tests, a sensor-dependent system was assembled where the direct comparison between the Hall sensors signals and the detected signals was performed. The obtained results showed that the output sensorless detector signals are very similar to the Hall signals at speeds of more than 2500 rpm. Therefore, the sensorless technique is recommended as a responsible or redundant system to be used in rotary blood pumps.

New Technique of High-Performance Torque Control Developed for Induction Machines

NASA Technical Reports Server (NTRS)

Kenny, Barbara H.

2003-01-01

Two forms of high-performance torque control for motor drives have been described in the literature: field orientation control and direct torque control. Field orientation control has been the method of choice for previous NASA electromechanical actuator research efforts with induction motors. Direct torque control has the potential to offer some advantages over field orientation, including ease of implementation and faster response. However, the most common form of direct torque control is not suitable for the highspeed, low-stator-flux linkage induction machines designed for electromechanical actuators with the presently available sample rates of digital control systems (higher sample rates are required). In addition, this form of direct torque control is not suitable for the addition of a high-frequency carrier signal necessary for the "self-sensing" (sensorless) position estimation technique. This technique enables low- and zero-speed position sensorless operation of the machine. Sensorless operation is desirable to reduce the number of necessary feedback signals and transducers, thus improving the reliability and reducing the mass and volume of the system. This research was directed at developing an alternative form of direct torque control known as a "deadbeat," or inverse model, solution. This form uses pulse-width modulation of the voltage applied to the machine, thus reducing the necessary sample and switching frequency for the high-speed NASA motor. In addition, the structure of the deadbeat form allows the addition of the high-frequency carrier signal so that low- and zero-speed sensorless operation is possible. The new deadbeat solution is based on using the stator and rotor flux as state variables. This choice of state variables leads to a simple graphical representation of the solution as the intersection of a constant torque line with a constant stator flux circle. Previous solutions have been expressed only in complex mathematical terms without a method to clearly visualize the solution. The graphical technique allows a more insightful understanding of the operation of the machine under various conditions.

The Technique of Changing the Drive Method of Micro Step Drive and Sensorless Drive for Hybrid Stepping Motor

NASA Astrophysics Data System (ADS)

Yoneda, Makoto; Dohmeki, Hideo

The position control system with the advantage large torque, low vibration, and high resolution can be obtained by the constant current micro step drive applied to hybrid stepping motor. However loss is large, in order not to be concerned with load torque but to control current uniformly. As the one technique of a position control system in which high efficiency is realizable, the same sensorless control as a permanent magnet motor is effective. But, it was the purpose that the control method proposed until now controls speed. Then, this paper proposed changing the drive method of micro step drive and sensorless drive. The change of the drive method was verified from the simulation and the experiment. On no load, it was checked not producing change of a large speed at the time of a change by making electrical angle and carrying out zero reset of the integrator. On load, it was checked that a large speed change arose. The proposed system could change drive method by setting up the initial value of an integrator using the estimated result, without producing speed change. With this technique, the low loss position control system, which employed the advantage of the hybrid stepping motor, has been built.

NORDA’s Pattern Analysis Laboratory: Current Contributions to Naval Mapping, Charting, and Geodesy

DTIC Science & Technology

1989-04-01

magnetic observatories (McLeod, 1988). Using system integrates a suite of sensors and control devices the PAL’s VAX 11/780, spherical harmonic models to...DJAO:[FPS]*.OLB 5. Miscellaneous Utilities CALENDAR (NORDA events) 780 $ CALENDAR (menu-driven) DIALER modem controller 780 $ R AUTO DIAL:DIALER DTC...Utilities CALENDAR (NORDA events) 780 CALENDAR (menu-driven) DIALER modem controller 780 $ R AUTO DIAL:DIALER DTC Desk Top Calendar 780 $ DTC (menu-driven

Sensorless Control of Permanent Magnet Machine for NASA Flywheel Technology Development

NASA Technical Reports Server (NTRS)

Kenny, Barbara H.; Kascak, Peter E.

2002-01-01

This paper describes the position sensorless algorithms presently used in the motor control for the NASA "in-house" development work of the flywheel energy storage system. At zero and low speeds a signal injection technique, the self-sensing method, is used to determine rotor position. At higher speeds, an open loop estimate of the back EMF of the machine is made to determine the rotor position. At start up, the rotor is set to a known position by commanding dc into one of the phase windings. Experimental results up to 52,000 rpm are presented.

Sensorless Modeling of Varying Pulse Width Modulator Resolutions in Three-Phase Induction Motors

PubMed Central

Marko, Matthew David; Shevach, Glenn

2017-01-01

A sensorless algorithm was developed to predict rotor speeds in an electric three-phase induction motor. This sensorless model requires a measurement of the stator currents and voltages, and the rotor speed is predicted accurately without any mechanical measurement of the rotor speed. A model of an electric vehicle undergoing acceleration was built, and the sensorless prediction of the simulation rotor speed was determined to be robust even in the presence of fluctuating motor parameters and significant sensor errors. Studies were conducted for varying pulse width modulator resolutions, and the sensorless model was accurate for all resolutions of sinusoidal voltage functions. PMID:28076418

Sensorless Modeling of Varying Pulse Width Modulator Resolutions in Three-Phase Induction Motors.

PubMed

Marko, Matthew David; Shevach, Glenn

2017-01-01

A sensorless algorithm was developed to predict rotor speeds in an electric three-phase induction motor. This sensorless model requires a measurement of the stator currents and voltages, and the rotor speed is predicted accurately without any mechanical measurement of the rotor speed. A model of an electric vehicle undergoing acceleration was built, and the sensorless prediction of the simulation rotor speed was determined to be robust even in the presence of fluctuating motor parameters and significant sensor errors. Studies were conducted for varying pulse width modulator resolutions, and the sensorless model was accurate for all resolutions of sinusoidal voltage functions.

Sensorless sliding mode observer for a five-phase permanent magnet synchronous motor drive.

PubMed

Hosseyni, Anissa; Trabelsi, Ramzi; Mimouni, Med Faouzi; Iqbal, Atif; Alammari, Rashid

2015-09-01

This paper deals with the sensorless vector controlled five-phase permanent magnet synchronous motor (PMSM) drive based on a sliding mode observer (SMO). The observer is designed considering the back electromotive force (EMF) of five-phase permanent magnet synchronous motor. The SMO structure and design are illustrated. Stability of the proposed observer is demonstrated using Lyapunov stability criteria. The proposed strategy is asymptotically stable in the context of Lyapunov theory. Simulated results on a five-phase PMSM drive are displayed to validate the feasibility and the effectiveness of the proposed control strategy. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

Dietary habits during the 2 months following the Chernobyl accident and differentiated thyroid cancer risk in a population-based case-control study.

PubMed

Xhaard, Constance; Rubino, Carole; Souchard, Vincent; Maillard, Stéphane; Ren, Yan; Borson-Chazot, Françoise; Sassolas, Geneviève; Schvartz, Claire; Colonna, Marc; Lacour, Brigitte; Woronoff, Anne Sophie; Velten, Michel; Marrer, Emilie; Bailly, Laurent; Mariné Barjoan, Eugènia; Schlumberger, Martin; Drozdovitch, Vladimir; Bouville, Andre; Orgiazzi, Jacques; Adjadj, Elisabeth; de Vathaire, Florent

2018-02-01

The Chernobyl nuclear power plant accident occurred in Ukraine on April 26th 1986. In France, the radioactive fallout and thyroid radiation doses were much lower than in highly contaminated areas. However, a number of risk projections have suggested that a small excess in differentiated thyroid cancer (DTC) might occur in eastern France due to this low-level fallout. In order to investigate this potential impact, a case-control study on DTC risk factors was started in 2005, focusing on cases who were less than 15 years old at the time of the Chernobyl accident. Here, we aim to evaluate the relationship between some specific reports of potentially contaminated food between April and June 1986 - in particular fresh dairy products and leafy vegetables - and DTC risk. After excluding subjects who were not born before the Chernobyl accident, the study included 747 cases of DTC matched with 815 controls. Odds ratios were calculated using conditional logistic regression models and were reported for all participants, for women only, for papillary cancer only, and excluding microcarcinomas. The DTC risk was slightly higher for participants who had consumed locally produced leafy vegetables. However, this association was not stronger in the more contaminated areas than in the others. Conversely, the reported consumption of fresh dairy products was not statistically associated with DTC risk. Because the increase in DTC risk associated with a higher consumption of locally produced vegetables was not more important in the most contaminated areas, our study lacked power to provide evidence for a strong association between consumption of potentially contaminated food and DTC risk. Copyright © 2017 Elsevier Ltd. All rights reserved.

78 FR 33876 - Self-Regulatory Organizations; The Depository Trust Company; Notice of Filing of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-05

... functionalities allow receiving DTC participants (``Participants'') to exercise control over which transactions to... without regard to risk management controls, the Participant that initiated the original delivery versus... Participant and to the Corporation.\\5\\ \\5\\ DTC's risk management controls, including Collateral Monitor and...

Sensorless optimal sinusoidal brushless direct current for hard disk drives

NASA Astrophysics Data System (ADS)

Soh, C. S.; Bi, C.

2009-04-01

Initiated by the availability of digital signal processors and emergence of new applications, market demands for permanent magnet synchronous motors have been surging. As its back-emf is sinusoidal, the drive current should also be sinusoidal for reducing the torque ripple. However, in applications like hard disk drives, brushless direct current (BLDC) drive is adopted instead of sinusoidal drive for simplification. The adoption, however, comes at the expense of increased harmonics, losses, torque pulsations, and acoustics. In this paper, we propose a sensorless optimal sinusoidal BLDC drive. First and foremost, the derivation for an optimal sinusoidal drive is presented, and a power angle control scheme is proposed to achieve an optimal sinusoidal BLDC. The scheme maintains linear relationship between the motor speed and drive voltage. In an attempt to execute the sensorless drive, an innovative power angle measurement scheme is devised, which takes advantage of the freewheeling diodes and measures the power angle through the detection of diode voltage drops. The objectives as laid out will be presented and discussed in this paper, supported by derivations, simulations, and experimental results. The proposed scheme is straightforward, brings about the benefits of sensorless sinusoidal drive, negates the need for current sensors by utilizing the freewheeling diodes, and does not incur additional cost.

Sensorless position estimation and control of permanent-magnet synchronous motors using a saturation model

NASA Astrophysics Data System (ADS)

Kassem Jebai, Al; Malrait, François; Martin, Philippe; Rouchon, Pierre

2016-03-01

Sensorless control of permanent-magnet synchronous motors at low velocity remains a challenging task. A now well-established method consists of injecting a high-frequency signal and using the rotor saliency, both geometric and magnetic-saturation induced. This paper proposes a clear and original analysis based on second-order averaging of how to recover the position information from signal injection; this analysis blends well with a general model of magnetic saturation. It also proposes a simple parametric model of the saturated motor, based on an energy function which simply encompasses saturation and cross-saturation effects. Experimental results on a surface-mounted motor and an interior magnet motor illustrate the relevance of the approach.

Determinants of hypofibrinolysis in patients with digestive tract cancer.

PubMed

Gronostaj, Katarzyna; Richter, Piotr; Nowak, Wojciech; Undas, Anetta

2016-01-01

Recently, we demonstrated that digestive tract cancer (DTC) is associated with reduced fibrin clot permeability and impaired fibrinolysis. We investigated determinants of fibrinolysis in DTC patients. In 44 consecutive patients with DTC and 47 controls matched for age, sex, and cardiovascular risk, we evaluated fibrinolysis proteins, platelet activation markers, thrombin formation, together with plasma clot lysis time assays in the absence (CLT) and presence of carboxypeptidase potato inhibitor (CLT CPI) that blocks thrombin activatable fibrinolysis inhibitor (TAFI). In the DTC group CLT (by 22.3%) and CLT CPI (by 27.4%) were longer compared with controls. The DTC patients had higher plasma fibrinolysis inhibitors, plasminogen activator inhibitor 1 (PAI-1) (by 18.2%), TAFI activity (by 17.3%), and antigen (by 11.2%). The patients had markedly increased platelet markers - soluble CD40 ligand (by 338%) and P-selectin (by 97%), together with von Willebrand factor (vWF) antigen (by 61%). Thrombin-antithrombin complexes (TAT) (by 48.7%) and soluble thrombomodulin (sTM) (by 17.2%) were also increased in the DTC group (all p < 0.05). Patients with high-grade tumours (n = 26) compared with remainders (n = 18) had longer CLT, higher tissue-type plasminogen activator antigen, both TAFI antigen and activity levels, vWF, and sTM. Multiple regression analysis after adjustment for potential confounders showed that independent predictors of CLT in DTC patients were TAT, TAFI activity, and vWF. The only independent predictor of CLT CPI was TAT. Hypofibrinolysis in DTC patients is largely driven by enhanced thrombin generation, TAFI, and endothelial injury.

Effects of iodine-131 radiotherapy on Th17/Tc17 and Treg/Th17 cells of patients with differentiated thyroid carcinoma.

PubMed

Zhang, Lixia; Chen, Jinyan; Xu, Caiyun; Qi, Lili; Ren, Yan

2018-03-01

T helper 17 (Th17), T cytotoxic 17 (Tc17) and regulatory T (Treg) cells serve important roles in a number of inflammatory and autoimmune diseases. The aim of the present study was to examine the distribution of Th17, Tc17 and Treg cells in patients with differentiated thyroid cancer (DTC) prior to as well as 7, 30 and 90 days following radioactive iodine-131 ( 131 I) therapy, and to elucidate the probable effects of 131 I therapy on Th17/Tc17 and Treg/Th17 cells in patients with DTC. A total of 40 patients with DTC (26 female; 14 male) between the ages of 24 and 72 years, as well as 13 age- and sex-matched healthy subjects were included in this study. The number of Th17, Tc17 and Treg cells in the peripheral blood of patients with DTC and of healthy Controls were assessed by flow cytometry. Th17 and Tc17 cells were counted as percentages of the number of CD3 + T cells; Treg cells were counted as a percentage of the number of CD4 + T cells. In addition, the serum levels of interleukin (IL)-17, IL-23, IL-10 and transforming growth factor (TGF)-β1 were examined by ELISA. The frequencies of Th17, Tc17 and Treg cells, as well as the serum levels of IL-17, IL-23, IL-10 and TGF-β1 were significantly elevated in patients with DTC compared with healthy Controls, whereas 131 I therapy significantly decreased them. In addition, elevated Th17/Tc17 ratio and reduced Treg/Th17 ratio were observed in patients with DTC at day 0, however, these ratios returned to normal levels following 131 I therapy for 90 days as compared with healthy Controls. Notably, Th17/Tc17 and Treg/Th17 ratios varied following 131 I therapy for 7 and 30 days. In addition, a strong positive correlation between Th17 and Tc17 cells was observed in the healthy Controls and patients with DTC that received 131 I treatment for 90 days, whereas a weak positive correlation between Th17 and Treg cell levels was identified in the healthy Controls and no obvious correlation between Th17 and Treg cells was observed in all patients with DTC pre- and post- 131 I therapy during the entire treatment period. These data suggested a significant involvement of Th17, Tc17 and Treg cells in the pathology of DTC. Restoring the balance of these cells may contribute to the recovery of patients with DTC following 131 I therapy.

A New Unified Analysis of Estimate Errors by Model-Matching Phase-Estimation Methods for Sensorless Drive of Permanent-Magnet Synchronous Motors and New Trajectory-Oriented Vector Control, Part II

NASA Astrophysics Data System (ADS)

Shinnaka, Shinji

This paper presents a new unified analysis of estimate errors by model-matching extended-back-EMF estimation methods for sensorless drive of permanent-magnet synchronous motors. Analytical solutions about estimate errors, whose validity is confirmed by numerical experiments, are rich in universality and applicability. As an example of universality and applicability, a new trajectory-oriented vector control method is proposed, which can realize directly quasi-optimal strategy minimizing total losses with no additional computational loads by simply orienting one of vector-control coordinates to the associated quasi-optimal trajectory. The coordinate orientation rule, which is analytically derived, is surprisingly simple. Consequently the trajectory-oriented vector control method can be applied to a number of conventional vector control systems using model-matching extended-back-EMF estimation methods.

Decreased staging of differentiated thyroid cancer in patients with chronic lymphocytic thyroiditis.

PubMed

Borowczyk, M; Janicki, A; Dworacki, G; Szczepanek-Parulska, E; Danieluk, M; Barnett, J; Antonik, M; Kałużna, M; Bromińska, B; Czepczyński, R; Bączyk, M; Ziemnicka, K; Ruchała, M

2018-04-04

The biological association between chronic lymphocytic thyroiditis (CLT) and differentiated thyroid cancer (DTC) has not been elucidated yet. The aim of the study was to assess whether the presence of CLT exerts any influence on clinical or histological presentation of DTC. Nine hundred and seven consecutive patients with DTC treated in the years 1998-2016 were divided into two groups according to the presence or absence of concomitant CLT. The statistical differences were analysed. Out of 907 patients included in the study, 331 were diagnosed with DTC and CLT (studied group), while 576 patients with DTC but without CLT constituted a control group. The distribution of papillary and follicular thyroid cancer did not differ. In CLT group, the prevalence of pT1 was greater than for pT2-pT4 DTC (P = 0.0003; OR = 1.69, 95% CI 1.27-2.24) compared to controls (68.3 vs. 56.1%, respectively). The presence of multifocal lesions was similar. The thyroid capsule infiltration without extrathyroidal invasion (P < 0.0001; OR = 0.21, 95% CI 0.14-0.31) was more frequent in the studied group, unlike extracapsular invasion, which was significantly more often present in patients with DTC but without CLT (P = 0.004; OR = 1.66; 95% CI 1.17-2.34) as well as nodal involvement (P = 0.048; OR = 0.65, 95% CI 0.42-0.99). The collected data indicate a protective role of CLT in preventing the spread of the DTC. The presence of CLT might limit tumour growth to the primary site.

Analysis of field-oriented controlled induction motor drives under sensor faults and an overview of sensorless schemes.

PubMed

Arun Dominic, D; Chelliah, Thanga Raj

2014-09-01

To obtain high dynamic performance on induction motor drives (IMD), variable voltage and variable frequency operation has to be performed by measuring speed of rotation and stator currents through sensors and fed back them to the controllers. When the sensors are undergone a fault, the stability of control system, may be designed for an industrial process, is disturbed. This paper studies the negative effects on a 12.5 hp induction motor drives when the field oriented control system is subjected to sensor faults. To illustrate the importance of this study mine hoist load diagram is considered as shaft load of the tested machine. The methods to recover the system from sensor faults are discussed. In addition, the various speed sensorless schemes are reviewed comprehensively. Copyright © 2014 ISA. Published by Elsevier Ltd. All rights reserved.

Disseminated Tumor Cells in Prostate Cancer Patients after Radical Prostatectomy and without Evidence of Disease Predicts Biochemical Recurrence

PubMed Central

Morgan, Todd M.; Lange, Paul H.; Porter, Michael P.; Lin, Daniel W.; Ellis, William J.; Gallaher, Ian S.; Vessella, Robert L.

2011-01-01

Purpose Men with apparently localized prostate cancer often relapse years after radical prostatectomy (RP). We sought to determine if epithelial-like cells identified from bone marrow (BM) in patients after RP (commonly called disseminated tumor cells, DTC) were associated with biochemical recurrence (BR). Experimental Design We obtained BM aspirates from 569 men prior to RP and from 34 healthy men with PSA<2.5 ng/ml to establish a comparison group. Additionally, an analytic cohort consisting of 98 patients after RP with no evidence of disease (NED) was established to evaluate the relationship between DTC and BR. Epithelial cells in the BM were detected by magnetic bead enrichment with antibodies to CD45 and CD61 (negative selection) followed by antibodies to human epithelial antigen (positive selection) and confirmation with FITC-labeled anti-BerEP4 antibody. Results DTC were present in 72% (408/569) of patients prior to RP. There was no correlation with pathologic stage, Gleason grade, or pre-operative PSA. Three of 34 controls (8.8%) had DTC present. In patients NED post-RP, DTC were present in 56/98 (57%). DTC were detected in 12/14 (86%) NED patients post-RP who subsequently suffered BR. Presence of DTC in NED patients was an independent predictor of recurrence (HR 6.9, CI 1.03–45.9). Conclusions Approximately 70% of men undergoing RP had DTC detected in their BM prior to surgery, suggesting that these cells escape early in the disease. Though pre-operative DTC status does not correlate with pathologic risk factors, persistence of DTC after RP in NED patients was an independent predictor of recurrence. PMID:19147774

Sensorless Sinusoidal Drives for Fan and Pump Motors by V/f Control

NASA Astrophysics Data System (ADS)

Kiuchi, Mitsuyuki; Ohnishi, Tokuo

This paper proposes sensorless sinusoidal driving methods of permanent magnet synchronous motors for fans and pumps by V/f control. The proposed methods are simple methods that control the motor peak current constant by voltage or frequency control, and are characterized by DC link current detection using a single shunt resistor at carrier wave signal bottom timing. As a result of the dumping factor from square torque load characteristics of fan and pump motors, it is possible to control stable starting and stable steady state by V/f control. In general, pressure losses as a result of the fluid pass of fan and pump systems are nearly constant; therefore, the flow rate and motor torque are determined by revolutions. Accordingly, high efficiency driving is possible by setting corresponding currents to q-axis currents (torque currents) at target revolutions. Because of the simple current detection and motor control methods, the proposed methods are optimum for fan and pump motor driving systems of home appliances.

Fuzzy crane control with sensorless payload deflection feedback for vibration reduction

NASA Astrophysics Data System (ADS)

Smoczek, Jaroslaw

2014-05-01

Different types of cranes are widely used for shifting cargoes in building sites, shipping yards, container terminals and many manufacturing segments where the problem of fast and precise transferring a payload suspended on the ropes with oscillations reduction is frequently important to enhance the productivity, efficiency and safety. The paper presents the fuzzy logic-based robust feedback anti-sway control system which can be applicable either with or without a sensor of sway angle of a payload. The discrete-time control approach is based on the fuzzy interpolation of the controllers and crane dynamic model's parameters with respect to the varying rope length and mass of a payload. The iterative procedure combining a pole placement method and interval analysis of closed-loop characteristic polynomial coefficients is proposed to design the robust control scheme. The sensorless anti-sway control application developed with using PAC system with RX3i controller was verified on the laboratory scaled overhead crane.

Lesion symptom map of cognitive-postural interference in multiple sclerosis.

PubMed

Ruggieri, Serena; Fanelli, Fulvia; Castelli, Letizia; Petsas, Nikolaos; De Giglio, Laura; Prosperini, Luca

2018-04-01

To investigate the disease-altered structure-function relationship underlying the cognitive-postural interference (CPI) phenomenon in multiple sclerosis (MS). We measured postural sway of 96 patients and 48 sex-/age-matched healthy controls by force platform in quiet standing (single-task (ST)) while performing the Stroop test (dual-task (DT)) to estimate the dual-task cost (DTC) of balance. In patient group, binary T2 and T1 lesion masks and their corresponding lesion volumes were obtained from magnetic resonance imaging (MRI) of brain. Normalized brain volume (NBV) was also estimated by SIENAX. Correlations between DTC and lesion location were determined by voxel-based lesion symptom mapping (VLSM) analyses. Patients had greater DTC than controls ( p < 0.001). Among whole brain MRI metrics, only T1 lesion volume correlated with DTC ( r = -0.27; p < 0.01). However, VLSM analysis did not reveal any association with DTC using T1 lesion masks. By contrast, we found clusters of T2 lesions in distinct anatomical regions (anterior and superior corona radiata, bilaterally) to be correlated with DTC ( p < 0.01 false discovery rate (FDR)-corrected). A multivariable stepwise regression model confirmed findings from VLSM analysis. NBV did not contribute to fit the model. Our findings suggest that the CPI phenomenon in MS can be explained by disconnection along specific areas implicated in task-switching abilities and divided attention.

Stigma-reducing components in direct-to-consumer prescription ads: onset controllability, offset controllability, and recategorization.

PubMed

An, Soontae; Kang, Hannah

2011-01-01

This study analyzed direct-to-consumer (DTC) print ads for stigmatized illnesses from 1998 to 2008. Attribution theory and recategorization theory were used as theoretical frames to assess whether those DTC ads contained message components to reduce stigma. DTC ads for 10 stigmatized illnesses in National Geographic, Better Homes and Gardens, Ladies' Home Journal, and Time were analyzed for the presence of onset controllability, offset controllability, and recategorization. Results showed that only 3.7% of ads offered the three message components together and, in fact, 21% of the ads did not contain any of the stigma-reducing message elements. Recategorization cue was the most prevalent component, while cues for onset and offset controllability were relatively less frequent, indicating the lack of educational components. Copyright © Taylor & Francis Group, LLC

High Ripples Reduction in DTC of Induction Motor by Using a New Reduced Switching Table

NASA Astrophysics Data System (ADS)

Mokhtari, Bachir; Benkhoris, Mohamed F.

2016-05-01

The direct torque and flux control (DTC) of electrical motors is characterized by ripples of torque and flux. Among the many solutions proposed to reduce them is to use modified switching tables which is very advantageous; because its implementation is easy and requires no additional cost compared to other solutions. This paper proposes a new reduced switching table (RST) to improve the DTC by reducing harmful ripples of torque and flux. This new switching table is smaller than the conventional one (CST) and depends principally at the flux error. This solution is studied by simulation under Matlab/Simulink and experimentally validated on a testbed with DSPACE1103. The results obtained of a DTC with RST applied to a three-phase induction motor (IM) show a good improvement and an effectiveness of proposed solution, the torque ripple decreases about 47% and 3% for the stator flux compared with a basic DTC.

Randomized study of placebo and framing information in direct-to-consumer print advertisements for prescription drugs.

PubMed

O'Donoghue, Amie C; Sullivan, Helen W; Aikin, Kathryn J

2014-12-01

Research suggests that quantitative information in direct-to-consumer (DTC) prescription drug ads may be helpful for consumers. The objective was to examine the effect of adding placebo rates and framing to DTC ads. In study 1, 2,000 Internet panel members with chronic pain participated in a randomized controlled experiment of DTC ads varying in placebo rate and framing. In study 2, 596 physicians ranked DTC ads varying in placebo rate and framing by how well they conveyed scientific information and their usefulness for patients. In study 1, participants who viewed placebo rates were able to recall them and use them to form certain perceptions. A mixed frame led to lower placebo rate recall and perceived efficacy. In study 2, overall, physicians preferred a placebo/single frame ad. Adding placebo rates to DTC ads may be useful for consumers. The evidence does not support using a mixed frame.

EFFICIENCY OPTIMIZATIN CONTROL OF AC INDUCTION MOTORS: INITIAL LABORATORY RESULTS

EPA Science Inventory

The report discusses the development of a fuzzy logic, energy-optimizing controller to improve the efficiency of motor/drive combinations that operate at varying loads and speeds. This energy optimizer is complemented by a sensorless speed controller that maintains motor shaft re...

Episode-specific drinking-to-cope motivation and next-day stress-reactivity.

PubMed

Armeli, Stephen; O'Hara, Ross E; Covault, Jon; Scott, Denise M; Tennen, Howard

2016-11-01

Research consistently shows drinking-to-cope (DTC) motivation is uniquely associated with drinking-related problems. We furthered this line of research by examining whether DTC motivation is predictive of processes indicative of poor emotion regulation. Specifically, we tested whether nighttime levels of episode-specific DTC motivation, controlling for drinking level, were associated with intensified affective reactions to stress the following day (i.e. stress-reactivity). We used a micro-longitudinal design to test this hypothesis in two college student samples from demographically distinct institutions: a large, rural state university (N = 1421; 54% female) and an urban historically Black college/university (N = 452; 59% female). In both samples the within-person association between daily stress and negative affect on days following drinking episodes was stronger in the positive direction when previous night's drinking was characterized by relatively higher levels of DTC motivation. We also found evidence among students at the state university that average levels of DTC motivation moderated the daily stress-negative affect association. Findings are consistent with the notion that DTC motivation confers a unique vulnerability that affects processes associated with emotion regulation.

FOXE1 Association with Differentiated Thyroid Cancer and Its Progression

PubMed Central

Penna-Martinez, Marissa; Epp, Friederike; Kahles, Heinrich; Ramos-Lopez, Elizabeth; Hinsch, Nora; Hansmann, Martin-Leo; Selkinski, Ivan; Grünwald, Frank; Holzer, Katharina; Bechstein, Wolf O.; Zeuzem, Stefan; Vorländer, Christian

2014-01-01

Background: Single nucleotide polymorphisms (SNPs) near thyroid transcription factor genes (FOXE1 rs965513/NKX2-1 rs944289) have been shown to be associated with differentiated thyroid cancer (DTC) in Caucasoid populations. We investigated the role of those SNPs in German patients with DTC and also extended our analysis to tumor stages and lymphocytic infiltration of the tumors (ITL). Methods: Patients with DTC (n=243; papillary, PTC; follicular, FTC) and healthy controls (HC; n=270) were analyzed for the rs965513 and rs944289 SNPs. Results: The case-control analysis for rs965513 SNP showed that the genotypes “AA,” “AG,” and minor allele “A” were more frequent in patients with DTC than in HC (pronounced in PTC pgenotype=0.000084, pallele=0.006 than FTC pgenotype=0.29 and pallele=0.06). Furthermore, subgroup analysis of the DTC patients stratified for primary tumor stage (T1–T2, T3–T4), the absence or presence of regional lymph node metastases (N0, N1), for distant metastases (M0, M1), as well as for ITL, showed an association of rs965513 with stages T1–T2, T1–T3, N1, and absence of ITL. The NKX2-1 SNP rs944289, however, was not associated with DTC. Conclusion: Our results confirm that the FOXE1 rs965513 SNP confers an increased risk for DTC in the German population, particularly allele “A” and the genotypes “AA” and “AG” for PTC. This increased risk was also observed in advanced tumor stages and absence of ITL, which may reflect the course of a more aggressive disease. The NKX2-1 rs944289 SNP, however, appears to play a secondary role in the development of DTC in the German population. PMID:24325646

Electric propulsion using the permanent magnet synchronous motor without rotor position transducers

NASA Astrophysics Data System (ADS)

Batzel, Todd Douglas

The permanent magnet synchronous motor (PMSM) is increasingly playing an important role in electric propulsion systems due to its many advantages over competing technologies. For successful operation of the PMSM, rotor position and speed information is required. A resolver or encoder attached to the shaft of the machine usually provides this information. Many applications, however, cannot tolerate the use of the position sensor because of space and weight limitations, reliability concerns, or packaging issues. Thus, there has been an intense interest in the development of a so-called position sensorless drive, where the PMSM stator itself is used as the rotor position sensor. In this work, a sensorless electric drive is developed for various undersea propulsion applications, where the rotor position sensor is often undesirable due to the harsh operating environment as well as space and weight limitations. In this work, an observer is developed which enables sensorless operation of the PMSM over a wide speed range. In addition, a method is presented for estimating the standstill rotor angle, an operating condition at which the rotor position observers are typically ill conditioned. In this work two design methodologies are applied to the sensorless electric drive application, including a model-based and a neural network-based approach. Implementation issues for the sensorless electric drive are discussed, and experimental results are presented in order to demonstrate the effectiveness of the proposed techniques to the sensorless PMSM.

Implementation of a MFAC based position sensorless drive for high speed BLDC motors with nonideal back EMF.

PubMed

Li, Haitao; Ning, Xin; Li, Wenzhuo

2017-03-01

In order to improve the reliability and reduce power consumption of the high speed BLDC motor system, this paper presents a model free adaptive control (MFAC) based position sensorless drive with only a dc-link current sensor. The initial commutation points are obtained by detecting the phase of EMF zero-crossing point and then delaying 30 electrical degrees. According to the commutation error caused by the low pass filter (LPF) and other factors, the relationship between commutation error angle and dc-link current is analyzed, a corresponding MFAC based control method is proposed, and the commutation error can be corrected by the controller in real time. Both the simulation and experimental results show that the proposed correction method can achieve ideal commutation effect within the entire operating speed range. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

Fast Fourier and discrete wavelet transforms applied to sensorless vector control induction motor for rotor bar faults diagnosis.

PubMed

Talhaoui, Hicham; Menacer, Arezki; Kessal, Abdelhalim; Kechida, Ridha

2014-09-01

This paper presents new techniques to evaluate faults in case of broken rotor bars of induction motors. Procedures are applied with closed-loop control. Electrical and mechanical variables are treated using fast Fourier transform (FFT), and discrete wavelet transform (DWT) at start-up and steady state. The wavelet transform has proven to be an excellent mathematical tool for the detection of the faults particularly broken rotor bars type. As a performance, DWT can provide a local representation of the non-stationary current signals for the healthy machine and with fault. For sensorless control, a Luenberger observer is applied; the estimation rotor speed is analyzed; the effect of the faults in the speed pulsation is compensated; a quadratic current appears and used for fault detection. Copyright © 2014 ISA. Published by Elsevier Ltd. All rights reserved.

Design and realization of adaptive optical principle system without wavefront sensing

NASA Astrophysics Data System (ADS)

Wang, Xiaobin; Niu, Chaojun; Guo, Yaxing; Han, Xiang'e.

2018-02-01

In this paper, we focus on the performance improvement of the free space optical communication system and carry out the research on wavefront-sensorless adaptive optics. We use a phase only liquid crystal spatial light modulator (SLM) as the wavefront corrector. The optical intensity distribution of the distorted wavefront is detected by a CCD. We develop a wavefront controller based on ARM and a software based on the Linux operating system. The wavefront controller can control the CCD camera and the wavefront corrector. There being two SLMs in the experimental system, one simulates atmospheric turbulence and the other is used to compensate the wavefront distortion. The experimental results show that the performance quality metric (the total gray value of 25 pixels) increases from 3037 to 4863 after 200 iterations. Besides, it is demonstrated that our wavefront-sensorless adaptive optics system based on SPGD algorithm has a good performance in compensating wavefront distortion.

A New Unified Analysis of Estimate Errors by Model-Matching Phase-Estimation Methods for Sensorless Drive of Permanent-Magnet Synchronous Motors and New Trajectory-Oriented Vector Control, Part I

NASA Astrophysics Data System (ADS)

Shinnaka, Shinji; Sano, Kousuke

This paper presents a new unified analysis of estimate errors by model-matching phase-estimation methods such as rotor-flux state-observers, back EMF state-observers, and back EMF disturbance-observers, for sensorless drive of permanent-magnet synchronous motors. Analytical solutions about estimate errors, whose validity is confirmed by numerical experiments, are rich in universality and applicability. As an example of universality and applicability, a new trajectory-oriented vector control method is proposed, which can realize directly quasi-optimal strategy minimizing total losses with no additional computational loads by simply orienting one of vector-control coordinates to the associated quasi-optimal trajectory. The coordinate orientation rule, which is analytically derived, is surprisingly simple. Consequently the trajectory-oriented vector control method can be applied to a number of conventional vector control systems using one of the model-matching phase-estimation methods.

American Thyroid Association consensus review and statement regarding the anatomy, terminology, and rationale for lateral neck dissection in differentiated thyroid cancer.

PubMed

Stack, Brendan C; Ferris, Robert L; Goldenberg, David; Haymart, Megan; Shaha, Ashok; Sheth, Sheila; Sosa, Julie Ann; Tufano, Ralph P

2012-05-01

Cervical lymph node metastases from differentiated thyroid cancer (DTC) are common. Thirty to eighty percent of patients with papillary thyroid cancer harbor lymph node metastases, with the central neck being the most common compartment involved. The goals of this study were to: (1) identify appropriate methods for determining metastatic DTC in the lateral neck and (2) address the extent of lymph node dissection for the lateral neck necessary to control nodal disease balanced against known risks of surgery. A literature review followed by formulation of a consensus statement was performed. Four proposals regarding management of the lateral neck are made for consideration by organizations developing management guidelines for patients with thyroid nodules and DTC including the next iteration of management guidelines developed by the American Thyroid Association (ATA). Metastases to lateral neck nodes must be considered in the evaluation of the newly diagnosed thyroid cancer patient and for surveillance of the previously treated DTC patient. Lateral neck lymph nodes are a significant consideration in the surgical management of patients with DTC. When current guidelines formulated by the ATA and by other international medical societies are followed, initial evaluation of the DTC patient with ultrasound (or other modalities when indicated) will help to identify lateral neck lymph nodes of concern. These findings should be addressed using fine-needle aspiration biopsy. A comprehensive neck dissection of at least nodal levels IIa, III, IV, and Vb should be performed when indicated to optimize disease control.

Self-reported responsiveness to direct-to-consumer drug advertising and medication use: results of a national survey.

PubMed

Dieringer, Nicholas J; Kukkamma, Lisa; Somes, Grant W; Shorr, Ronald I

2011-09-23

ABSTRACT: BACKGROUND: Direct-to-consumer (DTC) marketing of pharmaceuticals is controversial, yet effective. Little is known relating patterns of medication use to patient responsiveness to DTC. METHODS: We conducted a secondary analysis of data collected in national telephone survey on knowledge of and attitudes toward DTC advertisements. The survey of 1081 U.S. adults (response rate = 65%) was conducted by the Food and Drug Administration (FDA). Responsiveness to DTC was defined as an affirmative response to the item: "Has an advertisement for a prescription drug ever caused you to ask a doctor about a medical condition or illness of your own that you had not talked to a doctor about before?" Patients reported number of prescription and over-the-counter (OTC) medicines taken as well as demographic and personal health information. RESULTS: Of 771 respondents who met study criteria, 195 (25%) were responsive to DTC. Only 7% respondents taking no prescription were responsive, whereas 45% of respondents taking 5 or more prescription medications were responsive. This trend remained significant (p trend .0009) even when controlling for age, gender, race, educational attainment, income, self-reported health status, and whether respondents "liked" DTC advertising. There was no relationship between the number of OTC medications taken and the propensity to discuss health-related problems in response to DTC advertisements (p = .4). CONCLUSION: There is a strong cross-sectional relationship between the number of prescription, but not OTC, drugs used and responsiveness to DTC advertising. Although this relationship could be explained by physician compliance with patient requests for medications, it is also plausible that DTC advertisements have a particular appeal to patients prone to taking multiple medications. Outpatients motivated to discuss medical conditions based on their exposure to DTC advertising may require a careful medication history to evaluate for therapeutic duplication or overmedication.

Episode-Specific Drinking-to-Cope Motivation and Next-Day Stress-Reactivity

PubMed Central

Armeli, Stephen; O’Hara, Ross E.; Covault, Jon; Scott, Denise M.; Tennen, Howard

2016-01-01

Background Research consistently shows drinking-to-cope (DTC) motivation is uniquely associated with drinking-related problems. We furthered this line of research by examining whether DTC motivation is predictive of processes indicative of poor emotion regulation. Specifically, we tested whether nighttime levels of episode-specific DTC motivation, controlling for drinking level, were associated with intensified affective reactions to stress the following day (i.e., stress-reactivity). Design and Methods We used a micro-longitudinal design to test this hypothesis in two college student samples from demographically distinct institutions: a large, rural state university (N = 1421; 54% female) and an urban historically Black college/university (N = 452; 59% female). Results In both samples the within-person association between daily stress and negative affect on days following drinking episodes was stronger in the positive direction when previous night’s drinking was characterized by relatively higher levels of DTC motivation. We also found evidence among students at the state university that average levels of DTC motivation moderated the daily stress-negative affect association. Conclusions Findings are consistent with the notion that DTC motivation confers a unique vulnerability that affects processes associated with emotion regulation. PMID:26691066

External Beam Radiation in Differentiated Thyroid Carcinoma

PubMed Central

Billan, Salem; Charas, Tomer

2016-01-01

The treatment of differentiated thyroid carcinoma (DTC) is surgery followed in some cases by adjuvant treatment, mostly with radioactive iodine (RAI). External beam radiotherapy (EBRT) is less common and not a well-established treatment modality in DTC. The risk of recurrence depends on three major prognostic factors: extra-thyroid extension, patient’s age, and tumor with reduced iodine uptake. Increased risk for recurrence is a major factor in the decision whether to treat the patient with EBRT. Data about the use of EBRT in DTC are limited to small retrospective studies. Most series have demonstrated an increase in loco-regional control. The risk/benefit from giving EBRT requires careful patient selection. Different scoring systems have been proposed by different investigators and centers. The authors encourage clinicians treating DTC to become familiarized with those scoring systems and to use them in the management of different cases. The irradiated volume should include areas of risk for microscopic disease. Determining those areas in each case can be difficult and requires detailed knowledge of the surgery and pathological results, and also understanding of the disease-spreading pattern. Treatment with EBRT in DTC can be beneficial, and data support the use of EBRT in high-risk patients. Randomized controlled trials are needed for better confirmation of the role of EBRT. PMID:26886956

Full-order Luenberger observer based on fuzzy-logic control for sensorless field-oriented control of a single-sided linear induction motor.

PubMed

Holakooie, Mohammad Hosein; Ojaghi, Mansour; Taheri, Asghar

2016-01-01

This paper investigates sensorless indirect field oriented control (IFOC) of SLIM with full-order Luenberger observer. The dynamic equations of SLIM are first elaborated to draw full-order Luenberger observer with some simplifying assumption. The observer gain matrix is derived from conventional procedure so that observer poles are proportional to SLIM poles to ensure the stability of system for wide range of linear speed. The operation of observer is significantly impressed by adaptive scheme. A fuzzy logic control (FLC) is proposed as adaptive scheme to estimate linear speed using speed tuning signal. The parameters of FLC are tuned using an off-line method through chaotic optimization algorithm (COA). The performance of the proposed observer is verified by both numerical simulation and real-time hardware-in-the-loop (HIL) implementation. Moreover, a detailed comparative study among proposed and other speed observers is obtained under different operation conditions. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

Modified artificial fish school algorithm for free space optical communication with sensor-less adaptive optics system

NASA Astrophysics Data System (ADS)

Cao, Jingtai; Zhao, Xiaohui; Li, Zhaokun; Liu, Wei; Gu, Haijun

2017-11-01

The performance of free space optical (FSO) communication system is limited by atmospheric turbulent extremely. Adaptive optics (AO) is the significant method to overcome the atmosphere disturbance. Especially, for the strong scintillation effect, the sensor-less AO system plays a major role for compensation. In this paper, a modified artificial fish school (MAFS) algorithm is proposed to compensate the aberrations in the sensor-less AO system. Both the static and dynamic aberrations compensations are analyzed and the performance of FSO communication before and after aberrations compensations is compared. In addition, MAFS algorithm is compared with artificial fish school (AFS) algorithm, stochastic parallel gradient descent (SPGD) algorithm and simulated annealing (SA) algorithm. It is shown that the MAFS algorithm has a higher convergence speed than SPGD algorithm and SA algorithm, and reaches the better convergence value than AFS algorithm, SPGD algorithm and SA algorithm. The sensor-less AO system with MAFS algorithm effectively increases the coupling efficiency at the receiving terminal with fewer numbers of iterations. In conclusion, the MAFS algorithm has great significance for sensor-less AO system to compensate atmospheric turbulence in FSO communication system.

How Drug Treatment Courts Work: An Analysis of Mediators

ERIC Educational Resources Information Center

Gottfredson, Denise C.; Kearley, Brook W.; Najaka, Stacy S.; Rocha, Carlos M.

2007-01-01

This study examines program elements related to reductions in drug use and crime among Drug Treatment Courts (DTC) participants as well as theoretical mechanisms--increased social controls and improved perceptions of procedural justice--expected to mediate the effects of DTC on these outcomes. Data are from 157 research participants interviewed…

MRAS state estimator for speed sensorless ISFOC induction motor drives with Luenberger load torque estimation.

PubMed

Zorgani, Youssef Agrebi; Koubaa, Yassine; Boussak, Mohamed

2016-03-01

This paper presents a novel method for estimating the load torque of a sensorless indirect stator flux oriented controlled (ISFOC) induction motor drive based on the model reference adaptive system (MRAS) scheme. As a matter of fact, this method is meant to inter-connect a speed estimator with the load torque observer. For this purpose, a MRAS has been applied to estimate the rotor speed with tuned load torque in order to obtain a high performance ISFOC induction motor drive. The reference and adjustable models, developed in the stationary stator reference frame, are used in the MRAS scheme in an attempt to estimate the speed of the measured terminal voltages and currents. The load torque is estimated by means of a Luenberger observer defined throughout the mechanical equation. Every observer state matrix depends on the mechanical characteristics of the machine taking into account the vicious friction coefficient and inertia moment. Accordingly, some simulation results are presented to validate the proposed method and to highlight the influence of the variation of the inertia moment and the friction coefficient on the speed and the estimated load torque. The experimental results, concerning to the sensorless speed with a load torque estimation, are elaborated in order to validate the effectiveness of the proposed method. The complete sensorless ISFOC with load torque estimation is successfully implemented in real time using a digital signal processor board DSpace DS1104 for a laboratory 3 kW induction motor. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

Influence of individual differences in disease perception on consumer response to direct-to-consumer genomic testing

PubMed Central

Boeldt, D.L.; Schork, N.J.; Topol, E.J.; Bloss, C.S.

2016-01-01

Individuals who undergo multiplex direct-to-consumer (DTC) genomic testing receive genetic risk results for multiple conditions. To date, research has not investigated the influence of individual differences in disease perceptions among consumers on testing outcomes. A total of 2037 participants received DTC genomic testing and completed baseline and follow-up surveys assessing disease perceptions and health behaviors. Participants were asked to indicate their most feared disease of those tested. Perceived seriousness and controllability of the disease via lifestyle or medical intervention were assessed. Participants most frequently reported heart attack (19.1%) and Alzheimer’s disease (18.6%) as their most feared disease. Perceived seriousness and control over the feared disease both influenced response to DTC genomic testing. Greater perceived seriousness and diminished perceived control were associated with higher, but not clinically significant levels of anxiety and distress. In some cases these associations were modified by genetic risk. No significant associations were observed for diet, exercise and screening behaviors. Individual differences in disease perceptions influence psychological outcomes following DTC genomic testing. Higher perceived seriousness may make a consumer more psychologically sensitive to test results and greater perceived control may protect against adverse psychological outcomes. Findings may inform development of educational and counseling services. PMID:24798746

Influence of individual differences in disease perception on consumer response to direct-to-consumer genomic testing.

PubMed

Boeldt, D L; Schork, N J; Topol, E J; Bloss, C S

2015-03-01

Individuals who undergo multiplex direct-to-consumer (DTC) genomic testing receive genetic risk results for multiple conditions. To date, research has not investigated the influence of individual differences in disease perceptions among consumers on testing outcomes. A total of 2037 participants received DTC genomic testing and completed baseline and follow-up surveys assessing disease perceptions and health behaviors. Participants were asked to indicate their most feared disease of those tested. Perceived seriousness and controllability of the disease via lifestyle or medical intervention were assessed. Participants most frequently reported heart attack (19.1%) and Alzheimer's disease (18.6%) as their most feared disease. Perceived seriousness and control over the feared disease both influenced response to DTC genomic testing. Greater perceived seriousness and diminished perceived control were associated with higher, but not clinically significant levels of anxiety and distress. In some cases these associations were modified by genetic risk. No significant associations were observed for diet, exercise and screening behaviors. Individual differences in disease perceptions influence psychological outcomes following DTC genomic testing. Higher perceived seriousness may make a consumer more psychologically sensitive to test results and greater perceived control may protect against adverse psychological outcomes. Findings may inform development of educational and counseling services. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Control algorithms and applications of the wavefront sensorless adaptive optics

NASA Astrophysics Data System (ADS)

Ma, Liang; Wang, Bin; Zhou, Yuanshen; Yang, Huizhen

2017-10-01

Compared with the conventional adaptive optics (AO) system, the wavefront sensorless (WFSless) AO system need not to measure the wavefront and reconstruct it. It is simpler than the conventional AO in system architecture and can be applied to the complex conditions. Based on the analysis of principle and system model of the WFSless AO system, wavefront correction methods of the WFSless AO system were divided into two categories: model-free-based and model-based control algorithms. The WFSless AO system based on model-free-based control algorithms commonly considers the performance metric as a function of the control parameters and then uses certain control algorithm to improve the performance metric. The model-based control algorithms include modal control algorithms, nonlinear control algorithms and control algorithms based on geometrical optics. Based on the brief description of above typical control algorithms, hybrid methods combining the model-free-based control algorithm with the model-based control algorithm were generalized. Additionally, characteristics of various control algorithms were compared and analyzed. We also discussed the extensive applications of WFSless AO system in free space optical communication (FSO), retinal imaging in the human eye, confocal microscope, coherent beam combination (CBC) techniques and extended objects.

Fuel sensor-less control of a liquid feed fuel cell under dynamic loading conditions for portable power sources (II)

NASA Astrophysics Data System (ADS)

Chang, C. L.; Chen, C. Y.; Sung, C. C.; Liou, D. H.; Chang, C. Y.; Cha, H. C.

This work presents a new fuel sensor-less control scheme for liquid feed fuel cells that is able to control the supply to a fuel cell system for operation under dynamic loading conditions. The control scheme uses cell-operating characteristics, such as potential, current, and power, to regulate the fuel concentration of a liquid feed fuel cell without the need for a fuel concentration sensor. A current integral technique has been developed to calculate the quantity of fuel required at each monitoring cycle, which can be combined with the concentration regulating process to control the fuel supply for stable operation. As verified by systematic experiments, this scheme can effectively control the fuel supply of a liquid feed fuel cell with reduced response time, even under conditions where the membrane electrolyte assembly (MEA) deteriorates gradually. This advance will aid the commercialization of liquid feed fuel cells and make them more adaptable for use in portable and automotive power units such as laptops, e-bikes, and handicap cars.

Study on Stability of High Speed Traction Drive CVT for Aircraft Generator

NASA Astrophysics Data System (ADS)

Goi, Tatsuhiko; Tanaka, Hirohisa; Nakashima, Kenichi; Watanabe, Koji

A half-toroidal traction drive CVT has a feature of small spin at traction pitch in whole speed ratio range of 1:4, which suits to transmit high rotational speed with minimum temperature increase of traction surface. Research activity on traction drive CVT has commenced in 1996 for applying it to an aircraft 24,000rpm constant-speed generator instead of a hydro-static transmission. This paper shows fundamental design of 90kW traction drive integrated drive generator, ``T-IDG", and stability analysis on a sensor-less electro-hydraulic speed control servo-mechanism by bond graphs. The performance test of T-IDG mounted on a test bench and an actual jet engine proved that the control system using sensor-less servomechanism can keep the generator speed within MIL-STD-704E allowable limit against steep changes of speed and load.

Sensorless control of ship propulsion interior permanent magnet synchronous motor based on a new sliding mode observer.

PubMed

Ren, Jun-Jie; Liu, Yan-Cheng; Wang, Ning; Liu, Si-Yuan

2015-01-01

This paper proposes a sensorless speed control strategy for ship propulsion interior permanent magnet synchronous motor (IPMSM) based on a new sliding-mode observer (SMO). In the SMO the low-pass filter and the method of arc-tangent calculation of extended electromotive force (EMF) or phase-locked loop (PLL) technique are not used. The calculation of the rotor speed is deduced from the Lyapunov function stability analysis. In order to reduce system chattering, sigmoid functions with switching gains being adaptively updated by fuzzy logic systems are innovatively incorporated into the SMO. Finally, simulation results for a 4.088 MW ship propulsion IPMSM and experimental results from a 7.5 kW IPMSM drive are provided to verify the effectiveness of the proposed SMO method. Copyright © 2014 ISA. Published by Elsevier Ltd. All rights reserved.

Wavefront sensorless adaptive optics temporal focusing-based multiphoton microscopy

PubMed Central

Chang, Chia-Yuan; Cheng, Li-Chung; Su, Hung-Wei; Hu, Yvonne Yuling; Cho, Keng-Chi; Yen, Wei-Chung; Xu, Chris; Dong, Chen Yuan; Chen, Shean-Jen

2014-01-01

Temporal profile distortions reduce excitation efficiency and image quality in temporal focusing-based multiphoton microscopy. In order to compensate the distortions, a wavefront sensorless adaptive optics system (AOS) was integrated into the microscope. The feedback control signal of the AOS was acquired from local image intensity maximization via a hill-climbing algorithm. The control signal was then utilized to drive a deformable mirror in such a way as to eliminate the distortions. With the AOS correction, not only is the axial excitation symmetrically refocused, but the axial resolution with full two-photon excited fluorescence (TPEF) intensity is also maintained. Hence, the contrast of the TPEF image of a R6G-doped PMMA thin film is enhanced along with a 3.7-fold increase in intensity. Furthermore, the TPEF image quality of 1μm fluorescent beads sealed in agarose gel at different depths is improved. PMID:24940539

Which lessons can we learn from the European Union legal framework of medicines for the regulation of direct-to-consumer genetic tests?

PubMed

van Hellemondt, Rachèl; Hendriks, Aart; Breuning, Martijn

2012-01-01

The legal framework of the European Union (EU) for regulating access to and supply of direct-to-consumer (DTC) genetic tests is very liberal compared to the legal and regulatory framework for (internet) medicines. Nevertheless, both health related products can cause equally serious damage to the well being of individuals. In this contribution we examine whether the legal framework of the EU for the safety and responsible use of (internet) medicines could be an example for regulating access to and supply of DTC genetic tests. The EU laws governing medicines can, notwithstanding their shortcomings, serve as an example for (central) authorising the marketing of DTC genetic tests on the internal market in accordance with strict criteria regarding predictive value and clinical usefulness. Furthermore, a legal framework controlling DTC genetic tests also should introduce system supervision as well as quality criteria with respect to the information to be provided to consumers in order to enhance health protection. However, DTC genetic tests purchased through online ordering are difficult to supervise by any agency. Adequately protecting individuals against questionable testing kits calls for international vigilance and comprehensive measures by the international community. For Europe, it is important to rank the regulation of DTC genetic tests on the European regulatory agenda.

Wavefront sensorless adaptive optics optical coherence tomography for in vivo retinal imaging in mice

PubMed Central

Jian, Yifan; Xu, Jing; Gradowski, Martin A.; Bonora, Stefano; Zawadzki, Robert J.; Sarunic, Marinko V.

2014-01-01

We present wavefront sensorless adaptive optics (WSAO) Fourier domain optical coherence tomography (FD-OCT) for in vivo small animal retinal imaging. WSAO is attractive especially for mouse retinal imaging because it simplifies optical design and eliminates the need for wavefront sensing, which is difficult in the small animal eye. GPU accelerated processing of the OCT data permitted real-time extraction of image quality metrics (intensity) for arbitrarily selected retinal layers to be optimized. Modal control of a commercially available segmented deformable mirror (IrisAO Inc.) provided rapid convergence using a sequential search algorithm. Image quality improvements with WSAO OCT are presented for both pigmented and albino mouse retinal data, acquired in vivo. PMID:24575347

Wind Velocity and Position Sensor-less Operation for PMSG Wind Generator

NASA Astrophysics Data System (ADS)

Senjyu, Tomonobu; Tamaki, Satoshi; Urasaki, Naomitsu; Uezato, Katsumi; Funabashi, Toshihisa; Fujita, Hideki

Electric power generation using non-conventional sources is receiving considerable attention throughout the world. Wind energy is one of the available non-conventional energy sources. Electrical power generation using wind energy is possible in two ways, viz. constant speed operation and variable speed operation using power electronic converters. Variable speed power generation is attractive, because maximum electric power can be generated at all wind velocities. However, this system requires a rotor speed sensor, for vector control purpose, which increases the cost of the system. To alleviate the need of rotor speed sensor in vector control, we propose a new sensor-less control of PMSG (Permanent Magnet Synchronous Generator) based on the flux linkage. We can estimate the rotor position using the estimated flux linkage. We use a first-order lag compensator to obtain the flux linkage. Furthermore‚we estimate wind velocity and rotation speed using a observer. The effectiveness of the proposed method is demonstrated thorough simulation results.

Harmonic reduction of Direct Torque Control of six-phase induction motor.

PubMed

Taheri, A

2016-07-01

In this paper, a new switching method in Direct Torque Control (DTC) of a six-phase induction machine for reduction of current harmonics is introduced. Selecting a suitable vector in each sampling period is an ordinal method in the ST-DTC drive of a six-phase induction machine. The six-phase induction machine has 64 voltage vectors and divided further into four groups. In the proposed DTC method, the suitable voltage vectors are selected from two vector groups. By a suitable selection of two vectors in each sampling period, the harmonic amplitude is decreased more, in and various comparison to that of the ST-DTC drive. The harmonics loss is greater reduced, while the electromechanical energy is decreased with switching loss showing a little increase. Spectrum analysis of the phase current in the standard and new switching table DTC of the six-phase induction machine and determination for the amplitude of each harmonics is proposed in this paper. The proposed method has a less sampling time in comparison to the ordinary method. The Harmonic analyses of the current in the low and high speed shows the performance of the presented method. The simplicity of the proposed method and its implementation without any extra hardware is other advantages of the proposed method. The simulation and experimental results show the preference of the proposed method. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

Cytokine production in peripheral blood cells of patients with differentiated thyroid cancer: elevated Th2/Th9 cytokine production before and reduced Th2 cytokine production after radioactive iodine therapy.

PubMed

Simonovic, Snezana Zivancevic; Mihaljevic, Olgica; Majstorovic, Ivana; Djurdjevic, Predrag; Kostic, Irena; Djordjevic, Olivera Milosevic; Teodorovic, Ljiljana Mijatovic

2015-01-01

Cytokines play a key role in the regulation of cells of the immune system and also have been implicated in the pathogenesis of malignant diseases. The aim of this study was to evaluate cytokine profiles in patients with differentiated thyroid cancer (DTC) before and 7 days after radioactive iodine (131-I) therapy. Cytokine levels were determined in supernatants obtained from phytohemagglutinin-stimulated whole blood cultures of 13 patients with DTC and 13 control subjects. The concentrations of selected cytokines: Th1-interferon gamma (IFN-γ), interleukin 2 (IL-2) and tumor necrosis factor alpha (TNF-α); Th2-interleukin 4 (IL-4), interleukin 5 (IL-5), interleukin 13 (IL-13) and interleukin 10 (IL-10); Th9-interleukin-9 (IL-9); and Th17-interleukin 17 (IL-17A) were measured using multiplex cytokine detection systems for Human Th1/Th2/Th9/Th17/Th22. We have shown that peripheral blood cells of DTC patients produce significantly higher concentrations of Th2/Th9 cytokines (IL-5, IL-13 and IL-9) than control subjects. The 131-I therapy led to reduced secretion of Th2 cytokines (IL-4, IL-5 and IL-13). Despite this, the calculated cytokine ratios (Th1/Th2) in DTC patients before and 7 days after 131-I therapy were not different from those in healthy subjects. DTC patients have significantly higher concentrations of Th2/Th9 cytokines (IL-5, IL-13 and IL-9) than control subjects. There is no influence of hypothyroidism or stage of disease on cytokine production in DTC patients before 131-I therapy. The radioactive 131-I therapy leads to reduced secretion of Th2 cytokines (IL-4, IL-5 and IL-13). Additional studies are needed to determine the significance of these findings.

Weight Changes in Patients with Differentiated Thyroid Carcinoma during Postoperative Long-Term Follow-up under Thyroid Stimulating Hormone Suppression

PubMed Central

Sohn, Seo Young; Joung, Ji Young; Cho, Yoon Young; Park, Sun Mi; Jin, Sang Man; Chung, Jae Hoon

2015-01-01

Background There are limited data about whether patients who receive initial treatment for differentiated thyroid cancer (DTC) gain or lose weight during long-term follow-up under thyroid stimulating hormone (TSH) suppression. This study was aimed to evaluate whether DTC patients under TSH suppression experience long-term weight gain after initial treatment. We also examined the impact of the radioactive iodine ablation therapy (RAIT) preparation method on changes of weight, comparing thyroid hormone withdrawal (THW) and recombinant human TSH (rhTSH). Methods We retrospectively reviewed 700 DTC patients who underwent a total thyroidectomy followed by either RAIT and levothyroxine (T4) replacement or T4 replacement alone. The control group included 350 age-matched patients with benign thyroid nodules followed during same period. Anthropometric data were measured at baseline, 1 to 2 years, and 3 to 4 years after thyroidectomy. Comparisons were made between weight and body mass index (BMI) at baseline and follow-up. Results Significant gains in weight and BMI were observed 3 to 4 years after initial treatment for female DTC but not in male patients. These gains among female DTC patients were also significant compared to age-matched control. Women in the THW group gained a significant amount of weight and BMI compared to baseline, while there was no increase in weight or BMI in the rhTSH group. There were no changes in weight and BMI in men according to RAIT preparation methods. Conclusion Female DTC patients showed significant gains in weight and BMI during long-term follow-up after initial treatment. These changes were seen only in patients who underwent THW for RAIT. PMID:26248858

Family history of cancer and risk of sporadic differentiated thyroid carcinoma.

PubMed

Xu, Li; Li, Guojun; Wei, Qingyi; El-Naggar, Adel K; Sturgis, Erich M

2012-03-01

Thyroid cancer incidence in the United States, particularly in women, has increased dramatically since the 1980s. Although the causes of thyroid cancer in most patients remain largely unknown, evidence suggests the existence of an inherited predisposition to development of differentiated thyroid carcinoma (DTC). Therefore, the authors explored the association between sporadic DTC and family history of cancer. In a retrospective hospital-based case-control study of prospectively recruited subjects who completed the study questionnaire upon enrollment, unconditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) as estimates of the DTC risk associated with first-degree family history of cancer. The study included 288 patients with sporadic DTC and 591 cancer-free controls. Family history of thyroid cancer in first-degree relatives was associated with increased DTC risk (adjusted OR, 4.1; 95% CI, 1.7-9.9). All DTC cases in patients with a first-degree family history of thyroid cancer were cases of papillary thyroid carcinoma (PTC) (adjusted OR, 4.6; 95% CI, 1.9-11.1). Notably, the risk of PTC was highest in subjects with a family history of thyroid cancer in siblings (OR, 7.4; 95% CI, 1.8-30.4). In addition, multifocal primary tumor was more common among PTC patients with first-degree family history of thyroid cancer than among PTC patients with no first-degree family history of thyroid cancer (68.8% vs 35.5%, P = .01). The study suggests that family history of thyroid cancer in first-degree relatives, particularly in siblings, is associated with an increased risk of sporadic PTC. Copyright © 2011 American Cancer Society.

Family History of Cancer and Risk of Sporadic Differentiated Thyroid Carcinoma

PubMed Central

Xu, Li; Li, Guojun; Wei, Qingyi; El-Naggar, Adel K.; Sturgis, Erich M.

2011-01-01

BACKGROUND Thyroid cancer incidence in the United States, particularly in women, has increased dramatically since 1980s. While the causes of thyroid cancer in most patients remain largely unknown, evidence suggests the existence of an inherited predisposition to development of differentiated thyroid cancer (DTC). Therefore, we explored the association between sporadic DTC and family history of cancer. METHODS In a retrospective hospital-based case-control study of prospectively recruited subjects who completed the study questionnaire upon enrollment, unconditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) as estimates of the DTC risk associated with first-degree family history of cancer. RESULTS The study included 288 patients with sporadic DTC and 591 cancer-free controls. Family history of thyroid cancer in first-degree relatives was associated with increased DTC risk (adjusted OR = 4.1, 95% CI: 1.7–9.9). All DTC cases in patients with a first-degree family history of thyroid cancer were cases of papillary thyroid carcinoma (PTC) (adjusted OR = 4.6, 95 CI%: 1.9–11.1). Notably, the risk of PTC was highest in subjects with a family history of thyroid cancer in siblings (OR = 7.4, 95% CI: 1.8–30.4). In addition, multifocal primary tumor was more common among PTC patients with first-degree family history of thyroid cancer than among PTC patients with no first-degree family history of thyroid cancer (68.8% vs. 35.5%, p = 0.01). CONCLUSIONS Our study suggests that family history of thyroid cancer in first-degree relatives, particularly in siblings, is associated with an increased risk of sporadic PTC. PMID:21800288

Direct-to-consumer marketing of prescription drugs: a current perspective for neurologists and psychiatrists.

PubMed

Hollon, Matthew F

2004-01-01

In the US and New Zealand, the past decade has seen tremendous growth in the marketing of prescription drugs directly to patients. The pharmaceutical industry has applied pressure in other countries to relax regulations governing such marketing although this has not yet been successful. While we still have much to learn about the potential impact on the public's health of direct-to-consumer (DTC) marketing, some data are available. This article summarises the current literature on the benefits and risks of DTC marketing. This marketing strategy has grown substantially in the US, but only select drugs are advertised. Whether there is net benefit or harm to the public's health as a result of DTC marketing depends critically on which drugs are advertised and the quality of the information provided in promotional material. Critical reviews of this promotional material suggest the information is of poor quality. Notably, 18% of the 50 drugs advertised most intensively in the US were medications used to treat psychiatric and neurological disorders. The impairments in decisional capacity often seen in psychiatric and neurological illness leave patients vunerable to the controlling influence of DTC marketing and, thus, undermine the patient autonomy that is said to be promoted by this marketing strategy. If there is any benefit from DTC marketing it is for significantly undertreated conditions. International restrictions on DTC marketing should remain in place until further evidence of net benefit or harm emerges from the DTC marketing experiment that is taking place in the US and New Zealand.

Online, direct-to-consumer access to insulin: patient safety considerations and reform.

PubMed

Lovett, Kimberly M; Liang, Bryan A; Mackey, Timothy K

2012-11-01

The online, direct-to-consumer (DTC) medical marketplace is proliferating more rapidly than regulation is evolving to ensure proper patient safety and public health controls. Along with this growing body of unrestrained medical testing and pharmaceuticals offered DTC online, most types of insulin and insulin administration products may now be purchased without prescriptions or physician guidance. Given the relatively significant risks of insulin use, the abuse potential, the high prevalence of diabetes mellitus, and the rising population of uninsured and underinsured, it is imperative to reform the online DTC medical marketplace to ensure that patient safety and public health are protected. © 2012 Diabetes Technology Society.

Online, Direct-to-Consumer Access to Insulin: Patient Safety Considerations and Reform

PubMed Central

Lovett, Kimberly M.; Liang, Bryan A.; Mackey, Timothy K.

2012-01-01

The online, direct-to-consumer (DTC) medical marketplace is proliferating more rapidly than regulation is evolving to ensure proper patient safety and public health controls. Along with this growing body of unrestrained medical testing and pharmaceuticals offered DTC online, most types of insulin and insulin administration products may now be purchased without prescriptions or physician guidance. Given the relatively significant risks of insulin use, the abuse potential, the high prevalence of diabetes mellitus, and the rising population of uninsured and underinsured, it is imperative to reform the online DTC medical marketplace to ensure that patient safety and public health are protected. PMID:23294798

In the process of drinking to cope among college students: An examination of specific vs. global coping motives for depression and anxiety symptoms.

PubMed

Bravo, Adrian J; Pearson, Matthew R

2017-10-01

The present study sought to address an issue in the drinking to cope (DTC) motives literature, namely the inconsistent application of treating DTC motives as a single construct and splitting it into DTC-depression and DTC-anxiety motives. Specifically, we aimed to determine if the effects of anxiety and depression on alcohol-related problems are best explained via their associations with DTC with specific affects or via their associations with a more global measure of DTC by testing four distinct models: the effects of anxiety/depression on alcohol-related problems mediated by DTC-anxiety only (Model 1), these effects mediated by DTC-depression only (Model 2), these effects mediated by a combined, global DTC factor (Model 3), and these effects mediated by both DTC-anxiety and DTC-depression (Model 4). Using path analysis/structural equation modeling across two independent samples, we found that there was a significant total indirect effect of both anxiety and depressive symptoms on alcohol-related problems in every model. However, there was a slightly larger indirect effect in all models using the global DTC motives factor compared to even the model that included the two distinct DTC motives. Our results provide some preliminary evidence that at least at the between-subjects level, a global DTC motives factor may have more predictive validity than separate DTC motives. Additional research is needed to examine how to best operationalize DTC motives at different levels of analysis (e.g., within-subjects vs. between subjects) and in different populations (e.g., college students vs. individuals with alcohol use disorder). Copyright © 2017. Published by Elsevier Ltd.

Legislation on direct-to-consumer genetic testing in seven European countries.

PubMed

Borry, Pascal; van Hellemondt, Rachel E; Sprumont, Dominique; Jales, Camilla Fittipaldi Duarte; Rial-Sebbag, Emmanuelle; Spranger, Tade Matthias; Curren, Liam; Kaye, Jane; Nys, Herman; Howard, Heidi

2012-07-01

An increasing number of private companies are now offering direct-to-consumer (DTC) genetic testing services. Although a lot of attention has been devoted to the regulatory framework of DTC genetic testing services in the USA, only limited information about the regulatory framework in Europe is available. We will report on the situation with regard to the national legislation on DTC genetic testing in seven European countries (Belgium, the Netherlands, Switzerland, Portugal, France, Germany, the United Kingdom). The paper will address whether these countries have legislation that specifically address the issue of DTC genetic testing or have relevant laws that is pertinent to the regulatory control of these services in their countries. The findings show that France, Germany, Portugal and Switzerland have specific legislation that defines that genetic tests can only be carried out by a medical doctor after the provision of sufficient information concerning the nature, meaning and consequences of the genetic test and after the consent of the person concerned. In the Netherlands, some DTC genetic tests could fall under legislation that provides the Minister the right to refuse to provide a license to operate if a test is scientifically unsound, not in accordance with the professional medical practice standards or if the expected benefit is not in balance with the (potential) health risks. Belgium and the United Kingdom allow the provision of DTC genetic tests.

Legislation on direct-to-consumer genetic testing in seven European countries

PubMed Central

Borry, Pascal; van Hellemondt, Rachel E; Sprumont, Dominique; Jales, Camilla Fittipaldi Duarte; Rial-Sebbag, Emmanuelle; Spranger, Tade Matthias; Curren, Liam; Kaye, Jane; Nys, Herman; Howard, Heidi

2012-01-01

An increasing number of private companies are now offering direct-to-consumer (DTC) genetic testing services. Although a lot of attention has been devoted to the regulatory framework of DTC genetic testing services in the USA, only limited information about the regulatory framework in Europe is available. We will report on the situation with regard to the national legislation on DTC genetic testing in seven European countries (Belgium, the Netherlands, Switzerland, Portugal, France, Germany, the United Kingdom). The paper will address whether these countries have legislation that specifically address the issue of DTC genetic testing or have relevant laws that is pertinent to the regulatory control of these services in their countries. The findings show that France, Germany, Portugal and Switzerland have specific legislation that defines that genetic tests can only be carried out by a medical doctor after the provision of sufficient information concerning the nature, meaning and consequences of the genetic test and after the consent of the person concerned. In the Netherlands, some DTC genetic tests could fall under legislation that provides the Minister the right to refuse to provide a license to operate if a test is scientifically unsound, not in accordance with the professional medical practice standards or if the expected benefit is not in balance with the (potential) health risks. Belgium and the United Kingdom allow the provision of DTC genetic tests. PMID:22274578

New sensorless, efficient optimized and stabilized v/f control for pmsm machines

NASA Astrophysics Data System (ADS)

Jafari, Seyed Hesam

With the rapid advances in power electronics and motor drive technologies in recent decades, permanent magnet synchronous machines (PMSM) have found extensive applications in a variety of industrial systems due to its many desirable features such as high power density, high efficiency, and high torque to current ratio, low noise, and robustness. In low dynamic applications like pumps, fans and compressors where the motor speed is nearly constant, usage of a simple control algorithm that can be implemented with least number of the costly external hardware can be highly desirable for industry. In recent published works, for low power PMSMs, a new sensorless volts-per-hertz (V/f) controlling method has been proposed which can be used for PMSM drive applications where the motor speed is constant. Moreover, to minimize the cost of motor implementation, the expensive rotor damper winding was eliminated. By removing the damper winding, however, instability problems normally occur inside of the motor which in some cases can be harmful for a PMSM drive. As a result, to address the instability issue, a stabilizing loop was developed and added to the conventional V/f. By further studying the proposed sensorless stabilized V/f, and calculating power loss, it became known that overall motor efficiency still is needed to be improved and optimized. This thesis suggests a new V/f control method for PMSMs, where both efficiency and stability problems are addressed. Also, although in nearly all recent related research, methods have been applied to low power PMSM, for the first time, in this thesis, the suggested method is implemented for a medium power 15 kW PMSM. A C2000 F2833x Digital Signal Processor (DSP) is used as controller part for the student custom built PMSM drive, but instead of programming the DSP in Assembly or C, the main control algorithm was developed in a rapid prototype software environment which here Matlab Simulink embedded code library is used.

"It's our DNA, we deserve the right to test!" A content analysis of a petition for the right to access direct-to-consumer genetic testing.

PubMed

Su, Yeyang; Borry, Pascal; Otte, Ina C; Howard, Heidi C

2013-09-01

Various companies are currently advertising or selling genetic tests over the internet using a model of provision referred to as 'direct-to-consumer' (DTC). This commercial offer of DTC genetic testing (GT) has fueled a number of scientific, ethical and policy debates. To date there have been few studies published regarding the users' perspective. This study aimed to obtain information regarding the issues raised by individuals who signed a petition in support of DTC GT and the 'unrestricted' access to their genetic information. We conducted qualitative content analysis of comments written by individuals who signed a public online petition initiated by DIYgenomics (CA, USA) to support "personal access to genetic information". Of the 523 individuals who signed the petition sponsored by DIYgenomics, 247 individuals also wrote individual comments. A content analysis of these comments reveals that petitioners raised six main issues in support of unrestricted access to DTC GT: that their ownership of their DNA should allow them to have unrestricted access to their genomic information; that they should have the right to their genomic information; that the government has no place in (further) regulating DTC GT; that healthcare professionals should not be placed as intermediaries when purchasing DTC GT services; that many petioners who had already obtained DTC GT had positive experiences with this model of provision; and that genealogy or ancestry DNA testing is one of the main activities petitioners wish to have 'unrestricted' or 'direct' access. These results give insight into why individuals may support unrestricted access to their genomic information and confirm some of the motivations of users for purchasing DTC GT. Our analysis also brings to the forefront themes that have been raised less often in empirical studies involving motivations to purchase DTC GT services; these include the strongly held beliefs of some petitioners that, since they own their DNA, they should have the right to access the information without (further) government control or physician involvement. Interestingly, the comments left by petitioners also reveal a certain distrust of governmental agencies and healthcare professionals. This urges us to further study the public's views of these services and the potential impact of these views in order to responsibly address the ongoing debate on DTC GT.

Thyroid remnant ablation success and disease outcome in stage III or IV differentiated thyroid carcinoma: recombinant human thyrotropin versus thyroid hormone withdrawal.

PubMed

Vallejo Casas, Juan A; Mena Bares, Luisa M; Gálvez Moreno, Maria A; Moreno Ortega, Estefanía; Marlowe, Robert J; Maza Muret, Francisco R; Albalá González, María D

2016-06-01

Most publications to date compare outcomes after post-surgical thyroid remnant ablation stimulated by recombinant human thyrotropin (rhTSH) versus thyroid hormone withholding/withdrawal (THW) in low-recurrence risk differentiated thyroid carcinoma (DTC) patients. We sought to perform this comparison in high-risk patients. We retrospectively analyzed ~9-year single-center experience in 70 consecutive adults with initial UICC (Union for International Cancer Control) stage III/IV, M0 DTC undergoing rhTSH-aided (N.=54) or THW-aided (N.=16) high-activity ablation. Endpoints included ablation success and DTC outcome. Assessed ≥1 year post-ablation, ablation success comprised a) no visible scintigraphic thyroid bed uptake or pathological extra-thyroidal uptake; b) undetectable stimulated serum thyroglobulin (Tg) without interfering autoantibodies; c) both criteria. DTC outcome, determined at the latest visit, comprised either 1) "no evidence of disease" (NED): undetectable Tg, negative Tg autoantibodies, negative most recent whole-body scan, no suspicious findings clinically, on neck ultrasonography, or on other imaging; 2) persistent disease: failure to attain NED; or 3) recurrence: loss of NED. After the first ablative activity, ablation success by scintigraphic plus biochemical criteria was 64.8% in rhTSH patients, 56.3% in THW patients (P=NS). After 3.5-year versus 6.2-year median follow-up (P<0.05), DTC outcomes were NED, 85.2%, persistent disease, 13.0%, recurrence, 1.9%, in the rhTSH group and NED, 87.5%, persistent or recurrent disease, 6.3% each, in the THW group (P=NS). In patients with initial stage III/IV, M0 DTC, rhTSH-aided and THW-assisted ablation were associated with comparable remnant eradication or DTC cure rates.

Drinking-to-cope motivation and negative mood-drinking contingencies in a daily diary study of college students.

PubMed

O'Hara, Ross E; Armeli, Stephen; Tennen, Howard

2014-07-01

This study examined whether global drinking-to-cope (DTC) motivation moderates negative mood-drinking contingencies and negative mood-motivation contingencies at the daily level of analysis. Data came from a daily diary study of college student drinking (N = 1,636; 53% female; Mage = 19.2 years). Fixed-interval models tested whether global DTC motivation moderated relations between daily negative mood and that evening's drinking and episodic DTC. Time-to-drink models examined whether global DTC motivation moderated the effects of weekly negative mood on the immediacy of drinking and DTC in the weekly cycle. More evening drinking occurred on days characterized by relatively higher anxiety or anger, and students were more likely to report DTC on days when they experienced greater sadness. However, only the daily Anxiety × Global DTC Motivation interaction for number of drinks consumed was consistent with hypotheses. Moreover, students reported drinking, heavy drinking, and DTC earlier in weeks characterized by relatively higher anxiety or anger, but no hypothesized interactions with global DTC motivation were found. RESULTS indicate that negative mood is associated with increased levels of drinking and drinking for coping reasons among college students but that the strength of these relations does not differ by global levels of DTC motivation. These findings raise the possibility that global DTC measures are insufficient for examining within-person DTC processes. Further implications of these results are discussed, including future directions that may determine the circumstances under which, and for whom, DTC occurs.

Model-based wavefront sensorless adaptive optics system for large aberrations and extended objects.

PubMed

Yang, Huizhen; Soloviev, Oleg; Verhaegen, Michel

2015-09-21

A model-based wavefront sensorless (WFSless) adaptive optics (AO) system with a 61-element deformable mirror is simulated to correct the imaging of a turbulence-degraded extended object. A fast closed-loop control algorithm, which is based on the linear relation between the mean square of the aberration gradients and the second moment of the image intensity distribution, is used to generate the control signals for the actuators of the deformable mirror (DM). The restoration capability and the convergence rate of the AO system are investigated with different turbulence strength wave-front aberrations. Simulation results show the model-based WFSless AO system can restore those images degraded by different turbulence strengths successfully and obtain the correction very close to the achievable capability of the given DM. Compared with the ideal correction of 61-element DM, the averaged relative error of RMS value is 6%. The convergence rate of AO system is independent of the turbulence strength and only depends on the number of actuators of DM.

A sensor-less LED dimming system based on daylight harvesting with BIPV systems.

PubMed

Yoo, Seunghwan; Kim, Jonghun; Jang, Cheol-Yong; Jeong, Hakgeun

2014-01-13

Artificial lighting in office buildings typically requires 30% of the total energy consumption of the building, providing a substantial opportunity for energy savings. To reduce the energy consumed by indoor lighting, we propose a sensor-less light-emitting diode (LED) dimming system using daylight harvesting. In this study, we used light simulation software to quantify and visualize daylight, and analyzed the correlation between photovoltaic (PV) power generation and indoor illumination in an office with an integrated PV system. In addition, we calculated the distribution of daylight illumination into the office and dimming ratios for the individual control of LED lights. Also, we were able directly to use the electric power generated by PV system. As a result, power consumption for electric lighting was reduced by 40 - 70% depending on the season and the weather conditions. Thus, the dimming system proposed in this study can be used to control electric lighting to reduce energy use cost-effectively and simply.

Analysis of sensorless control of brushless DC motor using unknown input observer with different gains

NASA Astrophysics Data System (ADS)

Astik, Mitesh B.; Bhatt, Praghnesh; Bhalja, Bhavesh R.

2017-03-01

A sensorless control scheme based on an unknown input observer is presented in this paper in which back EMF of the Brushless DC Motor (BLDC) is continuously estimated from available line voltages and currents. During negative rotation of motor, actual and estimated speed fail to track the reference speed and if the corrective action is not taken by the observer, the motor goes into saturation. To overcome this problem, the speed estimation algorithm has been implemented in this paper to control the dynamic behavior of the motor during negative rotation. The Ackermans method was used to calculate the gains of an unknown input observer which is based on the appropriate choice of the eigenvalues in advance. The criteria to choose eigenvalue is to obtain a balance between faster convergence rate and the least noise level. Simulations have been carried out for different disturbances such as step changes in motor reference speed and load torque. The comparative simulation results clearly depict that the disturbance effects in actual and estimated responses minimizes as observer gain setting increases.

Association of Arg194Trp, Arg280His and Arg399Gln Polymorphisms in X-ray Repair Cross-Complementing Group 1 Gene and Risk of Differentiated Thyroid Carcinoma in Iran

PubMed Central

Fard-Esfahani, Pezhman; Fard-Esfahani, Armaghan; Fayaz, Shima; Ghanbarzadeh, Bahareh; Saidi, Parinaz; Mohabati, Reyhaneh; Bidoki, Seyed Kazem; Majdi, Mina

2011-01-01

Background: X-ray repair cross-complementing group 1 (XRCC1) gene is a DNA repair gene and its non-synonymous single nucleotide polymorphisms (SNP) may influence DNA repair capacity which has been considered as a modifying risk factor for cancer development. Methods: A case-control study was conducted to investigate impact of three frequently studied polymorphisms (Arg194Trp, Arg280His and Arg399Gln) on developing differentiated thyroid carcinoma (DTC). Results: Increased risks for DTC were shown in homozygous (odds ratio [OR]: 3.66, 95% confidence interval [CI]: 0.38-35.60) and in dominant trait (OR: 1.22, 95% CI: 1.64-2.32) of Arg194Trp genotype. Also, for Arg280His genotype, an increased risk for DTC was shown in dominant trait (OR: 1.42, 95% confidence interval [CI]: 0.76-2.68), while a mildly reduction of risk for DTC (OR: 0.77, 95% [CI]: 0.50-1.17) was estimated in dominant Gln genotype of Arg399Gln. Considering combinatory effects of Arg194Trp and Arg280His genotypes on DTC, the calculated OR and 95% CI for being heterozygous for one of Arg194Trp or Arg280His genotypes were 1.57 and 0.90-2.74, respectively. Conclusion: Genotyping of codons 194, 280 and 399 in XRCC1 gene may use in risk assessment of DTC. PMID:21987112

Direct torque control method applied to the WECS based on the PMSG and controlled with backstepping approach

NASA Astrophysics Data System (ADS)

Errami, Youssef; Obbadi, Abdellatif; Sahnoun, Smail; Ouassaid, Mohammed; Maaroufi, Mohamed

2018-05-01

This paper proposes a Direct Torque Control (DTC) method for Wind Power System (WPS) based Permanent Magnet Synchronous Generator (PMSG) and Backstepping approach. In this work, generator side and grid-side converter with filter are used as the interface between the wind turbine and grid. Backstepping approach demonstrates great performance in complicated nonlinear systems control such as WPS. So, the control method combines the DTC to achieve Maximum Power Point Tracking (MPPT) and Backstepping approach to sustain the DC-bus voltage and to regulate the grid-side power factor. In addition, control strategy is developed in the sense of Lyapunov stability theorem for the WPS. Simulation results using MATLAB/Simulink validate the effectiveness of the proposed controllers.

Eosinophil Cationic Protein in Patients with Differentiated Thyroid Cancer Treated with Radioactive Iodine 131.

PubMed

Zivancevic-Simonovic, Snezana; Mihaljevic, Olgica; Kostic, Irena; Ilic, Nevenka; Mihajlovic, Dusan; Vasiljevic, Dragan; Mijatovic-Teodorovic, Ljiljana; Miletic-Drakulic, Svetlana; Colic, Miodrag

2017-09-01

Published data indicate the involvement of eosinophil granulocytes and eosinophil cationic protein (ECP) in tumor defense. The aim of this study was to analyze serum ECP concentrations in patients with differentiated thyroid cancer (DTC) before, 3 days and 7 days after radioactive iodine (131-I) therapy. Association of ECP concentrations with histological type of tumor, stage of disease and/or levels of selected T-helper 2 (Th2) cytokines was examined. The study population included 17 DTC patients and 10 control subjects. ECP was measured by fluoroimmunoassay (FIA). Th2 (cytokines interleukin 4 (IL-4), interleukin 5 (IL-5), and interleukin 13 (IL-13)) were determined by enzyme-linked immunosorbent assays (ELISA). We found that ECP values in DTC patients before radioactive iodine therapy were approximately two-fold higher than in the controls, but the difference was statistically significant only if the patients with DTC and associated Hashimoto thyroiditis (HT) were included. There was no correlation between the serum concentrations of IL-5 and ECP. Radioactive iodine therapy led to a decrease in serum ECP level which did not follow the decline in serum protein levels. Additional studies are needed to determine the significance of these findings. © 2017 by the Association of Clinical Scientists, Inc.

Method and apparatus for sensorless operation of brushless permanent magnet motors

DOEpatents

Sriram, Tillasthanam V.

1998-01-01

A sensorless method and apparatus for providing commutation timing signals for a brushless permanent magnet motor extracts the third harmonic back-emf of a three-phase stator winding and independently cyclically integrates the positive and negative half-cycles thereof and compares the results to a reference level associated with a desired commutation angle.

Method and apparatus for sensorless operation of brushless permanent magnet motors

DOEpatents

Sriram, T.V.

1998-04-14

A sensorless method and apparatus for providing commutation timing signals for a brushless permanent magnet motor extracts the third harmonic back-emf of a three-phase stator winding and independently cyclically integrates the positive and negative half-cycles thereof and compares the results to a reference level associated with a desired commutation angle. 23 figs.

The effects of involvement and ad type on attitudes toward direct-to-consumer advertising of prescription drugs.

PubMed

Limbu, Yam; Torres, Ivonne M

2009-01-01

This article examines consumers' attitudes toward Direct-to-Consumer (DTC) advertising of prescription drugs that are influenced by the use different types of DTC ads and product involvement. Our findings suggest that product involvement and the type of DTC ad are significant predictors of consumers' attitudinal responses toward DTC advertising. High involvement consumers have more favorable attitudes toward the drug's price, DTC ad and brand name, and a higher intention to ask a doctor about the advertised drug than low involvement consumers. In contrast to Informational and Reminder DTC ads, Persuasive ads have more favorable effects on consumers' reactions to DTC prescription drug advertising.

Episode-specific drinking-to-cope motivation, daily mood, and fatigue-related symptoms among college students.

PubMed

Armeli, Stephen; O'Hara, Ross E; Ehrenberg, Ethan; Sullivan, Tami P; Tennen, Howard

2014-09-01

The goal of the present study was to examine whether within-person, episode-specific changes in drinking-to-cope (DTC) motivation from the previous evening were associated with concurrent daily mood and fatigue-related symptoms among college student drinkers (N = 1,421; 54% female). We conducted an Internet-based daily diary study in which students reported over 30 days on their previous night's drinking level and motivation and their current mood (i.e., sadness, anxiety, anger/hostility, and positive mood) and fatigue-related symptoms. Hypotheses were tested using hierarchical linear models in which the current day's outcome was predicted by last night's levels of DTC motivation and drinking, controlling for drinking to enhance motivation, sex, current day's physical symptoms and drinking, and yesterday's level of the outcome. Subsequent models also predicted outcomes 2 days following the drinking event. Relative increases in previous night's DTC motivation were associated with higher levels of current day negative mood and fatigue-related symptoms and lower levels of positive mood. Also, the association between episode-specific DTC motivation and negative mood was stronger in the positive direction when individuals reported higher levels of nonsocial drinking from the previous night. Last, episode-specific DTC showed similar associations with sadness and anger/hostility 2 days after the drinking event. The results are generally consistent with the posited attention allocation and ego-depletion mechanisms. Findings suggest that the deleterious effects of repeated episodes of DTC, over time, could help to explain the increased likelihood of alcohol-related problems seen in prior studies.

Intergenerational effects of parental substance-related convictions and adult drug treatment court participation on children's school performance.

PubMed

Gifford, Elizabeth J; Sloan, Frank A; Eldred, Lindsey M; Evans, Kelly E

2015-09-01

This study examined the intergenerational effects of parental conviction of a substance-related charge on children's academic performance and, conditional on a conviction, whether completion of an adult drug treatment court (DTC) program was associated with improved school performance. State administrative data from North Carolina courts, birth records, and school records were linked for 2005-2012. Math and reading end-of-grade test scores and absenteeism were examined for 5 groups of children, those with parents who: were not convicted on any criminal charge, were convicted on a substance-related charge and not referred by a court to a DTC, were referred to a DTC but did not enroll, enrolled in a DTC but did not complete, and completed a DTC program. Accounting for demographic and socioeconomic factors, the school performance of children whose parents were convicted of a substance-related offense was worse than that of children whose parents were not convicted on any charge. These differences were statistically significant but substantially reduced after controlling for socioeconomic characteristics; for example, mother's educational attainment. We found no evidence that parent participation in an adult DTC program led to improved school performance of their children. While the children of convicted parents fared worse on average, much--but not all--of this difference was attributed to socioeconomic factors, with the result that parental conviction remained a risk factor for poorer school performance. Even though adult DTCs have been shown to have other benefits, we could detect no intergenerational benefit in improved school performance of their children. (c) 2015 APA, all rights reserved).

Observation of Discrete-Time-Crystal Signatures in an Ordered Dipolar Many-Body System

NASA Astrophysics Data System (ADS)

Rovny, Jared; Blum, Robert L.; Barrett, Sean E.

2018-05-01

A discrete time crystal (DTC) is a robust phase of driven systems that breaks the discrete time translation symmetry of the driving Hamiltonian. Recent experiments have observed DTC signatures in two distinct systems. Here we show nuclear magnetic resonance observations of DTC signatures in a third, strikingly different system: an ordered spatial crystal. We use a novel DTC echo experiment to probe the coherence of the driven system. Finally, we show that interactions during the pulse of the DTC sequence contribute to the decay of the signal, complicating attempts to measure the intrinsic lifetime of the DTC.

Observation of Discrete-Time-Crystal Signatures in an Ordered Dipolar Many-Body System.

PubMed

Rovny, Jared; Blum, Robert L; Barrett, Sean E

2018-05-04

A discrete time crystal (DTC) is a robust phase of driven systems that breaks the discrete time translation symmetry of the driving Hamiltonian. Recent experiments have observed DTC signatures in two distinct systems. Here we show nuclear magnetic resonance observations of DTC signatures in a third, strikingly different system: an ordered spatial crystal. We use a novel DTC echo experiment to probe the coherence of the driven system. Finally, we show that interactions during the pulse of the DTC sequence contribute to the decay of the signal, complicating attempts to measure the intrinsic lifetime of the DTC.

Association between CYP2E1 polymorphisms and risk of differentiated thyroid carcinoma.

PubMed

Pellé, Lucia; Cipollini, Monica; Tremmel, Roman; Romei, Cristina; Figlioli, Gisella; Gemignani, Federica; Melaiu, Ombretta; De Santi, Chiara; Barone, Elisa; Elisei, Rossella; Seiser, Eric; Innocenti, Federico; Zanger, Ulrich M; Landi, Stefano

2016-12-01

Differentiated thyroid carcinoma (DTC) results from complex interactions between genetic and environmental factors. Known etiological factors include exposure to ionizing radiations, previous thyroid diseases, and hormone factors. It has been speculated that dietary acrylamide (AA) formed in diverse foods following the Maillard's reaction could be a contributing factor for DTC in humans. Upon absorption, AA is biotransformed mainly by cytochrome P450 2E1 (CYP2E1) to glycidamide (GA). Considering that polymorphisms within CYP2E1 were found associated with endogenous levels of AA-Valine and GA-Valine hemoglobin adducts in humans, we raised the hypothesis that specific CYP2E1 genotypes could be associated with the risk of DTC. Analysis of four haplotype tagging SNPs (ht-SNPs) within the locus in a discovery case-control study (N = 350/350) indicated an association between rs2480258 and DTC risk. This ht-SNP resides within a linkage disequilibrium block spanning intron VIII and the 3'-untranslated region. Extended analysis in a large replication set (2429 controls and 767 cases) confirmed the association, with odds ratios for GA and AA genotypes of 1.24 (95 % confidence interval (CI) 1.03-1.48) and 1.56 (95 % CI, 1.06-2.30), respectively. Functionally, the minor allele was associated with low levels of CYP2E1 mRNA and protein expression as well as lower enzymatic activity in a series of 149 human liver samples. Our data support the hypothesis that inter-individual differences in CYP2E1 activity could modulate the risk of developing DTC suggesting that the exposure to specific xenobiotics, such as AA, could play a role in this process.

A high speed model-based approach for wavefront sensorless adaptive optics systems

NASA Astrophysics Data System (ADS)

Lianghua, Wen; Yang, Ping; Shuai, Wang; Wenjing, Liu; Shanqiu, Chen; Xu, Bing

2018-02-01

To improve temporal-frequency property of wavefront sensorless adaptive optics (AO) systems, a fast general model-based aberration correction algorithm is presented. The fast general model-based approach is based on the approximately linear relation between the mean square of the aberration gradients and the second moment of far-field intensity distribution. The presented model-based method is capable of completing a mode aberration effective correction just applying one disturbing onto the deformable mirror(one correction by one disturbing), which is reconstructed by the singular value decomposing the correlation matrix of the Zernike functions' gradients. Numerical simulations of AO corrections under the various random and dynamic aberrations are implemented. The simulation results indicate that the equivalent control bandwidth is 2-3 times than that of the previous method with one aberration correction after applying N times disturbing onto the deformable mirror (one correction by N disturbing).

Wavefront sensorless adaptive optics OCT with the DONE algorithm for in vivo human retinal imaging [Invited

PubMed Central

Verstraete, Hans R. G. W.; Heisler, Morgan; Ju, Myeong Jin; Wahl, Daniel; Bliek, Laurens; Kalkman, Jeroen; Bonora, Stefano; Jian, Yifan; Verhaegen, Michel; Sarunic, Marinko V.

2017-01-01

In this report, which is an international collaboration of OCT, adaptive optics, and control research, we demonstrate the Data-based Online Nonlinear Extremum-seeker (DONE) algorithm to guide the image based optimization for wavefront sensorless adaptive optics (WFSL-AO) OCT for in vivo human retinal imaging. The ocular aberrations were corrected using a multi-actuator adaptive lens after linearization of the hysteresis in the piezoelectric actuators. The DONE algorithm succeeded in drastically improving image quality and the OCT signal intensity, up to a factor seven, while achieving a computational time of 1 ms per iteration, making it applicable for many high speed applications. We demonstrate the correction of five aberrations using 70 iterations of the DONE algorithm performed over 2.8 s of continuous volumetric OCT acquisition. Data acquired from an imaging phantom and in vivo from human research volunteers are presented. PMID:28736670

Wavefront sensorless adaptive optics OCT with the DONE algorithm for in vivo human retinal imaging [Invited].

PubMed

Verstraete, Hans R G W; Heisler, Morgan; Ju, Myeong Jin; Wahl, Daniel; Bliek, Laurens; Kalkman, Jeroen; Bonora, Stefano; Jian, Yifan; Verhaegen, Michel; Sarunic, Marinko V

2017-04-01

In this report, which is an international collaboration of OCT, adaptive optics, and control research, we demonstrate the Data-based Online Nonlinear Extremum-seeker (DONE) algorithm to guide the image based optimization for wavefront sensorless adaptive optics (WFSL-AO) OCT for in vivo human retinal imaging. The ocular aberrations were corrected using a multi-actuator adaptive lens after linearization of the hysteresis in the piezoelectric actuators. The DONE algorithm succeeded in drastically improving image quality and the OCT signal intensity, up to a factor seven, while achieving a computational time of 1 ms per iteration, making it applicable for many high speed applications. We demonstrate the correction of five aberrations using 70 iterations of the DONE algorithm performed over 2.8 s of continuous volumetric OCT acquisition. Data acquired from an imaging phantom and in vivo from human research volunteers are presented.

BP artificial neural network based wave front correction for sensor-less free space optics communication

NASA Astrophysics Data System (ADS)

Li, Zhaokun; Zhao, Xiaohui

2017-02-01

The sensor-less adaptive optics (AO) is one of the most promising methods to compensate strong wave front disturbance in free space optics communication (FSO). The back propagation (BP) artificial neural network is applied for the sensor-less AO system to design a distortion correction scheme in this study. This method only needs one or a few online measurements to correct the wave front distortion compared with other model-based approaches, by which the real-time capacity of the system is enhanced and the Strehl Ratio (SR) is largely improved. Necessary comparisons in numerical simulation with other model-based and model-free correction methods proposed in Refs. [6,8,9,10] are given to show the validity and advantage of the proposed method.

Trust in prescription drug brand websites: website trust cues, attitude toward the website, and behavioral intentions.

PubMed

Huh, Jisu; Shin, Wonsun

2014-01-01

Direct-to-consumer (DTC) prescription drug brand websites, as a form of DTC advertising, are receiving increasing attention due to the growing number and importance as an ad and a consumer information source. This study examined consumer trust in a DTC website as an important factor influencing consumers' attitude toward the website and behavioral intention. Applying the conceptual framework of website trust, the particular focus of investigation was the effect of the website trust cue factor on consumers' perceived DTC website trust and subsequent attitudinal and behavioral responses. Results show a significant relation between the website trust cue factor and consumers' perceived DTC website trust. Perceived DTC website trust, in turn, was found to be significantly associated with consumers' attitude toward the DTC website and behavioral intention.

The association of consumer cost-sharing and direct-to-consumer advertising with prescription drug use.

PubMed

Hansen, Richard A; Schommer, Jon C; Cline, Richard R; Hadsall, Ronald S; Schondelmeyer, Stephen W; Nyman, John A

2005-06-01

Previous research on the impact of various cost-sharing strategies on prescription drug use has not considered the impact of direct-to-consumer (DTC) advertising. To explore the association of cost-containment strategies with prescription drug use and to determine if the association is moderated by DTC prescription drug advertising. The study population included 288 280 employees and dependents aged 18 to 65 years with employer-sponsored health insurance contributing to the MEDSTAT MarketScan administrative data set. Person-level enrollment and claims data were obtained for beneficiaries enrolled continuously during July 1997 through December 1998. Direct-to-consumer advertising data were obtained from Competitive Media Reporting and linked to the MEDSTAT enrollment files. Localized DTC advertising expenditures for one class of medication were evaluated and matched with prescription claims for eligible MEDSTAT contributors. The association of various types and levels of cost-sharing incentives with incident product use was evaluated, controlling for the level of DTC advertising, health status, and other demographic covariates. The relationship of cost-sharing amounts with drug use was modified by the level of DTC advertising in a geographic market. This relationship was dependent on the type of cost-sharing, distinguishing between co-payments for provider visits and co-payments for prescription drugs. Compared with low-advertising markets, individuals residing in markets with high levels of advertising and paying provider co-payments of $10.00 or more were more likely to use the advertised product. In the same markets, higher prescription drug co-payments were associated with a decreased likelihood of using the advertised product. A similar relationship was not observed for the nonadvertised competitor. Among insured individuals, response to cost-sharing strategies is moderated by DTC prescription drug advertising. The relative ability of cost-sharing strategies to influence drug use should be interpreted with caution in the presence of DTC advertising.

Telehealth physician oversight over direct to consumer testing: doctors working with patients towards patient empowerment.

PubMed

Chung, Rick

2012-06-01

Patient empowerment has increased the demand for direct to consumer (DTC) laboratory testing. Multiple professional societies and advocacy groups have raised concerns over how DTC laboratory testing is being offered to consumers without proper physician oversight. Physician telehealth services can properly oversee DTC laboratory testing in a safe and medically sound manner. Using telehealth protocols and standards established by professional health organizations and state regulators, physician telehealth oversight in DTC laboratory test ordering can be effective to increase patient access to healthcare services. With proper physician oversight in test interpretation, post-test counseling, and information collaboration, DTC laboratory testing can remain a reliable and convenient option for consumers. Working within the channel of distribution of most DTC laboratory testing, physician telehealth services can properly oversee DTC laboratory testing in a safe and medically sound manner to ensure that proper test interpretation, counseling, and information collaboration are achieved. Physician telehealth services can properly oversee DTC laboratory testing to ensure that proper test interpretation, counseling, and information collaboration are achieved.

The Impact of Risk Information Exposure on Women’s Beliefs about Direct-to-Consumer Genetic Testing for BRCA Mutations

PubMed Central

Gray, Stacy W.; Hornik, Robert C.; Schwartz, J. Sanford; Armstrong, Katrina

2011-01-01

Despite an increase in direct-to-consumer (DTC) genetic testing, little is known about how variations in website content might alter consumer behavior. We evaluated the impact of risk information provision on women’s attitudes about DTC BRCA testing. We conducted a randomized experiment; women viewed a “mock” BRCA testing website without (control group: CG) or with information on the potential risks of DTC testing (RG; framed two ways: unattributed information [UR] and information presented by experts [ER]). 767 women participated; mean age was 37 years, mean education was 15 years, and 79% of subjects were white. Women in the RG had less positive beliefs about DTC testing (mean RG=23.8, CG=25.2; p=0.001), lower intentions to get tested (RG= 2.8, CG= 3.1; p=0.03), were more likely to prefer clinic-based testing (RG=5.1, CG=4.8; p=0.03) and to report that they had seen enough risk information (RG=5.3, CG= 4.7; p<0.001). UR and ER exposure produced similar effects. Effects did not differ for women with or without a personal/family history of breast/ovarian cancer. Exposing women to the potential risks of DTC BRCA testing altered their beliefs, preferences, and intentions. Risk messages appear to be salient to women irrespective of their chance of having a BRCA mutation. PMID:21992449

Intergenerational effects of parental substance-related convictions and adult drug treatment court participation on children’s school performance

PubMed Central

Gifford, Elizabeth J.; Sloan, Frank A.; Evans, Kelly E.

2015-01-01

Objective This study examined the intergenerational effects of parental conviction of a substance-related charge on children’s academic performance and, conditional on a conviction, whether completion of an adult drug treatment court (DTC) program was associated with improved school performance. Method State administrative data from North Carolina courts, birth records, and school records were linked for 2005–12. Math and reading end-of-grade test scores and absenteeism were examined for 5 groups of children, those with parents who: were not convicted on any criminal charge, were convicted on a substance-related charge and not referred by a court to a DTC, were referred to a DTC but did not enroll, enrolled in a DTC but did not complete, and completed a DTC program. Results Accounting for demographic and socioeconomic factors, the school performance of children whose parents were convicted of a substance-related offense was worse than that of children whose parents were not convicted on any charge. These differences were statistically significant but substantially reduced after controlling for socioeconomic characteristics, e.g., mother’s educational attainment. We found no evidence that parent participation in an adult DTC program led to improved school performance of their children. Conclusion While the children of convicted parents fared worse on average, much—but not all—of this difference was attributed to socioeconomic factors, with the result that parental conviction remained a risk factor for poorer school performance. Even though adult DTCs have been shown to have other benefits, we could detect no intergenerational benefit in improved school performance of their children. PMID:26460705

Direct-to-consumer advertising of prescription medications: implications for patients with cancer.

PubMed

Viale, Pamela Hallquist

2002-04-01

To review the phenomenon of direct-to-consumer (DTC) advertising of prescription medications in the media, with an overview of pertinent studies in the literature regarding patients' and healthcare professionals' perspectives on DTC advertising. Journal articles, media, and clinical experience. DTC advertising of prescription medications is extremely prevalent in U.S. society. Advertising of medications is an expensive business; yearly spending is expected to reach $7.5 billion by 2005. Although opinions vary regarding DTC advertising, healthcare professionals, including oncology nurses, must be prepared to discuss DTC-advertised medications and treatments with their patients. Communication is the key to helping patients decipher the deluge of DTC advertisements in the media and determine the accuracy of this ever-increasing source of medical information. Oncology nurses need to be aware of the increases in DTC advertising of prescription medications and the importance of guiding patients through appropriate medication choices by education.

76 FR 77281 - Self-Regulatory Organizations; The Depository Trust Company; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-12

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-65901; File No. SR-DTC-2011-10] Self-Regulatory... DTC participants. DTC's experience demonstrates that when participants, issuers, underwriters, agents... Exchange Act Release 24818 (August 19, 1987), 52 FR 31833 (August 24, 1987) (File No. SR-DTC-87-10); 25948...

Disease-specific direct-to-consumer advertising for reminding consumers to take medications.

PubMed

Bhutada, Nilesh S; Rollins, Brent L

2015-01-01

To assess the relationship between disease-specific direct-to-consumer (DTC) advertising, via traditional advertising effectiveness measures, and consumers' self-reported medication-taking behavior. Data were gathered for 514 respondents (age 18 and above) using an online survey panel. Participants were exposed to a disease-specific (i.e., nonbranded) DTC advertising for depression. The advertising stimulus created for the study was based on the Food and Drug Administration guidelines for disease-specific DTC advertising and modeled after current print disease-specific DTC advertising. Participants reviewed the advertising stimulus through the online program and then responded to a questionnaire containing closed-ended questions assessing the constructs. Data were analyzed using chi-square tests. All tests were interpreted at an a priori alpha of 0.05. Significantly more respondents who were highly involved, paid more attention to the advertisement, and were responsive to DTC advertisements in the past indicated that the disease-specific DTC advertising stimulus reminded them to take their depression and other medications. These exploratory results show disease-specific DTC advertising can help people remember to take their prescription medication when viewed, which may lead to more positive medication-taking behavior and increased medication adherence. Additionally, given the fair balance and legal issues surrounding product-specific DTC advertising, disease-specific DTC advertising can serve as an effective component of the marketing mix for pharmaceutical manufacturers. Future research should attempt to study the impact of disease-specific DTC advertising on consumers' actual medication adherence using standardized adherence measures such as prescription records.

"For the good of the patient," survey of the physicians of the National Medical Association regarding perceptions of DTC advertising, Part II, 2006.

PubMed Central

Morris, Albert W.; Gadson, Sandra L.; Burroughs, Valentine

2007-01-01

BACKGROUND: Since the advent of direct-to-consumer (DTC) advertising in the 1980s, there have been numerous studies and surveys on the topic, addressing issues as varied as its impact on patient understanding of health conditions to its repercussions for drug spending. However, until 2001, there was a dearth of research on DTC advertising's impact on minority populations, specifically the African-American community. The National Medical Association (NMA) remedied that in 2001 by undertaking a landmark study that gauged African-American physicians' perceptions of DTC advertising, its impact on the doctor-patient relationship and, perhaps most importantly, its role in educating underserved populations about critical health issues and potential treatments. In 2006, the NMA decided to once again poll its members on this critical issue to gauge not only current perceptions but how the community's understanding of DTC advertising has changed since 2001. RESULTS: The 2006 survey revealed several clear trends: NMA physicians are more positive toward DTC advertising now than they were in 2001; African-American physicians see DTC advertising as providing substantial educational benefits; physicians believe that DTC advertising helps rather than hurts the doctor-patient relationship; and African-American physicians see the benefits of DTC advertising outweighing its drawbacks. It must be noted that NMA physicians also had clear concerns about DTC advertising that point to potential areas of improvement for pharmaceutical companies. PMID:17393955

"For the good of the patient," survey of the physicians of the National Medical Association regarding perceptions of DTC advertising, Part II, 2006.

PubMed

Morris, Albert W; Gadson, Sandra L; Burroughs, Valentine

2007-03-01

Since the advent of direct-to-consumer (DTC) advertising in the 1980s, there have been numerous studies and surveys on the topic, addressing issues as varied as its impact on patient understanding of health conditions to its repercussions for drug spending. However, until 2001, there was a dearth of research on DTC advertising's impact on minority populations, specifically the African-American community. The National Medical Association (NMA) remedied that in 2001 by undertaking a landmark study that gauged African-American physicians' perceptions of DTC advertising, its impact on the doctor-patient relationship and, perhaps most importantly, its role in educating underserved populations about critical health issues and potential treatments. In 2006, the NMA decided to once again poll its members on this critical issue to gauge not only current perceptions but how the community's understanding of DTC advertising has changed since 2001. The 2006 survey revealed several clear trends: NMA physicians are more positive toward DTC advertising now than they were in 2001; African-American physicians see DTC advertising as providing substantial educational benefits; physicians believe that DTC advertising helps rather than hurts the doctor-patient relationship; and African-American physicians see the benefits of DTC advertising outweighing its drawbacks. It must be noted that NMA physicians also had clear concerns about DTC advertising that point to potential areas of improvement for pharmaceutical companies.

Comparison of differentiated thyroid cancer in children and adolescents (≤20 years) with young adults.

PubMed

Alzahrani, Ali S; Alkhafaji, Dania; Tuli, Mahmoud; Al-Hindi, Hindi; Sadiq, Bakr Bin

2016-04-01

Age is a major prognostic factor in differentiated thyroid cancer (DTC). It is not clear if paediatric DTC has a different histopathological profile and outcome than DTC in adult patients <45 years of age. To assess whether DTC in children and adolescents differs from young age group by comparing paediatric DTC (age ≤ 20) with DTC in patients >20 to <45 years of age. We studied all cases of paediatric DTC seen during the period 1998-2011. We compared this group with a large sample of 213 consecutive adult patients in the age group >20 to <45 years seen during the period 1998-1999 in terms of their pathological features, extent of the disease and long-term outcome. Both groups were managed by the same team at a single institution. A total of 310 DTC were studied including 97 paediatric patients [median age 17 years (range, 8-20)] and 213 young adult patients [median age 33 years (range, 20·5-44·9)]. There was no difference in gender distribution, tumour subtypes, size and tumour multifocality, but there was a significantly higher rate of extrathyroidal extension [40/75 (53·3%) vs 81/213 (38·0%), P = 0·03], lymph node [57/73 (78%) vs 102/183 (55·7%), P < 0·0001] and distant metastases [16/97 (16·5%) vs 8/213 (3·8%), P < 0·0001] in the paediatric than the adult groups. Kaplan-Meier analysis showed a higher risk of persistent/recurrent disease in the paediatric group than adults (log-rank test 0·03). However, there was no mortality secondary to DTC in both groups. Paediatric DTC is distinct from DTC in the young adults (age >20 to <45 years). It is characterized by a higher rate of extrathyroidal extension, lymph node and distant metastases and a higher risk of persistent/recurrent DTC. © 2015 John Wiley & Sons Ltd.

Lack of CHEK2 gene mutations in differentiated thyroid carcinoma patients using high resolution melting analysis.

PubMed

Fayaz, Shima; Fard-Esfahani, Pezhman; Torbati, Peyman Mohammadi

2014-01-01

Recently, mutations in the genes involved in cell cycle control, including CHEK2, are being considered as etiological factors in different kinds of cancers. The CHEK2 protein plays an important role in protecting damaged DNA from entering mitosis. In this study the potential effects of two common mutations IVS2+1G?A and Ile157Thr of CHEK2 gene in differentiated thyroid carcinoma (DTC) were evaluated. A total of 100 patients admitted to the Research Institute for Nuclear Medicine were diagnosed with DTC based on pathology reports of surgery samples. An additional 100 people were selected as a control group with no cancer history. PCR-HRM (high resolution melting) analysis was performed to deal with each of mutations in all case and control samples separately. During the analysis of IVS2+1G?A and Ile157Thr mutations of CHEK2 gene in the case and control groups, all the samples were identified as wild homozygote type. The finding suggests that IVS2+1G?A and Ile157Thr mutations of CHEK2 gene do not constitute a risk factor for DTC in the Iranian population. However, further studies with a larger population are required to confirm the outcome.

Improving Dual-Task Control With a Posture-Second Strategy in Early-Stage Parkinson Disease.

PubMed

Huang, Cheng-Ya; Chen, Yu-An; Hwang, Ing-Shiou; Wu, Ruey-Meei

2018-03-31

To examine the task prioritization effects on postural-suprapostural dual-task performance in patients with early-stage Parkinson disease (PD) without clinically observed postural symptoms. Cross-sectional study. Participants performed a force-matching task while standing on a mobile platform, and were instructed to focus their attention on either the postural task (posture-first strategy) or the force-matching task (posture-second strategy). University research laboratory. Individuals (N=16) with early-stage PD who had no clinically observed postural symptoms. Not applicable. Dual-task change (DTC; percent change between single-task and dual-task performance) of posture error, posture approximate entropy (ApEn), force error, and reaction time (RT). Positive DTC values indicate higher postural error, posture ApEn, force error, and force RT during dual-task conditions compared with single-task conditions. Compared with the posture-first strategy, the posture-second strategy was associated with smaller DTC of posture error and force error, and greater DTC of posture ApEn. In contrast, greater DTC of force RT was observed under the posture-second strategy. Contrary to typical recommendations, our results suggest that the posture-second strategy may be an effective dual-task strategy in patients with early-stage PD who have no clinically observed postural symptoms in order to reduce the negative effect of dual tasking on performance and facilitate postural automaticity. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Genetic counseling and the ethical issues around direct to consumer genetic testing.

PubMed

Hawkins, Alice K; Ho, Anita

2012-06-01

Over the last several years, direct to consumer(DTC) genetic testing has received increasing attention in the public, healthcare and academic realms. DTC genetic testing companies face considerable criticism and scepticism,particularly from the medical and genetic counseling community. This raises the question of what specific aspects of DTC genetic testing provoke concerns, and conversely,promises, for genetic counselors. This paper addresses this question by exploring DTC genetic testing through an ethic allens. By considering the fundamental ethical approaches influencing genetic counseling (the ethic of care and principle-based ethics) we highlight the specific ethical concerns raised by DTC genetic testing companies. Ultimately,when considering the ethics of DTC testing in a genetic counseling context, we should think of it as a balancing act. We need careful and detailed consideration of the risks and troubling aspects of such testing, as well as the potentially beneficial direct and indirect impacts of the increased availability of DTC genetic testing. As a result it is essential that genetic counselors stay informed and involved in the ongoing debate about DTC genetic testing and DTC companies. Doing so will ensure that the ethical theories and principles fundamental to the profession of genetic counseling are promoted not just in traditional counseling sessions,but also on a broader level. Ultimately this will help ensure that the public enjoys the benefits of an increasingly genetic based healthcare system.

Nutrigenomics and ethics interface: direct-to-consumer services and commercial aspects.

PubMed

Ries, Nola M; Castle, David

2008-12-01

A growing variety and number of genetic tests are advertised and sold directly to consumers (DTC) via the Internet, including nutrigenomic tests and associated products and services. Consumers have more access to genetic information about themselves, but access does not entail certainty about the implications of test results. Potential personal and public health harms and benefits are associated with DTC access to genetic testing services. Early policy responses to direct-to-consumer (DTC) genetic testing often involved calls for bans, and some jurisdictions prohibited DTC genetic tests. Recent policy responses by oversight bodies acknowledge expansion in the range of DTC tests available and suggest that a "one-size-fits-all" regulatory approach is not appropriate for all genetic tests. This review discusses ethical and regulatory aspects of DTC genetic testing, focusing particularly on nutrigenomic tests. We identify policy options for regulating DTC genetic tests, including full or partial prohibitions, enforcement of existing truth-in-advertising laws, and more comprehensive information disclosure about genetic tests. We advocate the latter option as an important means to improve transparency about current evidence on the strengths and limits of gene-disease associations and allow consumers to make informed purchasing decisions in the DTC marketplace.

Drinking to Cope Motivation as a Prospective Predictor of Negative Affect.

PubMed

Armeli, Stephen; Sullivan, Tami P; Tennen, Howard

2015-07-01

Consistent with research indicating that drinking to cope (DTC) motivation might exacerbate negative affective states within or immediately proximal to discrete drinking episodes, we examined whether yearly deviations in more global levels of DTC motivation prospectively predicted depressive and anxious affect over several weeks. College students (N = 521, 52% women) completed baseline measures of drinking motives, recent depression and anxiety symptoms, recent alcohol use, and alcohol use disorder symptoms on a secure website. Approximately 2 weeks after completing this survey, participants completed the 30-day daily diary portion of the study in which they reported on their current-day affective states. This yearly assessment burst in which participants completed a baseline survey and a daily diary assessment was repeated for 3 additional years. We found that changes in DTC motivation were positively associated with changes in depressive and anxious affect in the subsequent month, after we controlled for changes in concurrent anxiety and depressive symptoms, drinking level, enhancement drinking motivation, and alcohol use disorder symptoms. Our findings are consistent with the notion that DTC motivation confers a unique vulnerability for emotion dysregulation, and that drinking for such reasons possibly prolongs or exacerbates negative affective states.

Direct-to-consumer testing: more risks than opportunities.

PubMed

Lippi, G; Favaloro, E J; Plebani, M

2011-12-01

As a result of incessant genetic discoveries and remarkable technological advancements, the availability and the consequent consumer's request for genetic testing are growing exponentially, leading to the development of a 'parallel' market, i.e. the direct-to-consumer (DTC) testing, also known as 'direct access testing' (DAT). Analogous to the traditional laboratory diagnostics, drawbacks of DTC testing might arise from any step characterising the total testing process, and include poor control of both appropriateness and preanalytical requirements, potential operation outside national or international regulation for in vitro diagnostic testing, little evidence of quality as well as the risk of transfer of genetic materials from the companies to other entities. Another important issue is the test panels offered to consumers, which are often based on preliminary, speculative or unsupported scientific information. Finally, the potential of this type of testing to generate anxiety or false reassurance should also be carefully considered. Although DTC testing carries some theoretical advantages (e.g. greater consumer autonomy and empowerment), solid clinical studies and costs vs. benefit analyses are needed to definitely establish whether DTC testing might be effective for decreasing the burden of diseases, delay their onset or modify their progression and therefore the clinical outcome. © 2011 Blackwell Publishing Ltd.

Silver-gelatine bionanocomposites for qualitative detection of a pesticide by SERS.

PubMed

Fateixa, S; Soares, S F; Daniel-da-Silva, A L; Nogueira, H I S; Trindade, T

2015-03-07

The controlled release of pesticides using hydrogel vehicles is an important procedure to limit the amount of these compounds in the environment, providing an effective way for crop protection. A key-step in the formulation of new materials for these purposes encompasses the monitoring of available pesticides in the gel matrix under variable working conditions. In this work, we report a series of bionanocomposites made of Ag nanoparticles (NPs) and gelatine A for the surface enhanced Raman scattering (SERS) detection of sodium diethyldithiocarbamate (EtDTC) as a pesticide model. These studies demonstrate the effectiveness of these substrates for the detection of EtDTC in aqueous solutions in a concentration as low as 10(-5) M. We have monitored the Raman signal enhancement of this analyte in bionanocomposites having an increasing amount of gelatine due to their relevance in formulating hydrogels of variable gel strengths. Under these conditions, the bionanocomposites have shown an effective SERS activity using EtDTC, demonstrating their effectiveness in the qualitative detection of this analyte. Finally, experiments involving the release of EtDTC from Ag/gelatine samples have been monitored by SERS, which attest the potential of this spectroscopic method in the laboratorial monitoring of hydrogels for pesticide release.

If It Works for Pills, Can It Work for Skills? Direct-to-Consumer Social Marketing of Evidence-Based Psychological Treatments.

PubMed

Friedberg, Robert D; Bayar, Hasan

2017-06-01

The emergence of evidence-based psychological treatments (EVPTs) is a scientific success story, but unfortunately the application of these empirically supported procedures has been slow to gain ground in treatment-as-usual settings. This Open Forum commentary argues that direct-to-consumer (DTC) marketing, which has worked well in communicating the advantages of various medicines, should perhaps be considered for use in social marketing of EVPTs. DTC marketing of pharmaceuticals is a long-standing advertising strategy in the United States. In fact, DTC marketing of psychotropic medicines is quite a success story. The authors recommend various strategies for using marketing science to devise DTC advertising of EVPTs, discuss previous research on DTC campaigns, and describe initiatives launched in the United Kingdom and Europe to promote EVPTs. Suggestions for evaluating and regulating DTC marketing of EVPTs are included. Finally, the potential for DTC marketing of EVPTs to increase mental health literacy and reduce health disparities is explored.

Direct-to-consumer DNA testing and the GP.

PubMed

Trent, Ronald

2014-07-01

From early 2000 a new form of DNA genetic testing became available commercially. It bypasses the medical practitioner and can be ordered directly by the individual. To understand direct-to-consumer (DTC) DNA genetic testing and be able to respond appropriately if asked to be involved by a patient. Presently, all but one or two DTC DNA genetic testing laboratories are located outside Australia. The industry promotes itself as a means to better health through giving individuals complete control over their results. When communicating with patients about DTC DNA genetic testing, general practitioners will need to make a determination about the clinical utility of the test and the laboratory validity, both of which can be difficult in the current environment. Assistance may be available through public hospital clinical genetics services, although waiting times can be long. There is likely to be tighter regulation of these types of testing in the future, which may include involvement of medical practitioners.

Bearingless Flywheel Systems, Winding and Control Schemes, and Sensorless Control

NASA Technical Reports Server (NTRS)

Kascak, Peter E (Inventor); Jansen, Ralph H (Inventor); Trase, Larry M (Inventor); Dever, Timothy P (Inventor); Kraft, Thomas G (Inventor)

2016-01-01

Flywheel systems are disclosed that provide increased energy density and operational effectiveness. A first bearingless motor and a second bearingless motor may be configured to simultaneously suspend the central rotor in a radial direction and to rotate the central rotor. However, certain implementations may have one motor or more than two motors, depending on the design. A plurality of the flywheel systems may be collectively controlled to perform community energy storage with higher storage capacities than individual flywheel systems.

A Flywheel Energy Storage System Demonstration for Space Applications

NASA Technical Reports Server (NTRS)

Kenny, Barbara H.; Kascak, Peter E.; Jansen, Ralph; Dever, Timothy

2003-01-01

A novel control algorithm for the charge and discharge modes of operation of a flywheel energy storage system for space applications is presented. The motor control portion of the algorithm uses sensorless field oriented control with position and speed estimates determined from a signal injection technique at low speeds and a back EMF technique at higher speeds. The charge and discharge portion of the algorithm use command feed-forward and disturbance decoupling, respectively, to achieve fast response with low gains. Simulation and experimental results are presented.

Prescription drug advertising: is it a driving force on drug pricing?

PubMed

Millstein, Lloyd G

2003-01-01

It has been shown that drug companies will sell more drugs when they use DTC advertising, but it is also true that many consumers who are suffering--unaware there is help for their symptoms--will learn from these ads that help is available. Advertising to consumers, like advertising to professionals, will continue to be one of the best methods of providing information. Of course, healthcare professionals also have the sales representatives, their colleagues, medical journals, and medical conventions as additional options for needed information. The consumer may or may not use other methods, such as the Internet, the library or friends or family, but the advertising is a starting point for a dialogue. If the DTC ad provides consumers with "information," which is different from "advertising," the drug company will be providing a worthwhile service to consumers and potential patients. No doubt consumers will begin demanding higher quality information from DTC ads and will frown upon the ads that are blatantly trying just to sell a drug. It will also reap the benefits of improved consumer awareness and patient compliance. A DTC ad that is consumer-friendly, does not use fear appeal, is educational in tone, and downplays the "hard sell" and hype will go a long way in offering important information to the casual observer. Oversight by the FDA will ensure the information meets the requirements they have set down for prescription drug advertising. That is, advertising will be truthful and fairly balanced and will meet what the government, consumers and, no doubt, the medical community wants. Attempting to control drug costs, by controlling advertising, will not be an easy task. This has an implication across all product areas, not just drugs. DTC advertising has become a lightening rod for cost containment issues, but is it alone driving demand for prescription products? I don't think so.

Attitudes About Regulation Among Direct-to-Consumer Genetic Testing Customers

PubMed Central

Green, Robert C.; Kaufman, David

2013-01-01

Introduction: The first regulatory rulings by the U.S. Food and Drug Administration on direct-to-consumer (DTC) genetic testing services are expected soon. As the process of regulating these and other genetic tests moves ahead, it is important to understand the preferences of DTC genetic testing customers about the regulation of these products. Methods: An online survey of customers of three DTC genetic testing companies was conducted 2–8 months after they had received their results. Participants were asked about the importance of regulating the companies selling DTC genetic tests. Results: Most of the 1,046 respondents responded that it would be important to have a nongovernmental (84%) or governmental agency (73%) monitor DTC companies' claims to ensure the consistency with scientific evidence. However, 66% also felt that it was important that DTC tests be available without governmental oversight. Nearly, all customers favored a policy to ensure that insurers and law enforcement officials could not access their information. Discussion: Although many DTC customers want access to genetic testing services without restrictions imposed by the government regulation, most also favor an organization operating alongside DTC companies that will ensure that the claims made by the companies are consistent with sound scientific evidence. This seeming contradiction may indicate that DTC customers want to ensure that they have unfettered access to high-quality information. Additionally, policies to help ensure privacy of data would be welcomed by customers, despite relatively high confidence in the companies. PMID:23560882

Attitudes about regulation among direct-to-consumer genetic testing customers.

PubMed

Bollinger, Juli Murphy; Green, Robert C; Kaufman, David

2013-05-01

The first regulatory rulings by the U.S. Food and Drug Administration on direct-to-consumer (DTC) genetic testing services are expected soon. As the process of regulating these and other genetic tests moves ahead, it is important to understand the preferences of DTC genetic testing customers about the regulation of these products. An online survey of customers of three DTC genetic testing companies was conducted 2-8 months after they had received their results. Participants were asked about the importance of regulating the companies selling DTC genetic tests. Most of the 1,046 respondents responded that it would be important to have a nongovernmental (84%) or governmental agency (73%) monitor DTC companies' claims to ensure the consistency with scientific evidence. However, 66% also felt that it was important that DTC tests be available without governmental oversight. Nearly, all customers favored a policy to ensure that insurers and law enforcement officials could not access their information. Although many DTC customers want access to genetic testing services without restrictions imposed by the government regulation, most also favor an organization operating alongside DTC companies that will ensure that the claims made by the companies are consistent with sound scientific evidence. This seeming contradiction may indicate that DTC customers want to ensure that they have unfettered access to high-quality information. Additionally, policies to help ensure privacy of data would be welcomed by customers, despite relatively high confidence in the companies.

Nonlinear SVM-DTC for induction motor drive using input-output feedback linearization and high order sliding mode control.

PubMed

Ammar, Abdelkarim; Bourek, Amor; Benakcha, Abdelhamid

2017-03-01

This paper presents a nonlinear Direct Torque Control (DTC) strategy with Space Vector Modulation (SVM) for an induction motor. A nonlinear input-output feedback linearization (IOFL) is implemented to achieve a decoupled torque and flux control and the SVM is employed to reduce high torque and flux ripples. Furthermore, the control scheme performance is improved by inserting a super twisting speed controller in the outer loop and a load torque observer to enhance the speed regulation. The combining of dual nonlinear strategies ensures a good dynamic and robustness against parameters variation and disturbance. The system stability has been analyzed using Lyapunov stability theory. The effectiveness of the control algorithm is investigated by simulation and experimental validation using Matlab/Simulink software with real-time interface based on dSpace 1104. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

Real time optimization algorithm for wavefront sensorless adaptive optics OCT (Conference Presentation)

NASA Astrophysics Data System (ADS)

Verstraete, Hans R. G. W.; Heisler, Morgan; Ju, Myeong Jin; Wahl, Daniel J.; Bliek, Laurens; Kalkman, Jeroen; Bonora, Stefano; Sarunic, Marinko V.; Verhaegen, Michel; Jian, Yifan

2017-02-01

Optical Coherence Tomography (OCT) has revolutionized modern ophthalmology, providing depth resolved images of the retinal layers in a system that is suited to a clinical environment. A limitation of the performance and utilization of the OCT systems has been the lateral resolution. Through the combination of wavefront sensorless adaptive optics with dual variable optical elements, we present a compact lens based OCT system that is capable of imaging the photoreceptor mosaic. We utilized a commercially available variable focal length lens to correct for a wide range of defocus commonly found in patient eyes, and a multi-actuator adaptive lens after linearization of the hysteresis in the piezoelectric actuators for aberration correction to obtain near diffraction limited imaging at the retina. A parallel processing computational platform permitted real-time image acquisition and display. The Data-based Online Nonlinear Extremum seeker (DONE) algorithm was used for real time optimization of the wavefront sensorless adaptive optics OCT, and the performance was compared with a coordinate search algorithm. Cross sectional images of the retinal layers and en face images of the cone photoreceptor mosaic acquired in vivo from research volunteers before and after WSAO optimization are presented. Applying the DONE algorithm in vivo for wavefront sensorless AO-OCT demonstrates that the DONE algorithm succeeds in drastically improving the signal while achieving a computational time of 1 ms per iteration, making it applicable for high speed real time applications.

Fast correction approach for wavefront sensorless adaptive optics based on a linear phase diversity technique.

PubMed

Yue, Dan; Nie, Haitao; Li, Ye; Ying, Changsheng

2018-03-01

Wavefront sensorless (WFSless) adaptive optics (AO) systems have been widely studied in recent years. To reach optimum results, such systems require an efficient correction method. This paper presents a fast wavefront correction approach for a WFSless AO system mainly based on the linear phase diversity (PD) technique. The fast closed-loop control algorithm is set up based on the linear relationship between the drive voltage of the deformable mirror (DM) and the far-field images of the system, which is obtained through the linear PD algorithm combined with the influence function of the DM. A large number of phase screens under different turbulence strengths are simulated to test the performance of the proposed method. The numerical simulation results show that the method has fast convergence rate and strong correction ability, a few correction times can achieve good correction results, and can effectively improve the imaging quality of the system while needing fewer measurements of CCD data.

Adjustable Speed Drive Project for Teaching a Servo Systems Course Laboratory

ERIC Educational Resources Information Center

Rodriguez-Resendiz, J.; Herrera-Ruiz, G.; Rivas-Araiza, E. A.

2011-01-01

This paper describes an adjustable speed drive for a three-phase motor, which has been implemented as a design for a servo system laboratory course in an engineering curriculum. The platform is controlled and analyzed in a LabVIEW environment and run on a PC. Theory is introduced in order to show the sensorless algorithms. These are computed by…

Novel genome-wide association study-based candidate loci for differentiated thyroid cancer risk.

PubMed

Figlioli, Gisella; Köhler, Aleksandra; Chen, Bowang; Elisei, Rossella; Romei, Cristina; Cipollini, Monica; Cristaudo, Alfonso; Bambi, Franco; Paolicchi, Elisa; Hoffmann, Per; Herms, Stefan; Kalemba, Michał; Kula, Dorota; Pastor, Susana; Marcos, Ricard; Velázquez, Antonia; Jarząb, Barbara; Landi, Stefano; Hemminki, Kari; Försti, Asta; Gemignani, Federica

2014-10-01

Genome-wide association studies (GWASs) on differentiated thyroid cancer (DTC) have identified robust associations with single nucleotide polymorphisms (SNPs) at 9q22.33 (FOXE1), 14q13.3 (NKX2-1), and 2q35 (DIRC3). Our recently published GWAS suggested additional susceptibility loci specific for the high-incidence Italian population. The purpose of this study was to identify novel Italian-specific DTC risk variants based on our GWAS and to test them further in low-incidence populations. We investigated 45 SNPs selected from our GWAS first in an Italian population. SNPs that showed suggestive evidence of association were investigated in the Polish and Spanish cohorts. The combined analysis of the GWAS and the Italian replication study (2260 case patients and 2218 control subjects) provided strong evidence of association with rs10136427 near BATF (odds ratio [OR] =1.40, P = 4.35 × 10(-7)) and rs7267944 near DHX35 (OR = 1.39, P = 2.13 × 10(-8)). A possible role in DTC susceptibility in the Italian populations was also found for rs13184587 (ARSB) (P = 8.54 × 10(-6)) and rs1220597 (SPATA13) (P = 3.25 × 10(-6)). Only the associations between rs10136427 and rs7267944 and DTC risk were replicated in the Polish and the Spanish populations with little evidence of population heterogeneity (GWAS and all replications combined, OR = 1.30, P = 9.30 × 10(-7) and OR = 1.32, P = 1.34 × 10(-8), respectively). In silico analyses provided new insights into the possible functional consequences of the SNPs that showed the strongest association with DTC. Our findings provide evidence for novel DTC susceptibility variants. Further studies are warranted to identify the specific genetic variants responsible for the observed associations and to functionally validate our in silico predictions.

Walking and cognition, but not symptoms, correlate with dual task cost of walking in multiple sclerosis.

PubMed

Motl, Robert W; Sosnoff, Jacob J; Dlugonski, Deirdre; Pilutti, Lara A; Klaren, Rachel; Sandroff, Brian M

2014-03-01

Performing a cognitive task while walking results in a reduction of walking performance among persons with MS. To date, very little is known about correlates of this dual task cost (DTC) of walking in MS. We examined walking performance, cognitive processing speed, and symptoms of fatigue, depression, anxiety, and pain as correlates of DTC of walking in MS. 82 persons with MS undertook a 6-min walk test (6MWT) and completed the Symbol Digit Modalities Test (SDMT), Fatigue Severity Scale (FSS), Short-form of the McGill Pain Questionnaire (SF-MPQ), Hospital Anxiety and Depression Scale (HADS), and self-reported Expanded Disability Status Scale (SR-EDSS). The participants completed 4 trials of walking at a self-selected pace on an electronic walkway that recorded spatiotemporal parameters of gait. The first 2 trials were performed without a cognitive task, whereas the second 2 trials were completed while performing a modified Word List Generation task. There were significant and large declines in gait performance with the addition of a cognitive task for velocity (p<.001, η2=.52), cadence (p<.001, η2=.49), and step length (p<.001, η2=.23). 6MWT and SDMT scores correlated with DTC for velocity (r=-.41, p<.001 and r=-.32, p<.001, respectively) and step length (r=-.45, p<.001 and r=-.37, p<.001, respectively); there were no significant associations between FSS, SF-MPQ, and HADS scores with the DTC of walking. Regression analyses indicated that 6MW, but not SDMT, explained variance in DTC for velocity (ΔR2=.11, p<.001) and step length (ΔR2=.13, p<.001), after controlling for SR-EDSS scores. Walking performance might be a target of interventions for reducing the DTC of walking in MS. Copyright © 2013 Elsevier B.V. All rights reserved.

Critical Time Crystals in Dipolar Systems

NASA Astrophysics Data System (ADS)

Ho, Wen Wei; Choi, Soonwon; Lukin, Mikhail D.; Abanin, Dmitry A.

2017-07-01

We analyze the quantum dynamics of periodically driven, disordered systems in the presence of long-range interactions. Focusing on the stability of discrete time crystalline (DTC) order in such systems, we use a perturbative procedure to evaluate its lifetime. For 3D systems with dipolar interactions, we show that the corresponding decay is parametrically slow, implying that robust, long-lived DTC order can be obtained. We further predict a sharp crossover from the stable DTC regime into a regime where DTC order is lost, reminiscent of a phase transition. These results are in good agreement with the recent experiments utilizing a dense, dipolar spin ensemble in diamond [Nature (London) 543, 221 (2017), 10.1038/nature21426]. They demonstrate the existence of a novel, critical DTC regime that is stabilized not by many-body localization but rather by slow, critical dynamics. Our analysis shows that the DTC response can be used as a sensitive probe of nonequilibrium quantum matter.

What nurse practitioners should know about direct-to-consumer advertising of prescription medications.

PubMed

Viale, Pamela Hallquist

2003-07-01

To describe the marketing strategies of direct-to-consumer (DTC) advertising and the risks, benefits, and potential influence on the prescribing practices of nurse practitioners (NPs). Journal articles, media sources, and clinical experience. The effect of DTC advertising of prescription medications on NPs has not been well studied. Although there are studies that examine the effects of DTC advertising on physician prescribing as well as the effects of this practice on the consumer, opinions on the benefits of DTC advertising are varied. NPs need to recognize the potential influence of DTC advertising and to be prepared to guide patients toward appropriate medication choices by participating in a partnership with patients. Health care providers, including NPs, need to work with the pharmaceutical industry to encourage accountability of DTC advertising, thus improving dissemination of correct information and promoting positive outcomes for health consumers and patients.

A comparison of the International Classification of Functioning, Disability, and Health to the disability tax credit.

PubMed

Conti-Becker, Angela; Doralp, Samantha; Fayed, Nora; Kean, Crystal; Lencucha, Raphael; Leyshon, Rhysa; Mersich, Jackie; Robbins, Shawn; Doyle, Phillip C

2007-01-01

The Disability Tax Credit (DTC) Certification is an assessment tool used to provide Canadians with disability tax relief The International Classification of Functioning, Disability and Health (ICF) provides a universal framework for defining disability. The purpose of this study was to evaluate the DTC and familiarize occupational therapists with the process of mapping measures to the ICF classification system. Concepts within the DTC were identified and mapped to appropriate ICF codes (Cieza et al., 2005). The DTC was linked to 45 unique ICF codes (16 Body Functions, 19 Activities and Participation, and 8 Environmental Factors). The DTC encompasses various domains of the ICF; however, there is no consideration of Personal Factors, Body Structures, and key aspects of Activities and Participation. Refining the DTC to address these aspects will provide an opportunity for fair and just determinations for those who experience disability.

Radiation-Induced Differentiated Thyroid Cancer Is Associated with Improved Overall Survival but Not Thyroid Cancer-Specific Mortality or Disease-Free Survival.

PubMed

White, Michael G; Cipriani, Nicole A; Abdulrasool, Layth; Kaplan, Sharone; Aschebrook-Kilfoy, Briseis; Angelos, Peter; Kaplan, Edwin L; Grogan, Raymon H; Onel, Kenan

2016-08-01

Radiation is a well-described risk factor for differentiated thyroid carcinoma (DTC). Although the natural history of DTC following nuclear disasters and in healthcare workers with chronic radiation exposure (RE) has been described, little is known about DTC following short-term exposure to therapeutic medical radiation for benign disease. This study compares DTC morphology and outcomes in patients with and without a prior history of therapeutic external RE. A retrospective review was performed of patients with DTC treated at The University of Chicago between 1951 and 1987, with a median follow-up of 27 years (range 0.3-60 years). Patients were classified as either having (RE+) or not having (RE-) a history of therapeutic RE. Variables examined included sex, age at RE, dose of RE, indication for RE, DTC histology, and outcome. Morphology was determined by blinded retrospective review of all available histologic slides. Outcomes were assessed using Cox proportional hazards model and Kaplan-Meier curves. Of 257 DTC patients, 165 (64%) were RE- and 92 (36%) were RE+, with males comprising a greater proportion of the RE+ group (43.5% vs. 27.3%; p = 0.01). A total of 94.2% of DTC cases were classic papillary cancers; histology did not differ between RE+ and RE- cohorts (p = 0.73). RE was associated with an increased median overall survival (OS; 43 years vs. 38 years; hazard ratio [HR] = 0.55 [confidence interval (CI) 0.34-0.89]; p = 0.01). Survival for males in the RE- group was significantly worse than it was for RE- females (HR = 1.78 [CI 1.05-3.03]; p = 0.03) or RE+ males (HR = 2.98 [CI 1.39-6.38]; p = 0.01). Recurrence did not differ between the RE+ and RE- groups (HR = 0.85 [CI 0.52-1.41]; p = 0.54), nor did DTC-specific mortality (HR = 0.54 [CI 0.21-1.37]; p = 0.20). While DTC following RE has historically been considered a more aggressive variant than DTC in the absence of RE, the present data indicate that RE+ DTC is associated with better OS than RE- DTC, especially for males. Additionally, recent reports are confirmed of equivalent rates of thyroid cancer recurrence. These results warrant further investigation into the factors underlying this unexpected finding.

Advanced simulation model for IPM motor drive with considering phase voltage and stator inductance

NASA Astrophysics Data System (ADS)

Lee, Dong-Myung; Park, Hyun-Jong; Lee, Ju

2016-10-01

This paper proposes an advanced simulation model of driving system for Interior Permanent Magnet (IPM) BrushLess Direct Current (BLDC) motors driven by 120-degree conduction method (two-phase conduction method, TPCM) that is widely used for sensorless control of BLDC motors. BLDC motors can be classified as SPM (Surface mounted Permanent Magnet) and IPM motors. Simulation model of driving system with SPM motors is simple due to the constant stator inductance regardless of the rotor position. Simulation models of SPM motor driving system have been proposed in many researches. On the other hand, simulation models for IPM driving system by graphic-based simulation tool such as Matlab/Simulink have not been proposed. Simulation study about driving system of IPMs with TPCM is complex because stator inductances of IPM vary with the rotor position, as permanent magnets are embedded in the rotor. To develop sensorless scheme or improve control performance, development of control algorithm through simulation study is essential, and the simulation model that accurately reflects the characteristic of IPM is required. Therefore, this paper presents the advanced simulation model of IPM driving system, which takes into account the unique characteristic of IPM due to the position-dependent inductances. The validity of the proposed simulation model is validated by comparison to experimental and simulation results using IPM with TPCM control scheme.

Direct-to-consumer (DTC) antidepressant advertising and consumer misperceptions about the chemical imbalance theory of depression: the moderating role of skepticism.

PubMed

Park, Jin Seong; Ahn, Ho-Young Anthony

2013-01-01

Based on a survey with members of an online consumer panel (N= 699), this study revealed that: (a) a substantial percentage of consumers held misperceptions about the chemical imbalance theory of depression; (b) personal and interpersonal experiences with depression positively related to such misperceptions; (c) overall, exposure to direct-to-consumer (DTC) antidepressant advertising did not significantly relate to misperceptions; and (d) DTC exposure magnified misperceptions when consumers were highly trustful of DTC advertising, whereas exposure diluted misperceptions when consumers were highly skeptical. Theoretical and practical implications of the research are discussed, especially in light of the social responsibility of DTC advertising.

A Sensorless Predictive Current Controlled Boost Converter by Using an EKF with Load Variation Effect Elimination Function

PubMed Central

Tong, Qiaoling; Chen, Chen; Zhang, Qiao; Zou, Xuecheng

2015-01-01

To realize accurate current control for a boost converter, a precise measurement of the inductor current is required to achieve high resolution current regulating. Current sensors are widely used to measure the inductor current. However, the current sensors and their processing circuits significantly contribute extra hardware cost, delay and noise to the system. They can also harm the system reliability. Therefore, current sensorless control techniques can bring cost effective and reliable solutions for various boost converter applications. According to the derived accurate model, which contains a number of parasitics, the boost converter is a nonlinear system. An Extended Kalman Filter (EKF) is proposed for inductor current estimation and output voltage filtering. With this approach, the system can have the same advantages as sensored current control mode. To implement EKF, the load value is necessary. However, the load may vary from time to time. This can lead to errors of current estimation and filtered output voltage. To solve this issue, a load variation elimination effect elimination (LVEE) module is added. In addition, a predictive average current controller is used to regulate the current. Compared with conventional voltage controlled system, the transient response is greatly improved since it only takes two switching cycles for the current to reach its reference. Finally, experimental results are presented to verify the stable operation and output tracking capability for large-signal transients of the proposed algorithm. PMID:25928061

The attitudes and beliefs of oncology nurse practitioners regarding direct-to-consumer advertising of prescription medications.

PubMed

Viale, Pamela Hallquist; Sanchez Yamamoto, Deanna

2004-07-01

To obtain information about the knowledge and attitudes of oncology nurse practitioners (ONPs) concerning the effect of direct-to-consumer (DTC) advertising of prescription medications on prescribing patterns. Exploratory survey. Oncology Nursing Society Nurse Practitioner Special Interest Group members in the United States. 221 of 376 ONPs completed the survey (58%). Researcher-developed 12-question postal survey. Knowledge and attitudes of ONPs on DTC advertising effects on prescribing patterns. The findings were similar to those of previous studies of physicians regarding the number of visits when patients requested DTC-advertised medications. Major differences were the positive attitudes of ONPs toward potentially longer patient visits to explain and educate patients regarding medication requests based on DTC advertising and smaller percentages of ONPs who felt "pressured" to prescribe requested medications. ONPs have mixed opinions regarding the practice of DTC advertising but do not believe that they are influenced heavily by advertising with regard to prescriptive practices. ONPs consider patient encounters for education purposes as appropriate and include information about requested DTC-advertised medications in their approach to patient care. This is an exploratory survey of a specialty group of ONPs. More research is needed to further explore the practice of DTC advertising and potential influences on the prescribing patterns of ONPs. DTC advertising of prescription medications is increasing; ONPs need to increase their knowledge base about the potential for influences of prescriptive practices.

Difficult-to-control hypertension: identification of clinical predictors and use of ICT-based integrated care to facilitate blood pressure control.

PubMed

Visco, Valeria; Finelli, Rosa; Pascale, Antonietta Valeria; Mazzeo, Pietro; Ragosa, Nicola; Trimarco, Valentina; Illario, Maddalena; Ciccarelli, Michele; Iaccarino, Guido

2018-05-01

Difficult-to-control (DTC) hypertension represents a burden in real life that can be partially solved through identification of the characteristics of clinical patterns and tailoring antihypertensive strategies, including ICT-enabled integrated care (ICT-IC). In the quest for clinical predictors of DTC hypertension, we screened 482 hypertensive patients who were consecutively referred to the departmental hypertension clinic. Following a data quality check, patients were divided into controlled (C, 49.37%) and uncontrolled (UC, 50.63%) groups based on their systolic blood pressure (BP) at follow-up. We then performed statistical analysis on the demographic, clinical, laboratory, and ultrasound data and observed that older age, female sex, higher BP levels, and a family history of hypertension were predictors of DTC hypertension. We then developed a pilot service of ICT-IC, including weekly home visits by nurses and patient education on self-monitoring of BP, heart rate, body weight, and oxygen saturation using 3G-connected devices. Self-monitored data were transmitted to the hospital servers on the electronic chart of the patient for remote assessment by the hospital hypertension specialists. A total of 20 UC patients (M/F = 10/10; age: 72.04 ± 2.17 years) were enrolled to verify the efficacy of BP control without changes in medical treatment. After 1 month of the ICT-IC program, BP was reduced both at the office assessment (systolic BP (SBP): 162.40 ± 2.23 mm Hg, beginning of the program vs. 138.20 ± 4.26 mm Hg at 1 month, p < 0.01) and at home (SBP: 149.83 ± 3.44, beginning of the program vs. 134.16 ± 1.67 mm Hg at 1 month, p < 0.01). We concluded that DTC hypertension can be predicted based on the clinical characteristics at the first visit. For these patients, ICT-IC is a feasible therapeutic strategy to achieve BP control.

Assessment of Direct-to-Consumer Genetic Testing Policy in Korea Based on Consumer Preference.

PubMed

Jeong, Gicheol

2017-01-01

In June 2016, Korea permitted direct-to-consumer genetic testing (DTC-GT) on 42 genes. However, both the market and industry have not yet been fully activated. Considering the aforementioned context, this study provides important insights. The Korean DTC-GT policy assessment is based on consumer preference analysis using a discrete choice experiment. In August 2016, a web-based survey was conducted to collect data from 1,200 respondents. The estimation results show that consumers prefer a DTC-GT product that is cheap, tests various items or genes, offers accurate test results, and guarantees the confidentiality of all information. However, consumers are not entirely satisfied by current DTC-GT products due to the existence of insufficient and/or inadequate policies. First, the permitted testing of 42 genes is insufficient to satisfy consumers' curiosity regarding their genes. Second, the accuracy of the DTC-GT products has not been fully verified, assessed, and communicated to consumers. Finally, regulatory loopholes that allow information leaks in the DTC-GT process can occur. These findings imply that DTC-GT requires an improvement in government policy-making criteria and the implementation of practical measures to guarantee test accuracy and genetic information. © 2017 S. Karger AG, Basel.

Proposition for sensorless self-excitation by a piezoelectric device

NASA Astrophysics Data System (ADS)

Tanaka, Y.; Kokubun, Y.; Yabuno, H.

2018-04-01

In this paper, we propose a method to realize self-excitation in an oscillator actuated by a piezoelectric device without a sensor. In general, the positive feedback associated with the oscillator velocity causes the self-excitation. Instead of measuring the velocity with a sensor, we utilize the electro-mechanical coupling effect in the oscillator and piezoelectric device. We drive the piezoelectric device with a current proportional to the linear combination of the voltage across the terminals of the piezoelectric device and its differential voltage signal. Then, the oscillator with the piezoelectric device behaves like a third-order system, which has three eigenvalues. The self-excitation can be realized because appropriate feedback gains can set two of the eigenvalues to be conjugate complex roots with a positive real part and the other eigenvalue to be a negative real root. To confirm the validity of the proposed method, we experimentally demonstrated the sensorless self-excitation and, as an application example, carried out mass sensing in a sensorless self-excited macrocantilever.

Health-Care Referrals from Direct-to-Consumer Genetic Testing

PubMed Central

Giovanni, Monica A.; Fickie, Matthew R.; Lehmann, Lisa S.; Green, Robert C.; Meckley, Lisa M.; Veenstra, David

2010-01-01

Background: Direct-to-consumer genetic testing (DTC-GT) provides personalized genetic risk information directly to consumers. Little is known about how and why consumers then communicate the results of this testing to health-care professionals. Aim: To query specialists in clinical genetics about their experience with individuals who consulted them after DTC-GT. Methods: Invitations to participate in a questionnaire were sent to three different groups of genetic professionals, totaling 4047 invitations, asking questions about individuals who consulted them after DTC-GT. For each case reported, respondents were asked to describe how the case was referred to them, the patient's rationale for DTC-GT, and the type of DTC-GT performed. Respondents were also queried about the consequences of the consultations in terms of additional testing ordered. The costs associated with each consultation were estimated. A clinical case series was compiled based upon clinician responses. Results: The invitation resulted in 133 responses describing 22 cases of clinical interactions following DTC-GT. Most consultations (59.1%) were self-referred to genetics professionals, but 31.8% were physician referred. Among respondents, 52.3% deemed the DTC-GT to be “clinically useful.” BRCA1/2 testing was considered clinically useful in 85.7% of cases; 35.7% of other tests were considered clinically useful. Subsequent referrals from genetics professionals to specialists and/or additional diagnostic testing were common, generating individual downstream costs estimated to range from $40 to $20,600. Conclusions: This clinical case series suggests that approximately half of clinical geneticists who saw patients after DTC-GT judged that testing was clinically useful, especially the BRCA1/2 testing. Further studies are needed in larger and more diverse populations to better understand the interactions between DTC-GT and the health-care system. PMID:20979566

Health-care referrals from direct-to-consumer genetic testing.

PubMed

Giovanni, Monica A; Fickie, Matthew R; Lehmann, Lisa S; Green, Robert C; Meckley, Lisa M; Veenstra, David; Murray, Michael F

2010-12-01

direct-to-consumer genetic testing (DTC-GT) provides personalized genetic risk information directly to consumers. Little is known about how and why consumers then communicate the results of this testing to health-care professionals. to query specialists in clinical genetics about their experience with individuals who consulted them after DTC-GT. invitations to participate in a questionnaire were sent to three different groups of genetic professionals, totaling 4047 invitations, asking questions about individuals who consulted them after DTC-GT. For each case reported, respondents were asked to describe how the case was referred to them, the patient's rationale for DTC-GT, and the type of DTC-GT performed. Respondents were also queried about the consequences of the consultations in terms of additional testing ordered. The costs associated with each consultation were estimated. A clinical case series was compiled based upon clinician responses. the invitation resulted in 133 responses describing 22 cases of clinical interactions following DTC-GT. Most consultations (59.1%) were self-referred to genetics professionals, but 31.8% were physician referred. Among respondents, 52.3% deemed the DTC-GT to be "clinically useful." BRCA1/2 testing was considered clinically useful in 85.7% of cases; 35.7% of other tests were considered clinically useful. Subsequent referrals from genetics professionals to specialists and/or additional diagnostic testing were common, generating individual downstream costs estimated to range from $40 to $20,600. this clinical case series suggests that approximately half of clinical geneticists who saw patients after DTC-GT judged that testing was clinically useful, especially the BRCA1/2 testing. Further studies are needed in larger and more diverse populations to better understand the interactions between DTC-GT and the health-care system.

31P NMR study of discrete time-crystalline signatures in an ordered crystal of ammonium dihydrogen phosphate

NASA Astrophysics Data System (ADS)

Rovny, Jared; Blum, Robert L.; Barrett, Sean E.

2018-05-01

The rich dynamics and phase structure of driven systems include the recently described phenomenon of the "discrete time crystal" (DTC), a robust phase which spontaneously breaks the discrete time translation symmetry of its driving Hamiltonian. Experiments in trapped ions and diamond nitrogen vacancy centers have recently shown evidence for this DTC order. Here, we show nuclear magnetic resonance (NMR) data of DTC behavior in a third, strikingly different, system: a highly ordered spatial crystal in three dimensions. We devise a DTC echo experiment to probe the coherence of the driven system. We examine potential decay mechanisms for the DTC oscillations, and demonstrate the important effect of the internal Hamiltonian during nonzero duration pulses.

Automating the Transition Between Sensorless Motor Control Methods for the NASA Glenn Research Center Flywheel Energy Storage System

NASA Technical Reports Server (NTRS)

Fehrmann, Elizabeth A.; Kenny, Barbara H.

2004-01-01

The NASA Glenn Research Center (GRC) has been working to advance the technology necessary for a flywheel energy storage system for the past several years. Flywheels offer high efficiency, durability, and near-complete discharge capabilities not produced by typical chemical batteries. These characteristics show flywheels to be an attractive alternative to the more typical energy storage solutions. Flywheels also offer the possibility of combining what are now two separate systems in space applications into one: energy storage, which is currently provided by batteries, and attitude control, which is currently provided by control moment gyroscopes (CMGs) or reaction wheels. To date, NASA Glenn research effort has produced the control algorithms necessary to demonstrate flywheel operation up to a rated speed of 60,000 RPM and the combined operation of two flywheel machines to simultaneously provide energy storage and single axis attitude control. Two position-sensorless algorithms are used to control the motor/generator, one for low (0 to 1200 RPM) speeds and one for high speeds. The algorithm allows the transition from the low speed method to the high speed method, but the transition from the high to low speed method was not originally included. This leads to a limitation in the existing motor/generator control code that does not allow the flywheels to be commanded to zero speed (and back in the negative speed direction) after the initial startup. In a multi-flywheel system providing both energy storage and attitude control to a spacecraft, speed reversal may be necessary.

Motor Control and Regulation for a Flywheel Energy Storage System

NASA Technical Reports Server (NTRS)

Kenny, Barbara; Lyons, Valerie

2003-01-01

This talk will focus on the motor control algorithms used to regulate the flywheel system at the NASA Glenn Research Center. First a discussion of the inner loop torque control technique will be given. It is based on the principle of field orientation and is implemented without a position or speed sensor (sensorless control). Then the outer loop charge and discharge algorithm will be presented. This algorithm controls the acceleration of the flywheel during charging and the deceleration while discharging. The algorithm also allows the flywheel system to regulate the DC bus voltage during the discharge cycle.

Fluorescence "turn on" detection of mercuric ion based on bis(dithiocarbamato)copper(II) complex functionalized carbon nanodots.

PubMed

Yuan, Chao; Liu, Bianhua; Liu, Fei; Han, Ming-Yong; Zhang, Zhongping

2014-01-21

A new "turn on" fluorescence nanosensor for selective Hg(2+) determination is reported based on bis(dithiocarbamato)copper(II) functionalized carbon nanodots (CuDTC2-CDs). The CuDTC2 complex was conjugated to the prepared amine-coated CDs by the condensation of carbon disulfide onto the nitrogen atoms in the surface amine groups, followed by the coordination of copper(II) to the resulting dithiocarbamate groups (DTC) and finally by the additional coordination of ammonium N-(dithicarbaxy) sarcosine (DTCS) to form the CuDTC2-complexing CDs. The CuDTC2 complex at surface strongly quenched the bright-blue fluorescence of the CDs by a combination of electron transfer and energy transfer mechanism. Hg(2+) could immediately switch on the fluorescence of the CuDTC2-CDs by promptly displacing the Cu(2+) in the CuDTC2 complex and thus shutting down the energy transfer pathway, in which the sensitive limit for Hg(2+) as low as 4 ppb was reached. Moreover, a paper-based sensor has been fabricated by printing the CuDTC2-CDs probe ink on a piece of cellulose acetate paper using a commercial inkjet printer. The fluorescence "turn on" on the paper provided the most conveniently visual detection of aqueous Hg(2+) ions by the observation with naked eye. The very simple and effective strategy reported here facilitates the development of portable and reliable fluorescence nanosensors for the determination of Hg(2+) in real samples.

Implementation outcomes of Multidimensional Family Therapy-Detention to Community: a reintegration program for drug-using juvenile detainees.

PubMed

Liddle, Howard A; Dakof, Gayle A; Henderson, Craig; Rowe, Cindy

2011-06-01

Responding to urgent calls for effective interventions to address young offenders' multiple and interconnected problems, a new variant of an existing empirically-validated intervention for drug-using adolescents, Multidimensional Family Therapy (MDFT)-Detention to Community (DTC) was tested in a two-site controlled trial. This article (a) outlines the rationale and protocol basics of the MDFT-DTC intervention, a program for substance-using juvenile offenders that links justice and substance abuse treatment systems to facilitate adolescents' post-detention community reintegration; (b) presents implementation outcomes, including fidelity, treatment engagement and retention rates, amount of services received, treatment satisfaction, and substance abuse-juvenile justice system collaboration outcomes; and (c) details the implementation and sustainability challenges in a cross-system (substance abuse treatment and juvenile justice) adolescent intervention. Findings support the effectiveness of the MDFT-DTC intervention, and the need to develop a full implementation model in which transfer and dissemination issues could be explored more fully, and tested experimentally.

Adverse effect of combination of chronic psychosocial stress and high fat diet on hippocampus-dependent memory in rats.

PubMed

Alzoubi, K H; Abdul-Razzak, K K; Khabour, O F; Al-Tuweiq, G M; Alzubi, M A; Alkadhi, K A

2009-12-01

The combined effects of high fat diet (HFD) and chronic stress on the hippocampus-dependent spatial learning and memory were studied in rats using the radial arm water maze (RAWM). Chronic psychosocial stress and/or HFD were simultaneously administered for 3 months to young adult male Wister rats. In the RAWM, rats were subjected to 12 learning trials as well as short-term and long-term memory tests. This procedure was applied on a daily basis until the animal reaches days to criterion (DTC) in the 12th learning trial and in memory tests. DTC is the number of days that the animal takes to make zero error in two consecutive days. Groups were compared based on the number of errors per trial or test as well as on the DTC. Chronic stress, HFD and chronic stress/HFD animal groups showed impaired learning as indicated by committing significantly (P<0.05) more errors than untreated control group in trials 6 through 9 of day 4. In memory tests, chronic stress, HFD and chronic stress/HFD groups showed significantly impaired performance compared to control group. Additionally, the stress/HFD was the only group that showed significantly impaired performance in memory tests on the 5th training day, suggesting more severe memory impairment in that group. Furthermore, DTC value for above groups indicated that chronic stress or HFD, alone, resulted in a mild impairment of spatial memory, but the combination of chronic stress and HFD resulted in a more severe and long-lasting memory impairment. The data indicated that the combination of stress and HFD produced more deleterious effects on hippocampal cognitive function than either chronic stress or HFD alone.

Design of BLDCM emulator for transmission control units

NASA Astrophysics Data System (ADS)

Liu, Chang; He, Yongyi; Zhang, Bodong

2018-04-01

According to the testing requirements of the transmission control unit, a brushless DC motor emulating system is designed based on motor simulation and power hardware-in-the-loop. The discrete motor model is established and a real-time numerical method is designed to solve the motor states. The motor emulator directly interacts with power stage of the transmission control unit using a power-efficient circuit topology and is compatible with sensor-less control. Experiments on a laboratory prototype help to verify that the system can emulate the real motor currents and voltages whenever the motor is starting up or suddenly loaded.

Public Awareness of Direct-to-Consumer Genetic Tests: Findings from the 2013 U.S. Health Information National Trends Survey.

PubMed

Agurs-Collins, Tanya; Ferrer, Rebecca; Ottenbacher, Allison; Waters, Erika A; O'Connell, Mary E; Hamilton, Jada G

2015-12-01

Although the availability of direct-to-consumer (DTC) genetic testing has increased in recent years, the general public's awareness of this testing is not well understood. This study examined levels of public awareness of DTC genetic testing, sources of information about testing, and psychosocial factors associated with awareness of testing in the USA. Data were obtained from the nationally representative 2013 U.S. Health Information National Trends Survey. Guided by a social-cognitive conceptual framework, univariable and multivariable logistic regressions were conducted to identify factors associated with awareness of DTC genetic tests. Of 3185 participants, 35.6% were aware of DTC genetic tests, with the majority learning about these tests through radio, television, and the Internet. In the final adjusted model, participants with annual incomes of $99,999 or less had lower odds of being aware of DTC genetic testing (ORs ranging from 0.46-0.61) than did those participants with incomes of $100,000 or more. The odds of awareness of DTC genetic tests were significantly higher for those who actively seek cancer information (OR=1.91, 95% CI=1.36-2.69), use the Internet (OR=1.81, 95% CI=1.05-3.13), and have high numeracy skills (OR=1.67, 95% CI=1.17-2.38). It will be critical for healthcare researchers and practitioners to understand predictors and consequences of the public's awareness of DTC genetic tests, as well as how such awareness may translate into DTC genetic testing uptake, health behavior change, and ultimately disease prevention.

Direct-to-consumer genetic testing for predicting sports performance and talent identification: Consensus statement

PubMed Central

Webborn, Nick; Williams, Alun; McNamee, Mike; Bouchard, Claude; Pitsiladis, Yannis; Ahmetov, Ildus; Ashley, Euan; Byrne, Nuala; Camporesi, Silvia; Collins, Malcolm; Dijkstra, Paul; Eynon, Nir; Fuku, Noriyuki; Garton, Fleur C; Hoppe, Nils; Holm, Søren; Kaye, Jane; Klissouras, Vassilis; Lucia, Alejandro; Maase, Kamiel; Moran, Colin; North, Kathryn N; Pigozzi, Fabio; Wang, Guan

2015-01-01

The general consensus among sport and exercise genetics researchers is that genetic tests have no role to play in talent identification or the individualised prescription of training to maximise performance. Despite the lack of evidence, recent years have witnessed the rise of an emerging market of direct-to-consumer marketing (DTC) tests that claim to be able to identify children's athletic talents. Targeted consumers include mainly coaches and parents. There is concern among the scientific community that the current level of knowledge is being misrepresented for commercial purposes. There remains a lack of universally accepted guidelines and legislation for DTC testing in relation to all forms of genetic testing and not just for talent identification. There is concern over the lack of clarity of information over which specific genes or variants are being tested and the almost universal lack of appropriate genetic counselling for the interpretation of the genetic data to consumers. Furthermore independent studies have identified issues relating to quality control by DTC laboratories with different results being reported from samples from the same individual. Consequently, in the current state of knowledge, no child or young athlete should be exposed to DTC genetic testing to define or alter training or for talent identification aimed at selecting gifted children or adolescents. Large scale collaborative projects, may help to develop a stronger scientific foundation on these issues in the future. PMID:26582191

New Molecular Design Concurrently Providing Superior Pure Blue, Thermally Activated Delayed Fluorescence and Optical Out-Coupling Efficiencies.

PubMed

Rajamalli, P; Senthilkumar, N; Huang, P-Y; Ren-Wu, C-C; Lin, H-W; Cheng, C-H

2017-08-16

Simultaneous enhancement of out-coupling efficiency, internal quantum efficiency, and color purity in thermally activated delayed fluorescence (TADF) emitters is highly desired for the practical application of these materials. We designed and synthesized two isomeric TADF emitters, 2DPyM-mDTC and 3DPyM-pDTC, based on di(pyridinyl)methanone (DPyM) cores as the new electron-accepting units and di(tert-butyl)carbazole (DTC) as the electron-donating units. 3DPyM-pDTC, which is structurally nearly planar with a very small ΔE ST , shows higher color purity, horizontal ratio, and quantum yield than 2DPyM-mDTC, which has a more flexible structure. An electroluminescence device based on 3DPyM-pDTC as the dopant emitter can reach an extremely high external quantum efficiency of 31.9% with a pure blue emission. This work also demonstrates a way to design materials with a high portion of horizontal molecular orientation to realize a highly efficient pure-blue device based on TADF emitters.

A survey of decision tree classifier methodology

NASA Technical Reports Server (NTRS)

Safavian, S. Rasoul; Landgrebe, David

1990-01-01

Decision Tree Classifiers (DTC's) are used successfully in many diverse areas such as radar signal classification, character recognition, remote sensing, medical diagnosis, expert systems, and speech recognition. Perhaps, the most important feature of DTC's is their capability to break down a complex decision-making process into a collection of simpler decisions, thus providing a solution which is often easier to interpret. A survey of current methods is presented for DTC designs and the various existing issue. After considering potential advantages of DTC's over single stage classifiers, subjects of tree structure design, feature selection at each internal node, and decision and search strategies are discussed.

Two new miniature inverted-repeat transposable elements in the genome of the clam Donax trunculus.

PubMed

Šatović, Eva; Plohl, Miroslav

2017-10-01

Repetitive sequences are important components of eukaryotic genomes that drive their evolution. Among them are different types of mobile elements that share the ability to spread throughout the genome and form interspersed repeats. To broaden the generally scarce knowledge on bivalves at the genome level, in the clam Donax trunculus we described two new non-autonomous DNA transposons, miniature inverted-repeat transposable elements (MITEs), named DTC M1 and DTC M2. Like other MITEs, they are characterized by their small size, their A + T richness, and the presence of terminal inverted repeats (TIRs). DTC M1 and DTC M2 are 261 and 286 bp long, respectively, and in addition to TIRs, both of them contain a long imperfect palindrome sequence in their central parts. These elements are present in complete and truncated versions within the genome of the clam D. trunculus. The two new MITEs share only structural similarity, but lack any nucleotide sequence similarity to each other. In a search for related elements in databases, blast search revealed within the Crassostrea gigas genome a larger element sharing sequence similarity only to DTC M1 in its TIR sequences. The lack of sequence similarity with any previously published mobile elements indicates that DTC M1 and DTC M2 elements may be unique to D. trunculus.

A sensorless method for measuring the point mobility of mechanical structures

NASA Astrophysics Data System (ADS)

Boulandet, R.; Michau, M.; Herzog, P.; Micheau, P.; Berry, A.

2016-09-01

This paper presents a convenient and cost-effective experimental tool for measuring the mobility characteristics of a mechanical structure. The objective is to demonstrate that the point mobility measurement can be performed using only an electrodynamic inertial exciter. Unlike previous work based on voice coil actuators, no load cell or accelerometer is needed. Instead, it is theoretically shown that the mobility characteristics of the structure can be estimated from variations in the electrical input impedance of the actuator fixed onto it, provided that the electromechanical parameters of the actuator are known. The proof of concept is made experimentally using a cheap commercially available actuator on a simply supported plate, leading to a good dynamic range from 100 Hz to 1 kHz. The methodology to assess the basic parameters of the actuator is also given. Measured data are compared to a standard shaker testing and the strengths and weaknesses of the sensorless mobility measuring device are discussed. It is believed that this sensorless mobility measuring device can be a convenient experimental tool to determine the dynamic characteristics of a wide range of mechanical structures.

In vivo imaging of human photoreceptor mosaic with wavefront sensorless adaptive optics optical coherence tomography.

PubMed

Wong, Kevin S K; Jian, Yifan; Cua, Michelle; Bonora, Stefano; Zawadzki, Robert J; Sarunic, Marinko V

2015-02-01

Wavefront sensorless adaptive optics optical coherence tomography (WSAO-OCT) is a novel imaging technique for in vivo high-resolution depth-resolved imaging that mitigates some of the challenges encountered with the use of sensor-based adaptive optics designs. This technique replaces the Hartmann Shack wavefront sensor used to measure aberrations with a depth-resolved image-driven optimization algorithm, with the metric based on the OCT volumes acquired in real-time. The custom-built ultrahigh-speed GPU processing platform and fast modal optimization algorithm presented in this paper was essential in enabling real-time, in vivo imaging of human retinas with wavefront sensorless AO correction. WSAO-OCT is especially advantageous for developing a clinical high-resolution retinal imaging system as it enables the use of a compact, low-cost and robust lens-based adaptive optics design. In this report, we describe our WSAO-OCT system for imaging the human photoreceptor mosaic in vivo. We validated our system performance by imaging the retina at several eccentricities, and demonstrated the improvement in photoreceptor visibility with WSAO compensation.

77 FR 11175 - Self-Regulatory Organizations; The Depository Trust Company; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-24

... support the Request. In order to facilitate this automation, DTC will create a function that will provide... automation, DTC will be able to reduce the notification time frame on full call MMIs so that effective April... automation input mechanism. Additionally, at the request of the Options Clearing Corporation (``OCC''), DTC...

Awareness of and attitudes toward direct-to-consumer prescription drug advertising among young adults.

PubMed

Alperstein, Neil M

2014-01-01

This study examines awareness and knowledge of and attitudes toward direct-to-consumer (DTC) prescription drug advertising among young adults between 18 and 24 years of age. The study finds that young adults are not as aware of prescription drug advertising as older consumers, however, they are aware of specific heavily advertised drugs, especially those for allergy medications, birth control, and sleep aids. Young adults hold mixed to negative views about advertising in general, and they do not view DTC prescription drug advertising as a beneficial source of information, nor do they believe such advertising serves to educate consumers.

General practitioner attitudes to direct-to-consumer genetic testing in New Zealand.

PubMed

Ram, Sanyogita; Russell, Bruce; Gubb, Mary; Taylor, Rebekah; Butler, Cassandra; Khan, Imran; Shelling, Andrew

2012-10-26

The aim of the study was to explore the attitudes of general practitioners (GPs) towards direct to consumer (DTC) genetic testing and elicit their perceptions of the risks and benefits associated with DTC genetic testing. A postal questionnaire was mailed to a national random sample of 300 registered GPs from a list provided by the New Zealand Medical Council. Non-responders were followed up with an abridged survey questionnaire. Responses were received from 38% of the GPs contacted. This consisted of 113 responses from the full questionnaire. The proportion of respondents who had heard about DTC genetic testing was 47.8%. Respondents considered convenience to be the greatest benefit for the individual requesting DTC genetic testing. Misunderstanding of results and inadequate provision of information were perceived to be the greatest risks associated. Lack of knowledge, experience and time were all considered barriers to GPs providing genetic counselling, and a genetic specialist was highlighted as the most appropriate to provide this. Respondents thought advertising of DTC genetic testing should be regulated in a similar manner to DTC advertising of prescription medicines. Clinical validity of tests and counselling were thought to be the most important aspects to be regulated. As public access to DTC genetic testing increases, the role of GPs knowledge and training to reflect this growth will become increasingly more important. The 'Patient-Doctor-Counsellor Model of Delivery of Genetic Services' may be more appropriate for the provision of this service than the current model of direct access by patients. The involvement of health professionals in the DTC genetic testing process will aid patients in making informed health decisions, and ensure increased benefit from recent advances in genetic information.

Prioritising drug and therapeutics committee (DTC) decisions: a national survey.

PubMed

Tan, Ee Lyn; Day, Richard O; Brien, Jo-anne E

2007-04-01

A national survey was conducted to explore stakeholder opinions about: (1) the domains of activity and criteria used to determine "important" decisions; (2) the "importance" of Drug and Therapeutics Committee (DTC) decisions as an appropriate approach for prioritising implementation and actions and (3) how DTC decisions could be prioritised for action. This is a study of DTCs conducted in the Australian health care setting. A semi-structured questionnaire was sent to Directors of Pharmacies or Chief Pharmacists in Australian hospitals. Questionnaires could be returned by email or by fax. Two weeks after initial mail-out, non-responders were followed-up. Responses were collated and analysed using descriptive statistics. Free-text responses were collated. QSR NVivo was used as a data management tool. The response rate was 61%. All respondents indicated that "patient safety" was a domain of importance for a decision. Other domains of important DTC decisions include: "ensuring the practice of evidence based medicine within their institution" (94%), "cost" (93%), "ensure practice according to legislative requirements" (87%). Most respondents agreed that some DTC decisions were more important than others. Given constraints on time and resources, the majority agreed that DTC decisions should be prioritised for implementation, although most had no suggestions about how this could be done. Some suggested that the domains of importance could be the basis for priority assignment. Currently DTC decisions and policies are implemented in an ad hoc manner. As a result implementation may be incomplete and ineffective, and may pose a risk of serious consequences in patient care. This study identifies the domains or criteria of DTC decisions so that DTCs may allocate scarce resources to the systematic implementation of important decisions.

Advanced generation anti-prostate specific membrane antigen designer T cells for prostate cancer immunotherapy.

PubMed

Ma, Qiangzhong; Gomes, Erica M; Lo, Agnes Shuk-Yee; Junghans, Richard P

2014-02-01

Adoptive immunotherapy by infusion of designer T cells (dTc) engineered with chimeric antigen receptors (CARs) for tumoricidal activity represents a potentially highly specific modality for the treatment of cancer. In this study, 2nd generation (gen) anti-prostate specific membrane antigen (PSMA) dTc were developed for improving the efficacy of previously developed 1st gen dTc for prostate cancer immunotherapy. The 1st gen dTc are modified with chimeric immunoglobulin-T cell receptor (IgTCR) while the 2nd gen dTc are engineered with an immunoglobulin-CD28-T cell receptor (IgCD28TCR), which incorporates a CD28 costimulatory signal for optimal T cell activation. A 2nd gen anti-PSMA IgCD28TCR CAR was constructed by inserting the CD28 signal domain into the 1st gen CAR. 1st and 2nd gen anti-PSMA dTc were created by transducing human T cells with anti-PSMA CARs and their antitumor efficacy was compared for specific activation on PSMA-expressing tumor contact, cytotoxicity against PSMA-expressing tumor cells in vitro, and suppression of tumor growth in an animal model. The 2nd gen dTc can be optimally activated to secrete larger amounts of cytokines such as IL2 and IFNγ than 1st gen and to proliferate more vigorously on PSMA-expressing tumor contact. More importantly, the 2nd gen dTc preserve the PSMA-specific cytotoxicity in vitro and suppress tumor growth in animal models with significant higher potency. Our results demonstrate that 2nd gen anti-PSMA designer T cells exhibit superior antitumor functions versus 1st gen, providing a rationale for advancing this improved agent toward clinical application in prostate cancer immunotherapy. © 2013 Wiley Periodicals, Inc.

Consumers' views of direct-to-consumer genetic information.

PubMed

McBride, Colleen M; Wade, Christopher H; Kaphingst, Kimberly A

2010-01-01

In this report, we describe the evolution and types of genetic information provided directly to consumers, discuss potential advantages and disadvantages of these products, and review research evaluating consumer responses to direct-to-consumer (DTC) genetic testing. The available evidence to date has focused on predictive tests and does not suggest that individuals, health care providers, or health care systems have been harmed by a DTC provision of genetic information. An understanding of consumer responses to susceptibility tests has lagged behind. The Multiplex Initiative is presented as a case study of research to understand consumers' responses to DTC susceptibility tests. Three priority areas are recommended for accelerated research activities to inform public policy regarding DTC genetic information: (a) exploring consumer's long-term responses to DTC genetic testing on a comprehensive set of outcomes, (b) evaluating optimal services to support decision making about genetic testing, and (c) evaluating best practices in promoting genetic competencies among health providers.

Control of a High Speed Flywheel System for Energy Storage in Space Applications

NASA Technical Reports Server (NTRS)

Kenny, Barbara H.; Kascak, Peter E.; Jansen, Ralph; Dever, Timothy; Santiago, Walter

2004-01-01

A novel control algorithm for the charge and discharge modes of operation of a flywheel energy storage system for space applications is presented. The motor control portion of the algorithm uses sensorless field oriented control with position and speed estimates determined from a signal injection technique at low speeds and a back EMF technique at higher speeds. The charge and discharge portion of the algorithm use command feed-forward and disturbance decoupling, respectively, to achieve fast response with low gains. Simulation and experimental results are presented demonstrating the successful operation of the flywheel control up to the rated speed of 60,000 rpm.

Optimal model-based sensorless adaptive optics for epifluorescence microscopy.

PubMed

Pozzi, Paolo; Soloviev, Oleg; Wilding, Dean; Vdovin, Gleb; Verhaegen, Michel

2018-01-01

We report on a universal sample-independent sensorless adaptive optics method, based on modal optimization of the second moment of the fluorescence emission from a point-like excitation. Our method employs a sample-independent precalibration, performed only once for the particular system, to establish the direct relation between the image quality and the aberration. The method is potentially applicable to any form of microscopy with epifluorescence detection, including the practically important case of incoherent fluorescence emission from a three dimensional object, through minor hardware modifications. We have applied the technique successfully to a widefield epifluorescence microscope and to a multiaperture confocal microscope.

DTC advertising harms patients and should be tightly regulated.

PubMed

Lurie, Peter

2009-01-01

Like all interventions in health care, direct-to-consumer (DTC) advertising should be evaluated by comparing its risks to its benefits, in the context of the available or potentially available alternatives. The objective, of course, is to realize any unique benefits while minimizing the risks. On balance, the adverse effects of DTC advertising outweigh the still-undemonstrated benefits of the advertising.

78 FR 40250 - Self-Regulatory Organizations; The Depository Trust Company (“DTC”); Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-03

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-69864; File No. SR-DTC-2013-08] Self-Regulatory Organizations; The Depository Trust Company (``DTC''); Notice of Filing and Immediate Effectiveness of Proposed Rule Change To Implement a Fee Associated With the Expansion of DTC's Ability To Collect and Pass Through Fees Owed by Participants to...

Do perceptions of direct-to-consumer pharmaceutical advertising vary based on urban versus rural living?

PubMed

Spake, Deborah F; Joseph, Mathew; Megehee, Carol M

2014-01-01

This study explores the connection between perceptions of direct-to-consumer (DTC) advertising based on where people live and shop. Urban consumers were found to be more skeptical of DTC advertising, but more likely to believe that physicians select pharmaceuticals based on the efficacy of the product. Those living in rural areas were more motivated to visit a doctor and more likely to feel an equal doctor-patient relationship after exposure to DTC advertising. Interaction effects among gender, income, and education were detected, as well as an interaction effects between location and income on views of DTC advertising.

Subjective health literacy and older adults' assessment of direct-to-consumer prescription drug ads.

PubMed

An, Soontae; Muturi, Nancy

2011-01-01

Older adults are increasingly the intended target of direct-to-consumer (DTC) prescription drug ads, but limited evidence exists as to how they assess the educational value of DTC ads and, more importantly, whether their assessment depends on their level of health literacy. In-person interviews of 170 older adults revealed that those with low subjective health literacy evaluated the educational value of DTC ads significantly lower than did those with high subjective health literacy. The results prompt us to pay more scholarly attention to determining how effectively DTC ads convey useful medical information, particularly to those with limited health literacy.

Alert management for home healthcare based on home automation analysis.

PubMed

Truong, T T; de Lamotte, F; Diguet, J-Ph; Said-Hocine, F

2010-01-01

Rising healthcare for elder and disabled people can be controlled by offering people autonomy at home by means of information technology. In this paper, we present an original and sensorless alert management solution which performs multimedia and home automation service discrimination and extracts highly regular home activities as sensors for alert management. The results of simulation data, based on real context, allow us to evaluate our approach before application to real data.

Ethical and clinical practice considerations for genetic counselors related to direct-to-consumer marketing of genetic tests.

PubMed

Wade, Christopher H; Wilfond, Benjamin S

2006-11-15

Several companies utilize direct-to-consumer (DTC) advertising for genetic tests and some, but not all, bypass clinician involvement by offering DTC purchase of the tests. This article examines how DTC marketing strategies may affect genetic counselors, using available cardiovascular disease susceptibility tests as an illustration. The interpretation of these tests is complex and includes consideration of clinical validity and utility, and the further complications of gene-environment interactions and pleiotropy. Although it is unclear to what extent genetic counselors will encounter clients who have been exposed to DTC marketing strategies, these strategies may influence genetic counseling interactions if they produce directed interest in specific tests and unrealistic expectations for the tests' capacity to predict disease. Often, a client's concern about risk for cardiovascular diseases is best addressed by established clinical tests and a family history assessment. Ethical dilemmas may arise for genetic counselors who consider whether to accept clients who request test interpretation or to order DTC-advertised tests that require a clinician's authorization. Genetic counselors' obligations to care for clients extend to interpreting DTC tests, although this obligation may be fulfilled by referral or consultation with specialists. Genetic counselors do not have an obligation to order DTC-advertised tests that have minimal clinical validity and utility at a client's request. This can be a justified restriction on autonomy based on consideration of risks to the client, the costs, and the implications for society. Published 2006 Wiley-Liss, Inc.

Fatigue and fatigue-related symptoms in patients treated for different causes of hypothyroidism.

PubMed

Louwerens, Marloes; Appelhof, Bente C; Verloop, Herman; Medici, Marco; Peeters, Robin P; Visser, Theo J; Boelen, Anita; Fliers, Eric; Smit, Johannes W A; Dekkers, Olaf M

2012-12-01

Research on determinants of well-being in patients on thyroid hormone replacement therapy is warranted, as persistent fatigue-related complaints are common in this population. In this study, we evaluated the impact of different states of hypothyroidism on fatigue and fatigue-related symptoms. Furthermore, the relationship between fatigue and the TSH receptor (TSHR)-Asp727Glu polymorphism, a common genetic variant of the TSHR, was analyzed. A cross-sectional study was performed in 278 patients (140 patients treated for differentiated thyroid carcinoma (DTC) and 138 with autoimmune hypothyroidism (AIH)) genotyped for the TSHR-Asp727Glu polymorphism. The multidimensional fatigue inventory (MFI-20) was used to assess fatigue, with higher MFI-20 scores indicating more fatigue-related complaints. MFI-20 scores were related to disease status and Asp727Glu polymorphism status. AIH patients scored significantly higher than DTC patients on all five MFI-20 subscales (P<0.001), independent of clinical and thyroid hormone parameters. The frequency of the TSHR-Glu727 allele was 7.2%. Heterozygous DTC patients had more favorable MFI-20 scores than wild-type DTC patients on four of five subscales. The modest effect of the TSHR-Asp727Glu polymorphism on fatigue was found in DTC patients only. AIH patients had significantly higher levels of fatigue compared with DTC patients, which could not be attributed to clinical or thyroid hormone parameters. The modest effect of the TSHR-Asp727Glu polymorphism on fatigue in DTC patients should be confirmed in other cohorts.

A 3-stage model for assessing the probable economic effects of direct-to-consumer advertising of pharmaceuticals.

PubMed

Vogel, Ronald J; Ramachandran, Sulabha; Zachry, Woodie M

2003-01-01

The pharmaceutical industry employs a variety of marketing strategies that have previously been directed primarily toward physicians. However, mass media direct-to-consumer (DTC) advertising of prescription drugs has emerged as a ubiquitous promotional strategy. This article explores the economics of DTC advertising in greater depth than has been done in the past by using a 3-stage economic model to assess the pertinent literature and to show the probable effects of DTC advertising in the United States. Economics literature on the subject was searched using the Journal of Economic Literature. Health services literature was searched using computer callback devices. Spending on DTC advertising in the United States increased from $17 million in 1985 to $2.5 billion in 2000. Proponents of DTC advertising claim that it provides valuable product-related information to health care professionals and patients, may contribute to better use of medications, and helps patients take charge of their own health care. Opponents argue that DTC advertising provides misleading messages rather than well-balanced, evidence-based information. The literature is replete with opinions about the effects of prescription drug advertising on pharmaceutical drug prices and physician-prescribing patterns, but few studies have addressed the issues beyond opinion surveys. The economic literature on advertising effects in other markets, however, may provide insight. DTC advertising indirectly affects the price and the quantity of production of pharmaceuticals via its effect on changes in consumer demand.

Obatoclax and LY3009120 Efficiently Overcome Vemurafenib Resistance in Differentiated Thyroid Cancer.

PubMed

Wei, Wei-Jun; Sun, Zhen-Kui; Shen, Chen-Tian; Song, Hong-Jun; Zhang, Xin-Yun; Qiu, Zhong-Ling; Luo, Quan-Yong

2017-01-01

Although the prognosis of differentiated thyroid cancer (DTC) is relatively good, 30-40% of patients with distant metastases develop resistance to radioactive iodine therapy due to tumor dedifferentiation. For DTC patients harboring BRAF V600E mutation, Vemurafenib, a BRAF kinase inhibitor, has dramatically changed the therapeutic landscape, but side effects and drug resistance often lead to termination of the single agent treatment. In the present study, we showed that either LY3009120 or Obatoclax (GX15-070) efficiently inhibited cell cycle progression and induced massive death of DTC cells. We established that BRAF/CRAF dimerization was an underlying mechanism for Vemurafenib resistance. LY3009120, the newly discovered pan-RAF inhibitor, successfully overcame Vemurafenib resistance and suppressed the growth of DTC cells in vitro and in vivo. We also observed that expression of anti-apoptotic Bcl-2 increased substantially following BRAF inhibitor treatment in Vemurafenib-resistant K1 cells, and both Obatoclax and LY3009120 efficiently induced apoptosis of these resistant cells. Specifically, Obatoclax exerted its anti-cancer activity by inducing loss of mitochondrial membrane potential (ΔΨm), dysfunction of mitochondrial respiration, reduction of cellular glycolysis, autophagy, neutralization of lysosomes, and caspase-related apoptosis. Furthermore, the cancer killing effects of LY3009120 and Obatoclax extended to two more Vemurafenib-resistant DTC cell lines, KTC-1 and BCPAP. Taken together, our results highlighted the potential value of LY3009120 for both Vemurafenib-sensitive and -resistant DTC and provided evidence for the combination therapy using Vemurafenib and Obatoclax for radioiodine-refractory DTC.

Direct-to-consumer marketing of osteoporosis drugs and bone densitometry.

PubMed

Hollon, Matthew F; Larson, Eric B; Koepsell, Thomas D; Downer, Ann E

2003-01-01

To determine whether there is an association between a woman's exposure to direct-to-consumer (DTC) advertisements for 2 osteoporosis drugs and presentation for bone densitometry. A matched case-control study was conducted between October and December 1998 at an academic primary care clinic in Seattle, WA. Seventeen women from the study population (aged >/=18 y, seen in the previous 2 y at the academic primary care clinic) presented for bone densitometry. All 51 women completed a self-administered questionnaire. Women familiar with 1 of 2 osteoporosis drugs due to exposure to advertisements had 9 times the odds of densitometry (unadjusted OR 9.3, 95% CI 1.0 to 86). Multivariate analysis, including confounders such as education level and whether a woman had previously had 3 screening tests (mammography, Pap smear, serum cholesterol), revealed a significant and strong association between exposure to advertisements and densitometry (adjusted OR 29, 95% CI 1.6 to 511). DTC marketing may increase health services utilization. Further independent evaluation of DTC marketing based on available observational evidence is feasible and warranted.

Incremental Adaptive Fuzzy Control for Sensorless Stroke Control of A Halbach-type Linear Oscillatory Motor

NASA Astrophysics Data System (ADS)

Lei, Meizhen; Wang, Liqiang

2018-01-01

The halbach-type linear oscillatory motor (HT-LOM) is multi-variable, highly coupled, nonlinear and uncertain, and difficult to get a satisfied result by conventional PID control. An incremental adaptive fuzzy controller (IAFC) for stroke tracking was presented, which combined the merits of PID control, the fuzzy inference mechanism and the adaptive algorithm. The integral-operation is added to the conventional fuzzy control algorithm. The fuzzy scale factor can be online tuned according to the load force and stroke command. The simulation results indicate that the proposed control scheme can achieve satisfied stroke tracking performance and is robust with respect to parameter variations and external disturbance.

An exploratory study of adolescent female reactions to direct-to-consumer advertising: the case of the Human Papillomavirus (HPV) Vaccine.

PubMed

Leader, Amy E; Cashman, Rebecca; Voytek, Chelsea D; Baker, Jillian L; Brawner, Bridgette M; Frank, Ian

2011-10-01

When the human papillomavirus (HPV) vaccine was approved in 2006, an extensive direct-to-consumer (DTC) advertising campaign raised awareness and promoted vaccination. This study explores adolescents' exposure to and understanding of the messages in these advertisements. Sixty-seven African American females participated in a focus group about DTC advertising for the HPV vaccine. Virtually all adolescents had seen an HPV vaccine DTC advertisement, but most did not understand the health information contained in it. If DTC advertising is to be an effective source of health information for adolescents in the future, it must take into account the unique features of an adolescent audience.

How direct-to-consumer television advertising for osteoarthritis drugs affects physicians' prescribing behavior.

PubMed

Bradford, W David; Kleit, Andrew N; Nietert, Paul J; Steyer, Terrence; McIlwain, Thomas; Ornstein, Steven

2006-01-01

Concern about the potential pernicious effect of direct-to-consumer (DTC) drug advertising on physicians' prescribing patterns was heightened with the 2004 withdrawal of Vioxx, a heavily advertised treatment for osteoarthritis. We examine how DTC advertising has affected physicians' prescribing behavior for osteoarthritis patients. We analyzed monthly clinical information on fifty-seven primary care practices during 2000-2002, matched to monthly brand-specific advertising data for local and network television. DTC advertising of Vioxx and Celebrex increased the number of osteoarthritis patients seen by physicians each month. DTC advertising of Vioxx increased the likelihood that patients received both Vioxx and Celebrex, but Celebrex ads only affected Vioxx use.

Turning point or tipping point: new FDA draft guidances and the future of DTC advertising.

PubMed

Pitts, Peter J

2004-01-01

According to Food and Drug Administration (FDA) research, direct-to-consumer (DTC) drug ads are not as empowering as they were even three years ago. How will the FDA's new draft guidances reverse this trend and affect the future of DTC advertising? Will they be a turning point, resulting in pharmaceutical companies' embracing an educational public health imperative, or a tipping point with politicians and the public zeroing in on aggressively targeted DTC ads as the postimportation pharmaceutical bête noire? The FDA believes that its new guidances strengthen the strategic argument that a better-informed consumer lays the groundwork for a better potential customer.

Message strategies in direct-to-consumer pharmaceutical advertising: a content analysis using Taylor's six-segment message strategy wheel.

PubMed

Tsai, Wan-Hsiu Sunny; Lancaster, Alyse R

2012-01-01

This exploratory study applies Taylor's (1999) six-segment message strategy wheel to direct-to-consumer (DTC) pharmaceutical television commercials to understand message strategies adopted by pharmaceutical advertisers to persuade consumers. A convenience sample of 96 DTC commercial campaigns was analyzed. The results suggest that most DTC drug ads used a combination approach, providing consumers with medical and drug information while simultaneously appealing to the viewer's ego-related needs and desires. In contrast to ration and ego strategies, other approaches including routine, acute need, and social are relatively uncommon while sensory was the least common message strategy. Findings thus recognized the educational value of DTC commercials.

The effects of the Union for International Cancer Control/American Joint Committee on Cancer Tumour, Node, Metastasis system version 8 on staging of differentiated thyroid cancer: a comparison to version 7.

PubMed

Verburg, Frederik A; Mäder, Uwe; Luster, Markus; Reiners, Christoph

2018-06-01

To assess the changes resulting from the changes from UICC/AJCC TNM version 7 to version 8 and to subsequently determine whether TNM version 8 is an improvement compared to previous iterations of the TNM system and other staging systems for differentiated thyroid cancer (DTC) with regard to prognostic power. Database study of DTC patients treated in our centre between 1978 up to and including 1 July 2014. Results were compared to our previous comparison of prognostic systems using the same data set. 2257 DTC patients. Staging in accordance with TNM 7 and TNM 8. Thyroid cancer-specific mortality; comparison was based on p-values of univariate Cox regression analyses as well as analysis of the proportion of variance explained (PVE). There is a redistribution from stage 3 to lower stages affecting 206 (9.1%) patients. DTC-related mortality according to Kaplan-Meier for younger and older patients in TNM 7 had a slightly lower prognostic power than that in accordance with TNM 8 (P = 8.0 10 -16 and P = 1.5 10 -21 , respectively). Overall staging is lower in 627/2257 (27.8%) patients. PVE (TNM 7: 0.29; TNM 8: 0.28) and the P-value of Cox regressions (TNM 7: P = 7.1*10 -52 ; TNM 8: P = 3.9*10 -49 ) for TNM version 8 are marginally lower than that for TNM version 7, but still better than for any other DTC staging system. TNM 8 results in a marked downstaging of patients compared to TNM 7. Although some changes, like the change in age boundary, appear to be associated with an improvement in prognostic power, the overall effect of the changes does not improve the predictive power compared to TNM 7. © 2018 John Wiley & Sons Ltd.

PD-1+Tim-3+ CD8+ T Lymphocytes Display Varied Degrees of Functional Exhaustion in Patients with Regionally Metastatic Differentiated Thyroid Cancer

PubMed Central

Severson, Jill J.; Serracino, Hilary S.; Mateescu, Valerica; Raeburn, Christopher D.; C.McIntyre, Robert; Sams, Sharon B.; Haugen, Bryan R.; French, Jena D.

2015-01-01

Regional metastatic differentiated thyroid cancer (mDTC) provides a unique model in which to study the tumor-immune interface. These lymph node (LN) metastases persist for years, generally without progression to distant metastases. While the immune system likely impedes disease progression, it is unsuccessful in eliminating disease. Our previous studies revealed that programmed death-1 (PD-1)+ T cells were enriched in tumor-involved lymph nodes (TILN). Tumor-associated leukocytes and tumor cells were collected from grossly involved LNs from 12 patients to further characterize the phenotype and functional potential of mDTC-associated PD-1+ T cells. PD-1+CD4+ and PD-1+CD8+ T cells were enriched in 8/12 TILN samples. PD-1+ T cells co-expressed Tim-3 and CD69 and failed to down-regulate CD27. CD8+ T cells, but not CD4+ T cells, from these samples were variably deficient in their ability to produce effector cytokines when compared to control TILNs that lacked resident PD-1+ T cells. PD-1+CD8+ T cells were capable of exocytosis but lacked intracellular perforin. Surprisingly, T-cell proliferative capacity was largely maintained in all samples. Thus, while PD-1 expression by mDTC-associated CD8+ T cells was associated with dysfunction, exhaustion was not complete. Notably, molecular markers of exhaustion did not translate to dysfunction in all samples or in CD4+ T cells. Regulatory T (Treg) cells, PD-L1, and galectin-9 were commonly found in mDTC and likely contributed to the initiation of T-cell exhaustion and disease progression. Therapies that release the effects of PD-1 and Tim-3 and reduce the suppressive effects of Tregs may encourage tumor elimination in patients with mDTC. PMID:25701326

Direct-to-Consumer Genetic Testing and Personal Genomics Services: A Review of Recent Empirical Studies

PubMed Central

Ostergren, Jenny

2013-01-01

Direct-to-consumer genetic testing (DTC-GT) has sparked much controversy and undergone dramatic changes in its brief history. Debates over appropriate health policies regarding DTC-GT would benefit from empirical research on its benefits, harms, and limitations. We review the recent literature (2011-present) and summarize findings across (1) content analyses of DTC-GT websites, (2) studies of consumer perspectives and experiences, and (3) surveys of relevant health care providers. Findings suggest that neither the health benefits envisioned by DTC-GT proponents (e.g., significant improvements in positive health behaviors) nor the worst fears expressed by its critics (e.g., catastrophic psychological distress and misunderstanding of test results, undue burden on the health care system) have materialized to date. However, research in this area is in its early stages and possesses numerous key limitations. We note needs for future studies to illuminate the impact of DTC-GT and thereby guide practice and policy regarding this rapidly evolving approach to personal genomics. PMID:24058877

Current landscape of direct-to-consumer genetic testing and its role in ophthalmology: a review.

PubMed

Sanfilippo, Paul G; Kearns, Lisa S; Wright, Philip; Mackey, David A; Hewitt, Alex W

2015-08-01

The sequencing of the human genome has seen the emergence of the direct-to-consumer (DTC) genetic-testing market, which allows individuals to obtain information about their genetic profile and its many health and lifestyle implications. Genetics play an important role in the development of many eye diseases, however, little information is available describing the influence of the DTC industry in ophthalmology. In this review, we examined DTC companies providing genetic test products for eye disease. Of all eye conditions, the majority of DTC companies provided susceptibility testing or risk assessment for age-related macular degeneration (AMD). For the 15 companies noted to offer products, we found considerable variation in the cost, scope and clarity of informational content of DTC genetic testing for ophthalmic conditions. The clinical utility of these tests remains in question, and the American Academy of Ophthalmology recommendations against routine testing for many conditions probably still apply. © 2015 Royal Australian and New Zealand College of Ophthalmologists.

Perceived diabetes task competence mediates the relationship of both negative and positive affect with blood glucose in adolescents with type 1 diabetes.

PubMed

Fortenberry, Katherine T; Butler, Jorie M; Butner, Jonathan; Berg, Cynthia A; Upchurch, Renn; Wiebe, Deborah J

2009-02-01

Adolescents dealing with type 1 diabetes experience disruptions in affect and diabetes management that may influence their blood glucose. A daily diary format examined whether daily fluctuations in both negative and positive affect were associated with adolescents' perceived diabetes task competence (DTC) and blood glucose, and whether perceived DTC mediated the relationship between daily affect and blood glucose. Sixty-two adolescents with type 1 diabetes completed a 2-week daily diary, which included daily measures of affect and perceived DTC, then recorded their blood glucose readings at the end of the day. We utilized hierarchical linear modeling to examine whether daily perceived DTC mediated the relationship between daily emotion and blood glucose. Daily perceived DTC mediated the relationship of both negative and positive affect with daily blood glucose. This study suggests that within the ongoing process of self-regulation, daily affect may be associated with blood glucose by influencing adolescents' perception of competence on daily diabetes tasks.

Improving the Representation of Human Factors in Operational Analysis

DTIC Science & Technology

2010-10-01

Defence Equipment and Support (DE&S) via Human Factors Integration Defence Technology Centre ( HFI DTC) activities. In particular this study’s Theme...Framework has been exploited in the HFI DTC Social Organisational Framework study, and the study team has provided a short extract for contribution to...the HFI DTC Handbook. The study has also been explicitly referenced in support to future MOD OA research studies. 8 SUMMARY AND CONCLUSIONS This

Unexpected effect of furosemide on radioiodine urinary excretion in patients with differentiated thyroid carcinomas treated with iodine 131.

PubMed

Matovic, Milovan D; Jankovic, Slobodan M; Jeremic, Marija; Tasic, Zoran; Vlajkovic, Marina

2009-08-01

In patients receiving (131)I for therapeutic purposes, diuretics are frequently used in an attempt to accelerate elimination of unbound radioiodine, reduce its adverse effects, and shorten the hospital stay. The aims of our study were to investigate the influence of furosemide therapy on urinary excretion of (131)I in patients with differentiated thyroid cancer (DTC), referred to radioiodine ablation after thyroidectomy, and to investigate whether diuretics are useful in daily practice in patients with DTC. Forty-three patients with DTC who had normal renal function and low (131)I uptake in cervical region (3.55 +/- 3.45%) were included in this study. The furosemide (20 mg) and potassium chloride (250 mg) were given orally to 23 patients 3 hours after the (131)I administration, and then q8h for 3 days. Twenty patients did not receive either furosemide or potassium chloride. After (131)I administration, the patients collected their urine for 3 days, and radioactivity of urine sample from each micturition was expressed as percentage of the administered dose. Radioactivity of blood samples was measured after 72 hours, and the values were corrected for decay of (131)I and expressed in relation to the administered dose. Initial whole-body measurement (immediately after (131)I administration) and the whole-body measurement after 72 hours were recorded for all patients. The 72-hour whole-body measurement was corrected for decay of (131)I, and expressed as a percentage of the initial whole-body measurement. Urinary excretion of (131)I was significantly lower in the patients who were taking furosemide and potassium chloride compared with the control group. The whole-body measurements after 72 hours (13.22 +/- 6.55% vs. 8.24 +/- 3.39% of the initial; p < 0.01, respectively) and the blood radioactivity (34.66 +/- 24.84 vs. 11.64 +/- 8.32 cpm/mL per 1 MBq of administered (131)I, p < 0.01) were found to be unexpectedly higher in the patients who were taking furosemide and potassium chloride compared with the control group. Our results demonstrated that furosemide given as an adjuvant medication in patients with DTC causes a significant decrease in urinary excretion of radioiodine and its higher blood concentration. Therefore, furosemide should not be recommended as an adjuvant therapy to radioiodine ablation in patients with DTC previously iodine depleted by low-iodine diet.

Assessing controversial direct-to-consumer advertising for hereditary breast cancer testing: reactions from women and their physicians in a managed care organization.

PubMed

Mouchawar, Judy; Laurion, Suzanne; Ritzwoller, Debra P; Ellis, Jennifer; Kulchak-Rahm, Alanna; Hensley-Alford, Sharon

2005-10-01

To describe the impact on patients and physicians at a managed care organization (MCO) of a direct-to-consumer advertising (DTC-ad) campaign concerning testing for the BRCA1 and BRCA2 genes. Observational study. In 2003, we mailed a 30-item questionnaire to 750 randomly chosen female members of Kaiser Permanente Colorado (KPCO) aged 25 to 54 years, and 100 female KPCO members with a history of breast cancer genetic referral. We mailed a 7-item questionnaire to 180 randomly chosen KPCO primary care providers. Of 394 patient respondents, 245 (62%) reported exposure to the DTC-ad of whom 63% reported that the DTC-ad caused no anxiety at all. A high level of perceived breast cancer risk and being of Hispanic ethnicity each were independently associated with reported anxiety due to the DTC-ad (adjusted odds ratio [OR] = 3.23, 95% confidence interval [CI] = 1.35, 7.73, and adjusted OR = 4.19, 95% CI = 1.48, 11.83, respectively). Greater knowledge was seen among respondents exposed to the DTC-ad than among those reporting no exposure (P = .015). Of the physician respondents, 84% reported that the DTC-ad caused no strain on the doctor-patient relationship, and nearly 80% reported no effect on daily clinical practice. Genetic referrals soared more than 200% compared with the prior year, when there was no advertising. The DTC-ad had a marked impact on genetic services, but little apparent negative impact on patients or primary care providers at an MCO.

Obatoclax and LY3009120 Efficiently Overcome Vemurafenib Resistance in Differentiated Thyroid Cancer

PubMed Central

Wei, Wei-Jun; Sun, Zhen-Kui; Shen, Chen-Tian; Song, Hong-Jun; Zhang, Xin-Yun; Qiu, Zhong-Ling; Luo, Quan-Yong

2017-01-01

Although the prognosis of differentiated thyroid cancer (DTC) is relatively good, 30-40% of patients with distant metastases develop resistance to radioactive iodine therapy due to tumor dedifferentiation. For DTC patients harboring BRAFV600E mutation, Vemurafenib, a BRAF kinase inhibitor, has dramatically changed the therapeutic landscape, but side effects and drug resistance often lead to termination of the single agent treatment. In the present study, we showed that either LY3009120 or Obatoclax (GX15-070) efficiently inhibited cell cycle progression and induced massive death of DTC cells. We established that BRAF/CRAF dimerization was an underlying mechanism for Vemurafenib resistance. LY3009120, the newly discovered pan-RAF inhibitor, successfully overcame Vemurafenib resistance and suppressed the growth of DTC cells in vitro and in vivo. We also observed that expression of anti-apoptotic Bcl-2 increased substantially following BRAF inhibitor treatment in Vemurafenib-resistant K1 cells, and both Obatoclax and LY3009120 efficiently induced apoptosis of these resistant cells. Specifically, Obatoclax exerted its anti-cancer activity by inducing loss of mitochondrial membrane potential (ΔΨm), dysfunction of mitochondrial respiration, reduction of cellular glycolysis, autophagy, neutralization of lysosomes, and caspase-related apoptosis. Furthermore, the cancer killing effects of LY3009120 and Obatoclax extended to two more Vemurafenib-resistant DTC cell lines, KTC-1 and BCPAP. Taken together, our results highlighted the potential value of LY3009120 for both Vemurafenib-sensitive and -resistant DTC and provided evidence for the combination therapy using Vemurafenib and Obatoclax for radioiodine-refractory DTC. PMID:28382170

An Approach to Sensorless Detection of Human Input Torque and Its Application to Power Assist Motion in Electric Wheelchair

NASA Astrophysics Data System (ADS)

Kaida, Yukiko; Murakami, Toshiyuki

A wheelchair is an important apparatus of mobility for people with disability. Power-assist motion in an electric wheelchair is to expand the operator's field of activities. This paper describes force sensorless detection of human input torque. Reaction torque estimation observer calculates the total disturbance torque first. Then, the human input torque is extracted from the estimated disturbance. In power-assist motion, assist torque is synthesized according to the product of assist gain and the average torque of the right and left input torque. Finally, the proposed method is verified through the experiments of power-assist motion.

Use of digital micromirror devices as dynamic pinhole arrays for adaptive confocal fluorescence microscopy

NASA Astrophysics Data System (ADS)

Pozzi, Paolo; Wilding, Dean; Soloviev, Oleg; Vdovin, Gleb; Verhaegen, Michel

2018-02-01

In this work, we present a new confocal laser scanning microscope capable to perform sensorless wavefront optimization in real time. The device is a parallelized laser scanning microscope in which the excitation light is structured in a lattice of spots by a spatial light modulator, while a deformable mirror provides aberration correction and scanning. A binary DMD is positioned in an image plane of the detection optical path, acting as a dynamic array of reflective confocal pinholes, images by a high performance cmos camera. A second camera detects images of the light rejected by the pinholes for sensorless aberration correction.

Medicine, market and communication: ethical considerations in regard to persuasive communication in direct-to-consumer genetic testing services.

PubMed

Schaper, Manuel; Schicktanz, Silke

2018-06-05

Commercial genetic testing offered over the internet, known as direct-to-consumer genetic testing (DTC GT), currently is under ethical attack. A common critique aims at the limited validation of the tests as well as the risk of psycho-social stress or adaption of incorrect behavior by users triggered by misleading health information. Here, we examine in detail the specific role of advertising communication of DTC GT companies from a medical ethical perspective. Our argumentative analysis departs from the starting point that DTC GT operates at the intersection of two different contexts: medicine on the one hand and the market on the other. Both fields differ strongly with regard to their standards of communication practices and the underlying normative assumptions regarding autonomy and responsibility. Following a short review of the ethical contexts of medical and commercial communication, we provide case examples for persuasive messages of DTC GT websites and briefly analyze their design with a multi-modal approach to illustrate some of their problematic implications. We observe three main aspects in DTC GT advertising communication: (1) the use of material suggesting medical professional legitimacy as a trust-establishing tool, (2) the suggestion of empowerment as a benefit of using DTC GT services and (3) the narrative of responsibility as a persuasive appeal to a moral self-conception. While strengthening and respecting the autonomy of a patient is the focus in medical communication, specifically genetic counselling, persuasive communication is the normal mode in marketing of consumer goods, presuming an autonomous, rational, independent consumer. This creates tension in the context of DTC GT regarding the expectation and normative assessment of communication strategies. Our analysis can even the ground for a better understanding of ethical problems associated with intersections of medical and commercial communication and point to perspectives of analysis of DTC GT advertising.

Risky business: risk perception and the use of medical services among customers of DTC personal genetic testing.

PubMed

Kaufman, David J; Bollinger, Juli M; Dvoskin, Rachel L; Scott, Joan A

2012-06-01

Direct-to-consumer genetic testing has generated speculation about how customers will interpret results and how these interpretations will influence healthcare use and behavior; however, few empirical data on these topics exist. We conducted an online survey of DTC customers of 23andMe, deCODEme, and Navigenics to begin to address these questions. Random samples of U.S. DTC customers were invited to participate. Survey topics included demographics, perceptions of two sample DTC results, and health behaviors following DTC testing. Of 3,167 DTC customers invited, 33% (n = 1,048) completed the survey. Forty-three percent of respondents had sought additional information about a health condition tested; 28% had discussed their results with a healthcare professional; and 9% had followed up with additional lab tests. Sixteen percent of respondents had changed a medication or supplement regimen, and one-third said they were being more careful about their diet. Many of these health-related behaviors were significantly associated with responses to a question that asked how participants would perceive their colon cancer risk (as low, moderate, or high) if they received a test result showing an 11% lifetime risk, as compared to 5% risk in the general population. Respondents who would consider themselves to be at high risk for colon cancer were significantly more likely to have sought information about a disease (p = 0.03), discussed results with a physician (p = 0.05), changed their diet (p = 0.02), and started exercising more (p = 0.01). Participants' personal health contexts--including personal and family history of disease and quality of self-perceived health--were also associated with health-related behaviors after testing. Subjective interpretations of genetic risk data and personal context appear to be related to health behaviors among DTC customers. Sharing DTC test results with healthcare professionals may add perceived utility to the tests.

The number of 131I therapy courses needed to achieve complete remission is an indicator of prognosis in patients with differentiated thyroid carcinoma.

PubMed

Thies, Elena-Daphne; Tanase, Karina; Maeder, Uwe; Luster, Markus; Buck, Andreas K; Hänscheid, Heribert; Reiners, Christoph; Verburg, Frederik A

2014-12-01

To assess the risk of differentiated thyroid cancer (DTC) recurrence, DTC-related mortality and life expectancy in relation to the number of courses of (131)I therapy (RIT) and cumulative (131)I activities required to achieve complete remission (CR). The study was a database review of 1,229 patients with DTC, 333 without and 896 with CR (negative TSH-stimulated thyroglobulin and negative (131)I diagnostic whole-body scintigraphy) after one or more courses of RIT. The median follow-up was 9.0 years (range 0.1 - 31.8 years) after CR. Recurrence rates at 5 years, 10 years and the end of follow-up were 1.0 ± 0.3%, 4.0 ± 0.7 % and 6.2 ± 1.1 %, and DTC-related mortality was 0.1 ± 0.1%, 0.5 ± 0.3% and 3.4 ± 1.1%, respectively. Recurrence rates also increased with an increasing number of RIT courses required (p = 0.001). DTC-related mortality increased from four RIT courses. In patients with CR after one RIT course, there were no differences in recurrence or DTC-related mortality rates between low-risk and high-risk patients. In patients requiring two RIT courses these rates remain elevated in high-risk patients. Recurrence and DTC-related mortality rates were only significantly elevated in those requiring a cumulative activity over 22.2 GBq (600 mCi) from multiple RIT courses for CR. Regardless of the number of RIT courses or activity needed, life expectancy was not significantly lowered. If more than one RIT course is needed to achieve CR, higher recurrence and DTC-related mortality rates are observed, especially in high-risk patients. Patients requiring >22.2 GBq (131)I for CR should be followed in the same way as patients in whom CR is never reached as long-term mortality rates are similar.

RECONCEPTUALIZING CONSENT FOR DIRECT-TO-CONSUMER HEALTH SERVICES.

PubMed

Spector-Bagdady, Kayte

2015-01-01

The market for direct-to-consumer (DTC) health services continues to grow rapidly with former patients converting to customers for the opportunity to purchase varied diagnostic tests without the involvement of their clinician. For the first time a DTC genetic testing company is advertising health-related reports "that meet [Food and Drug Administration] standards for being clinically and scientifically valid." Ethicists and regulatory agencies alike have recognized the need for a more informed transaction in the DTC context, but how should we classify a commercial transaction for something normally protected by a duty of care? How can we assure informed agreements in an industry with terms and conditions as varied as the services performed? The doctrine of "informed consent" began as an ethical construct building on the promise of beneficence in the clinical relationship and elevating the principle of autonomy--but in the DTC context should we hold providers to legal standards of informed consent and associated medical malpractice liability, or contractual obligations where consumers would seek remedy for breach? This Article analyzes the fine balance that must be struck in an industry where companies are selling services for entertainment or non-medical purposes that possess the capacity to produce serious and disquieting medical information. It begins by reviewing current standards of consent in the clinical setting from both a legal and ethical perspective and then lays forth current standards for DTC consent using two currently controversial case studies: that of keepsake fetal ultrasound and genetic testing. DTC keepsake ultrasound and genetic testing providers attempt to de-medicalize the devices used for these procedures from their intended medical uses to non-medical uses. But while keepsake ultrasound is marketed as "intended for entertainment purposes only," it can provide medical information as an incidental finding. 23andMe currently purports to be the only DTC genetics service that "includes" reports that meet FDA qualifications, despite disclaimers of intent to "provide medical advice." The attempted de-medicalization of these devices, therefore, has not been fully transformative, and DTC providers should have more robust ethical and legal duties than the average goods and services seller. This Article delineates these responsibilities, beginning with ethical duties surrounding marketing, entering into, and providing DTC services. It then turns to the legal paradigms necessary to enable, or at least allow for, DTC providers to meet these ethical obligations. While it argues that contractual, as opposed to fiduciary, requirements are most appropriate and that waivers of liability will likely be upheld, it also advocates for a heightened expectation of disclosure during contracting.

Improved direct torque control of an induction generator used in a wind conversion system connected to the grid.

PubMed

Abdelli, Radia; Rekioua, Djamila; Rekioua, Toufik; Tounzi, Abdelmounaïm

2013-07-01

This paper presents a modulated hysteresis direct torque control (MHDTC) applied to an induction generator (IG) used in wind energy conversion systems (WECs) connected to the electrical grid through a back-to-back converter. The principle of this strategy consists in superposing to the torque reference a triangular signal, as in the PWM strategy, with the desired switching frequency. This new modulated reference is compared to the estimated torque by using a hysteresis controller as in the classical direct torque control (DTC). The aim of this new approach is to lead to a constant frequency and low THD in grid current with a unit power factor and a minimum voltage variation despite the wind variation. To highlight the effectiveness of the proposed method, a comparison was made with classical DTC and field oriented control method (FOC). The obtained simulation results, with a variable wind profile, show an adequate dynamic of the conversion system using the proposed method compared to the classical approaches. Copyright © 2013 ISA. Published by Elsevier Ltd. All rights reserved.

Simulink-aided Design and Implementation of Sensorless BLDC Motor Digital Control System

NASA Astrophysics Data System (ADS)

Zhilenkov, A. A.; Tsvetkov, Y. N.; Chistov, V. B.; Nyrkov, A. P.; Sokolov, S. S.

2017-07-01

The paper describes the process of creating of brushless direct current motor’s digital control system. The target motor has no speed sensor, so back-EMF method is used for commutation control. Authors show how to model the control system in MatLab/Simulink and to test it onboard STM32F4 microcontroller.This technology allows to create the most flexible system, which will control possible with a personal computer by communication lines. It is possible to examine the signals in the circuit of the actuator without any external measuring instruments - testers, oscilloscopes, etc. - and output waveforms and measured values of signals directly on the host PC.

78 FR 13924 - Self-Regulatory Organizations; The Depository Trust Company; Notice of Filing Amendment No. 2 and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-01

... systemic risk since the reversals may override DTC's risk management controls such as the Collateral...,\\11\\ require that clearing agencies establish, implement, maintain and enforce written policies and...

Internet-Based Direct-to-Consumer Genetic Testing: A Systematic Review.

PubMed

Covolo, Loredana; Rubinelli, Sara; Ceretti, Elisabetta; Gelatti, Umberto

2015-12-14

Direct-to-consumer genetic tests (DTC-GT) are easily purchased through the Internet, independent of a physician referral or approval for testing, allowing the retrieval of genetic information outside the clinical context. There is a broad debate about the testing validity, their impact on individuals, and what people know and perceive about them. The aim of this review was to collect evidence on DTC-GT from a comprehensive perspective that unravels the complexity of the phenomenon. A systematic search was carried out through PubMed, Web of Knowledge, and Embase, in addition to Google Scholar according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist with the key term "Direct-to-consumer genetic test." In the final sample, 118 articles were identified. Articles were summarized in five categories according to their focus on (1) knowledge of, attitude toward use of, and perception of DTC-GT (n=37), (2) the impact of genetic risk information on users (n=37), (3) the opinion of health professionals (n=20), (4) the content of websites selling DTC-GT (n=16), and (5) the scientific evidence and clinical utility of the tests (n=14). Most of the articles analyzed the attitude, knowledge, and perception of DTC-GT, highlighting an interest in using DTC-GT, along with the need for a health care professional to help interpret the results. The articles investigating the content analysis of the websites selling these tests are in agreement that the information provided by the companies about genetic testing is not completely comprehensive for the consumer. Given that risk information can modify consumers' health behavior, there are surprisingly few studies carried out on actual consumers and they do not confirm the overall concerns on the possible impact of DTC-GT. Data from studies that investigate the quality of the tests offered confirm that they are not informative, have little predictive power, and do not measure genetic risk appropriately. The impact of DTC-GT on consumers' health perceptions and behaviors is an emerging concern. However, negative effects on consumers or health benefits have yet to be observed. Nevertheless, since the online market of DTC-GT is expected to grow, it is important to remain aware of a possible impact.

Internet-Based Direct-to-Consumer Genetic Testing: A Systematic Review

PubMed Central

Rubinelli, Sara; Ceretti, Elisabetta; Gelatti, Umberto

2015-01-01

Background Direct-to-consumer genetic tests (DTC-GT) are easily purchased through the Internet, independent of a physician referral or approval for testing, allowing the retrieval of genetic information outside the clinical context. There is a broad debate about the testing validity, their impact on individuals, and what people know and perceive about them. Objective The aim of this review was to collect evidence on DTC-GT from a comprehensive perspective that unravels the complexity of the phenomenon. Methods A systematic search was carried out through PubMed, Web of Knowledge, and Embase, in addition to Google Scholar according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist with the key term “Direct-to-consumer genetic test.” Results In the final sample, 118 articles were identified. Articles were summarized in five categories according to their focus on (1) knowledge of, attitude toward use of, and perception of DTC-GT (n=37), (2) the impact of genetic risk information on users (n=37), (3) the opinion of health professionals (n=20), (4) the content of websites selling DTC-GT (n=16), and (5) the scientific evidence and clinical utility of the tests (n=14). Most of the articles analyzed the attitude, knowledge, and perception of DTC-GT, highlighting an interest in using DTC-GT, along with the need for a health care professional to help interpret the results. The articles investigating the content analysis of the websites selling these tests are in agreement that the information provided by the companies about genetic testing is not completely comprehensive for the consumer. Given that risk information can modify consumers’ health behavior, there are surprisingly few studies carried out on actual consumers and they do not confirm the overall concerns on the possible impact of DTC-GT. Data from studies that investigate the quality of the tests offered confirm that they are not informative, have little predictive power, and do not measure genetic risk appropriately. Conclusions The impact of DTC-GT on consumers’ health perceptions and behaviors is an emerging concern. However, negative effects on consumers or health benefits have yet to be observed. Nevertheless, since the online market of DTC-GT is expected to grow, it is important to remain aware of a possible impact. PMID:26677835

Prognostic significance of human pituitary tumor-transforming gene immunohistochemical expression in differentiated thyroid cancer.

PubMed

Sáez, Carmen; Martínez-Brocca, M Asunción; Castilla, Carolina; Soto, Alfonso; Navarro, Elena; Tortolero, María; Pintor-Toro, José A; Japón, Miguel A

2006-04-01

Human securin pituitary tumor-transforming gene (hPTTG) is overexpressed in a variety of primary neoplasias, including differentiated thyroid cancer (DTC). The objective of this study was to examine the immunohistochemical expression of hPTTG in DTC and its association with known prognostic factors. hPTTG expression was analyzed by immunostaining on paraffin-embedded tissues. Clinical data were used to determine any associations between the expression of hPTTG and prognostic variables of DTC. A median follow-up of 43 months allowed us to analyze the persistence of disease and the response to radioiodine therapy. The study was conducted at a tertiary university hospital. Ninety-five patients undergoing surgical resection for DTC (n = 60) or benign nodular thyroid disease (n = 35) were studied. The main outcome measure was the association between hPTTG expression and prognostic factors in DTC. Among DTC cases, 21 (35%) had low and 39 (65%) had high hPTTG immunostaining. Adjacent nonneoplastic thyroid tissue was largely unstained. Among benign nodular thyroid disease cases, immunostaining was detected focally in eight (22.8%). A significant association was found between hPTTG expression and the presence of nodal (P < 0.01) or distant metastases (P < 0.05). A significant association with TNM was also found, because 83.3% of advanced TNM stages showed elevated hPTTG (P < 0.05). The association between hPTTG overexpression and decreased radioiodine uptake during follow-up was also significant (P < 0.05). The expression levels of hPTTG were confirmed as an independent prognostic factor for persistent disease (relative risk, 3.0; 95% confidence interval, 1.1-8.7; P < 0.05). Immunohistochemical analysis of hPTTG is of potential value in the determination of tumor aggressiveness in DTC.

Association of fall history with the Timed Up and Go test score and the dual task cost: A cross-sectional study among independent community-dwelling older adults.

PubMed

Asai, Tsuyoshi; Oshima, Kensuke; Fukumoto, Yoshihiro; Yonezawa, Yuri; Matsuo, Asuka; Misu, Shogo

2018-05-21

To investigate the associations between fall history and the Timed Up and Go (TUG) test (single-TUG test), TUG test while counting aloud backwards from 100 (dual-TUG test) and the dual-task cost (DTC) among independent community-dwelling older adults. This cross-sectional study included 537 older adults who lived independently in the community. Data on fall history in the previous year were obtained by self-administrated questionnaire. The single- and dual-TUG tests were carried out, and the DTC value was computed from these results. Associations between fall history and these TUG-related values were analyzed using multivariate logistic regression models. The participants were divided into fall risk groups using the cut-off values of those significantly associated with falling, and the odds ratios (OR) were computed. Slower single-TUG test scores and lower DTC values were significantly associated with fall history after adjusting for potential confounders (single-TUG test score: OR 1.133, 95% CI 1.029-1.249; DTC value: OR 0.984, 95% CI 0.968-0.998). Older adults with slower single-TUG test scores and lower DTC values reported a fall history more often than those in other categories (OR compared with the lower-risk single-TUG and lower-risk DTC groups: 3.474, 95% CI 1.881-6.570). Slower single-TUG test scores and lower DTC values are associated with fall history among independent community-dwelling older adults. To some extent, dual task performance might provide added value for fall assessment, compared with administering the TUG test alone. Geriatr Gerontol Int 2018; ••: ••-••. © 2018 Japan Geriatrics Society.

Effects of Direct-to-Consumer Advertising and Clinical Guidelines on Appropriate Use of Human Papillomavirus DNA Tests

PubMed Central

2011-01-01

Background Both clinical guidelines and direct-to-consumer (DTC) advertising influence use of new health care technologies, but little is known about their relative effects. The introduction of a cervical cancer screening test in 2000 offered a unique opportunity to assess the two strategies. Objective To evaluate the effects of clinical guidelines and a targeted DTC advertising campaign on overall and appropriate use of human papillomavirus (HPV) DNA tests. Research Design Quasi-experimental study using difference-in-differences analysis. Data were MarketScan private insurance claims for 500,000 women ages 21 to 64 enrolled at least 12 consecutive months from January 2001 through December 2005. Results Both clinical guidelines and DTC advertising were associated with increases in overall HPV DNA test use. DTC advertising was associated with a statistically significant increase in HPV DNA test use in two groups of DTC cities (+5.57 percent, p<0.0001; +2.54 percent, p<0.0001). DTC advertising was associated with comparable increases in the probability of appropriate and inappropriate use of the HPV DNA test in primary screening. Clinical guideline releases from the American College of Obstetricians and Gynecologists, and by a co-sponsored panel, were associated with greater increases in HPV DNA tests for appropriate primary screening than for inappropriate primary screening (β=0.3347, p<0.05 and β=0.4175, p<0.01). Conclusions DTC advertising was associated with increased overall use of a cervical cancer screening test, while clinical guidelines were differentially associated with increased appropriate use. These findings suggest distinct influences of consumer marketing and professional guidelines on the use of health care products and services. PMID:21150798

Effects of direct-to-consumer advertising and clinical guidelines on appropriate use of human papillomavirus DNA tests.

PubMed

Price, Rebecca Anhang; Frank, Richard G; Cleary, Paul D; Goldie, Sue J

2011-02-01

Both clinical guidelines and direct-to-consumer (DTC) advertising influence the use of new health care technologies, but little is known about their relative effects. The introduction of a cervical cancer screening test in 2000 offered a unique opportunity to assess the 2 strategies. To evaluate the effects of clinical guidelines and a targeted DTC advertising campaign on overall and appropriate use of human papillomavirus (HPV) DNA tests. Quasi-experimental study using difference-in-differences analysis. Data were MarketScan private insurance claims for 500,000 women aged 21 to 64 enrolled at least 12 consecutive months from January 2001 through December 2005. Both clinical guidelines and DTC advertising were associated with increases in overall HPV DNA test use. DTC advertising was associated with a statistically significant increase in HPV DNA test use in 2 groups of DTC cities (+5.57%, P < 0.0001; +2.54%, P < 0.0001). DTC advertising was associated with comparable increases in the probability of appropriate and inappropriate use of the HPV DNA test in primary screening. Clinical guideline releases from the American College of Obstetricians and Gynecologists, and by a cosponsored panel, were associated with greater increases in HPV DNA tests for appropriate primary screening than for inappropriate primary screening (β = 0.3347, P < 0.05 and β = 0.4175, P < 0.01). DTC advertising was associated with increased overall use of a cervical cancer screening test, whereas clinical guidelines were differentially associated with increased appropriate use. These findings suggest distinct influences of consumer marketing and professional guidelines on the use of health care products and services.

In Vivo Evaluation of Active and Passive Physiological Control Systems for Rotary Left and Right Ventricular Assist Devices.

PubMed

Gregory, Shaun D; Stevens, Michael C; Pauls, Jo P; Schummy, Emma; Diab, Sara; Thomson, Bruce; Anderson, Ben; Tansley, Geoff; Salamonsen, Robert; Fraser, John F; Timms, Daniel

2016-09-01

Preventing ventricular suction and venous congestion through balancing flow rates and circulatory volumes with dual rotary ventricular assist devices (VADs) configured for biventricular support is clinically challenging due to their low preload and high afterload sensitivities relative to the natural heart. This study presents the in vivo evaluation of several physiological control systems, which aim to prevent ventricular suction and venous congestion. The control systems included a sensor-based, master/slave (MS) controller that altered left and right VAD speed based on pressure and flow; a sensor-less compliant inflow cannula (IC), which altered inlet resistance and, therefore, pump flow based on preload; a sensor-less compliant outflow cannula (OC) on the right VAD, which altered outlet resistance and thus pump flow based on afterload; and a combined controller, which incorporated the MS controller, compliant IC, and compliant OC. Each control system was evaluated in vivo under step increases in systemic (SVR ∼1400-2400 dyne/s/cm(5) ) and pulmonary (PVR ∼200-1000 dyne/s/cm(5) ) vascular resistances in four sheep supported by dual rotary VADs in a biventricular assist configuration. Constant speed support was also evaluated for comparison and resulted in suction events during all resistance increases and pulmonary congestion during SVR increases. The MS controller reduced suction events and prevented congestion through an initial sharp reduction in pump flow followed by a gradual return to baseline (5.0 L/min). The compliant IC prevented suction events; however, reduced pump flows and pulmonary congestion were noted during the SVR increase. The compliant OC maintained pump flow close to baseline (5.0 L/min) and prevented suction and congestion during PVR increases. The combined controller responded similarly to the MS controller to prevent suction and congestion events in all cases while providing a backup system in the event of single controller failure. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Thyroid Cancer Induction: Nitrates as Independent Risk Factors or Risk Modulators after Radiation Exposure, with a Focus on the Chernobyl Accident.

PubMed

Drozd, Valentina M; Branovan, Igor; Shiglik, Nikolay; Biko, Johannes; Reiners, Christoph

2018-03-01

In recent decades, differentiated thyroid cancer (DTC) incidence has been increasing worldwide. The important contributions to this phenomenon of "overdiagnosis" driven by wider use of improved ultrasound systems are amply documented, notwithstanding the "real" carcinogenic effects of ionizing radiation, e.g., from the Chernobyl accident or health care interventions. Less well understood is the role of nitrates - as environmental pollutants, in diet, and in medication - in thyroid carcinogenesis. Increasing exposure to nitrates is associated with rising incidence of esophageal, stomach, bladder, and colon cancers. Recent data suggest that in agricultural areas with higher mean nitrate levels in groundwater, DTC risk is also elevated. Our work in Belarus after Chernobyl has shown that children in districts with high nitrate concentrations in drinking water had significantly higher thyroid cancer incidence after irradiation than did their counterparts in areas with lower nitrate concentrations. Notwithstanding thyroid shielding, increasing use of computed tomography and dental X-rays heightens radiation exposure of the salivary glands in the general population, especially in children and adolescents. When nitrate intake is increased, salivary gland irradiation may potentially result in carcinogenic elevations in plasma nitric oxide concentrations. In conclusion, excess nitrate intake seems to be an independent risk factor for DTC. Additionally, we hypothesize from our data that high nitrate levels modulate the carcinogenic effect of radiation on the thyroid. Cohort studies, case-control studies, or both, are needed to quantify the effects of nitrates on DTC risk in the presence or absence of radiation exposure, e.g., that associated with diagnostic or therapeutic health care interventions.

Direct-to-consumer genetic testing for predicting sports performance and talent identification: Consensus statement.

PubMed

Webborn, Nick; Williams, Alun; McNamee, Mike; Bouchard, Claude; Pitsiladis, Yannis; Ahmetov, Ildus; Ashley, Euan; Byrne, Nuala; Camporesi, Silvia; Collins, Malcolm; Dijkstra, Paul; Eynon, Nir; Fuku, Noriyuki; Garton, Fleur C; Hoppe, Nils; Holm, Søren; Kaye, Jane; Klissouras, Vassilis; Lucia, Alejandro; Maase, Kamiel; Moran, Colin; North, Kathryn N; Pigozzi, Fabio; Wang, Guan

2015-12-01

The general consensus among sport and exercise genetics researchers is that genetic tests have no role to play in talent identification or the individualised prescription of training to maximise performance. Despite the lack of evidence, recent years have witnessed the rise of an emerging market of direct-to-consumer marketing (DTC) tests that claim to be able to identify children's athletic talents. Targeted consumers include mainly coaches and parents. There is concern among the scientific community that the current level of knowledge is being misrepresented for commercial purposes. There remains a lack of universally accepted guidelines and legislation for DTC testing in relation to all forms of genetic testing and not just for talent identification. There is concern over the lack of clarity of information over which specific genes or variants are being tested and the almost universal lack of appropriate genetic counselling for the interpretation of the genetic data to consumers. Furthermore independent studies have identified issues relating to quality control by DTC laboratories with different results being reported from samples from the same individual. Consequently, in the current state of knowledge, no child or young athlete should be exposed to DTC genetic testing to define or alter training or for talent identification aimed at selecting gifted children or adolescents. Large scale collaborative projects, may help to develop a stronger scientific foundation on these issues in the future. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Experimental Studies in a Reconfigurable C4 Test-bed for Network Enabled Capability

DTIC Science & Technology

2006-06-01

Cross1, Dr R. Houghton1, and Mr R. McMaster1 Defence Technology Centre for Human factors Integration (DTC HFI ) BITlab, School of Engineering and Design...NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Defence Technology Centre for Human factors Integration (DTC HFI ) BITlab, School of...studies into NEC by the Human Factors Integration Defence Technology Centre ( HFI -DTC). DEVELOPMENT OF THE TESTBED In brief, the C4 test-bed

State of play in direct-to-consumer genetic testing for lifestyle-related diseases: market, marketing content, user experiences and regulation.

PubMed

Saukko, Paula

2013-02-01

Direct-to-consumer (DTC) genetic tests have aroused controversy. Critics have argued many of the tests are not backed by scientific evidence, misguide their customers and should be regulated more stringently. Proponents suggest that finding out genetic susceptibilities for diseases could encourage healthier behaviours and makes the results of genetics research available to the public. This paper reviews the state of play in DTC genetic testing, focusing on tests identifying susceptibilities for lifestyle-related diseases. It will start with mapping the market for the tests. The paper will review (1) research on the content of the online marketing of DTC tests, (2) studies on the effects of DTC genetic tests on customers and (3) academic and policy proposals on how to regulate the tests. Current studies suggest that the marketing of DTC genetic tests often exaggerates their predictive powers, which could misguide consumers. However, research indicates that the tests do not seem to have major negative effects (worry and confusion) but neither do they engender positive effects (lifestyle change) on current users. Research on regulation of the tests has most commonly suggested regulating the marketing claims of the companies. In conclusion, the risks and benefits of DTC genetic tests are less significant than what has been predicted by critics and proponents, which will be argued reflects broader historical trends transforming health and medicine.

Performance of dithiocarbamate-type flocculant in treating simulated polymer flooding produced water.

PubMed

Gao, Baoyu; Jia, Yuyan; Zhang, Yongqiang; Li, Qian; Yue, Qinyan

2011-01-01

Produced water from polymer flooding is difficult to treat due to its high polymer concentration, high viscosity, and emulsified characteristics. The dithiocarbamate flocculant, DTC (T403), was prepared by the amine-terminated polyoxypropane-ether compound known as Jeffamine-T403. The product was characterized by IR spectra and elemental analysis. The DTC agent chelating with Fe2+ produced a network polymer matrix, which captured and removed oil droplets efficiently. Oil removal by the flocculent on simulated produced water with 0, 200, 500, 900 mg/L of partially hydrolyzed polyacrylamide (HPAM) was investigated for aspects of effectiveness of DTC (T403) dosage and concentrations of HPAM and Fe2+ ions in the wastewater. Results showed that HPAM had a negative influence on oil removal efficiency when DTC (T403) dosage was lower than 20 mg/L. However, residual oil concentrations in tested samples with different concentrations of HPAM all decreased below 10 mg/L when DTC (T403) dosage reached 30 mg/L. The concentration of Fe2+ in the initial wastewater had a slight effect on oil removal at the range of 2-12 mg/L. Results showed that Fe3+ could not be used in place of Fe2+ as Fe3+ could not react with DTC under flocculated conditions. The effects of mineral salts ions were also investigated.

Methodological challenges surrounding direct-to-consumer advertising research--the measurement conundrum.

PubMed

Hansen, Richard A; Droege, Marcus

2005-06-01

Numerous studies have focused on the impact of direct-to-consumer (DTC) prescription drug advertising on consumer behavior and health outcomes. These studies have used various approaches to assess exposure to prescription drug advertising and to measure the subsequent effects of such advertisements. The objectives of this article are to (1) discuss measurement challenges involved in DTC advertising research, (2) summarize measurement approaches commonly identified in the literature, and (3) discuss contamination, time to action, and endogeneity as specific problems in measurement design and application. We conducted a review of the professional literature to identify illustrative approaches to advertising measurement. Specifically, our review of the literature focused on measurement of DTC advertising exposure and effect. We used the hierarchy-of-effects model to guide our discussion of processing and communication effects. Other effects were characterized as target audience action, sales, market share, and profit. Overall, existing studies have used a variety of approaches to measure advertising exposure and effect, yet the ability of measures to produce a valid and reliable understanding of the effects of DTC advertising can be improved. Our review provides a framework for conceptualizing DTC measurement, and can be used to identify gaps in the literature not sufficiently addressed by existing measures. Researchers should continue to explore correlations between exposure and effect of DTC advertising, but are obliged to improve and validate measurement in this area.

The general public's understanding and perception of direct-to-consumer genetic test results.

PubMed

Leighton, J W; Valverde, K; Bernhardt, B A

2012-01-01

Direct-to-consumer (DTC) genetic testing allows consumers to discover their risk for common complex disorders. The extent to which consumers understand typical results provided by DTC genetic testing is currently unknown. Misunderstanding of the results could lead to negative consequences including unnecessary concern, false reassurance or unwarranted changes in screening behaviors. We conducted a study to investigate consumers' perceptions and understanding of DTC test results. An online survey was posted on Facebook that included questions relating to 4 sample test results for risk of developing colorectal cancer, heart disease and skin cancer. Genetic counselors were used as a comparison group. 145 individuals from the general public and 171 genetic counselors completed the survey. A significant difference was found between the way the general public and genetic counselors interpreted the meaning of the DTC results. The general public respondents also believed that results in all 4 scenarios would be significantly more helpful than the genetic counselors did. Although the majority of general public respondents rated the results as easy to understand, they often misinterpreted them. These findings imply that the general public has the potential to misinterpret DTC results without appropriate assistance. Further research is needed to explore optimal methods of providing DTC test results and ways to minimize the risk of negative consequences for consumers. Copyright © 2011 S. Karger AG, Basel.

A survey of direct-to-consumer teledermatology services available to US patients: Explosive growth, opportunities and controversy.

PubMed

Fogel, Alexander L; Sarin, Kavita Y

2017-01-01

Introduction Direct-to-consumer (DTC) teledermatology is radically changing the way patients obtain dermatological care. Now, with a few clicks, patients can obtain dermatological consultations and prescription medications without a prior physician-patient relationship. To analyse all DTC teledermatology services available to US patients. Methods We performed Internet searches to identify DTC teledermatology services available through Internet webpages or through smartphone applications. For each service, the scope of care provided, cost, wait times, prescription policies and other relevant information were recorded. Results Twenty-two DTC teledermatology services are available to US patients in 45 states. Six (27%) services offer care from international physicians. Sixteen (73%) services allow patients to seek care for any reason, while six (27%) limit care to acne or anti-aging. The median reported response time for DTC teledermatology services is 48 hours from the time of patient request. The median consultation fee for companies providing care from US board-certified physicians is US$59. Across all services, consultation fees range from US$1.59 to US$250. Conclusions DTC teledermatology services are readily available to patients in most states. These services may reduce the cost of patient visits, expand access to care and increase patient convenience. However, the presence of services staffed by physicians who are not US board-certified, as well as the use of incautious language regarding prescription medications, is concerning.

Racial minority group interest in direct-to-consumer genetic testing: findings from the PGen study.

PubMed

Landry, Latrice; Nielsen, Daiva Elena; Carere, Deanna Alexis; Roberts, J Scott; Green, Robert C

2017-10-01

There is little information regarding direct-to-consumer (DTC) personal genetic testing (PGT) in non-White racial minorities. Using a web-based survey, we compared the pretest interests and attitudes toward DTC-PGT of racial minority and White DTC-PGT customers of 23andMe and Pathway Genomics using chi-square tests and multinomial regression. Data were available for 1487 participants (1389 White, 44 Black, and 54 Asian). Survey responses were similar across racial groups, although a greater proportion of Blacks compared to Whites reported being "very interested" in genetic information related to traits (91.9 vs. 70.8%, p = 0.009). A greater proportion of Asians compared to Whites reported that a "very important" consideration for pursuing DTC-PGT was limited information about their family health history (58.0 vs. 37.5%, p = 0.002). While a number of significant differences between groups were observed in unadjusted analyses, they did not remain significant after adjustment. This study provides a preliminary view of the interests for purchasing DTC-PGT among customers with racial minority backgrounds.

Direct-to-consumer genetic testing: good, bad or benign?

PubMed

Caulfield, T; Ries, N M; Ray, P N; Shuman, C; Wilson, B

2010-02-01

A wide variety of genetic tests are now being marketed and sold in direct-to-consumer (DTC) commercial transactions. However, risk information revealed through many DTC testing services, especially those based on emerging genome wide-association studies, has limited predictive value for consumers. Some commentators contend that tests are being marketed prematurely, while others support rapid translation of genetic research findings to the marketplace. The potential harms and benefits of DTC access to genetic testing are not yet well understood, but some large-scale studies have recently been launched to examine how consumers understand and use genetic risk information. Greater consumer access to genetic tests creates a need for continuing education for health care professionals so they can respond to patients' inquiries about the benefits, risks and limitations of DTC services. Governmental bodies in many jurisdictions are considering options for regulating practices of DTC genetic testing companies, particularly to govern quality of commercial genetic tests and ensure fair and truthful advertising. Intersectoral initiatives involving government regulators, professional bodies and industry are important to facilitate development of standards to govern this rapidly developing area of personalized genomic commerce.

'Only a click away - DTC genetics for ancestry, health, love…and more: A view of the business and regulatory landscape'.

PubMed

Phillips, Andelka M

2016-03-01

I provide an overview of the current state of the direct-to-consumer (DTC) genetic testing industry and the challenges that different types of testing pose for regulation. I consider the variety of services currently available. These range from health and ancestry tests to those for child talent, paternity, and infidelity. In light of the increasingly blurred lines among different categories of testing, I call for a broader discussion of DTC governance. I stress the importance of shifting our attention from the activities of the most prominent companies to viewing DTC genetics as an industry with a wide spectrum of services and raising a wide variety of issues. These issues go beyond questions of clinical utility and validity to those of data security, personal identity, race, and the nature of the family. Robust DTC testing has the power to provide meaningful clinical, genealogical and even forensic information to those who want it; in unscrupulous hands, however, it also has the power to deceive and exploit. I consider approaches to help ensure the former and minimize the latter.

Current ethical and legal issues in health-related direct-to-consumer genetic testing.

PubMed

Niemiec, Emilia; Kalokairinou, Louiza; Howard, Heidi Carmen

2017-09-01

A variety of health-related genetic testing is currently advertized directly to consumers. This article provides a timely overview of direct-to-consumer genetic testing (DTC GT) and salient ethical issues, as well as an analysis of the impact of the recently adopted regulation on in vitro diagnostic medical devices on DTC GT. DTC GT companies currently employ new testing approaches, report on a wide spectrum of conditions and target new groups of consumers. Such activities raise ethical issues including the questionable analytic and clinical validity of tests, the adequacy of informed consent, potentially misleading advertizing, testing in children, research uses and commercialization of genomic data. The recently adopted regulation on in vitro diagnostic medical devices may limit the offers of predisposition DTC GT in the EU market.

Model-based sensor-less wavefront aberration correction in optical coherence tomography.

PubMed

Verstraete, Hans R G W; Wahls, Sander; Kalkman, Jeroen; Verhaegen, Michel

2015-12-15

Several sensor-less wavefront aberration correction methods that correct nonlinear wavefront aberrations by maximizing the optical coherence tomography (OCT) signal are tested on an OCT setup. A conventional coordinate search method is compared to two model-based optimization methods. The first model-based method takes advantage of the well-known optimization algorithm (NEWUOA) and utilizes a quadratic model. The second model-based method (DONE) is new and utilizes a random multidimensional Fourier-basis expansion. The model-based algorithms achieve lower wavefront errors with up to ten times fewer measurements. Furthermore, the newly proposed DONE method outperforms the NEWUOA method significantly. The DONE algorithm is tested on OCT images and shows a significantly improved image quality.

Contrast-based sensorless adaptive optics for retinal imaging.

PubMed

Zhou, Xiaolin; Bedggood, Phillip; Bui, Bang; Nguyen, Christine T O; He, Zheng; Metha, Andrew

2015-09-01

Conventional adaptive optics ophthalmoscopes use wavefront sensing methods to characterize ocular aberrations for real-time correction. However, there are important situations in which the wavefront sensing step is susceptible to difficulties that affect the accuracy of the correction. To circumvent these, wavefront sensorless adaptive optics (or non-wavefront sensing AO; NS-AO) imaging has recently been developed and has been applied to point-scanning based retinal imaging modalities. In this study we show, for the first time, contrast-based NS-AO ophthalmoscopy for full-frame in vivo imaging of human and animal eyes. We suggest a robust image quality metric that could be used for any imaging modality, and test its performance against other metrics using (physical) model eyes.

Sensorless speed detection of squirrel-cage induction machines using stator neutral point voltage harmonics

NASA Astrophysics Data System (ADS)

Petrovic, Goran; Kilic, Tomislav; Terzic, Bozo

2009-04-01

In this paper a sensorless speed detection method of induction squirrel-cage machines is presented. This method is based on frequency determination of the stator neutral point voltage primary slot harmonic, which is dependent on rotor speed. In order to prove method in steady state and dynamic conditions the simulation and experimental study was carried out. For theoretical investigation the mathematical model of squirrel cage induction machines, which takes into consideration actual geometry and windings layout, is used. Speed-related harmonics that arise from rotor slotting are analyzed using digital signal processing and DFT algorithm with Hanning window. The performance of the method is demonstrated over a wide range of load conditions.

Effects of direct-to-consumer advertising of hydroxymethylglutaryl coenzyme a reductase inhibitors on attainment of LDL-C goals.

PubMed

Bradford, W David; Kleit, Andrew N; Nietert, Paul J; Ornstein, Steven

2006-12-01

Although highly controversial, directto-consumer (DTC) television advertising for prescription drugs is an established practice in the US health care industry. While the US Food and Drug Administration is currently reexamining its regulatory stance, little evidence exists regarding the impact of DTC advertising on patient health outcomes. The objective of this research was to study the relationship between heavy television promotion of 3 major hydroxymethylglutaryl coenzyme A reductase inhibitors ("statins") and the frequency with which patients are able to attain low-density lipoprotein cholesterol (LDL-C) blood-level goals after treatment with any statin. We used logistic regression to determine achievement of LDL-C goals at 6 months after statin treatment, using electronic medical record extract data from patients from geographically dispersed primary care practices in the United States. We identified LDL-C blood levels as being at or less than goal, as defined by risk-adjusted guidelines published by the National Heart, Lung, and Blood Institute from the Adult Treatment Panel III (ATP III) data. A total of 50,741 patients, identified from 88 practices, were diagnosed with hyperlipidemia and had begun therapy with any statin medication during the 1998-2004 time period. In addition, total dollars spent each month on television advertising at the national and local levels for atorvastatin, pravastatin, and simvastatin were obtained. DTC advertising data were merged by local media market where the physician practice was located and by the month in which the patient was first prescribed a statin. The models were run for all patients who initiated therapy, and also on a subsample of patients who continued to receive prescriptions for the drugs for at least 6 months. Logistic regressions were used to predict the likelihood that each patient attained the ATP III LDL-C blood-level goals as a function of DTC advertising and other factors. High levels of national DTC advertising when therapy was initiated were found to increase the likelihood that patients attained LDL-C goals at 6 months by 6% (P < 0.001)-although the effect was concentrated among patients with the least-restrictive ATP III LDL-C goals (

Direct-to-Consumer Marketing of Psychological Treatments: A Randomized Controlled Trial

PubMed Central

Gallo, Kaitlin P.; Comer, Jonathan S.; Barlow, David H.; Clarke, Roberta N.; Antony, Martin M.

2015-01-01

Objective Although direct-to-consumer (DTC) marketing of pharmacologic interventions is effective and common, similar approaches have yet to be evaluated in the promotion of psychological treatments (PTs). This is the first randomized controlled trial evaluating the potential of DTC marketing of PTs. Method Participants (N=344; 75.0% female, mean age=18.6, 48.5% non-Hispanic Caucasian) were randomly assigned to consume one of four extended commercial campaigns embedded within unrelated programming across 3 weeks. The four campaign conditions were: [1] PT campaign; [2] PT informing about Medication Side Effects campaign; [3] Medication campaign; and [4] Neutral campaign. Attitudes about and intention to seek psychological treatment were assessed prior to campaign exposure (T1), 1 week following the final week of campaign exposure (T2), and at a 3-month follow-up evaluation (T3). Results The percentage of participants who newly intended psychological treatment at T2 or T3 differed by condition, with those assigned to the PT campaign slightly more likely to have intended to receive psychological treatment at T2 or T3 than those in other conditions. Baseline reports of emotional symptoms moderated the effect of condition on attitudes toward PT and perceived likelihood of seeking treatment in the future. Conclusions Findings support the preliminary utility of DTC marketing of psychological treatments. Increasing consumer knowledge of PTs may be a worthwhile complement to current dissemination and implementation efforts aimed at promoting the uptake of PTs in mental health care. PMID:26098374

Direct-to-consumer marketing of psychological treatments: A randomized controlled trial.

PubMed

Gallo, Kaitlin P; Comer, Jonathan S; Barlow, David H; Clarke, Roberta N; Antony, Martin M

2015-10-01

Although direct-to-consumer (DTC) marketing of pharmacologic interventions is effective and common, similar approaches have yet to be evaluated in the promotion of psychological treatments (PTs). This is the first randomized controlled trial evaluating the potential of DTC marketing of PTs. Participants (N = 344; 75.0% female, mean age = 18.6 years, 48.5% non-Hispanic White) were randomly assigned to consume one of four extended commercial campaigns embedded within unrelated programming across 3 weeks. The four campaign conditions were a PT campaign, a PT informing about medication side effects campaign, a medication campaign, and a neutral campaign. Attitudes about and intention to seek psychological treatment were assessed prior to campaign exposure (T1), 1 week following the final week of campaign exposure (T2), and at a 3-month follow-up evaluation (T3). The percentage of participants who newly intended psychological treatment at T2 or T3 differed by condition, with those assigned to the PT campaign slightly more likely to have intended to receive psychological treatment at T2 or T3 than those in other conditions. Baseline reports of emotional symptoms moderated the effect of condition on attitudes toward PT and perceived likelihood of seeking treatment in the future. Findings support the preliminary utility of DTC marketing of psychological treatments. Increasing consumer knowledge of PTs may be a worthwhile complement to current dissemination and implementation efforts aimed at promoting the uptake of PTs in mental health care. (c) 2015 APA, all rights reserved).

Age differences in how consumers behave following exposure to DTC advertising.

PubMed

DeLorme, Denise E; Huh, Jisu; Reid, Leonard N

2006-01-01

This study was conducted to provide additional evidence on how consumers behave following direct-to-consumer (DTC) advertising exposure and to determine if there are differences in ad-prompted acts (drug inquiry and drug requests) between different age groups (i.e., older, mature, and younger adults). The results suggest that younger, mature, and older consumers are all moved to act by DTC drug ads, but that each age group behaves in different ways. Somewhat surprisingly, age was not predictive of ad-prompted behavior. DTC advertising was no more effective at moving older consumers to behave than their younger counterparts. These results suggest that age does not matter that much when it comes to the "moving power" of prescription drug advertising, even though research indicates that older consumers are more vulnerable to the persuasive effects of communication.

FDA direct-to-consumer advertising for prescription drugs: what are consumer preferences and response tendencies?

PubMed

Khanfar, Nile; Loudon, David; Sircar-Ramsewak, Feroza

2007-01-01

The effect of direct-to-consumer (DTC) television advertising of prescription medications is a growing concern of the United States (U.S.) Congress, state legislatures, and the Food and Drug Administration (FDA). This research study was conducted in order to examine consumers' perceived preferences of DTC television advertisement in relation to "reminder" "help-seeking," and "product-claim" FDA-approved advertisement categories. An additional objective was to examine the influence of DTC television advertising of prescription drugs on consumers' tendency to seek more information about the medication and/or the medical condition. The research indicates that DTC television drug ads appear to be insufficient for consumers to make informed decisions. Their mixed perception and acceptance of the advertisements seem to influence them to seek more information from a variety of medical sources.

Attitudes of cystic fibrosis patients and their parents towards direct-to-consumer genetic testing for carrier status.

PubMed

Janssens, Sandra; Kalokairinou, Louiza; Chokoshvilli, Davit; Binst, Carmen; Mahieu, Inge; Henneman, Lidewij; De Paepe, Anne; Borry, Pascal

2015-03-01

An increasing number of direct-to-consumer (DTC) genetic testing companies have started offering tests for carrier status of autosomal recessive disorders. A written questionnaire was administered to 47 patients and 65 parents of children with Cystic Fibrosis (CF), a common severe autosomal recessive disorder, to assess their views about the offer of DTC carrier tests. All participants were recruited from a CF patient registry in Belgium. We found that very few patients and parents were aware of the offer of DTC genetic testing for carrier status, and were generally skeptical. A strong preference for the healthcare system over commercial companies as the provider of the test was observed. However, many participants believe people should have a right to access DTC genetic tests provided by commercial companies.

Direct-to-consumer genetic testing in Slovenia: availability, ethical dilemmas and legislation.

PubMed

Vrecar, Irena; Peterlin, Borut; Teran, Natasa; Lovrecic, Luca

2015-01-01

Over the last few years, many private companies are advertising direct-to-consumer genetic testing (DTC GT), mostly with no or only minor clinical utility and validity of tests and without genetic counselling. International professional community does not approve provision of DTC GT and situation in some EU countries has been analysed already. The aim of our study was to analyse current situation in the field of DTC GT in Slovenia and related legal and ethical issues. Information was retrieved through internet search, performed independently by two authors, structured according to individual private company and the types of offered genetic testing. Five private companies and three Health Insurance Companies offer DTC GT and it is provided without genetic counselling. Available tests include testing for breast cancer, tests with other health-related information (complex diseases, drug responses) and other tests (nutrigenetic, ancestry, paternity). National legislation is currently being developed and Council of Experts in Medical Genetics has issued an opinion about Genetic Testing and Commercialization of Genetic Tests in Slovenia. Despite the fact that Slovenia has signed the Additional protocol to the convention on human rights and biomedicine, concerning genetic testing for health purposes, DTC GT in Slovenia is present and against all international recommendations. There is lack of or no medical supervision, clinical validity and utility of tests and inappropriate genetic testing of minors is available. There is urgent need for regulation of ethical, legal, and social aspects. National legislation on DTC GT is being prepared.

‘Only a click away — DTC genetics for ancestry, health, love…and more: A view of the business and regulatory landscape’

PubMed Central

Phillips, Andelka M.

2016-01-01

I provide an overview of the current state of the direct-to-consumer (DTC) genetic testing industry and the challenges that different types of testing pose for regulation. I consider the variety of services currently available. These range from health and ancestry tests to those for child talent, paternity, and infidelity. In light of the increasingly blurred lines among different categories of testing, I call for a broader discussion of DTC governance. I stress the importance of shifting our attention from the activities of the most prominent companies to viewing DTC genetics as an industry with a wide spectrum of services and raising a wide variety of issues. These issues go beyond questions of clinical utility and validity to those of data security, personal identity, race, and the nature of the family. Robust DTC testing has the power to provide meaningful clinical, genealogical and even forensic information to those who want it; in unscrupulous hands, however, it also has the power to deceive and exploit. I consider approaches to help ensure the former and minimize the latter. PMID:27047755

Is there a doctor in the house? : The presence of physicians in the direct-to-consumer genetic testing context.

PubMed

Howard, Heidi Carmen; Borry, Pascal

2012-04-01

Over the last couple of years, many commercial companies, the majority of which are based in the USA, have been advertising and offering direct-to-consumer (DTC) genetic testing services outside of the established health care system, and often without any involvement from a health care professional. In the last year, however, a number of DTC genetic testing companies have changed their provision model such that consumers must now contact a health care professional before being able to order the genetic testing service. In discussing the advent of this new model of service provision, this article also reviews the ethical and social issues surrounding DTC genetic testing and addresses the potential motivations for change, some barriers to achieving truly appropriate medical supervision and the present reality of DTC genetic testing for some psychiatric and neurological disorders. Since the advent of these commercial activities, critics have pointed a finger at the lack of medical supervision surrounding these services. The discussion herein, however, reveals how difficult it may be, despite the addition of a physician, to actually achieve adequate medical supervision within the present context of DTC genetic testing.

Direct-to-consumer personalized genomic testing

PubMed Central

Bloss, Cinnamon S.; Darst, Burcu F.; Topol, Eric J.; Schork, Nicholas J.

2011-01-01

Over the past 18 months, there have been notable developments in the direct-to-consumer (DTC) genomic testing arena, in particular with regard to issues surrounding governmental regulation in the USA. While commentaries continue to proliferate on this topic, actual empirical research remains relatively scant. In terms of DTC genomic testing for disease susceptibility, most of the research has centered on uptake, perceptions and attitudes toward testing among health care professionals and consumers. Only a few available studies have examined actual behavioral response among consumers, and we are not aware of any studies that have examined response to DTC genetic testing for ancestry or for drug response. We propose that further research in this area is desperately needed, despite challenges in designing appropriate studies given the rapid pace at which the field is evolving. Ultimately, DTC genomic testing for common markers and conditions is only a precursor to the eventual cost-effectiveness and wide availability of whole genome sequencing of individuals, although it remains unclear whether DTC genomic information will still be attainable. Either way, however, current knowledge needs to be extended and enhanced with respect to the delivery, impact and use of increasingly accurate and comprehensive individualized genomic data. PMID:21828075

Thyroid Cancer Induction: Nitrates as Independent Risk Factors or Risk Modulators after Radiation Exposure, with a Focus on the Chernobyl Accident

PubMed Central

Drozd, Valentina M.; Branovan, Igor; Shiglik, Nikolay; Biko, Johannes; Reiners, Christoph

2018-01-01

In recent decades, differentiated thyroid cancer (DTC) incidence has been increasing worldwide. The important contributions to this phenomenon of “overdiagnosis” driven by wider use of improved ultrasound systems are amply documented, notwithstanding the “real” carcinogenic effects of ionizing radiation, e.g., from the Chernobyl accident or health care interventions. Less well understood is the role of nitrates – as environmental pollutants, in diet, and in medication – in thyroid carcinogenesis. Increasing exposure to nitrates is associated with rising incidence of esophageal, stomach, bladder, and colon cancers. Recent data suggest that in agricultural areas with higher mean nitrate levels in groundwater, DTC risk is also elevated. Our work in Belarus after Chernobyl has shown that children in districts with high nitrate concentrations in drinking water had significantly higher thyroid cancer incidence after irradiation than did their counterparts in areas with lower nitrate concentrations. Notwithstanding thyroid shielding, increasing use of computed tomography and dental X-rays heightens radiation exposure of the salivary glands in the general population, especially in children and adolescents. When nitrate intake is increased, salivary gland irradiation may potentially result in carcinogenic elevations in plasma nitric oxide concentrations. In conclusion, excess nitrate intake seems to be an independent risk factor for DTC. Additionally, we hypothesize from our data that high nitrate levels modulate the carcinogenic effect of radiation on the thyroid. Cohort studies, case-control studies, or both, are needed to quantify the effects of nitrates on DTC risk in the presence or absence of radiation exposure, e.g., that associated with diagnostic or therapeutic health care interventions. PMID:29594057

Overwhelming rapid metabolic and structural response to apatinib in radioiodine refractory differentiated thyroid cancer.

PubMed

Lin, Yansong; Wang, Chen; Gao, Wen; Cui, Ruixue; Liang, Jun

2017-06-27

Currently, patients with radioiodine refractory differentiated thyroid cancer (RAIR-DTC) have limited treatment options. In this study, we aimed to assess the short-term efficacy and safety of apatinib in RAIR-DTC. Ten adult patients were prospectively enrolled to receive oral apatinib (750 mg q.d). The primary endpoints were change in serum thyroglobulin (Tg) concentration, disease control rate (DCR) and objective response rate (ORR) based on RECIST 1.1 criteria. The secondary endpoints included change in glucose metabolism, evaluated by maximum standard uptake value (SUVmax), and safety. As early as 2 weeks after apatinib treatment, the serum Tg concentration decreased by 21.0% in 8 patients available for detection without interference, and a further sharp decline by 81.4% compared with the baseline level occurred at 8 weeks post-treatment. The DCR and ORR were 100% (10/10) and 90% (9/10), respectively. The sum of tumor diameter shrank to 22.8±8.1 mm from 38.8±15.7 mm (P=0.001). Moreover, a significant decrease in SUVmax was observed from 6.53±5.14 to 2.56±1.67 and 2.45±1.48 at 4-week and 8-week time-points after treatment (P=0.032 and 0.020), respectively. The common grade 3 adverse events (AEs) included hand-foot-skin reaction (50%), hypertension (30%), and hypocalcemia (20%). No severe AE related to apatinib was observed during treatment. Hence, apatinib seems to be a promising therapeutic option for RAIR-DTC patients. Apart from RECIST 1.1 criteria, the biochemical marker (Tg) and glucose metabolism index (SUVmax) could be adopted in assessing the early response to TKI in RAIR-DTC.

Overwhelming rapid metabolic and structural response to apatinib in radioiodine refractory differentiated thyroid cancer

PubMed Central

Gao, Wen; Cui, Ruixue; Liang, Jun

2017-01-01

Currently, patients with radioiodine refractory differentiated thyroid cancer (RAIR-DTC) have limited treatment options. In this study, we aimed to assess the short-term efficacy and safety of apatinib in RAIR-DTC. Ten adult patients were prospectively enrolled to receive oral apatinib (750 mg q.d). The primary endpoints were change in serum thyroglobulin (Tg) concentration, disease control rate (DCR) and objective response rate (ORR) based on RECIST 1.1 criteria. The secondary endpoints included change in glucose metabolism, evaluated by maximum standard uptake value (SUVmax), and safety. As early as 2 weeks after apatinib treatment, the serum Tg concentration decreased by 21.0% in 8 patients available for detection without interference, and a further sharp decline by 81.4% compared with the baseline level occurred at 8 weeks post-treatment. The DCR and ORR were 100% (10/10) and 90% (9/10), respectively. The sum of tumor diameter shrank to 22.8±8.1 mm from 38.8±15.7 mm (P=0.001). Moreover, a significant decrease in SUVmax was observed from 6.53±5.14 to 2.56±1.67 and 2.45±1.48 at 4-week and 8-week time-points after treatment (P=0.032 and 0.020), respectively. The common grade 3 adverse events (AEs) included hand-foot-skin reaction (50%), hypertension (30%), and hypocalcemia (20%). No severe AE related to apatinib was observed during treatment. Hence, apatinib seems to be a promising therapeutic option for RAIR-DTC patients. Apart from RECIST 1.1 criteria, the biochemical marker (Tg) and glucose metabolism index (SUVmax) could be adopted in assessing the early response to TKI in RAIR-DTC. PMID:28178685

What do we know about direct-to-consumer advertising of prescription drugs?

PubMed

Calfee, John E

2003-01-01

Two papers, by Joel Weissman and colleagues and by Robert Dubois, add to our limited knowledge of the effects of direct-to-consumer (DTC) advertising of prescription drugs. Their results reinforce the largely positive findings from consumer surveys, while adding valuable new data and insights. These suggest that DTC ads probably improve patients' health outcomes and do not tend to lead to inappropriate prescribing. DTC advertising is emerging as a positive force in health care markets, consistent with what is known about the effects of advertising in many other markets.

Effects of comparative claims in prescription drug direct-to-consumer advertising on consumer perceptions and recall.

PubMed

O'Donoghue, Amie C; Williams, Pamela A; Sullivan, Helen W; Boudewyns, Vanessa; Squire, Claudia; Willoughby, Jessica Fitts

2014-11-01

Although pharmaceutical companies cannot make comparative claims in direct-to-consumer (DTC) ads for prescription drugs without substantial evidence, the U.S. Food and Drug Administration permits some comparisons based on labeled attributes of the drug, such as dosing. Researchers have examined comparative advertising for packaged goods; however, scant research has examined comparative DTC advertising. We conducted two studies to determine if comparative claims in DTC ads influence consumers' perceptions and recall of drug information. In Experiment 1, participants with osteoarthritis (n=1934) viewed a fictitious print or video DTC ad that had no comparative claim or made an efficacy comparison to a named or unnamed competitor. Participants who viewed print (but not video) ads with named competitors had greater efficacy and lower risk perceptions than participants who viewed unnamed competitor and noncomparative ads. In Experiment 2, participants with high cholesterol or high body mass index (n=5317) viewed a fictitious print or video DTC ad that had no comparative claim or made a comparison to a named or unnamed competitor. We varied the type of comparison (of indication, dosing, or mechanism of action) and whether the comparison was accompanied by a visual depiction. Participants who viewed print and video ads with named competitors had greater efficacy perceptions than participants who viewed unnamed competitor and noncomparative ads. Unlike Experiment 1, named competitors in print ads resulted in higher risk perceptions than unnamed competitors. In video ads, participants who saw an indication comparison had greater benefit recall than participants who saw dosing or mechanism of action comparisons. In addition, visual depictions of the comparison decreased risk recall for video ads. Overall, the results suggest that comparative claims in DTC ads could mislead consumers about a drug's efficacy and risk; therefore, caution should be used when presenting comparative claims in DTC ads. Published by Elsevier Ltd.

99mTc-EDDA/HYNIC-TOC in the diagnosis of differentiated thyroid carcinoma refractory to radioiodine treatment.

PubMed

Czepczyński, Rafał; Gryczyńska, Maria; Ruchała, Marek

2016-01-01

In majority of cases of differentiated thyroid carcinoma (DTC), the ablative radioiodine treatment shows high efficacy. In a small number of patients, mechanism of selective iodine uptake by the DTC cells is insufficient and alternative methods of diagnosis and treatment are needed. As demonstrated in vitro, DTC cells show expression of somatostatin recep-tors. Radiolabeled somatostatin analogs are widely used in the diagnosis of neuroendocrine tumors. The aim of the study was to evaluate the utility of peptide receptor scintigraphy with the use of 99mTc-EDDA/HYNIC-TOC in the diagnosis of DTC in patients with elevated thyroglobulin concentrations (Tg), negative WBS and no effect of the consecutive radioiodine therapies. Whole body scintigraphy as well as SPECT of neck and chest were performed 3 and 24 h after i.v. administration of 740 MBq 99mTc-EDDA/HYNIC-TOC. The obtained images were compared with other radionuclide and ra-diological imaging methods. Forty-three patients with DTC after surgery and ablative radioiodine treatment with negative WBS and elevated Tg were qualified. Patients' age: 18-83 years (mean 58.0). SRS showed foci of tracer accumulation in 29 cases (67.4%). Sensitivity was 69.0% specificity 78.6%. SRS correctly identified local recurrence in 8 pts., metastatic lymph nodes in 19 pts., lung metastases in 12 pts. and bone metastases in 5 pts. SRS showed high sensitivity in the detection of metastatic lymph nodes (100%) and bone metastases (83.3%) and lung metastases (63.2%). Positive SRS was found in pts. with higher Tg concentrations (130 ± 144 vs. 30 ± 54 ng/ml). Scintigraphy with the use of the studied technetium-99m-labeled somatostatin analog is useful in the evaluation of patients with advanced DTC. It shows relatively good sensitivity and specificity but not high enough to be recommended as a routine imaging method. The role of somatostatin receptor scintigraphy in DTC is complementary to other imaging modalities.

Contrast-based sensorless adaptive optics for retinal imaging

PubMed Central

Zhou, Xiaolin; Bedggood, Phillip; Bui, Bang; Nguyen, Christine T.O.; He, Zheng; Metha, Andrew

2015-01-01

Conventional adaptive optics ophthalmoscopes use wavefront sensing methods to characterize ocular aberrations for real-time correction. However, there are important situations in which the wavefront sensing step is susceptible to difficulties that affect the accuracy of the correction. To circumvent these, wavefront sensorless adaptive optics (or non-wavefront sensing AO; NS-AO) imaging has recently been developed and has been applied to point-scanning based retinal imaging modalities. In this study we show, for the first time, contrast-based NS-AO ophthalmoscopy for full-frame in vivo imaging of human and animal eyes. We suggest a robust image quality metric that could be used for any imaging modality, and test its performance against other metrics using (physical) model eyes. PMID:26417525

Sensorless position estimator applied to nonlinear IPMC model

NASA Astrophysics Data System (ADS)

Bernat, Jakub; Kolota, Jakub

2016-11-01

This paper addresses the issue of estimating position for an ionic polymer metal composite (IPMC) known as electro active polymer (EAP). The key step is the construction of a sensorless mode considering only current feedback. This work takes into account nonlinearities caused by electrochemical effects in the material. Owing to the recent observer design technique, the authors obtained both Lyapunov function based estimation law as well as sliding mode observer. To accomplish the observer design, the IPMC model was identified through a series of experiments. The research comprises time domain measurements. The identification process was completed by means of geometric scaling of three test samples. In the proposed design, the estimated position accurately tracks the polymer position, which is illustrated by the experiments.

Research of Co(II) Adsorption on Silica Gel Grafted with Dithiocarbamate (DTC-SiO2) in Aqueous Solution

NASA Astrophysics Data System (ADS)

Yao, Qingxu; Xu, Peng; Huo, Yonggang; Shang, Aiguo; Yu, Fengmei

2018-01-01

Dithiocarbamate grafted silica gel (DTC-SiO2) was prepared following two simple reaction steps. The properties of the composite were characterized by FTIR, SEM and element analysis. Its ability to remove Co2+ ions in aqueous solution with low concentration was also studied by static adsorption experiments. The effects of pH value in solution, contact time and temperature were investigated. The results show that the DTC-SiO2 exhibits excellent adsorption property for Co2+. The adsorption kinetics could be well described by pseudo-second-order model and the adsorption isotherms could be depicted by both Freundlich and Dubinin-Radushkevich models. The adsorption process belongs to chemisorption. The slightly influence of common interfering metal ions (Na+, K+, Ca2+ and Mg2+) on the adsorption capacity revealing the synthesized DTC-SiO2 performs excellent selective adsorption to Co2+.

Reducing the bioavailability of cadmium in contaminated soil by dithiocarbamate chitosan as a new remediation.

PubMed

Yin, Zheng; Cao, Jingjing; Li, Zhen; Qiu, Dong

2015-07-01

Dithiocarbamate chitosan (DTC-CTS) was used as a new amendment for remediation of cadmium (Cd)-contaminated soils to reduce the Cd bioavailability. Arabidopsis thaliana was chosen as a model plant to evaluate its efficiency. It was found that DTC-CTS could effectively improve the growth of A. thaliana. The amount of Cd up-taken by A. thaliana could be decreased by as much as 50% compared with that grown in untreated Cd-contaminated soil samples. The chlorophyll content and the aerial biomass of Arabidopsis also increased substantially and eventually returned to a level comparable to plants grown in non-contaminated soils, with the addition of DTC-CTS. These findings suggested that DTC-CTS amendment could be effective in immobilizing Cd and mitigating its accumulation in plants grown in Cd-contaminated soils, with potential application as an in situ remediation of Cd-polluted soils.

Consumer friendly or reader hostile? An evaluation of the readability of DTC print ads.

PubMed

Sheehan, Kim

2008-01-01

The Food and Drug Administration requires advertisements promoting prescription drugs to be written in "consumer friendly" language. The purpose of this study is to examine the language of Direct-to-Consumer prescription drug advertisements to determine if such language is easy for consumers to read and understand. A series of advertisements for a variety of products, appearing in popular consumer magazines, were analyzed using the Flesch and Gunning-Fogg formulas to determine if DTC advertisements are more or less complex than other advertisements that consumers read today. Results indicate that DTC ads are among the most difficult print ads to read. Additionally, certain types of information contained in these print ads (such as information discussing a drug's risks and contraindications) are significantly more difficult to read than information in any other type of ad copy in magazines today. Implications for DTC marketers and the FDA are included.

Direct-to-consumer advertising: its effects on stakeholders.

PubMed

Montoya, Isaac D; Lee-Dukes, Gwen; Shah, Dhvani

2008-01-01

The escalating growth in the development of pharmaceutical drugs has caused the pharmaceutical industry to market drugs directly to consumers. Direct-to-consumer (DTC) advertising has increased immensely in the past 15 years and continues to grow each year. The advantages of DTC advertising include an increase in consumer knowledge, patient autonomy, and possibly providing physicians and pharmacists with up-to-date information about the recent trends in the marketplace. However, there is also an equally notable list of disadvantages, which include concerns about the quality of information provided, loss in physician productivity due to time spent convincing patients that what they want is not in their best interest, and increases in the reimbursement expenditure of the insurers. Because of these conflicting outcomes, the issue of DTC advertising has become controversial. This report offers an overview of DTC advertising and focuses on its effects on physicians, pharmacists, consumers, insurers, the government, and pharmaceutical manufacturers.

Direct-to-consumer pharmaceutical advertising: physician and public opinion and potential effects on the physician-patient relationship.

PubMed

Robinson, Andrew R; Hohmann, Kirsten B; Rifkin, Julie I; Topp, Daniel; Gilroy, Christine M; Pickard, Jeffrey A; Anderson, Robert J

2004-02-23

Previous studies have shown that direct-to-consumer (DTC) pharmaceutical advertising can influence consumer behavior and that many physicians have negative views of these advertisements. Physician and public opinions about these advertisements and how they may affect the physician-patient relationship are not well established. Mail survey of 523 Colorado physicians and 261 national physicians and telephone survey of 500 Colorado households asking respondents to rate their agreement with statements about DTC advertising. Most physicians tended to view DTC advertisements negatively, indicating that such advertisements rarely provide enough information on cost (98.7%), alternative treatment options (94.9%), or adverse effects (54.8%). Most also believed that DTC advertisements affected interactions with patients by lengthening clinical encounters (55.9%), leading to patient requests for specific medications (80.7%), and changing patient expectations of physicians' prescribing practices (67.0%). Only 29.0% of public respondents agreed that DTC advertising is a positive trend in health care and 28.6% indicated that advertisements make them better informed about medical problems; fewer indicated that advertisements motivated them to seek care (10.5%) or led them to request specific medications from their physicians (13.3%). Most physicians have negative views of DTC pharmaceutical advertising and see several potential effects of these advertisements on the physician-patient relationship. Many public respondents have similarly negative views, and only a few agree that they change their expectations of or interactions with physicians. While these advertisements may be influencing only a few consumers, it seems that the impact on physicians and their interactions with patients may be significant.

Direct to consumer genetic testing-law and policy concerns in Ireland.

PubMed

de Paor, Aisling

2017-11-25

With rapid scientific and technological advances, the past few years has witnessed the emergence of a new genetic era and a growing understanding of the genetic make-up of human beings. These advances have propelled the introduction of companies offering direct to consumer (DTC) genetic testing, which facilitates the direct provision of such tests to consumers, (for example, via the internet). Although DTC genetic testing offers benefits by enhancing consumer accessibility to such technology, promoting proactive healthcare and increasing genetic awareness, it presents a myriad of challenges, from an ethical, legal and regulatory perspective. As DTC genetic testing usually eliminates the need for a medical professional in accessing genetic tests, this lack of professional guidance and counselling may result in misinterpretation and confusion regarding results. In addition, an evident concern relates to the scientific validity and quality of these tests. A further problem arising is the lack or inadequacy of regulation in this field. Despite the increasing accessibility of DTC genetic testing, this legislative vacuum is apparent in Ireland, where there is no concrete legislation. This article explores the main ethical, legal and regulatory issues arising with the advent of rapid advances in DTC genetic testing in Ireland. Further, with inevitable future advances in genetic science, as well as increasing internet accessibility, the challenges presented are likely to become more amplified. In consideration of the ethical and legal challenges, this paper highlights the regulation of DTC genetic testing as a growing concern in Ireland, recognising its importance to both the scientific community as well as in respect of enhancing consumer confidence in such technologies.

Patterns of differentiated thyroid cancer in Baluchistan Province of Pakistan: some initial observations.

PubMed

Iftikhar, A; Naseeb, A Khush; Khwaja, A; Mati, H; Karim, K; Hameeda, N

2011-10-01

The incidence of thyroid cancer is increasing in several countries. The main objective of this retrospective study was to find and describe province-specific estimates of incidence in males and females by age groups for differentiated thyroid cancer (DTC). This study reports on 87 cases of DTC from Baluchistan province of Pakistan treated with post operative radioiodine at the Center for Nuclear Medicine and Radiotherapy (CENAR) Quetta from January 2003 to December 2009. The patient data has been collected from CENAR Quetta. Patients with DTC were confirmed by clinical examination, thyroid scintigraphy (Thyroid scan), blood tests (T3, T4, TSH) and histopathalogy tests and then treated with radioiodine. The Median age of the patients was 35.5 years (Range 12-70 years). The final histological diagnosis was papillary carcinoma in 71 (81.6 %) cases, follicular carcinoma in 6 (6.9%) cases while 10 (11.5%) cases presented with mixed papillary and follicular carcinoma. About 53 % cases were found in females with age 21-40 years. No strike predominance was observed in any age group for males. Four patients presented with recurrence while six patients showed metastasis in cervical lymph nodes. The small annual incidence did not follow any definite pattern. DTC has a small incidence in Baluchistan due to lack of education and health care facilities. The incidence of DTC is higher in females when compared with males as per this study. This preliminary study will provide an insight to incidence of DTC, its treatment facilities and future planning strategies in Baluchistan, Pakistan.

External-beam radiotherapy for differentiated thyroid cancer locoregional control: A statement of the American Head and Neck Society

PubMed Central

Kiess, Ana P.; Agrawal, Nishant; Brierley, James D.; Duvvuri, Umamaheswar; Ferris, Robert L.; Genden, Eric; Wong, Richard J.; Tuttle, R. Michael; Lee, Nancy Y.; Randolph, Gregory W.

2016-01-01

The use of external-beam radiotherapy (EBRT) in differentiated thyroid cancer (DTC) is debated because of a lack of prospective clinical data, but recent retrospective studies have reported benefits in selected patients. The Endocrine Surgery Committee of the American Head and Neck Society provides 4 recommendations regarding EBRT for locoregional control in DTC, based on review of literature and expert opinion of the authors. (1) EBRT is recommended for patients with gross residual or unresectable locoregional disease, except for patients <45 years old with limited gross disease that is radioactive iodine (RAI)-avid. (2) EBRT should not be routinely used as adjuvant therapy after complete resection of gross disease. (3) After complete resection, EBRT may be considered in select patients >45 years old with high likelihood of microscopic residual disease and low likelihood of responding to RAI. (4) Cervical lymph node involvement alone should not be an indication for adjuvant EBRT. PMID:26716601

75 FR 6752 - Self-Regulatory Organizations; The Depository Trust Company; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-10

... submission received by DTC and would also create an hourly Extraordinary Processing/Research Fee of $100 per... revisions are consistent with DTC's overall pricing philosophy of aligning service fees with underlying...

d-Tubocurarine and Berbamine: Alkaloids That Are Permeant Blockers of the Hair Cell's Mechano-Electrical Transducer Channel and Protect from Aminoglycoside Toxicity

PubMed Central

Kirkwood, Nerissa K.; O'Reilly, Molly; Derudas, Marco; Kenyon, Emma J.; Huckvale, Rosemary; van Netten, Sietse M.; Ward, Simon E.; Richardson, Guy P.; Kros, Corné J.

2017-01-01

Aminoglycoside antibiotics are widely used for the treatment of life-threatening bacterial infections, but cause permanent hearing loss in a substantial proportion of treated patients. The sensory hair cells of the inner ear are damaged following entry of these antibiotics via the mechano-electrical transducer (MET) channels located at the tips of the hair cell's stereocilia. d-Tubocurarine (dTC) is a MET channel blocker that reduces the loading of gentamicin-Texas Red (GTTR) into rat cochlear hair cells and protects them from gentamicin treatment. Berbamine is a structurally related alkaloid that reduces GTTR labeling of zebrafish lateral-line hair cells and protects them from aminoglycoside-induced cell death. Both compounds are thought to reduce aminoglycoside entry into hair cells through the MET channels. Here we show that dTC (≥6.25 μM) or berbamine (≥1.55 μM) protect zebrafish hair cells in vivo from neomycin (6.25 μM, 1 h). Protection of zebrafish hair cells against gentamicin (10 μM, 6 h) was provided by ≥25 μM dTC or ≥12.5 μM berbamine. Hair cells in mouse cochlear cultures are protected from longer-term exposure to gentamicin (5 μM, 48 h) by 20 μM berbamine or 25 μM dTC. Berbamine is, however, highly toxic to mouse cochlear hair cells at higher concentrations (≥30 μM) whilst dTC is not. The absence of toxicity in the zebrafish assays prompts caution in extrapolating results from zebrafish neuromasts to mammalian cochlear hair cells. MET current recordings from mouse outer hair cells (OHCs) show that both compounds are permeant open-channel blockers, rapidly and reversibly blocking the MET channel with half-blocking concentrations of 2.2 μM (dTC) and 2.8 μM (berbamine) in the presence of 1.3 mM Ca2+ at −104 mV. Berbamine, but not dTC, also blocks the hair cell's basolateral K+ current, IK,neo, and modeling studies indicate that berbamine permeates the MET channel more readily than dTC. These studies reveal key properties of MET-channel blockers required for the future design of successful otoprotectants. PMID:28928635

"Clinicopathological features and treatment outcomes of differentiated thyroid cancer in Saudi children and adults".

PubMed

Al-Qahtani, Khalid Hussain; Tunio, Mutahir A; Al Asiri, Mushabbab; Aljohani, Naji J; Bayoumi, Yasser; Riaz, Khalid; AlShakweer, Wafa

2015-11-06

Age is an important prognostic factor in differentiated thyroid cancer (DTC). Our aim was to evaluate differences in clinicopathological features and treatment outcomes among children and adult patients with DTC. We studied 27 children (below 18 years) with DTC treated during the period 2000-2012 and were compared with (a) 78 adults aged 19-25 years and (b) 52 adults aged 26-30 years treated during the same period in terms of their clinicopathological features and long term treatment outcomes. Locoregional recurrence (LRR), locoregional control (LRC), distant metastasis (DM), distant metastasis control (DMC), disease free survival (DFS) and overall survival (OS) rates were evaluated. Mean age of children was 13.5 years (range: 5-18), while mean age of adults was 24.6 years (range: 19-30). In children, female: male ratio was 2.85:1, and in adults female: male ratio was 7.1:1 (P = 0.041). No significant difference in tumor size was seen between the two groups (P = 0.653). According to American Thyroid Association (ATA) risk stratification classification, the children (85.2 %) were found to have at high risk as compared to adults P = 0.001. Post-thyroidectomy complications and RAI induced toxicities were observed more in children than adults (P = 0.043 and P = 0.041 respectively). LRR occurred in 6 (22.2 %), 9 (11.5 %) and 3 (5.8 %) in age groups of <18 years, 19-25 years and 26-30 years respectively (P = 0.032); while DM was seen in 10 (37.0 %), 9 (10.3 %) and 5 (9.6 %) in age groups of <18 years, 19-25 years and 26-30 years respectively (P = 0.002). Ten year DFS rates were 67.3 % in age group below 18 years, 82.4 % in age group of 19-25 years and 90.1 % in age group of 26-30 years (P = 0.021). At the time of diagnosis, children with DTC were found to have more aggressive clinicopathological characteristics. Comparatively lower LRC, DMC and DFS rates in children warrants further multi-institutional studies.

75 FR 2570 - Self-Regulatory Organizations; The Depository Trust Company; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-15

... intraday by Fedwire to DTC when a DTC participant (``Participant'') has insufficient collateral \\5\\ or at.... The current early P&I withdrawal process allows Participants to withdraw intraday P&I payments for non...

Direct to confusion: lessons learned from marketing BRCA testing.

PubMed

Matloff, Ellen; Caplan, Arthur

2008-06-01

Myriad Genetics holds a patent on testing for the hereditary breast and ovarian cancer genes, BRCA1 and BRCA2, and therefore has a forced monopoly on this critical genetic test. Myriad launched a Direct-to-Consumer (DTC) marketing campaign in the Northeast United States in September 2007 and plans to expand that campaign to Florida and Texas in 2008. The ethics of Myriad's patent, forced monopoly and DTC campaign will be reviewed, as well as the impact of this situation on patient access and care, physician liability, and the future of DTC campaigns for genetic testing.

Ethical Issues for Direct-to-Consumer Digital Psychotherapy Apps: Addressing Accountability, Data Protection, and Consent

PubMed Central

Kreitmair, Karola

2018-01-01

This paper focuses on the ethical challenges presented by direct-to-consumer (DTC) digital psychotherapy services that do not involve oversight by a professional mental health provider. DTC digital psychotherapy services can potentially assist in improving access to mental health care for the many people who would otherwise not have the resources or ability to connect with a therapist. However, the lack of adequate regulation in this area exacerbates concerns over how safety, privacy, accountability, and other ethical obligations to protect an individual in therapy are addressed within these services. In the traditional therapeutic relationship, there are ethical obligations that serve to protect the interests of the client and provide warnings. In contrast, in a DTC therapy app, there are no clear lines of accountability or associated ethical obligations to protect the user seeking mental health services. The types of DTC services that present ethical challenges include apps that use a digital platform to connect users to minimally trained nonprofessional counselors, as well as services that provide counseling steered by artificial intelligence and conversational agents. There is a need for adequate oversight of DTC nonprofessional psychotherapy services and additional empirical research to inform policy that will provide protection to the consumer. PMID:29685865

Delayed risk stratification, to include the response to initial treatment (surgery and radioiodine ablation), has better outcome predictivity in differentiated thyroid cancer patients.

PubMed

Castagna, Maria Grazia; Maino, Fabio; Cipri, Claudia; Belardini, Valentina; Theodoropoulou, Alexandra; Cevenini, Gabriele; Pacini, Furio

2011-09-01

After initial treatment, differentiated thyroid cancer (DTC) patients are stratified as low and high risk based on clinical/pathological features. Recently, a risk stratification based on additional clinical data accumulated during follow-up has been proposed. To evaluate the predictive value of delayed risk stratification (DRS) obtained at the time of the first diagnostic control (8-12 months after initial treatment). We reviewed 512 patients with DTC whose risk assessment was initially defined according to the American (ATA) and European Thyroid Association (ETA) guidelines. At the time of the first control, 8-12 months after initial treatment, patients were re-stratified according to their clinical status: DRS. Using DRS, about 50% of ATA/ETA intermediate/high-risk patients moved to DRS low-risk category, while about 10% of ATA/ETA low-risk patients moved to DRS high-risk category. The ability of the DRS to predict the final outcome was superior to that of ATA and ETA. Positive and negative predictive values for both ATA (39.2 and 90.6% respectively) and ETA (38.4 and 91.3% respectively) were significantly lower than that observed with the DRS (72.8 and 96.3% respectively, P<0.05). The observed variance in predicting final outcome was 25.4% for ATA, 19.1% for ETA, and 62.1% for DRS. Delaying the risk stratification of DTC patients at a time when the response to surgery and radioiodine ablation is evident allows to better define individual risk and to better modulate the subsequent follow-up.

Wavefront sensorless adaptive optics versus sensor-based adaptive optics for in vivo fluorescence retinal imaging (Conference Presentation)

NASA Astrophysics Data System (ADS)

Wahl, Daniel J.; Zhang, Pengfei; Jian, Yifan; Bonora, Stefano; Sarunic, Marinko V.; Zawadzki, Robert J.

2017-02-01

Adaptive optics (AO) is essential for achieving diffraction limited resolution in large numerical aperture (NA) in-vivo retinal imaging in small animals. Cellular-resolution in-vivo imaging of fluorescently labeled cells is highly desirable for studying pathophysiology in animal models of retina diseases in pre-clinical vision research. Currently, wavefront sensor-based (WFS-based) AO is widely used for retinal imaging and has demonstrated great success. However, the performance can be limited by several factors including common path errors, wavefront reconstruction errors and an ill-defined reference plane on the retina. Wavefront sensorless (WFS-less) AO has the advantage of avoiding these issues at the cost of algorithmic execution time. We have investigated WFS-less AO on a fluorescence scanning laser ophthalmoscopy (fSLO) system that was originally designed for WFS-based AO. The WFS-based AO uses a Shack-Hartmann WFS and a continuous surface deformable mirror in a closed-loop control system to measure and correct for aberrations induced by the mouse eye. The WFS-less AO performs an open-loop modal optimization with an image quality metric. After WFS-less AO aberration correction, the WFS was used as a control of the closed-loop WFS-less AO operation. We can easily switch between WFS-based and WFS-less control of the deformable mirror multiple times within an imaging session for the same mouse. This allows for a direct comparison between these two types of AO correction for fSLO. Our results demonstrate volumetric AO-fSLO imaging of mouse retinal cells labeled with GFP. Most significantly, we have analyzed and compared the aberration correction results for WFS-based and WFS-less AO imaging.

Clinicopathological correlations of Bcl-xL and Bax expression in differentiated thyroid carcinoma.

PubMed

Martínez-Brocca, M Asunción; Castilla, Carolina; Navarro, Elena; Amaya, M José; Travado, Paulino; Japón, Miguel A; Sáez, Carmen

2008-02-01

The Bcl-2 family proteins are essential mediators in the apoptotic process. Our aim was to investigate whether anti-apoptotic Bcl-xL and pro-apoptotic Bax were over-expressed in a large series of differentiated thyroid carcinomas (DTC) and to study their association with tumour presentation at diagnosis and prognosis. We examined the immunohistochemical expression of Bcl-xL and Bax in benign nodular thyroid disease (BNTD) and DTC and their association with clinicopathological parameters. Thyroid tissue samples were collected from an unselected series of patients undergoing surgical resection for DTC (n = 74) or BNTD (n = 15). Among DTC cases, expression of Bcl-xL was found to be high in 43.2% and low or absent in 56.8%. Expression of Bax was high in 75.7% and low or absent in 24.3%. Non-neoplastic thyroid tissue was largely unstained for both proteins. Among BNTD cases, expression of Bcl-xL was high in 13.3% and low or absent in 86.6%. Expression of Bax was high in 14.3% and low or absent in 86.6%. A significant association was found between Bcl-xL expression and the presence of high-risk histological subtype (P < 0.05), and regional lymph node (P < 0.01) and distant metastases (P < 0.01). The association between high Bcl-xL expression levels and a longer time of persistent disease after radioiodine ablation was also significant (P < 0.01). Bcl-xL expression was confirmed as an independent prognostic factor for persistent disease in DTC (relative risk, 2.5; 95% confidence interval, 1.1-5.9; P < 0.05). Immunohistochemical expression of Bcl-xL might be a valuable tool in the prediction of tumour aggressiveness in DTC.

A Structural and Mutagenic Blueprint for Molecular Recognition of Strychnine and d-Tubocurarine by Different Cys-Loop Receptors

PubMed Central

Kuzmin, Dmitry; van Elk, René; Krijnen, Liz; Yakel, Jerrel L.; Tsetlin, Victor; Smit, August B.; Ulens, Chris

2011-01-01

Cys-loop receptors (CLR) are pentameric ligand-gated ion channels that mediate fast excitatory or inhibitory transmission in the nervous system. Strychnine and d-tubocurarine (d-TC) are neurotoxins that have been highly instrumental in decades of research on glycine receptors (GlyR) and nicotinic acetylcholine receptors (nAChR), respectively. In this study we addressed the question how the molecular recognition of strychnine and d-TC occurs with high affinity and yet low specificity towards diverse CLR family members. X-ray crystal structures of the complexes with AChBP, a well-described structural homolog of the extracellular domain of the nAChRs, revealed that strychnine and d-TC adopt multiple occupancies and different ligand orientations, stabilizing the homopentameric protein in an asymmetric state. This introduces a new level of structural diversity in CLRs. Unlike protein and peptide neurotoxins, strychnine and d-TC form a limited number of contacts in the binding pocket of AChBP, offering an explanation for their low selectivity. Based on the ligand interactions observed in strychnine- and d-TC-AChBP complexes we performed alanine-scanning mutagenesis in the binding pocket of the human α1 GlyR and α7 nAChR and showed the functional relevance of these residues in conferring high potency of strychnine and d-TC, respectively. Our results demonstrate that a limited number of ligand interactions in the binding pocket together with an energetic stabilization of the extracellular domain are key to the poor selective recognition of strychnine and d-TC by CLRs as diverse as the GlyR, nAChR, and 5-HT3R. PMID:21468359

A structural and mutagenic blueprint for molecular recognition of strychnine and d-tubocurarine by different cys-loop receptors.

PubMed

Brams, Marijke; Pandya, Anshul; Kuzmin, Dmitry; van Elk, René; Krijnen, Liz; Yakel, Jerrel L; Tsetlin, Victor; Smit, August B; Ulens, Chris

2011-03-01

Cys-loop receptors (CLR) are pentameric ligand-gated ion channels that mediate fast excitatory or inhibitory transmission in the nervous system. Strychnine and d-tubocurarine (d-TC) are neurotoxins that have been highly instrumental in decades of research on glycine receptors (GlyR) and nicotinic acetylcholine receptors (nAChR), respectively. In this study we addressed the question how the molecular recognition of strychnine and d-TC occurs with high affinity and yet low specificity towards diverse CLR family members. X-ray crystal structures of the complexes with AChBP, a well-described structural homolog of the extracellular domain of the nAChRs, revealed that strychnine and d-TC adopt multiple occupancies and different ligand orientations, stabilizing the homopentameric protein in an asymmetric state. This introduces a new level of structural diversity in CLRs. Unlike protein and peptide neurotoxins, strychnine and d-TC form a limited number of contacts in the binding pocket of AChBP, offering an explanation for their low selectivity. Based on the ligand interactions observed in strychnine- and d-TC-AChBP complexes we performed alanine-scanning mutagenesis in the binding pocket of the human α1 GlyR and α7 nAChR and showed the functional relevance of these residues in conferring high potency of strychnine and d-TC, respectively. Our results demonstrate that a limited number of ligand interactions in the binding pocket together with an energetic stabilization of the extracellular domain are key to the poor selective recognition of strychnine and d-TC by CLRs as diverse as the GlyR, nAChR, and 5-HT(3)R.

Clinical management and outcomes in patients with hyperfunctioning distant metastases from differentiated thyroid cancer after total thyroidectomy and radioactive iodine therapy.

PubMed

Qiu, Zhong-Ling; Shen, Chen-Tian; Luo, Quan-Yong

2015-02-01

Hyperfunctioning distant metastasis (HFDM) from differentiated thyroid cancer (DTC) is a rare entity. This study aimed to assess the outcomes of DTC patients presenting with HFDM after total thyroidectomy and radioactive iodine therapy. A total of 5367 DTC patients treated with (131)I after total thyroidectomy were analyzed retrospectively from January 1991 to June 2013. Therapeutic efficacy was evaluated based on changes in serum thyroglobulin (Tg) and anatomical imaging changes in metastatic lesions. The relationships between survival time and several variables were assessed by univariate and multivariate analyses using the Kaplan-Meier method and Cox's proportional hazards model respectively. Thirty-eight patients with HFDM from DTC were diagnosed, including four with hyperthyroidism, four with subclinical hyperthyroidism, and three with subclinical hypothyroidism. The remaining 27 were euthyroid. Of 25 patients with lung metastases, 84% (21/25) showed disappearance or shrinkage of lung nodules; of 24 patients with bone metastases, 66.67% (16/24) exhibited no obvious imaging changes in metastatic bone lesions after (131)I therapy. Serum Tg decreased significantly in 81.58% (31/38) and increased in 18.42% (7/38) after (131)I therapy. The 10-year survival rate of DTC patients with HFDM was 65.79% (25/38). Multivariate analyses identified age at occurrence of distant metastases (<45 years), only lung metastases, and papillary thyroid cancer (PTC; p=0.032, NA, and 0.043) as independent predictors of survival. The response of hyperfunctioning lung metastases to (131)I treatment was better than that of non-hyperfunctioning lung metastases in DTC, while hyperfunctioning bone metastases responded similarly compared to non-hyperfunctioning bone metastases. Patients younger than 45 years at occurrence of distant metastases, those with only lung metastases, and patients with PTC had better prognoses.

76 FR 44057 - Sunshine Act Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-22

... SECURITIES AND EXCHANGE COMMISSION Sunshine Act Meeting Notice is hereby given, pursuant to the provisions of the Government in the Sunshine Act, Public Law 94-409, that the Securities and Exchange... (DTC). DTC operates an automated, centralized system for book-entry movement of securities positions in...

Health care knowledge and consumer learning: the case of direct-to-consumer drug advertising.

PubMed

Delbaere, Marjorie; Smith, Malcolm C

2006-01-01

This research develops a framework for understanding how consumers process health-related information and interact with their caregivers. The context is direct-to-consumer (DTC) advertising by pharmaceutical companies in North America. This theoretical research presents a research framework and focuses on the presentation of information in advertisements, consumer-learning processes, consumer utilization of health care knowledge, and bias in perceived risk. The paper proposes that consumers who lack expertise with prescription drugs learn from DTC ads differently than those with expertise. Further, it is proposed that consumers also process the information in DTC ads differently depending on the perceived effectiveness of the drug being advertised, and ultimately utilize the knowledge taken from the ads in many different ways, some of which may appear irrational to health care providers. By understanding how consumers interpret and learn from DTC ads, health care organizations and providers may be able to improve health care delivery and consumer outcomes.

Direct-to-consumer advertising and its utility in health care decision making: a consumer perspective.

PubMed

Deshpande, Aparna; Menon, Ajit; Perri, Matthew; Zinkhan, George

2004-01-01

The growth in direct-to-consumer advertising(DTCA)over the past two decades has facilitated the communication of prescription drug information directly to consumers. Data from a 1999 national survey are employed to determine the factors influencing consumers' opinions of the utility of DTC ads for health care decision making. We also analyze whether consumers use DTC ad information in health care decision making and who are the key drivers of such information utilization. The study results suggest that consumers have positive opinions of DTCA utility, varying across demographics and perceptions of certain advertisement features. Specifically, consumers value information about both risks and benefits, but the perception of risk information is more important in shaping opinions of ad utility than the perception of benefit information. Consumers still perceive, however that the quality of benefit information in DTC ads is better than that of risk information. Opinions about ad utility significantly influence whether information from DTC ads is used in health care decision making.

The effect of disease risk probability and disease type on interest in clinic-based versus direct-to-consumer genetic testing services.

PubMed

Sherman, Kerry; Shaw, Laura-Kate; Champion, Katrina; Caldeira, Fernanda; McCaskill, Margaret

2015-10-01

The effect of disease-specific cognitions on interest in clinic-based and direct-to-consumer (DTC) genetic testing was assessed. Participants (N = 309) responded to an online hypothetical scenario and received genetic testing-related messages that varied by risk probability (25, 50, 75 %) and disease type (Alzheimer's disease vs. Type 2 Diabetes). Post-manipulation interest increased for both testing types, but was greater for clinic-based testing. Interest was greater for Type 2 Diabetes than for Alzheimer's disease, the latter perceived as more severe and likely, and less treatable and preventable. For DTC testing only, participants allocated to the high risk condition (75 %) had greater testing interest than those in the low (25 %) category. DTC testing is perceived as a viable, but less preferred, option compared with clinic-based testing. Particularly when considering DTC genetic testing, there is a need to emphasize subjective disease-related perceptions, including risk probability.

Direct-to-consumer communication on prescription only medicines via the internet in the Netherlands, a pilot study. Opinion of the pharmaceutical industry, patient associations and support groups.

PubMed

Fabius, A Mariette; Cheung, Ka-Chun; Rijcken, Cristianne J F; Vinkers, Christiaan H; Talsma, Herre

2004-06-01

Investigation of the current application of direct-to-consumer (DTC) communication on prescription only medicines via the Intemet in the Netherlands. Questionnaires were sent by e-mail to 43 Dutch innovative pharmaceutical industries and 130 Patient Association and Support Groups (PASGs). In this pilot study, the response of the pharmaceutical industry was rather low but the impression is that they were willing to invest in DTC communication. The majority of the websites of PASGs did not link to websites of pharmaceutical companies. The PASGs had no opinion whether patients can make a good distinction between DTC advertising and information on websites of the pharmaceutical industry nor about the quality. PASGs did not think unambiguously about the impact on the patient-doctor relationship. The impact of DTC communication on prescription only medicines via the internet is not yet clear in the Netherlands.

Direct-to-consumer marketing of psychological treatments for anxiety disorders.

PubMed

Gallo, Kaitlin P; Comer, Jonathan S; Barlow, David H

2013-12-01

Progress disseminating and implementing evidence-based psychological treatments (EBPTs) for the anxiety disorders has been gradual. To date, the dominant approach for promoting the uptake of EBPTs in clinical settings has been to target the education and training of mental health providers, with many consumers remaining unaware of the potential benefits of EBPTs for anxiety disorders. Direct-to-consumer (DTC) marketing may be a promising vehicle for increasing EBPT utilization rates in the treatment of anxiety disorders. This paper provides an overview of the rationale and important considerations for applying DTC efforts to promote evidence-based care in the treatment of anxiety disorders, and reviews current DTC efforts in this area, including resources on the Internet and other media and in-person events. We conclude with recommendations for future efforts in the DTC marketing of EBPTs for the anxiety disorders, including the need for increased funding and grassroots efforts to inform consumers about anxiety disorders and their most effective treatments. Copyright © 2013 Elsevier Ltd. All rights reserved.

Fault tolerant operation of switched reluctance machine

NASA Astrophysics Data System (ADS)

Wang, Wei

The energy crisis and environmental challenges have driven industry towards more energy efficient solutions. With nearly 60% of electricity consumed by various electric machines in industry sector, advancement in the efficiency of the electric drive system is of vital importance. Adjustable speed drive system (ASDS) provides excellent speed regulation and dynamic performance as well as dramatically improved system efficiency compared with conventional motors without electronics drives. Industry has witnessed tremendous grow in ASDS applications not only as a driving force but also as an electric auxiliary system for replacing bulky and low efficiency auxiliary hydraulic and mechanical systems. With the vast penetration of ASDS, its fault tolerant operation capability is more widely recognized as an important feature of drive performance especially for aerospace, automotive applications and other industrial drive applications demanding high reliability. The Switched Reluctance Machine (SRM), a low cost, highly reliable electric machine with fault tolerant operation capability, has drawn substantial attention in the past three decades. Nevertheless, SRM is not free of fault. Certain faults such as converter faults, sensor faults, winding shorts, eccentricity and position sensor faults are commonly shared among all ASDS. In this dissertation, a thorough understanding of various faults and their influence on transient and steady state performance of SRM is developed via simulation and experimental study, providing necessary knowledge for fault detection and post fault management. Lumped parameter models are established for fast real time simulation and drive control. Based on the behavior of the faults, a fault detection scheme is developed for the purpose of fast and reliable fault diagnosis. In order to improve the SRM power and torque capacity under faults, the maximum torque per ampere excitation are conceptualized and validated through theoretical analysis and experiments. With the proposed optimal waveform, torque production is greatly improved under the same Root Mean Square (RMS) current constraint. Additionally, position sensorless operation methods under phase faults are investigated to account for the combination of physical position sensor and phase winding faults. A comprehensive solution for position sensorless operation under single and multiple phases fault are proposed and validated through experiments. Continuous position sensorless operation with seamless transition between various numbers of phase fault is achieved.

Effects of image congruency on persuasiveness and recall in direct-to-consumer prescription drug advertising.

PubMed

Kiernicki, Kristen; Helme, Donald W

2017-01-01

Although direct-to-consumer (DTC) prescription drug advertising is regulated by the U.S. Food and Drug Administration, content analyses suggest advertisers may not disclose drug risks in the same way they describe drug benefits. This study tests the relationship between image congruency in televised DTC advertisements, recall of risks/benefits, and perceived persuasiveness. Advertisements for Nasonex, Advair, and Lunesta were shown to college students in either their original (image incongruent) or modified (image neutral) form. Risks were easier to recall with image-neutral advertisements. Gender also had a significant interaction effect, suggesting that males and females process DTC advertisement differently.

Novel EO/IR sensor technologies

NASA Astrophysics Data System (ADS)

Lewis, Keith

2011-10-01

The requirements for advanced EO/IR sensor technologies are discussed in the context of evolving military operations, with significant emphasis on the development of new sensing technologies to meet the challenges posed by asymmetric threats. The Electro-Magnetic Remote Sensing (EMRS DTC) was established in 2003 to provide a centre of excellence in sensor research and development, supporting new capabilities in key military areas such as precision attack, battlespace manoeuvre and information superiority. In the area of advanced electro-optic technology, the DTC has supported work on discriminative imaging, advanced detectors, laser components/technologies, and novel optical techniques. This paper provides a summary of some of the EO/IR technologies explored by the DTC.

Photolithography of Dithiocarbamate-Anchored Monolayers and Polymers on Gold

PubMed Central

Leonov, Alexei P.; Wei, Alexander

2011-01-01

Dithiocarbamate (DTC)-anchored monolayers and polymers were investigated as positive resists for UV photolithography on planar and roughened Au surfaces. DTCs were formed in situ by the condensation of CS2 with monovalent or polyvalent amines such as linear polyethyleneimine (PEI) under mildly basic aqueous conditions, just prior to surface passivation. The robust adsorption of the polyvalent PEI-DTC to Au surfaces supported high levels of resistance to photoablation, providing opportunities to generate thin films with gradient functionality. Treatment of photopatterned substrates with alkanethiols produced binary coatings, enabling a direct visual comparison of DTC- and thiol-passivated surfaces against chemically induced corrosion using confocal microscopy. PMID:21894240

Visual elements in direct-to-consumer advertising: Messages communicated to patients with arthritis.

PubMed

Willis, Erin

2017-01-01

Direct-to-consumer (DTC) advertising saturates popular health magazines, communicating persuasive messages to readers that may influence attitudes and behaviors. This research used a two-prong approach to investigate the visual elements used in DTC advertising and their influence on consumers' understanding of a disease and its treatment options. An analysis was conducted of DTC advertisements (N = 62) from a population sample of Arthritis Today magazine, 2000-2010. Three panels of people with arthritis were used to validate the findings and discuss implications for health literacy. Pharmaceutical companies have an opportunity to communicate tailored messages to readers of niche publications and improve disease management.

Direct-to-consumer drug advertising: you get what you pay for.

PubMed

Jeffords, James M

2004-01-01

Between 1997 and 2001 spending on direct-to-consumer (DTC) drug advertising more than doubled. Opinions differ as to whether and to what extent DTC advertising benefits the doctor-patient relationship. Some analysts argue that the current regulatory regime is sufficient, others advocate a stricter enforcement, and still others promote an outright ban. An alternative may be to use the purchasing power of the federal government to require the inclusion of comparative quality data, thus creating a basis for more informed consumer choice. This approach could create incentives for the pharmaceutical industry to adjust spending on DTC advertising while avoiding "big government" interference with commercial free speech.

A Drive Method of Permanent Magnet Synchronous Motor Using Torque Angle Estimation without Position Sensor

NASA Astrophysics Data System (ADS)

Tanaka, Takuro; Takahashi, Hisashi

In some motor applications, it is very difficult to attach a position sensor to the motor in housing. One of the examples of such applications is the dental handpiece-motor. In those designs, it is necessary to drive highly efficiency at low speed and variable load condition without a position sensor. We developed a method to control a motor high-efficient and smoothly at low speed without a position sensor. In this paper, the method in which permanent magnet synchronous motor is controlled smoothly and high-efficient by using torque angle control in synchronized operation is shown. The usefulness is confirmed by experimental results. In conclusion, the proposed sensor-less control method has been achieved to be very efficiently and smoothly.

Sensor-less force-reflecting macro-micro telemanipulation systems by piezoelectric actuators.

PubMed

Amini, H; Farzaneh, B; Azimifar, F; Sarhan, A A D

2016-09-01

This paper establishes a novel control strategy for a nonlinear bilateral macro-micro teleoperation system with time delay. Besides position and velocity signals, force signals are additionally utilized in the control scheme. This modification significantly improves the poor transparency during contact with the environment. To eliminate external force measurement, a force estimation algorithm is proposed for the master and slave robots. The closed loop stability of the nonlinear micro-micro teleoperation system with the proposed control scheme is investigated employing the Lyapunov theory. Consequently, the experimental results verify the efficiency of the new control scheme in free motion and during collision between the slave robot and the environment of slave robot with environment, and the efficiency of the force estimation algorithm. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

Prescription medication changes following direct-to-consumer personal genomic testing: Findings from the Impact of Personal Genomics (PGen) Study

PubMed Central

Carere, Deanna Alexis; VanderWeele, Tyler; Vassy, Jason L.; van der Wouden, Cathelijne; Roberts, J. Scott; Kraft, Peter; Green, Robert C.

2016-01-01

Purpose To measure the frequency of prescription medication changes following direct-to-consumer personal genomic testing (DTC-PGT) and their association with the pharmacogenomic results received. Methods New DTC-PGT customers were enrolled in 2012 and completed surveys prior to return of results and 6 months post-results; DTC-PGT results were linked to survey data. ‘Atypical response’ pharmacogenomic results were defined as those indicating an increase or decrease in risk of an adverse drug event or likelihood of therapeutic benefit. At follow-up, participants reported prescription medication changes and health care provider consultation. Results Follow-up data were available from 961 participants, of which 54 (5.6%) reported changing a medication they were taking, or starting a new medication, due to their DTC-PGT results. Of these, 45 (83.3%) reported consulting with a health care provider regarding the change. Pharmacogenomic results were available for 961 participants, of which 875 (91.2%) received ≥1 atypical response result. For each such result received, the odds of reporting a prescription medication change increased 1.57 times (95% confidence interval = 1.17, 2.11). Conclusion Receipt of pharmacogenomic results indicating atypical drug response is common with DTC-PGT, and associated with prescription medication changes; however, fewer than 1% of consumers report unsupervised changes at 6 months post-testing. PMID:27657683

Third-person effects and direct-to-consumer advertisements for antidepressants.

PubMed

Taylor, Laramie D; Bell, Robert A; Kravitz, Richard L

2011-02-01

This study examines the evidence for a third- person effect (TPE) in the reactions of individuals affected by depression to direct-to-consumer (DTC) advertisements for antidepressants. TPE predicts that people will perceive the self to be less vulnerable to such advertisements than others. Previous research has identified such an effect, but did so in general population surveys. Past Previous research has also found a link between depression and diminished self-serving biases; whether this would be the case for TPE is unknown. An online questionnaire was administered to 148 participants in an Internet depression support group to investigate their perceptions of the influence of direct-to-consumer (DTC) advertisements for antidepressants. Consistent with expectations derived from third-person effect TPE research, participants, although relatively neutral in their attitudes toward such advertisements, nevertheless perceived other individuals with depression as more influenced than themselves. Positive attitudes towards DTC advertisements and depressive symptoms at the time of the survey were each negatively associated with this third-person perception (TPE). Individuals who have been diagnosed with depression and who participated in an online depression support group believe that they are less vulnerable to the influence of DTC advertisements than the typical person with a history of depression. This is moderated by attitudes towards DTC advertisements as well as by depressive symptoms, each of which is associated with a weakened TPE. © 2010 Wiley-Liss, Inc.

Ethical Issues for Direct-to-Consumer Digital Psychotherapy Apps: Addressing Accountability, Data Protection, and Consent.

PubMed

Martinez-Martin, Nicole; Kreitmair, Karola

2018-04-23

This paper focuses on the ethical challenges presented by direct-to-consumer (DTC) digital psychotherapy services that do not involve oversight by a professional mental health provider. DTC digital psychotherapy services can potentially assist in improving access to mental health care for the many people who would otherwise not have the resources or ability to connect with a therapist. However, the lack of adequate regulation in this area exacerbates concerns over how safety, privacy, accountability, and other ethical obligations to protect an individual in therapy are addressed within these services. In the traditional therapeutic relationship, there are ethical obligations that serve to protect the interests of the client and provide warnings. In contrast, in a DTC therapy app, there are no clear lines of accountability or associated ethical obligations to protect the user seeking mental health services. The types of DTC services that present ethical challenges include apps that use a digital platform to connect users to minimally trained nonprofessional counselors, as well as services that provide counseling steered by artificial intelligence and conversational agents. There is a need for adequate oversight of DTC nonprofessional psychotherapy services and additional empirical research to inform policy that will provide protection to the consumer. ©Nicole Martinez-Martin, Karola Kreitmair. Originally published in JMIR Mental Health (http://mental.jmir.org), 23.04.2018.

Direct-to-Consumer Genetic Testing: User Motivations, Decision Making, and Perceived Utility of Results.

PubMed

Roberts, J Scott; Gornick, Michele C; Carere, Deanna Alexis; Uhlmann, Wendy R; Ruffin, Mack T; Green, Robert C

2017-01-01

To describe the interests, decision making, and responses of consumers of direct-to-consumer personal genomic testing (DTC-PGT) services. Prior to 2013 regulatory restrictions on DTC-PGT services, 1,648 consumers from 2 leading companies completed Web surveys before and after receiving test results. Prior to testing, DTC-PGT consumers were as interested in ancestry (74% very interested) and trait information (72%) as they were in disease risks (72%). Among disease risks, heart disease (68% very interested), breast cancer (67%), and Alzheimer disease (66%) were of greatest interest prior to testing. Interest in disease risks was associated with female gender and poorer self-reported health (p < 0.01). Many consumers (38%) did not consider the possibility of unwanted information before purchasing services; this group was more likely to be older, male, and less educated (p < 0.05). After receiving results, 59% of respondents said test information would influence management of their health; 2% reported regret about seeking testing and 1% reported harm from results. DTC-PGT has attracted controversy because of the health-related information it provides, but nonmedical information is of equal or greater interest to consumers. Although many consumers did not fully consider potential risks prior to testing, DTC-PGT was generally perceived as useful in informing future health decisions. © 2017 S. Karger AG, Basel.

Prescription medication changes following direct-to-consumer personal genomic testing: findings from the Impact of Personal Genomics (PGen) Study.

PubMed

Carere, Deanna Alexis; VanderWeele, Tyler J; Vassy, Jason L; van der Wouden, Cathelijne H; Roberts, J Scott; Kraft, Peter; Green, Robert C

2017-05-01

To measure the frequency of prescription medication changes following direct-to-consumer personal genomic testing (DTC-PGT) and their association with the pharmacogenomic results received. New DTC-PGT customers were enrolled in 2012 and completed surveys prior to the return of results and 6 months after results; DTC-PGT results were linked to survey data. "Atypical response" pharmacogenomic results were defined as those indicating an increase or decrease in risk of an adverse drug event or likelihood of therapeutic benefit. At follow-up, participants reported prescription medication changes and health-care provider consultation. Follow-up data were available from 961 participants, of whom 54 (5.6%) reported changing a medication they were taking or starting a new medication due to their DTC-PGT results. Of these, 45 (83.3%) reported consulting with a health-care provider regarding the change. Pharmacogenomic results were available for 961 participants, of which 875 (91.2%) received one or more atypical response results. For each such result received, the odds of reporting a prescription medication change increased 1.57 times (95% confidence interval = 1.17, 2.11). Receipt of pharmacogenomic results indicating an atypical drug response is common with DTC-PGT and is associated with prescription medication changes; however, fewer than 1% of consumers report unsupervised changes at 6 months after testing.Genet Med advance online publication 22 September 2016.

Topsoil thickness effects on phosphorus and potassium dynamics on claypan soils

USDA-ARS?s Scientific Manuscript database

Due to variable depth to claypan (DTC) across landscapes, nutrient supply from subsoils, and crop removal, precise P and K fertilizer management on claypan soil fields can be difficult. Therefore, a study was performed to determine if DTC derived from soil apparent electrical conductivity (ECa) coul...

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Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-13

...; Communicating Composite Scores in Direct-to-Consumer Advertising AGENCY: Food and Drug Administration, HHS... information entitled ``Communicating Composite Scores in Direct-to-Consumer (DTC) Advertising'' has been... ``Communicating Composite Scores in Direct-to-Consumer (DTC) Advertising'' to OMB for review and clearance under...

Cognitive and motor dual task gait training improve dual task gait performance after stroke - A randomized controlled pilot trial.

PubMed

Liu, Yan-Ci; Yang, Yea-Ru; Tsai, Yun-An; Wang, Ray-Yau

2017-06-22

This study investigated effects of cognitive and motor dual task gait training on dual task gait performance in stroke. Participants (n = 28) were randomly assigned to cognitive dual task gait training (CDTT), motor dual task gait training (MDTT), or conventional physical therapy (CPT) group. Participants in CDTT or MDTT group practiced the cognitive or motor tasks respectively during walking. Participants in CPT group received strengthening, balance, and gait training. The intervention was 30 min/session, 3 sessions/week for 4 weeks. Three test conditions to evaluate the training effects were single walking, walking while performing cognitive task (serial subtraction), and walking while performing motor task (tray-carrying). Parameters included gait speed, dual task cost of gait speed (DTC-speed), cadence, stride time, and stride length. After CDTT, cognitive-motor dual task gait performance (stride length and DTC-speed) was improved (p = 0.021; p = 0.015). After MDTT, motor dual task gait performance (gait speed, stride length, and DTC-speed) was improved (p = 0.008; p = 0.008; p = 0.008 respectively). It seems that CDTT improved cognitive dual task gait performance and MDTT improved motor dual task gait performance although such improvements did not reach significant group difference. Therefore, different types of dual task gait training can be adopted to enhance different dual task gait performance in stroke.

Sensorless adaptive optics for isoSTED nanoscopy

NASA Astrophysics Data System (ADS)

Antonello, Jacopo; Hao, Xiang; Allgeyer, Edward S.; Bewersdorf, Joerg; Rittscher, Jens; Booth, Martin J.

2018-02-01

The presence of aberrations is a major concern when using fluorescence microscopy to image deep inside tissue. Aberrations due to refractive index mismatch and heterogeneity of the specimen under investigation cause severe reduction in the amount of fluorescence emission that is collected by the microscope. Furthermore, aberrations adversely affect the resolution, leading to loss of fine detail in the acquired images. These phenomena are particularly troublesome for super-resolution microscopy techniques such as isotropic stimulated-emission-depletion microscopy (isoSTED), which relies on accurate control of the shape and co-alignment of multiple excitation and depletion foci to operate as expected and to achieve the super-resolution effect. Aberrations can be suppressed by implementing sensorless adaptive optics techniques, whereby aberration correction is achieved by maximising a certain image quality metric. In confocal microscopy for example, one can employ the total image brightness as an image quality metric. Aberration correction is subsequently achieved by iteratively changing the settings of a wavefront corrector device until the metric is maximised. This simplistic approach has limited applicability to isoSTED microscopy where, due to the complex interplay between the excitation and depletion foci, maximising the total image brightness can lead to introducing aberrations in the depletion foci. In this work we first consider the effects that different aberration modes have on isoSTED microscopes. We then propose an iterative, wavelet-based aberration correction algorithm and evaluate its benefits.

Motor Control of Two Flywheels Enabling Combined Attitude Control and Bus Regulation

NASA Technical Reports Server (NTRS)

Kenny, Barbara H.

2004-01-01

This presentation discussed the flywheel technology development work that is ongoing at NASA GRC with a particular emphasis on the flywheel system control. The "field orientation" motor/generator control algorithm was discussed and explained. The position-sensorless angle and speed estimation algorithm was presented. The motor current response to a step change in command at low (10 kRPM) and high (60 kRPM) was discussed. The flywheel DC bus regulation control was explained and experimental results presented. Finally, the combined attitude control and energy storage algorithm that controls two flywheels simultaneously was presented. Experimental results were shown that verified the operational capability of the algorithm. shows high speed flywheel energy storage (60,000 RPM) and the successful implementation of an algorithm to simultaneously control both energy storage and a single axis of attitude with two flywheels. Overall, the presentation demonstrated that GRC has an operational facility that

DSP-based adaptive backstepping using the tracking errors for high-performance sensorless speed control of induction motor drive.

PubMed

Zaafouri, Abderrahmen; Regaya, Chiheb Ben; Azza, Hechmi Ben; Châari, Abdelkader

2016-01-01

This paper presents a modified structure of the backstepping nonlinear control of the induction motor (IM) fitted with an adaptive backstepping speed observer. The control design is based on the backstepping technique complemented by the introduction of integral tracking errors action to improve its robustness. Unlike other research performed on backstepping control with integral action, the control law developed in this paper does not propose the increase of the number of system state so as not increase the complexity of differential equations resolution. The digital simulation and experimental results show the effectiveness of the proposed control compared to the conventional PI control. The results analysis shows the characteristic robustness of the adaptive control to disturbances of the load, the speed variation and low speed. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

A Novelty Design Of Minimization Of Electrical Losses In A Vector Controlled Induction Machine Drive

NASA Astrophysics Data System (ADS)

Aryza, Solly; Irwanto, M.; Lubis, Zulkarnain; Putera Utama Siahaan, Andysah; Rahim, Robbi; Furqan, Mhd.

2018-01-01

The induction motor has in the industry . More attention has been a focus to develop and design of induction motor drive. With the method of vector control novelty prove the efficiency of induction motor over their entire speed range. In this paper desirable to design a loss minimization controller which can improve the efficiency. Also, this research described Modeling of an induction motor with core loss included. Realization of methods vector control for an induction motor drive with loss element included. The case of the loss minimization condition. The procedure was successful to calculate the gains of a PI controller. Though the problem of obtaining a robust and sensorless induction motor drive is by no means completely solved, the results obtained as part of this work point in a promising direction.

76 FR 75570 - Self-Regulatory Organizations; The Depository Trust Company; Notice of Filing of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-02

... counterparty by counterparty basis. Currently, all free money market instrument (``MMI'') deliveries are routed... was built in 1990 to route money market instrument (``MMI'') transactions for receiver approval. In... orders involve no securities, only money. \\5\\ The net debit cap control is designed so that DTC may...

The attentional demands of ambulating with an assistive device in older adults with Alzheimer's disease.

PubMed

Muir-Hunter, S W; Montero-Odasso, M

2017-05-01

Ambulation with a mobility aid is a unique real-life situation of multi-tasking. These simultaneous motor tasks place increased demands on executive function in healthy young and older adults, but the demands have not been evaluated in people with Alzheimer's disease (AD). Mobility problems are common among adults with AD, leading to provision of a mobility aid to optimize independent activity. The study objectives were: (i) to determine the dual-task cost (DTC) associated with the use of a mobility aid in straight and complex path walking, and (ii) to evaluate the association between executive function and ambulation with a mobility aid in older adults with AD and age-sex matched cognitively normal controls. Fourteen people (mean age±SD, 72.6±9.9years) with a diagnosis of probable AD (MMSE range 12-25) and controls (mean age±SD, 72.9±9.5) walked at a self-selected pace and using a 4-wheeled walker in a 6m straight path and a Figure of 8 Test. Ambulation with the walker in a straight path produced a low DTC that was not different between the groups. Ambulation with the 4-wheeled walker in the complex path produced a significantly different DTC in the group with AD at -38.1±23.5% compared to -19.7±21.4% (p=0.041). Lower scores on executive function were associated with longer times across test conditions. Ambulation with a 4-wheeled walker, in particular maneuvering around obstacles, requires greater attentional costs in dementia. Future research should explore the timing for safely introducing mobility aids in AD and the role of improving executive function. Copyright © 2017 Elsevier B.V. All rights reserved.

Comparison of the Seventh and Eighth Editions of the American Joint Committee on Cancer/Union for International Cancer Control Tumor-Node-Metastasis Staging System for Differentiated Thyroid Cancer.

PubMed

Kim, Mijin; Kim, Won Gu; Oh, Hye-Seon; Park, Suyeon; Kwon, Hyemi; Song, Dong Eun; Kim, Tae Yong; Shong, Young Kee; Kim, Won Bae; Sung, Tae-Yon; Jeon, Min Ji

2017-09-01

To evaluate the efficacy and prognostic validity for disease-specific survival (DSS) of the eighth edition American Joint Committee on Cancer/Union for International Cancer Control tumor-node-metastasis (TNM) staging system (TNM-8) compared to the seventh edition (TNM-7) in patients with differentiated thyroid carcinoma (DTC). The seventh and eighth editions of the TNM staging system were applied to 1613 DTC patients who underwent thyroid surgery between 1996 and 2003. The proportion of variation explained and Harrell's c-index were evaluated to compare the predictive capability of DSS. The mean age of the patients was 44.7 years, and the median follow-up period was 11.2 years. When TNM-8 was applied, 63% of T3 and 3% of N1b DTCs were downgraded to T1/T2 and N1a, respectively. About 38% of patients were downstaged according to TNM-8. The 10-year DSS rates in TNM-7 stages I, II, III, and IV were 99.7%, 98.2%, 98.8%, and 83.2%, respectively. Those in TNM-8 stages I, II, III, and IV were 99.6%, 95.4%, 72.3%, and 48.6%, respectively. The proportion of variation explained values of TNM-7 and TNM-8 were 6.0% and 7.0%, respectively. The Harrell's c-index of TNM-7 was 0.86 and that of TNM-8 was 0.88. A significant number of patients were reclassified to lower stages with the application of TNM-8 compared to TNM-7. Applying TNM-8 could improve the accuracy of the staging system for predicting DSS in patients with DTC.

Re-induction of cell differentiation and (131)I uptake in dedifferentiated FTC-133 cell line by TSHR gene transfection.

PubMed

Feng, Fang; Wang, Hui; Hou, Shasha; Fu, Hongliang

2012-11-01

Radioiodine therapy is commonly used to treat differentiated thyroid cancer (DTC), but a major challenge is dedifferentiation of DTC with the loss of radioiodine uptake. TSHR is a key molecule regulating thyrocyte proliferation and function. This study aimed to test the therapeutic potential of TSHR in dedifferentiated DTC by gene transfection in order to restore cell differentiation and radioiodine uptake. Dedifferentiated FTC-133 (dFTC-133) cells were obtained by monoclonal culture of FTC-133 cell line after (131)I radiation. Recombinant plasmid pcDNA3.1-hTSHR was transfected into dFTC-133 cells by using Lipofectamine 2000 reagent. Immunofluorescence analysis was carried out to confirm TSHR expression and its location. Radioiodine uptake assay was thereafter investigated. mRNAs and proteins of TSHR and other thyroid differentiated markers were detected by real-time PCR and western blot respectively. Among the thyroid specific genes in dFTC-133 cells with stable low radioiodine uptake, TSHR was down-regulated most significantly compared with FTC-133. Then, after TSHR gene transfection, augmented expression of TSHR was observed in dFTC-133 cell surface and cytoplasm by immunofluorescence analysis. It was found that (125)I uptake was 2.9 times higher (t=28.63, P<.01) in cells with TSHR transfection than control. The mRNAs of TSHR, NIS, TPO and Tg were also significantly increased by 1.7 times (t=13.8, P<.05), 4 times (t=28.52, P<.05), 1.5 times (t=14.43, P<.05) and 2.2 times (t=19.83, P<.05) respectively compared with control group. Decreased TSHR expression correlated with FTC-133 ongoing dedifferentiation. TSHR transfection contributed to the re-differentiation of dedifferentiated thyroid follicular carcinoma cells. Copyright © 2012 Elsevier Inc. All rights reserved.

Evaluation of the diagnostic value of the first thyroglobulin determination in detecting metastases after differentiated thyroid carcinoma surgery.

PubMed

Makarewicz, J; Adamczewski, Z; Knapska-Kucharska, M; Lewiński, A

2006-10-01

Evaluation of the diagnostic value of the first thyroglobulin (Tg) level measurement, performed after thyroidectomy, before another treatment, as an early marker of either metastases or local recurrence of differentiated thyroid carcinoma (DTC). Data of 178 patients (160 women, 18 men, 14-79 years) with DTC and without known interference in Tg assay were evaluated retrospectively. In all patients, neck radioiodine uptake (Tup (24)), thyroid remnants volume (V), TSH and Tg were measured. The Tg/V and Tg/Tup (24) ratios were calculated to correct Tg concentration with regard to V and Tup (24). Six months after initial evaluation and routine therapy all patients underwent control examinations under endogenous TSH stimulation. During follow-up metastases or local recurrence were found in 32 patients. The groups of patients with no diagnosed metastases (M0) and with detected metastases (M1), did not differ with regard to V, serum TSH or Tup (24); difference between the two groups was found in Tg concentration (4.3 ng/ml VS 97.4 ng/ml; p=0.000001). The ratios of Tg/Tup (24) (p=0.000000) and Tg/V (p=0.004) were lower in the group M0 than M1. The areas under receiver operating characteristic curves (ROC) for Tg concentrations, Tg/Tup (24), and Tg/V ratios were 0.773 (95% CI - 0.655-0.892), 0.817 (0.709-0.925) and 0.712 (0.541-0.884), respectively. Both the absolute Tg concentration and Tg/V and Tg/Tup (24) ratios, determined after thyroidectomy but before another treatment in patients with metastases of DTC, diagnosed within 6 months after (131)I administration, are higher than those in patients without such metastases. This indicates that the mentioned parameters may be applied as early markers of either local recurrence or metastases of DTC. The highest discriminative value demonstrates Tg/Tup (24) ratio, Tg concentration has a lower value and Tg/V ratio has the lowest one.

Direct-to-consumer genetic testing: perceptions, problems, and policy responses.

PubMed

Caulfield, Timothy; McGuire, Amy L

2012-01-01

Direct-to-consumer (DTC) genetic testing has attracted a great amount of attention from policy makers, the scientific community, professional groups, and the media. Although it is unclear what the public demand is for these services, there does appear to be public interest in personal genetic risk information. As a result, many commentators have raised a variety of social, ethical, and regulatory issues associated with this emerging industry, including privacy issues, ensuring that DTC companies provide accurate information about the risks and limitations of their services, the possible adverse impact of DTC genetic testing on healthcare systems, and concern about how individuals may interpret and react to genetic risk information.

Power Maximization Control of Variable Speed Wind Generation System Using Permanent Magnet Synchronous Generator

NASA Astrophysics Data System (ADS)

Morimoto, Shigeo; Nakamura, Tomohiko; Takeda, Yoji

This paper proposes the sensorless output power maximization control of the wind generation system. A permanent magnet synchronous generator (PMSG) is used as a variable speed generator in the proposed system. The generator torque is suitably controlled according to the generator speed and thus the power from a wind turbine settles down on the maximum power point by the proposed MPPT control method, where the information of wind velocity is not required. Moreover, the maximum available generated power is obtained by the optimum current vector control. The current vector of PMSG is optimally controlled according to the generator speed and the required torque in order to minimize the losses of PMSG considering the voltage and current constraints. The proposed wind power generation system can be achieved without mechanical sensors such as a wind velocity detector and a position sensor. Several experimental results show the effectiveness of the proposed control method.

78 FR 65326 - Agency Information Collection Activities; Proposed Collection; Comment Request; Experimental...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-31

... Directed at Adolescents.'' This study is designed to examine how adolescents interpret DTC advertising... understanding of benefits and risks in DTC ads differ across this part of the lifespan. Design Overview Within... (benefit onset: immediate, delayed) x 2 (risk severity: high, low) factorial design, based on the rationale...

75 FR 71473 - Self-Regulatory Organizations; the Depository Trust Company; Notice of Filing of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-23

... the Requirement To Maintain a Balance Certificate in the Fast Automated Securities Transfer Program... custody a balance certificate. II. Self-Regulatory Organization's Statement of the Purpose of, and... Proposed Rule Change Under DTC's FAST program, DTC leaves securities in the form of balance certificates in...

76 FR 76790 - Self-Regulatory Organizations; The Depository Trust Company; Notice of Filing of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-08

... Order To Mitigate Systemic Risk, Specifically Liquidity Related, Associated With DTC End of Day Net... so, DTC believes it would reduce the systemic risk associated with a liquidity shortfall and would... facilitate the settlement of transactions while limiting systemic risk due to Participant failure. \\4\\ These...

[Personal genomics: are we debating the right Issues?].

PubMed

Vayena, E; Mauch, F

2012-07-25

The debate about personal genomics and their role in personalized medicine has been, to some extent, hijacked by the controversy about commercially available genomic tests sold directly to consumers. The clinical validity and utility of such tests are currently limited and most medical associations recommend that consumers refrain from testing. Conversely, DTC genomics proponents and particularly the DTC industry argue that there is personal utility in acquiring genomic information. While it is necessary to debate risks and benefits of DTC genomics, we should not lose sight of the increasingly important role that genomics will play in medical practice and public health. Therefore, and in anticipation of this shift we also need to focus on important implications from the use of genomics information such as genetic discrimination, privacy protection and equitable access to health care. Undoubtedly, personal genomics will challenge our social norms maybe more than our medicine. Sticking to the polarization of «to have or not to have DTC genomics» risks to takes us away from the critical issues we need to be debating.

F18-FDG-PET for recurrent differentiated thyroid cancer: a systematic meta-analysis

PubMed Central

Haslerud, Torjan; Brauckhoff, Katrin; Reisæter, Lars; Küfner Lein, Regina; Heinecke, Achim; Varhaug, Jan Erik

2015-01-01

Background Positron emission tomography (PET) with fluor-18-deoxy-glucose (FDG) is widely used for diagnosing recurrent or metastatic disease in patients with differentiated thyroid cancer (DTC). Purpose To assess the diagnostic accuracy of FDG-PET for DTC in patients after ablative therapy. Material and Methods A systematic search was conducted in Medline/PubMed, EMBASE, Cochrane Library, Web of Science, and Open Grey looking for all English-language original articles on the performance of FDG-PET in series of at least 20 patients with DTC having undergone ablative therapy including total thyroidectomy. Diagnostic performance measures were pooled using Reitsma’s bivariate model. Results Thirty-four publications between 1996 and 2014 met the inclusion criteria. Pooled sensitivity and specificity were 79.4% (95% confidence interval [CI], 73.9–84.1) and 79.4% (95% CI, 71.2–85.4), respectively, with an area under the curve of 0.858. Conclusion F18-FDG-PET is a useful method for detecting recurrent DTC in patients having undergone ablative therapy. PMID:26163534

Perceptions of genetic testing for personalized nutrition: a randomized trial of DNA-based dietary advice.

PubMed

Nielsen, Daiva E; Shih, Sarah; El-Sohemy, Ahmed

2014-01-01

Direct-to-consumer (DTC) genetic tests have facilitated easy access to personal genetic information related to health and nutrition; however, consumer perceptions of the nutritional information provided by these tests have not been evaluated. The objectives of this study were to assess individual perceptions of personalized nutrition and genetic testing and to determine whether a personalized nutrition intervention modifies perceptions. A double-blind, parallel-group, randomized controlled trial was conducted among healthy men and women aged 20-35 years (n = 138). Participants in the intervention group (n = 92) were given a report of DNA-based dietary advice and those in the control group (n = 46) were given a general dietary advice report. A survey was completed at baseline and 3 and 12 months after distributing the reports to assess perceptions between the two groups. No significant differences in perceptions of personalized nutrition and genetic testing were observed between the intervention and control group, so responses of both groups were combined. As compared to baseline, participant responses increased significantly toward the positive end of a Likert scale at 3 months for the statement 'I am interested in the relationship between diet and genetics' (mean change ± SD: 0.28 ± 0.99, p = 0.0002). The majority of participants indicated that a university research lab (47%) or health care professional (41%) were the best sources for obtaining accurate personal genetic information, while a DTC genetic testing company received the fewest selections (12%). Most participants (56%) considered dietitians to be the best source of personalized nutrition followed by medical doctors (27%), naturopaths (8%) and nurses (6%). These results suggest that perceptions of personalized nutrition changed over the course of the intervention. Individuals view a research lab or health care professional as better providers of genetic information than a DTC genetic testing company, and registered dietitians are considered to be the best providers of personalized nutrition advice. © 2014 S. Karger AG, Basel.

Evaluating online direct-to-consumer marketing of genetic tests: informed choices or buyers beware?

PubMed

Geransar, Rose; Einsiedel, Edna

2008-03-01

Commercialization of genetic technologies is expanding the horizons for the marketing and sales of genetic tests direct-to-consumers (DTCs). This study assesses the information provision and access requirements that are in place for genetic tests that are being advertised DTC over the Internet. Sets of key words specific to DTC genetic testing were entered into popular Internet search engines to generate a list of 24 companies engaging in DTC advertising. Company requirements for physician mediation, genetic counseling arrangements, and information provision were coded to develop categories for quantitative analysis within each variable. Results showed that companies offering risk assessment and diagnostic testing were most likely to require that testing be mediated by a clinician, and to recommend physician-arranged counseling. Companies offering enhancement testing were less likely to require physician mediation of services and more likely to provide long-distance genetic counseling. DTC advertisements often provided information on disease etiology; this was most common in the case of multifactorial diseases. The majority of companies cited outside sources to support the validity of claims about clinical utility of the tests being advertised; companies offering risk assessment tests most frequently cited all information sources. DTC advertising for genetic tests that lack independent professional oversight raises troubling questions about appropriate use and interpretation of these tests by consumers and carries implications for the standards of patient care. These implications are discussed in the context of a public healthcare system.

Biomimetic synthesis of highly biocompatible gold nanoparticles with amino acid-dithiocarbamate as a precursor for SERS imaging

NASA Astrophysics Data System (ADS)

Li, Li; Liu, Jianbo; Yang, Xiaohai; Huang, Jin; He, Dinggeng; Guo, Xi; Wan, Lan; He, Xiaoxiao; Wang, Kemin

2016-03-01

Amino acid-dithiocarbamate (amino acid-DTC) was developed as both the reductant and ligand stabilizer for biomimetic synthesis of gold nanoparticles (AuNPs), which served as an excellent surface-enhanced Raman scattering (SERS) contrast nanoprobe for cell imaging. Glycine (Gly), glutamic acid (Glu), and histidine (His) with different isoelectric points were chosen as representative amino acid candidates to synthesize corresponding amino acid-DTC compounds through mixing with carbon disulfide (CS2), respectively. The pyrogenic decomposition of amino acid-DTC initiated the reduction synthesis of AuNPs, and the strong coordinating dithiocarbamate group of amino acid-DTC served as a stabilizer that grafted onto the surface of the AuNPs, which rendered the as-prepared nanoparticles a negative surface charge and high colloidal stability. MTT cell viability assay demonstrated that the biomimetic AuNPs possessed neglectful toxicity to the human hepatoma cell, which guaranteed them good biocompatibility for biomedical application. Meanwhile, the biomimetic AuNPs showed a strong SERS effect with an enhancement factor of 9.8 × 105 for the sensing of Rhodamine 6G, and two distinct Raman peaks located at 1363 and 1509 cm-1 could be clearly observed in the cell-imaging experiments. Therefore, biomimetic AuNPs can be explored as an excellent SERS contrast nanoprobe for biomedical imaging, and the amino acid-DTC mediated synthesis of the AuNPs has a great potential in bio-engineering and biomedical imaging applications.

The Treatment of Differentiated Thyroid Cancer in Children: Emphasis on Surgical Approach and Radioactive Iodine Therapy

PubMed Central

Mazzaferri, Ernest L.; Verburg, Frederik A.; Reiners, Christoph; Luster, Markus; Breuer, Christopher K.; Dinauer, Catherine A.; Udelsman, Robert

2011-01-01

Pediatric thyroid cancer is a rare disease with an excellent prognosis. Compared with adults, epithelial-derived differentiated thyroid cancer (DTC), which includes papillary and follicular thyroid cancer, presents at more advanced stages in children and is associated with higher rates of recurrence. Because of its uncommon occurrence, randomized trials have not been applied to test best-care options in children. Even in adults that have a 10-fold or higher incidence of thyroid cancer than children, few prospective trials have been executed to compare treatment approaches. We recognize that treatment recommendations have changed over the past few decades and will continue to do so. Respecting the aggressiveness of pediatric thyroid cancer, high recurrence rates, and the problems associated with decades of long-term follow-up, a premium should be placed on treatments that minimize risk of recurrence and the adverse effects of treatments and facilitate follow-up. We recommend that total thyroidectomy and central compartment lymph node dissection is the surgical procedure of choice for children with DTC if it can be performed by a high-volume thyroid surgeon. We recommend radioactive iodine therapy for remnant ablation or residual disease for most children with DTC. We recommend long-term follow-up because disease can recur decades after initial diagnosis and therapy. Considering the complexity of DTC management and the potential complications associated with therapy, it is essential that pediatric DTC be managed by physicians with expertise in this area. PMID:21880704

Direct-to-Consumer Broadcast Advertisements for Pharmaceuticals: Off-Label Promotion and Adherence to FDA Guidelines.

PubMed

Klara, Kristina; Kim, Jeanie; Ross, Joseph S

2018-05-01

Direct-to-consumer (DTC) advertisements for prescription drugs in the United States are regulated by the Food and Drug Administration (FDA). Off-label promotion, or the advertisement of a drug for an indication not approved by the FDA, is prohibited. Our objective was to examine the presence of off-label promotion in broadcast DTC ads and to assess their adherence to FDA guidelines mandating fair balance in presentation of risks and benefits and prohibiting misleading advertisement claims. All English-language broadcast DTC ads for prescription drugs that aired in the United States from January 2015 to July 2016 were obtained from AdPharm, an online collection of healthcare advertisements. Ad length was measured and adherence to FDA guidelines was assessed for several categories: key regulatory items, indicators of false or misleading ads, and indicators of fair balance in presentation of risks and benefits. Our sample included 97 unique DTC ads, representing 60 unique drugs and 67 unique drug-indication combinations. No ads described drug risks quantitatively, whereas drug efficacy was presented quantitatively in 25 (26%) ads. Thirteen (13%) ads, all for diabetes medications, suggested off-label uses for weight loss and blood pressure reduction. The most commonly advertised drugs were indicated for the treatment of inflammatory conditions (n = 12; 18%), diabetes or diabetic neuropathy (n = 11; 16%), bowel or bladder dysfunction (n = 6; 9%), and infections or allergic reaction (n = 6; 9%). More than three-quarters (n = 51; 76%) advertised drugs to treat chronic conditions. Few broadcast DTC ads were fully compliant with FDA guidelines. The overall quality of information provided in ads was low, and suggestions of off-label promotion were common for diabetes medications. The impact of current DTC ads and off-label marketing on patient and prescriber decisions merits further scrutiny.

Consumer Perceptions of Interactions With Primary Care Providers After Direct-to-Consumer Personal Genomic Testing.

PubMed

van der Wouden, Cathelijne H; Carere, Deanna Alexis; Maitland-van der Zee, Anke H; Ruffin, Mack T; Roberts, J Scott; Green, Robert C

2016-04-19

Direct-to-consumer (DTC) personal genomic testing (PGT) allows individuals to learn about their genetic makeup without going through a physician, but some consumers share their results with their primary care provider (PCP). To describe the characteristics and perceptions of DTC PGT consumers who discuss their results with their PCP. Longitudinal, prospective cohort study. Online survey before and 6 months after results. DTC PGT consumers. Consumer satisfaction with the DTC PGT experience; whether and, if so, how many results could be used to improve health; how many results were not understood; and beliefs about the PCP's understanding of genetics. Participants were asked with whom they had discussed their results. Genetic reports were linked to survey responses. Among 1026 respondents, 63% planned to share their results with a PCP. At 6-month follow-up, 27% reported having done so, and 8% reported sharing with another health care provider only. Common reasons for not sharing results with a health care provider were that the results were not important enough (40%) or that the participant did not have time to do so (37%). Among participants who discussed results with their PCP, 35% were very satisfied with the encounter, and 18% were not at all satisfied. Frequently identified themes in participant descriptions of these encounters were actionability of the results or use in care (32%), PCP engagement or interest (25%), and lack of PCP engagement or interest (22%). Participants may not be representative of all DTC PGT consumers. A comprehensive picture of DTC PGT consumers who shared their results with a health care provider is presented. The proportion that shares results is expected to increase with time after testing as consumers find opportunities for discussion at later appointments or if results become relevant as medical needs evolve. National Institutes of Health.

Plenary III-04: Media Messages and Public Perceptions of Direct-to-Consumer Genetics: Results of a Media Analysis and Focus Group Study

PubMed Central

Rahm, Alanna Kulchak; Dearing, James; Feigelson, Heather Spencer; Tracer, David; Bull, Sheana

2011-01-01

Background Information about genetics and the promise of genomic medicine is commonplace in the mass media. How the mass media themselves contribute – or not – to the persistence of this issue and its perception by the public is the topic of this presentation. The purpose of this study is to investigate the structural and individual perspectives on the issue of direct-to-consumer (DTC) genetics, and assess the degree of correspondence across these perspectives. Methods I conducted a media analysis to determine how the issue of DTC genetics has been framed in mass media stories and the salient topics related to the issue. I conducted focus groups to determine individual knowledge, attitudes and beliefs about the issue of DTC genetics. Results A final sample of 398 mass media stories of DTC genetics from Lexis-Nexis Academic archives between September 1, 2007 and September 30, 2009 were coded for salience and frames. Fourteen focus groups were conducted between October, 2009 and March, 2010 with Kaiser Permanente Colorado members and medical staff. Focus group transcripts were coded for salience and framing of the issue and compared with the media analysis results.Study results found that the issue of DTC genetics was not very important to focus group participants except as it related to the topic of breast cancer. Mass media message topics and frames showed differences over time. Focus group participants were generally negative towards the issue while the mass media was mostly positive towards DTC genetics. Focus group participants used some of the many frames to understand the issue that were utilized by the mass media to package the issue, but participants mainly framed the issue in terms of prevention and a pandora’s box, while the mass media presented the issue more in terms of progressive and discrimination frames. Conclusions The mass media appears to function as a field of power for the issue of DTC genetics with the consumers in the middle of the contests. A higher-level concept of an “informed consumer” emerged from the focus groups that appears to provide consumers a degree of power in this battlefield as well.

Hashimoto's Thyroiditis Pathology and Risk for Thyroid Cancer

PubMed Central

Paparodis, Rodis; Imam, Shahnawaz; Todorova-Koteva, Kristina; Staii, Anca

2014-01-01

Background: Hashimoto's thyroiditis (HT) has been found to coexist with differentiated thyroid cancer (DTC) in surgical specimens, but an association between the two conditions has been discounted by the medical literature. Therefore, we performed this study to determine any potential relationship between HT and the risk of developing DTC. Methods: We collected data for thyrotropin (TSH), thyroxine (T4), thyroid peroxidase antibody (TPO-Ab) titers, surgical pathology, and weight-based levothyroxine (LT4) replacement dose for patients who were referred for thyroid surgery. Patients with HT at final pathology were studied further. To estimate thyroid function, patients with preoperative hypothyroid HT (Hypo-HT) were divided into three equal groups based on their LT4 replacement: LT4-Low (<0.90 μg/kg), LT4-Mid (0.90–1.43 μg/kg), and LT4-High (>1.43 μg/kg). A group of preoperatively euthyroid (Euth-HT) patients but with HT by pathology was also studied. All subjects were also grouped based on their TPO-Ab titer in TPO-high (titer >1:1000) or TPO-low/negative (titer <1:1000 or undetectable) groups. The relationship of HT and DTC was studied extensively. Results: Of 2811 subjects, 582 had HT on surgical pathology, 365 of whom were Euth-HT preoperatively. DTC was present in 47.9% of the Euth-HT, in 59.7% of LT4-Low, 29.8% of LT4-Mid, and 27.9% of LT4-High groups. The relative risk (RR) for DTC was significantly elevated for the Euth-HT and LT4-Low groups (p<0.001), but not for the LT4-Mid or LT4-High replacement dose groups. TPO-low/negative status conferred an increased RR in the Euth-HT and LT4-Low replacement dose groups (p<0.001 both), while TPO-high status decreased it in Euth-HT group (p<0.05) and made it nonsignificant in the LT4-Low group. Conclusions: HT pathology increases the risk for DTC only in euthyroid subjects and those with partially functional thyroid glands (LT4-Low) but not in fully hypothyroid HT (LT4-Mid and LT4-High). High TPO-Ab titers appear to protect against DTC in patients with HT. PMID:24708347

78 FR 20999 - Self-Regulatory Organizations; The Depository Trust Company; Notice of Filing of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-08

... Fund Deposit does not already satisfy the new requirement.\\8\\ \\4\\ See DTC Rules ( http://dtcc.com/legal... Participants Fund Deposit does not already satisfy the new requirement) be deposited with DTC on the same... Regarding the Collection of Participants' Required Participants Fund Deposits April 2, 2013. Pursuant to...

76 FR 2430 - Self-Regulatory Organizations; the Depository Trust Company; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-13

... Organizations; the Depository Trust Company; Notice of Filing and Immediate Effectiveness of Proposed Rule... Act of 1934 (``Act''),\\1\\ notice is hereby given that on December 28, 2010, The Depository Trust... included as Exhibit 5 to DTC's proposed rule filing, which can be viewed at DTC's Web site ( http://www...

Are Direct to Consumer Advertisements of Prescription Drugs Educational?: Comparing 1992 to 2002

ERIC Educational Resources Information Center

Curry, Timothy Jon; Jarosch, Jeff; Pacholok, Shelley

2005-01-01

We investigate the educational value of direct-to-consumer (DTC) prescription drug advertisements from 58 popular magazines published in 1992 and 2002. We find that the number of DTC prescription drug ads increased nine-fold from 1992 to 2002, while the advertisements for other health care products increased only slightly. We examine changes in…

77 FR 17534 - Self-Regulatory Organizations; The Depository Trust Company; Notice of Filing of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-26

... Association (``SIFMA'') formed the MMI Blue-Sky Task Force (``Task Force'') to address systemic and unique... processing. The Task Force, along other money market industry members,\\8\\ determined that DTC's current MMI... amount or proceeds after the 3 p.m. E.T. deadline for RTP instructions.\\9\\ Accordingly, DTC is proposing...

Using topsoil thickness to improve site-specific phosphorus and potassium management on claypan soil

USDA-ARS?s Scientific Manuscript database

Precise P and K fertilizer management on claypan soils can be difficult due to variable topsoil thickness, or depth to claypan (DTC), across landscapes, nutrient supply from subsoils, and crop removal. Therefore, a study was performed to determine if DTC could be used to improve P and K management f...

78 FR 36616 - Self-Regulatory Organizations; The Depository Trust Company; Order Approving Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-18

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-69741; File No. SR-DTC-2013-03] Self-Regulatory Organizations; The Depository Trust Company; Order Approving Proposed Rule Change in Connection With the Implementation of The Foreign Account Tax Compliance Act (FATCA) June 12, 2013. On April 22, 2013, The Depository Trust Company (``DTC'') filed...

75 FR 54680 - Self-Regulatory Organizations; The Depository Trust Company; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-08

...-Regulatory Organization's Statement of the Terms of Substance of the Proposed Rule Change The proposed rule change will amend DTC rules to provide that any officer having a rank of Managing Director or higher is... Organization's Statement on Burden on Competition DTC does not believe that the proposed rule change will...

77 FR 3833 - Self-Regulatory Organizations; The Depository Trust Company; Order Approving Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-25

... To Mitigate Systemic Risk, Specifically Liquidity Related, Associated With DTC End of Day Net Funds... weekend or holiday). In doing so, DTC believes it would reduce the systemic risk associated with a... systemic risk due to Participant failure. \\5\\ These net debit caps are supported by $3.2 billion of...

75 FR 69150 - Self-Regulatory Organizations; The Depository Trust Company; Order Approving Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-10

... Process in Providing Trustee Access to the Security Position Report Service November 4, 2010. I.... The current review process to approve a trustee's access to the SPR service for a security is done... a trustee's access to DTC's SPR service for an issue with an automated approval process, DTC will be...

77 FR 26796 - Self-Regulatory Organizations; The Depository Trust Company; Notice of Filing of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-07

... today's practices, DTC will process requests for these types of post-payable adjustments up to one year... interest. DTC has been requested a number of times by the Association of Global Custodians to focus more...\\ In fact, the Association of Global Custodians' recommendation was to adopt a new practice in which...

Coherence-Gated Sensorless Adaptive Optics Multiphoton Retinal Imaging

PubMed Central

Cua, Michelle; Wahl, Daniel J.; Zhao, Yuan; Lee, Sujin; Bonora, Stefano; Zawadzki, Robert J.; Jian, Yifan; Sarunic, Marinko V.

2016-01-01

Multiphoton microscopy enables imaging deep into scattering tissues. The efficient generation of non-linear optical effects is related to both the pulse duration (typically on the order of femtoseconds) and the size of the focused spot. Aberrations introduced by refractive index inhomogeneity in the sample distort the wavefront and enlarge the focal spot, which reduces the multiphoton signal. Traditional approaches to adaptive optics wavefront correction are not effective in thick or multi-layered scattering media. In this report, we present sensorless adaptive optics (SAO) using low-coherence interferometric detection of the excitation light for depth-resolved aberration correction of two-photon excited fluorescence (TPEF) in biological tissue. We demonstrate coherence-gated SAO TPEF using a transmissive multi-actuator adaptive lens for in vivo imaging in a mouse retina. This configuration has significant potential for reducing the laser power required for adaptive optics multiphoton imaging, and for facilitating integration with existing systems. PMID:27599635

Coherence-Gated Sensorless Adaptive Optics Multiphoton Retinal Imaging.

PubMed

Cua, Michelle; Wahl, Daniel J; Zhao, Yuan; Lee, Sujin; Bonora, Stefano; Zawadzki, Robert J; Jian, Yifan; Sarunic, Marinko V

2016-09-07

Multiphoton microscopy enables imaging deep into scattering tissues. The efficient generation of non-linear optical effects is related to both the pulse duration (typically on the order of femtoseconds) and the size of the focused spot. Aberrations introduced by refractive index inhomogeneity in the sample distort the wavefront and enlarge the focal spot, which reduces the multiphoton signal. Traditional approaches to adaptive optics wavefront correction are not effective in thick or multi-layered scattering media. In this report, we present sensorless adaptive optics (SAO) using low-coherence interferometric detection of the excitation light for depth-resolved aberration correction of two-photon excited fluorescence (TPEF) in biological tissue. We demonstrate coherence-gated SAO TPEF using a transmissive multi-actuator adaptive lens for in vivo imaging in a mouse retina. This configuration has significant potential for reducing the laser power required for adaptive optics multiphoton imaging, and for facilitating integration with existing systems.

78 FR 13917 - Self-Regulatory Organizations; The Depository Trust Company; Notice of Filing Amendment No. 1 and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-01

... systemic risk since the reversals may override DTC's risk management controls such as the Collateral...\\ The stated purpose of Title VIII is to mitigate systemic risk in the financial system and promote... soundness; Reduce systemic risks; and Support the stability of the broader financial system. The Commission...

Management of recurrent/persistent nodal disease in patients with differentiated thyroid cancer: a critical review of the risks and benefits of surgical intervention versus active surveillance.

PubMed

Tufano, Ralph P; Clayman, Gary; Heller, Keith S; Inabnet, William B; Kebebew, Electron; Shaha, Ashok; Steward, David L; Tuttle, R Michael

2015-01-01

The primary goals of this interdisciplinary consensus statement are to define the eligibility criteria for management of recurrent and persistent cervical nodal disease in patients with differentiated thyroid cancer (DTC) and to review the risks and benefits of surgical intervention versus active surveillance. A writing group was convened by the Surgical Affairs Committee of the American Thyroid Association and was tasked with identifying the important clinical elements to consider when managing recurrent/persistent nodal disease in patients with DTC based on the available evidence in the literature and the group's collective experience. The decision on how best to manage individual patients with suspected recurrent/persistent nodal disease is challenging and requires the consideration of a significant number of variables outlined by the members of the interdisciplinary team. Here we report on the consensus opinions that were reached by the writing group regarding the technical and clinical issues encountered in this patient population. Identification of recurrent/persistent disease requires a team decision-making process that includes the patient and physicians as to what, if any, intervention should be performed to best control the disease while minimizing morbidity. Several management principles and variables involved in the decision making for surgery versus active surveillance were developed that should be taken into account when deciding how best to manage a patient with DTC and suspected recurrent or persistent cervical nodal disease.

Direct-to-consumer genetic testing for addiction susceptibility: a premature commercialisation of doubtful validity and value.

PubMed

Mathews, Rebecca; Hall, Wayne; Carter, Adrian

2012-12-01

Genetic research on addiction liability and pharmacogenetic research on treatments for addiction have identified some genetic variants associated with disease risk and treatment. Genetic testing for addiction liability and treatment response has not been used widely in clinical practice because most of the genes identified only modestly predict addiction risk or treatment response. However, many of these genetic tests have been commercialized prematurely and are available direct to the consumer (DTC). The easy availability of DTC tests for addiction liability and lack of regulation over their use raises a number of ethical concerns. Of paramount concern is the limited predictive power and clinical utility of these tests. Many DTC testing companies do not provide the consumer with the necessary genetic counselling to assist them in interpreting and acting on their test results. They may also engage in misleading marketing to entice consumers to purchase their products. Consumers' genetic information may be vulnerable to misuse by third parties, as there are limited standards to protect the privacy of the genetic information. Non-consensual testing and inappropriate testing of minors may also occur. The United States Food and Drug Administration plans to regulate DTC genetic tests. Based on the ethical concerns we discuss below, we believe there is a strong case for regulation of DTC genetic tests for addiction liability and treatment response. We argue that until this occurs, these tests have more potential to cause harm than to contribute to improved prevention and treatment of addiction. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

Thyrotropin Suppressive Therapy for Low-Risk Small Thyroid Cancer: A Propensity Score-Matched Cohort Study.

PubMed

Park, Suyeon; Kim, Won Gu; Han, Minkyu; Jeon, Min Ji; Kwon, Hyemi; Kim, Mijin; Sung, Tae-Yon; Kim, Tae Yong; Kim, Won Bae; Hong, Suck Joon; Shong, Young Kee

2017-09-01

Thyrotropin (TSH) suppression has improved the clinical outcomes of patients with differentiated thyroid cancer (DTC). However, the efficacy of TSH suppressive therapy (TST) is unclear in patients with low-risk DTC. This study aimed to evaluate the efficacy of TST and optimal TSH levels of patients with low-risk DTC. This retrospective propensity score-matched cohort study included DTC patients (n = 446) who underwent lobectomy from 2002 to 2008 with or without TST (TST group and No-TST group). Disease-free survival (DFS) and dynamic risk stratification were compared between both groups using serum TSH levels. Approximately 74% of TST patients and 11% of No-TST patients had suppressed serum TSH levels (<2 mIU/L). The median follow-up period was 8.6 years. During follow-up, the disease recurred in 10 (2.7%) patients, with no significant difference in DFS between the groups (p = 0.63). The proportion of patients with excellent treatment response was similar between the TST (65.2%) and No-TST (64.4%) groups. Incomplete biochemical response was noted in 17.2% of the TST group patients and 9.4% of the No-TST group patients. No significant difference was observed in the DFS between both groups by comparing serum TSH level (p = 0.57). TST did not improve clinical outcomes, and serum TSH levels were not associated with recurrence in patients with low-risk small DTC. No clinical benefits were shown for TSH suppression in low-risk patients who underwent lobectomy. Thus, levothyroxine is not necessary for patients without evidence of hypothyroidism.

Application of molecular biology of differentiated thyroid cancer for clinical prognostication.

PubMed

Marotta, Vincenzo; Sciammarella, Concetta; Colao, Annamaria; Faggiano, Antongiulio

2016-11-01

Although cancer outcome results from the interplay between genetics and environment, researchers are making a great effort for applying molecular biology in the prognostication of differentiated thyroid cancer (DTC). Nevertheless, role of molecular characterisation in the prognostic setting of DTC is still nebulous. Among the most common and well-characterised genetic alterations related to DTC, including mutations of BRAF and RAS and RET rearrangements, BRAF V600E is the only mutation showing unequivocal association with clinical outcome. Unfortunately, its accuracy is strongly limited by low specificity. Recently, the introduction of next-generation sequencing techniques led to the identification of TERT promoter and TP53 mutations in DTC. These genetic abnormalities may identify a small subgroup of tumours with highly aggressive behaviour, thus improving specificity of molecular prognostication. Although knowledge of prognostic significance of TP53 mutations is still anecdotal, mutations of the TERT promoter have showed clear association with clinical outcome. Nevertheless, this genetic marker needs to be analysed according to a multigenetic model, as its prognostic effect becomes negligible when present in isolation. Given that any genetic alteration has demonstrated, taken alone, enough specificity, the co-occurrence of driving mutations is emerging as an independent genetic signature of aggressiveness, with possible future application in clinical practice. DTC prognostication may be empowered in the near future by non-tissue molecular prognosticators, including circulating BRAF V600E and miRNAs. Although promising, use of these markers needs to be refined by the technical sight, and the actual prognostic value is still yet to be validated. © 2016 Society for Endocrinology.

Radiofrequency ablation for postsurgical thyroid removal of differentiated thyroid carcinoma

PubMed Central

Xu, Dong; Wang, Lipin; Long, Bin; Ye, Xuemei; Ge, Minghua; Wang, Kejing; Guo, Liang; Li, Linfa

2016-01-01

Differentiated thyroid carcinoma (DTC) is the most common endocrine malignancy. Surgical removal with radioactive iodine therapy is recommended for recurrent thyroid carcinoma, and the postsurgical thyroid removal is critical. This study evaluated the clinical values of radiofrequency ablation (RFA) in the postsurgical thyroid removal for DTC. 35 DTC patients who had been treated by subtotal thyroidectomy received RFA for postsurgical thyroid removal. Before and two weeks after RFA, the thyroid was examined by ultrasonography and 99mTcO4 - thyroid imaging, and the serum levels of free triiodothyronine (FT3), free thyroxin (FT4), thyroid stimulating hormone (TSH) and thyroglobulin (Tg) were detected. The efficacy and complications of RFA were evaluated. Results showed that, the postsurgical thyroid removal by RFA was successfully performed in 35 patients, with no significant complication. After RFA, the average largest diameter and volume were significantly decreased in 35 patients (P > 0.05), and no obvious contrast media was observed in ablation area in the majority of patients. After RFA, the serum FT3, FT4 and Tg levels were markedly decreased (P < 0.05), and TSH level was significantly increased (P < 0.05). After RFA, radioiodine concentration in the ablation area was significantly reduced in the majority of patients. The reduction rate of thyroid update was 0.69±0.20%. DTC staging and interval between surgery and RFA had negative correlation (Pearson coefficient = -0.543; P = 0.001), with no obvious correlation among others influential factors. RFA is an effective and safe method for postsurgical thyroid removal of DTC. PMID:27186311

The dual task-cost of standing balance affects quality of life in mildly disabled MS people.

PubMed

Castelli, Letizia; De Luca, Francesca; Marchetti, Maria Rita; Sellitto, Giovanni; Fanelli, Fulvia; Prosperini, Luca

2016-05-01

The aim of this study was to explore the correlations between the dual-task cost (DTC) of standing balance and quality of life (QoL) in mildly disabled patients with multiple sclerosis (MS). In this cross-sectional study, patients affected by MS with an expanded disability status scale (EDSS) score of 3.0 or less and without an overt balance impairment were tested by means of static posturography under eyes-opened (single-task condition) and while performing the Stroop word-color test (dual-task condition), to estimate the DTC of standing balance. The self-reported 54-item MS quality of life questionnaire (MSQoL-54) was also administered to obtain a MS-specific assessment of health-related QoL. Among the 120 screened patients, 75 (53 women, 22 men) were tested. Although there was no impact of the DTC of standing balance on the physical and mental composite scores of MSQoL-54, patients who had a greater DTC of standing balance scored worse on role limitations due to physical problems (p = 0.007) and social function (p < 0.001), irrespective of demographic and other clinical characteristics including walking performance and cognitive status. However, the EDSS step and fatigue also contributed to reduced scores in these two QoL domains (p-values < 0.01). In conclusion, the phenomenon of cognitive-motor interference, investigated as DTC of standing balance, may affect specific QoL domains even in mildly disabled patients with MS and in the absence of an overt balance dysfunction.

Photoisomerization action spectroscopy of the carbocyanine dye DTC+ in the gas phase.

PubMed

Adamson, Brian D; Coughlan, Neville J A; da Silva, Gabriel; Bieske, Evan J

2013-12-19

Molecular photoisomerization plays a crucial role in diverse biological and technological contexts. Here, we combine ion mobility spectrometry and laser spectroscopy to characterize the photoisomerization of molecular cations in the gas phase. The target molecular ions, polymethine dye cations 3,3'-diethylthiacarbocyanine (DTC(+)), are propelled through helium buffer gas by an electric field and are photoisomerized by light from a tunable laser. Photoexcitation over the 450-570 nm range converts trans-DTC(+) to cis-DTC(+), noticeably modifying the ions' arrival time distribution. The photoisomerization action spectrum, which has a maximum at 535 nm, resembles the absorption spectrum of DTC(+) in solution but is shifted 25 nm to shorter wavelength. Comparisons between measured and calculated mobilities suggest that the photoisomer involves a twist about the second C-C bond in the methine chain (8,9-cis isomer) rather than a twist about the first methine C-C bond (2,8-cis isomer). It is postulated that the excited gas-phase ions internally convert from the S1 Franck-Condon region to the S0 manifold and explore the conformational landscape as they cool through He buffer gas collisions. Master equation simulations of the relaxation process in the S0 manifold suggest that the 8,9-cis isomer is preferred over the 2,8-cis isomer because it lies lower in energy and because it is separated from the trans isomer by a substantially higher barrier. The study demonstrates that the photoisomerization of molecular ions can be probed selectively in the gas phase, providing insights into photoisomerization mechanisms and information on the solvent-free absorption spectrum.

Direct-to-consumer genomics on the scales of autonomy

PubMed Central

Vayena, Effy

2015-01-01

Direct-to-consumer (DTC) genetic services have generated enormous controversy from their first emergence. A dramatic recent manifestation of this is the Food and Drug Administration's (FDA) cease and desist order against 23andMe, the leading provider in the market. Critics have argued for the restrictive regulation of such services, and even their prohibition, on the grounds of the harm they pose to consumers. Their advocates, by contrast, defend them as a means of enhancing the autonomy of those same consumers. Autonomy emerges as a key battle-field in this debate, because many of the ‘harm’ arguments can be interpreted as identifying threats to autonomy. This paper assesses whether DTC genomic services are a threat to, or instead, an enhancement of, personal autonomy. It deploys Joseph Raz's account of personal autonomy, with its emphasis on choice from a range of valuable options. It then seeks to counter claims that DTC genomics threatens autonomy because it involves manipulation in contravention of consumers’ independence or because it does not generate valuable options which can be meaningfully engaged with by consumers. It is stressed that the value of the options generated by DTC genomics should not be judged exclusively from the perspective of medical actionability, but should take into consideration plural utilities. Finally, the paper ends by broaching policy recommendations, suggesting that there is a strong autonomy-based argument for permitting DTC genomic services, and that the key question is the nature of the regulatory conditions under which they should be permitted. The discussion of autonomy in this paper helps illuminate some of these conditions. PMID:24797610

75 FR 69514 - Self-Regulatory Organizations; The Depository Trust Company; Notice of Filing of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-12

... these guidelines, DTC must, among other things, maintain a Total Risk-Based Capital Ratio of at least 10... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-63254; File No. SR-DTC-2010-14] Self-Regulatory... Preferred Stock November 5, 2010. Pursuant to Section 19(b)(1) of the Securities Exchange Act of 1934 (``Act...

75 FR 76506 - Self-Regulatory Organizations; The Depository Trust Company; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-08

... let the user know to use pledge code 01 instead. Effective December 2, 2010, DTC will extend the end... one code. The extended period for pledge affords greater flexibility in determining and securing... the respective rights of DTC or persons using the service. At any time within 60 days of the filing of...

The role of direct-to-consumer pharmaceutical advertisements and individual differences in getting people to talk to physicians.

PubMed

Krezmien, Elyse; Wanzer, Melissa Bekelja; Servoss, Timothy; LaBelle, Sara

2011-09-01

In this study, 384 respondents provided quantitative and descriptive information about direct-to-consumer (DTC) pharmaceutical advertisements and factors related to message reception and drug adoption. The authors applied M. Booth-Butterfield's ( 2008 ) Standard Model to explain how DTC advertising is used in getting individuals to talk to their doctors about pharmaceutical drugs. The researchers predicted that individuals who talked with their physicians about a pharmaceutical drug (referred to as talkers) would differ from those who did not talk with their physicians (referred to as nontalkers) in a number of meaningful ways. Findings from this data set indicate that individuals who talked with their physician about a specific medication were more likely to be female, older, higher in need for cognition, and reported higher physician satisfaction. Total number of channels (TV, radio, newspaper, magazines, and the Internet) was negatively associated with talking to a physician about a specific medication, as was exposure to DTC advertisement on television. The authors offer explanations for these findings along with descriptive accounts of how talkers and nontalkers differed in their recall of DTC advertisement information. Copyright © Taylor & Francis Group, LLC

Pharmaceutical advertising as a consumer empowerment device.

PubMed

Rubin, P H

2001-01-01

Pharmaceutical companies have greatly increased their level of "direct-to-consumer" (DTC) advertising in recent years. For 1998, estimates are that over $1.1 billion was spent on this form of advertising, increased from $850 million in 1997 and $600 million in 1996. In 1998, 84 separate drugs were advertised to consumers. The impetus was a decision in August of 1997 by the Food and Drug Administration to reduce the restrictions on DTC advertising on television. As a result, such ads have become very common on TV, and 32 products were advertised on TV in 1998. Pharmaceutical companies advertise because they think that advertising will make money for them. But how will this make money? It will make money by providing consumers with the information they need to make proper decisions about medication. That is, DTC advertising is profitable exactly because it empowers consumers and enables them to purchase useful drugs. The goals of advertising companies and consumers are both for consumers to have information about the most beneficial drug for particular conditions, and so advertising is beneficial both to manufacturers and to consumers. This article describes emerging trends in DTC within the context of the life sciences sector.

Cyclen dithiocarbamate-functionalized silver nanoparticles as a probe for colorimetric sensing of thiram and paraquat pesticides via host-guest chemistry

NASA Astrophysics Data System (ADS)

Rohit, Jigneshkumar V.; Kailasa, Suresh Kumar

2014-11-01

We have developed a simple and rapid colorimetric method for on-site analysis of thiram and paraquat using cyclen dithiocarbamate-functionalized silver nanoparticles (CN-DTC-Ag NPs) as a colorimetric probe. The synthesized CN-DTC-Ag NPs were characterized by UV-Visible spectroscopy (UV-Vis), Fourier transform infrared spectroscopy, dynamic light scattering, and transmission electron microscopic techniques. The CN-DTC molecules provide good supramolecular self assembly on the surfaces of Ag NPs to encapsulate thiram and paraquat selectively via "host-guest" chemistry, resulting in red-shift in surface plasmon resonance peak of CN-DTC-Ag NPs from 396 to 530 nm and 510 nm and color change from yellow to pink for thiram and to orange for paraquat, which can be naked-eye detected. The present method shows good linearity in the range of 10.0-20.0 µM and of 50.0-250 µM with limits of detection 2.81 × 10-6 M and 7.21 × 10-6 M for thiram and paraquat, respectively. This method was proved as a promising tool for on-site and real-time monitoring of thiram and paraquat in environmental water, potato, and wheat samples.

Assessment of genetic mutations in the XRCC2 coding region by high resolution melting curve analysis and the risk of differentiated thyroid carcinoma in Iran

PubMed Central

Fayaz, Shima; Fard-Esfahani, Pezhman; Fard-Esfahani, Armaghan; Mostafavi, Ehsan; Meshkani, Reza; Mirmiranpour, Hossein; Khaghani, Shahnaz

2012-01-01

Homologous recombination (HR) is the major pathway for repairing double strand breaks (DSBs) in eukaryotes and XRCC2 is an essential component of the HR repair machinery. To evaluate the potential role of mutations in gene repair by HR in individuals susceptible to differentiated thyroid carcinoma (DTC) we used high resolution melting (HRM) analysis, a recently introduced method for detecting mutations, to examine the entire XRCC2 coding region in an Iranian population. HRM analysis was used to screen for mutations in three XRCC2 coding regions in 50 patients and 50 controls. There was no variation in the HRM curves obtained from the analysis of exons 1 and 2 in the case and control groups. In exon 3, an Arg188His polymorphism (rs3218536) was detected as a new melting curve group (OR: 1.46; 95%CI: 0.432–4.969; p = 0.38) compared with the normal melting curve. We also found a new Ser150Arg polymorphism in exon 3 of the control group. These findings suggest that genetic variations in the XRCC2 coding region have no potential effects on susceptibility to DTC. However, further studies with larger populations are required to confirm this conclusion. PMID:22481871

Feasibility Study of Jupiter Icy Moons Orbiter Permanent Magnet Alternator Start Sequence

NASA Technical Reports Server (NTRS)

Kenny, Barbara H.; Tokars, Roger P.

2006-01-01

The Jupiter Icy Moons Orbiter (JIMO) mission was a proposed, (recently cancelled) long duration science mission to study three moons of Jupiter: Callisto, Ganymede, and Europa. One design of the JIMO spacecraft used a nuclear heat source in conjunction with a Brayton rotating machine to generate electrical power for the electric thrusters and the spacecraft bus. The basic operation of the closed cycle Brayton system was as follows. The working fluid, a heliumxenon gas mixture, first entered a compressor, then went through a recuperator and hot-side heat exchanger, then expanded across a turbine that drove an alternator, then entered the cold-side of the recuperator and heat exchanger and finally returned to the compressor. The spacecraft was to be launched with the Brayton system off-line and the nuclear reactor shut down. Once the system was started, the helium-xenon gas would be circulated into the heat exchangers as the nuclear reactors were activated. Initially, the alternator unit would operate as a motor so as to drive the turbine and compressor to get the cycle started. This report investigated the feasibility of the start up sequence of a permanent magnet (PM) machine, similar in operation to the alternator unit, without any position or speed feedback sensors ("sensorless") and with a variable load torque. It is found that the permanent magnet machine can start with sensorless control and a load torque of up to 30 percent of the rated value.

Direct-to-consumer advertising.

PubMed

Pines, W L

2000-11-01

These issues will be debated and should be, even as DTC advertising of prescription drugs becomes further entrenched. I hope that physicians will see DTC advertising not as a nuisance, but rather as an opportunity to enhance health care by enabling more people to understand diseases and treatments, treat more broadly diseases that now are underdiagnosed or undertreated, and become better communicators and deliver more caring medical attention to their patients.

Coping Skills Training and 12-Step Facilitation for Women Whose Partner Has Alcoholism: Effects on Depression, the Partner's Drinking, and Partner Physical Violence

ERIC Educational Resources Information Center

Rychtarik, Robert G.; McGillicuddy, Neil B.

2005-01-01

Women (N = 171), distressed from their partners' untreated alcoholism, received either coping skills training (CST), 12-step facilitation (TSF), or delayed treatment (DTC). CST and TSF resulted in lower depression levels than DTC but did not differ from one another. Skill acquisition mediated the treatment effects of CST; Al-Anon attendance did…

Direct-to-consumer genomics on the scales of autonomy.

PubMed

Vayena, Effy

2015-04-01

Direct-to-consumer (DTC) genetic services have generated enormous controversy from their first emergence. A dramatic recent manifestation of this is the Food and Drug Administration's (FDA) cease and desist order against 23andMe, the leading provider in the market. Critics have argued for the restrictive regulation of such services, and even their prohibition, on the grounds of the harm they pose to consumers. Their advocates, by contrast, defend them as a means of enhancing the autonomy of those same consumers. Autonomy emerges as a key battle-field in this debate, because many of the 'harm' arguments can be interpreted as identifying threats to autonomy. This paper assesses whether DTC genomic services are a threat to, or instead, an enhancement of, personal autonomy. It deploys Joseph Raz's account of personal autonomy, with its emphasis on choice from a range of valuable options. It then seeks to counter claims that DTC genomics threatens autonomy because it involves manipulation in contravention of consumers' independence or because it does not generate valuable options which can be meaningfully engaged with by consumers. It is stressed that the value of the options generated by DTC genomics should not be judged exclusively from the perspective of medical actionability, but should take into consideration plural utilities. Finally, the paper ends by broaching policy recommendations, suggesting that there is a strong autonomy-based argument for permitting DTC genomic services, and that the key question is the nature of the regulatory conditions under which they should be permitted. The discussion of autonomy in this paper helps illuminate some of these conditions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Is radioactive iodine- 131 treatment related to the occurrence of non-synchronous second primary malignancy in patients with differentiated thyroid cancer?

PubMed

Souza, Marcelo Cruzick de; Momesso, Denise P; Vaisman, Fernanda; Vieira Neto, Leonardo; Martins, Rosangela Aparecida Gomes; Corbo, Rossana; Vaisman, Mario

2016-02-01

Much controversy relates to the risk of non-synchronous second primary malignancies (NSSPM) after radioactive iodine treatment (RAI-131) in differentiated thyroid cancer (DTC) patients. This study evaluated the relationship between RAI-131 and NSSPM in DTC survivors with long-term follow-up. Retrospective analysis of 413 DTC cases was performed; 252 received RAI-131 and 161 were treated with thyroidectomy alone. Exclusion criteria were: prior or synchronous non-thyroidal malignancies (within the first year), familial syndromes associated to multiple neoplasms, ionizing radiation exposure or second tumors with unknown histopathology. During a mean follow-up of 11.0 ± 7.5 years, 17 (4.1%) patients developed solid NSSPM. Patients with NSSPM were older than those without (p = 0.02). RAI-131 and I-131 cumulative activity were similar in patients with and without NSSPM (p = 0.18 and p = 0.78, respectively). Incidence of NSSPM was 5.2% in patients with RAI-131 treatment and 2.5% in those without RAI-131 (p = 0.18). Using multivariate analysis, RAI-131 was not significantly associated with NSSPM occurrence (p = 0.35); age was the only independent predictor (p = 0.04). Under log rank statistical analysis, after 10 years of follow-up, it was observed a tendency of lower NSSPM-free survival among patients that received RAI-131 treatment (0.96 vs . 0.87; p = 0.06), what was not affected by age at DTC diagnosis. In our cohort of DTC survivors, with a long-term follow-up period, RAI-131 treatment and I-131 cumulative dose were not significantly associated with NSSPM occurrence. A tendency of premature NSSPM occurrence among patients treated with RAI-131 was observed, suggesting an anticipating oncogenic effect by interaction with other risk factors.

Ethical issues in consumer genome sequencing: Use of consumers' samples and data

PubMed Central

Niemiec, Emilia; Howard, Heidi Carmen

2016-01-01

High throughput approaches such as whole genome sequencing (WGS) and whole exome sequencing (WES) create an unprecedented amount of data providing powerful resources for clinical care and research. Recently, WGS and WES services have been made available by commercial direct-to-consumer (DTC) companies. The DTC offer of genetic testing (GT) has already brought attention to potentially problematic issues such as the adequacy of consumers' informed consent and transparency of companies' research activities. In this study, we analysed the websites of four DTC GT companies offering WGS and/or WES with regard to their policies governing storage and future use of consumers' data and samples. The results are discussed in relation to recommendations and guiding principles such as the “Statement of the European Society of Human Genetics on DTC GT for health-related purposes” (2010) and the “Framework for responsible sharing of genomic and health-related data” (Global Alliance for Genomics and Health, 2014). The analysis reveals that some companies may store and use consumers' samples or sequencing data for unspecified research and share the data with third parties. Moreover, the companies do not provide sufficient or clear information to consumers about this, which can undermine the validity of the consent process. Furthermore, while all companies state that they provide privacy safeguards for data and mention the limitations of these, information about the possibility of re-identification is lacking. Finally, although the companies that may conduct research do include information regarding proprietary claims and commercialisation of the results, it is not clear whether consumers are aware of the consequences of these policies. These results indicate that DTC GT companies still need to improve the transparency regarding handling of consumers' samples and data, including having an explicit and clear consent process for research activities. PMID:27047756

Ethical, Legal and Social Issues in Japan on the Determination of Blood Relationship via DNA Testing.

PubMed

Toya, Waki

2017-01-01

DNA paternity testing has recently become more widely available in Japan. The aim of this paper is to examine the issues surrounding (1) the implementing agency, whether the testing is conducted in a commercial direct-to-consumer (DTC) setting or a judicial non-DTC setting, and (2) the implementation conditions and more specifically the legal capacity of the proband (test subject). Literature research in Japanese and English was conducted. Some countries prohibit commercial DNA testing without the consent of the proband or her or his legally authorized representative. But as in some cases, the results of DTC paternity testing have proven to be unreliable. I propose a complete prohibition of DTC DNA paternity testing in Japan. In many cases of paternity testing, the proband is a minor. This has led to debate about whether proxy consent is sufficient for paternity testing or whether additional safeguards (such as a court order) are required. In cases where commercial DNA testing has been conducted and the test results are produced in court as evidence, the court must judge whether or not to admit these results as evidence. Another important issue is whether or not paternity testing should be legally mandated in certain cases. If we come to the conclusion that DNA test results are the only way to conclusively establish a parent-child relationship, then our society may prioritize even more genetic relatedness over other conceptions of a parent-child relationship. This prioritization could adversely affect families created through assisted reproductive technology (ART), especially in situations where children are not aware of their biological parentage. This paper argues for a complete prohibition of DTC DNA paternity testing in Japan, and highlights that broader ethical and legal deliberation on such genetic services is required.

Crowdsourced direct-to-consumer genomic analysis of a family quartet.

PubMed

Corpas, Manuel; Valdivia-Granda, Willy; Torres, Nazareth; Greshake, Bastian; Coletta, Alain; Knaus, Alexej; Harrison, Andrew P; Cariaso, Mike; Moran, Federico; Nielsen, Fiona; Swan, Daniel; Weiss Solís, David Y; Krawitz, Peter; Schacherer, Frank; Schols, Peter; Yang, Huangming; Borry, Pascal; Glusman, Gustavo; Robinson, Peter N

2015-11-07

We describe the pioneering experience of a Spanish family pursuing the goal of understanding their own personal genetic data to the fullest possible extent using Direct to Consumer (DTC) tests. With full informed consent from the Corpas family, all genotype, exome and metagenome data from members of this family, are publicly available under a public domain Creative Commons 0 (CC0) license waiver. All scientists or companies analysing these data ("the Corpasome") were invited to return results to the family. We released 5 genotypes, 4 exomes, 1 metagenome from the Corpas family via a blog and figshare under a public domain license, inviting scientists to join the crowdsourcing efforts to analyse the genomes in return for coauthorship or acknowldgement in derived papers. Resulting analysis data were compiled via social media and direct email. Here we present the results of our investigations, combining the crowdsourced contributions and our own efforts. Four companies offering annotations for genomic variants were applied to four family exomes: BIOBASE, Ingenuity, Diploid, and GeneTalk. Starting from a common VCF file and after selecting for significant results from company reports, we find no overlap among described annotations. We additionally report on a gut microbiome analysis of a member of the Corpas family. This study presents an analysis of a diverse set of tools and methods offered by four DTC companies. The striking discordance of the results mirrors previous findings with respect to DTC analysis of SNP chip data, and highlights the difficulties of using DTC data for preventive medical care. To our knowledge, the data and analysis results from our crowdsourced study represent the most comprehensive exome and analysis for a family quartet using solely DTC data generation to date.

Dithiocarbamates have a common toxic effect on zebrafish body axis formation

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

Tilton, Fred; La Du, Jane K.; Vue, Meng

2006-10-01

We previously determined that the dithiocarbamate pesticide sodium metam (NaM) and its active ingredient methylisothiocyanate (MITC) were developmentally toxic causing notochord distortions in the zebrafish. In this study, developing zebrafish were exposed to isothiocyanates (ITCs), dithiocarbamates (DTCs) and several degradation products to determine the teratogenic relationship of these chemical classes at the molecular level. All dithiocarbamates tested elicited notochord distortions with notochord NOELs from <4 to 40 ppb, while none of the ITCs caused notochord distortions with the exception of MITC. Carbon disulfide (CS{sub 2}), a common DTC degradate, also caused distortions at concentrations >200 times the DTCs. Whole mountmore » in situ hybridization of developmental markers for collagen (collagen2a1), muscle (myoD), and body axis formation (no tail) was perturbed well after cessation of treatment with pyrolidine-DTC (PDTC), dimethyl-DTC (DMDTC), NaM, MITC, and CS{sub 2}. Therefore, distinct albeit related chemical classes share a common toxic effect on zebrafish notochord development. To test the responsiveness of the distortion to metal perturbation, five metal chelators and 2 metals were studied. The membrane permeable copper chelator neocuproine (NCu) was found to cause notochord distortions similar to DTC-related molecules. DMDTC and NCu treated animals were protected with copper, and collagen 2a1 and no tail gene expression patterns were identical to controls in these animals. PDTC, NaM, MITC, and CS{sub 2} were not responsive to copper indicating that the chelation of metals is not the primary means by which these molecules elicit their developmental toxicity. Embryos treated with DMDTC, NaM, and NCu were rescued by adding triciaine (MS-222) which abolishes the spontaneous muscle contractions that begin at 18 hpf. In these animals, only collagen 2a1 expression showed a similar pattern to the other notochord distorting molecules. This indicates that the perturbation of no tail expression is in response to the muscle contractions distorting the notochord, while collagen 2a1 is associated with the impact of these molecules on much earlier developmental processes.« less

The management of metastatic radioiodine-refractory differentiated thyroid cancer requires an integrated approach including both directed and systemic therapies.

PubMed

Cooray, Shamil D; Topliss, Duncan J

2017-01-01

A 58-year-old man with metastatic radioiodine-refractory differentiated thyroid cancer (DTC) presented with left thigh and right flank numbness. He had known progressive and widespread bony metastases, for which he received palliative radiotherapy, and multiple bilateral asymptomatic pulmonary metastases. CT scan and MRI of the spine revealed metastases at right T10-L1 vertebrae with extension into the central canal and epidural disease at T10 and T11 causing cord displacement and canal stenosis but retention of spinal cord signal. Spinal surgery was followed by palliative radiotherapy resulting in symptom resolution. Two months later, sorafenib received approval for use in Australia and was commenced and up-titrated with symptomatic management of mild adverse effects. Follow-up CT scan three months after commencement of sorafenib revealed regression of pulmonary metastases but no evident change in most bone metastases except for an advancing lesion eroding into the right acetabulum. The patient underwent a right total hip replacement, intra-lesional curettage and cementing. After six months of sorafenib therapy, CT scanning showed enlarging liver lesions with marked elevation of serum thyroglobulin. Lenvatinib was commenced and sorafenib was ceased. He now has stable disease with a falling thyroglobulin more than 5 years after metastatic radioiodine-refractory DTC was diagnosed. In DTC, 5% of distant metastases become radioiodine-refractory, resulting in a median overall survival of 2.5-3.5 years. Tyrosine kinase inhibitor (TKI) therapy has recently been demonstrated to increase progression-free survival in these patients but poses some unique management issues and is best used as part of an integrated approach with directed therapy. Directed therapies may have greater potential to control localised disease and related symptoms when compared to systemic therapies.Consider TKI therapy in progressive disease where benefits outweigh risks.Active surveillance and timely intervention are required for TKI-related adverse effects.There is a need for further research on the clinical application of TKI therapy in advanced DTC, including comparative efficacy, sequencing and identifying responders.

Direct-to-Consumer Marketing: A Complementary Approach to Traditional Dissemination and implementation Efforts for Mental Health and Substance Abuse Interventions.

PubMed

Becker, Sara J

2015-03-01

The overall chasm between those who need treatment for mental health and substance abuse (M/SU) and those who receive effective treatment consists of two, interrelated gaps: the research-to-practice gap and the treatment gap. Prior efforts to disseminate evidence-based practice (EBP) for M/SU have predominantly targeted the research-to-practice gap, by focusing efforts toward treatment providers. This article introduces direct-to-consumer (DTC) marketing that targets patients and caregivers as a complementary approach to existing dissemination efforts. Specific issues discussed include: rationale for DTC marketing based on the concept of push versus pull marketing; overview of key stakeholders involved in DTC marketing; and description of the Marketing Mix planning framework. The applicability of these issues to the dissemination of EBP for M/SU is discussed.

Implementing Effective Affordability Constraints for Defense Acquisition Programs

DTIC Science & Technology

2014-03-01

interviewees reported that they could recall no instances when establishing or exceeding DTC goals was a topic of high -level deliberations. Review of...attention of high -level management for several years. Unlike, DTC, however, CAIV cost objectives were never systematically recorded in SARs, and for that...systems. The uncertainty can be expected to decrease as systems mature; however, it will still be high at least until the system completes initial

Visual presentations of efficacy data in direct-to-consumer prescription drug print and television advertisements: A randomized study.

PubMed

Sullivan, Helen W; O'Donoghue, Amie C; Aikin, Kathryn J; Chowdhury, Dhuly; Moultrie, Rebecca R; Rupert, Douglas J

2016-05-01

To determine whether visual aids help people recall quantitative efficacy information in direct-to-consumer (DTC) prescription drug advertisements, and if so, which types of visual aids are most helpful. Individuals diagnosed with high cholesterol (n=2504) were randomized to view a fictional DTC print or television advertisement with no visual aid or one of four visual aids (pie chart, bar chart, table, or pictograph) depicting drug efficacy. We measured drug efficacy and risk recall, drug perceptions and attitudes, and behavioral intentions. For print advertisements, a bar chart or table, compared with no visual aid, elicited more accurate drug efficacy recall. The bar chart was better at this than the pictograph and the table was better than the pie chart. For television advertisements, any visual aid, compared with no visual aid, elicited more accurate drug efficacy recall. The bar chart was better at this than the pictograph or the table. Visual aids depicting quantitative efficacy information in DTC print and television advertisements increased drug efficacy recall, which may help people make informed decisions about prescription drugs. Adding visual aids to DTC advertising may increase the public's knowledge of how well prescription drugs work. Published by Elsevier Ireland Ltd.

Nuclear Molecular and Theranostic Imaging for Differentiated Thyroid Cancer

PubMed Central

Sheikh, Arif; Polack, Berna; Rodriguez, Yvette; Kuker, Russ

2017-01-01

Traditional nuclear medicine is rapidly being transformed by the evolving concepts in molecular imaging and theranostics. The utility of new approaches in differentiated thyroid cancer (DTC) diagnostics and therapy has not been fully appreciated. The clinical information, relevant to disease management and patient care, obtained by scintigraphy is still being underestimated. There has been a trend towards moving away from the use of radioactive iodine (RAI) imaging in the management of the disease. This paradigm shift is supported by the 2015 American Thyroid Association Guidelines (1). A more systematic and comprehensive understanding of disease pathophysiology and imaging methodologies is needed for optimal utilization of different imaging modalities in the management of DTC. There have been significant developments in radiotracer and imaging technology, clinically proven to contribute to the understanding of tumor biology and the clinical assessment of patients with DTC. The research and development in the field continues to evolve, with expected emergence of many novel diagnostic and therapeutic techniques. The role for nuclear imaging applications will continue to evolve and be reconfigured in the changing paradigm. This article aims to review the clinical uses and controversies surrounding the use of scintigraphy, and the information it can provide in assisting in the management and treatment of DTC. PMID:28117289

A daily process examination of episode-specific drinking to cope motivation among college students.

PubMed

Ehrenberg, Ethan; Armeli, Stephen; Howland, Maryhope; Tennen, Howard

2016-06-01

Theory suggests that state- and trait-like factors should interact in predicting drinking to cope (DTC) motivation, yet no research to date has demonstrated this at the drinking episode level of analysis. Thus, we examined whether daily variation in positive and negative affect and avoidance and active coping were associated with DTC motivation during discrete drinking episodes and whether these associations were moderated by tension-reduction expectancies and other person-level risk factors. Using a secure website, 722 college student drinkers completed a one-time survey regarding their tension reduction expectancies and then reported daily for 30 days on their affect, coping strategies, drinking behaviors and motives for drinking. Individuals reported higher levels of DTC motivation on days when negative affect and avoidance coping were high and positive affect was low. We found only little support for the predicted interactive effects among the day- and person-level predictors. Our results support the state and trait conceptualizations of DTC motivation and provide evidence for the antecedent roles of proximal levels of daily affect and avoidance coping. Our inconsistent results for interaction effects including day-level antecedents raise the possibility that some of these synergistic processes might not generalize across level of analysis. Copyright © 2016 Elsevier Ltd. All rights reserved.

A Daily Process Examination of Episode-Specific Drinking to Cope Motivation among College Students

PubMed Central

HOWLAND, MARYHOPE; TENNEN, HOWARD

2016-01-01

Objective Theory suggests that state- and trait-like factors should interact in predicting drinking to cope (DTC) motivation, yet no research to date has demonstrated this at the drinking episode level of analysis. Thus, we examined whether daily variation in positive and negative affect and avoidance and active coping were associated with DTC motivation during discrete drinking episodes and whether these associations were moderated by tension-reduction expectancies and other person-level risk factors. Methods Using a secure website, 722 college student drinkers completed a one-time survey regarding their tension reduction expectancies and then reported daily for 30 days on their affect, coping strategies, drinking behaviors and motives for drinking. Results Individuals reported higher levels of DTC motivation on days when negative affect and avoidance coping were high and positive affect was low. We found only little support for the predicted interactive effects among the day- and person-level predictors. Conclusion Our results support the state and trait conceptualizations of DTC motivation and provide evidence for the antecedent roles of proximal levels of daily affect and avoidance coping. Our inconsistent results for interaction effects including day-level antecedents raises the possibility that some of these synergistic processes might not generalize across level of analysis. PMID:26894551

Analysis of cytokine release assay data using machine learning approaches.

PubMed

Xiong, Feiyu; Janko, Marco; Walker, Mindi; Makropoulos, Dorie; Weinstock, Daniel; Kam, Moshe; Hrebien, Leonid

2014-10-01

The possible onset of Cytokine Release Syndrome (CRS) is an important consideration in the development of monoclonal antibody (mAb) therapeutics. In this study, several machine learning approaches are used to analyze CRS data. The analyzed data come from a human blood in vitro assay which was used to assess the potential of mAb-based therapeutics to produce cytokine release similar to that induced by Anti-CD28 superagonistic (Anti-CD28 SA) mAbs. The data contain 7 mAbs and two negative controls, a total of 423 samples coming from 44 donors. Three (3) machine learning approaches were applied in combination to observations obtained from that assay, namely (i) Hierarchical Cluster Analysis (HCA); (ii) Principal Component Analysis (PCA) followed by K-means clustering; and (iii) Decision Tree Classification (DTC). All three approaches were able to identify the treatment that caused the most severe cytokine response. HCA was able to provide information about the expected number of clusters in the data. PCA coupled with K-means clustering allowed classification of treatments sample by sample, and visualizing clusters of treatments. DTC models showed the relative importance of various cytokines such as IFN-γ, TNF-α and IL-10 to CRS. The use of these approaches in tandem provides better selection of parameters for one method based on outcomes from another, and an overall improved analysis of the data through complementary approaches. Moreover, the DTC analysis showed in addition that IL-17 may be correlated with CRS reactions, although this correlation has not yet been corroborated in the literature. Copyright © 2014 Elsevier B.V. All rights reserved.

Depressive symptoms, ruminative thinking, drinking motives, and alcohol outcomes: A multiple mediation model among college students in three countries.

PubMed

Bravo, Adrian J; Pilatti, Angelina; Pearson, Matthew R; Mezquita, Laura; Ibáñez, Manuel I; Ortet, Generós

2018-01-01

Recent research suggests that ruminative thinking (specifically problem-focused thoughts) may explain why individuals engage in drinking to cope (DTC) when dealing with depressive symptoms; which in turn leads to increased negative alcohol-related consequences. Cross-cultural studies addressing these phenomena are scarce. The present study cross-culturally tested whether four rumination facets (problem-focused thoughts, counterfactual thinking, repetitive thoughts, and anticipatory thoughts) uniquely mediate the relationships between depressive symptoms and drinking motives/alcohol outcomes in a multicultural sample of college student drinkers (n=1429) from Spain, Argentina, and the U.S. Structural equation modeling was conducted to test the models, controlling for sex. Further, we conducted invariance testing to determine whether our models were culturally-specific or culturally-universal. Within both proposed models, no rumination facet uniquely mediated the relationship between depressive symptoms and drinking motives. However, an exploratory model with a second-order latent factor of ruminative thinking did significantly mediate these associations (exception was conformity motives). Further, there were two significant double-mediated associations that suggested that increased depressive symptoms is associated with increased ruminative thinking, which is associated with higher DTC motives, which in turn is associated with higher alcohol consumption and negative alcohol-related consequences. All models were found to be invariant across countries and sex, suggesting that these associations may be relatively universal. Rumination is relevant to understand the increased vulnerability of college drinkers to exhibit greater alcohol consumption and negative consequences via DTC motives when dealing with depressive symptoms. Copyright © 2017 Elsevier Ltd. All rights reserved.

Over-focused? The relation between patients' inclination for conscious control and single- and dual-task motor performance after stroke.

PubMed

Denneman, R P M; Kal, E C; Houdijk, H; Kamp, J van der

2018-05-01

Many stroke patients are inclined to consciously control their movements. This is thought to negatively affect patients' motor performance, as it disrupts movement automaticity. However, it has also been argued that conscious control may sometimes benefit motor performance, depending on the task or patientś motor or cognitive capacity. To assess whether stroke patients' inclination for conscious control is associated with motor performance, and explore whether the putative association differs as a function of task (single- vs dual) or patientś motor and cognitive capacity. Univariate and multivariate linear regression analysis were used to assess associations between patients' disposition to conscious control (i.e., Conscious Motor Processing subscale of Movement-Specific Reinvestment Scale; MSRS-CMP) and single-task (Timed-up-and-go test; TuG) and motor dual-task costs (TuG while tone counting; motor DTC%). We determined whether these associations were influenced by patients' walking speed (i.e., 10-m-walk test) and cognitive capacity (i.e., working memory, attention, executive function). Seventy-eight clinical stroke patients (<6 months post-stroke) participated. Patients' conscious control inclination was not associated with single-task TuG performance. However, patients with a strong inclination for conscious control showed higher motor DTC%. These associations were irrespective of patients' motor and cognitive abilities. Patients' disposition for conscious control was not associated with single task motor performance, but was associated with higher motor dual task costs, regardless of patients' motor or cognitive abilities. Therapists should be aware that patients' conscious control inclination can influence their dual-task performance while moving. Longitudinal studies are required to test whether reducing patients' disposition for conscious control would improve dual-tasking post-stroke. Copyright © 2018 Elsevier B.V. All rights reserved.

75 FR 80878 - Self-Regulatory Organizations; The Depository Trust Company; Order Granting Approval of a...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-23

...-capitalized'' under these guidelines, DTC must, among other things, maintain a Total Risk-Based Capital Ratio of at least 10%, a Leverage Ratio of at least 5%, and a Tier 1 Risk-Based Capital Ratio of at least 6... securities and funds which are in the custody or control of the clearing agency or for which it is...

Enhanced visualization of peripheral retinal vasculature with wavefront sensorless adaptive optics OCT angiography in diabetic patients

PubMed Central

Polans, James; Cunefare, David; Cole, Eli; Keller, Brenton; Mettu, Priyatham S.; Cousins, Scott W.; Allingham, Michael J.; Izatt, Joseph A.; Farsiu, Sina

2017-01-01

Optical coherence tomography angiography (OCTA) is a promising technique for non-invasive visualization of vessel networks in the human eye. We debut a system capable of acquiring wide field-of-view (>70°) OCT angiograms without mosaicking. Additionally, we report on enhancing the visualization of peripheral microvasculature using wavefront sensorless adaptive optics (WSAO). We employed a fast WSAO algorithm that enabled wavefront correction in <2 seconds by iterating the mirror shape at the speed of OCT B-scans rather than volumes. Also, we contrasted ~7° field-of-view OCTA angiograms acquired in the periphery with and without WSAO correction. On average, WSAO improved the sharpness of microvasculature by 65% in healthy and 38% in diseased eyes. Preliminary observations demonstrated that the location of 7° images could be identified directly from the wide field-of-view angiogram. A pilot study on a normal subject and patients with diabetic retinopathy showed the impact of utilizing WSAO for OCTA when visualizing peripheral vasculature pathologies. PMID:28059209

Increasing Responsiveness of the Army Rapid Acquisition Process: The Army Rapid Equipping Force

DTIC Science & Technology

2011-06-01

System Increment 2 (JNBCRS2) Joint Urgent Operational Needs (JUON) effort. These interviews played a critical role in providing information on the...Operational Assessment. 91 Interview by the authors with JNBCRS2 ATEC System Team: Mr. Dough Cunningham, DTC, and Ms. Emily Yost, AEC, Aberdeen...Mr. Dough Cunningham, DTC, and Ms. Emily Yost, AEC, Aberdeen Proving Ground, MD, October 2010. 110 Major Scott Schroer, JNBCRS2 Team Lead, and the

Direct-to-Consumer Marketing: A Complementary Approach to Traditional Dissemination and implementation Efforts for Mental Health and Substance Abuse Interventions

PubMed Central

Becker, Sara J.

2014-01-01

The overall chasm between those who need treatment for mental health and substance abuse (M/SU) and those who receive effective treatment consists of two, interrelated gaps: the research-to-practice gap and the treatment gap. Prior efforts to disseminate evidence-based practice (EBP) for M/SU have predominantly targeted the research-to-practice gap, by focusing efforts toward treatment providers. This article introduces direct-to-consumer (DTC) marketing that targets patients and caregivers as a complementary approach to existing dissemination efforts. Specific issues discussed include: rationale for DTC marketing based on the concept of push versus pull marketing; overview of key stakeholders involved in DTC marketing; and description of the Marketing Mix planning framework. The applicability of these issues to the dissemination of EBP for M/SU is discussed. PMID:25937710

DNA Binding and Antitumor Activity of α-Diimineplatinum(II) and Palladium(II) Dithiocarbamate Complexes

PubMed Central

Mansouri-Torshizi, Hassan; Saeidifar, Maryam; Khosravi, Fatemeh; Divsalar, Adeleh; Saboury, Ali Akbar; Hassani, Fatemeh

2011-01-01

The two water-soluble designed platinum(II) complex, [Pt(Oct-dtc)(bpy)]NO3 (Oct-dtc = Octyldithiocarbamate and bpy = 2,2′ -bipyridine) and palladium(II) complex, [Pd(Oct-dtc)(bpy)]NO3, have been synthesized and characterized by elemental analyses, molar conductivity measurements, IR, 1H NMR, and electronic spectra studies. Studies of antitumor activity of these complexes against human cell tumor lines (K562) have been carried out. They show Ic50 values lower than that of cisplatin. The complexes have been investigated for their interaction with calf thymus DNA (CT-DNA) by utilizing the electronic absorption spectroscopy, fluorescence spectra, and ethidium bromide displacement and gel filtration techniques. Both of these water-soluble complexes bound cooperatively and intercalatively to the CT-DNA at very low concentrations. Several binding and thermodynamic parameters are also described. PMID:22110410

Visual Identification of Light-Driven Breakage of the Silver-Dithiocarbamate Bond by Single Plasmonic Nanoprobes

PubMed Central

Gao, Peng Fei; Yuan, Bin Fang; Gao, Ming Xuan; Li, Rong Sheng; Ma, Jun; Zou, Hong Yan; Li, Yuan Fang; Li, Ming; Huang, Cheng Zhi

2015-01-01

Insight into the nature of metal-sulfur bond, a meaningful one in life science, interface chemistry and organometallic chemistry, is interesting but challenging. By utilizing the localized surface plasmon resonance properties of silver nanoparticles, herein we visually identified the photosensitivity of silver-dithiocarbamate (Ag-DTC) bond by using dark field microscopic imaging (iDFM) technique at single nanoparticle level. It was found that the breakage of Ag-DTC bond could be accelerated effectively by light irradiation, followed by a pH-dependent horizontal or vertical degradation of the DTC molecules, in which an indispensable preoxidation process of the silver was at first disclosed. These findings suggest a visualization strategy at single plasmonic nanoparticle level which can be excellently applied to explore new stimulus-triggered reactions, and might also open a new way to understand traditional organic reaction mechanisms. PMID:26493773

Eye-Tracking Evidence that Happy Faces Impair Verbal Message Comprehension: The Case of Health Warnings in Direct-to-Consumer Pharmaceutical Television Commercials

PubMed Central

Russell, Cristel Antonia; Swasy, John L.; Russell, Dale Wesley; Engel, Larry

2017-01-01

Risk warning or disclosure information in advertising is only effective in correcting consumers’ judgments if enough cognitive capacity is available to process that information. Hence, comprehension of verbal warnings in TV commercials may suffer if accompanied by positive visual elements. This research addresses this concern about cross-modality interference in the context of direct-to-consumer (DTC) pharmaceutical commercials in the United States by experimentally testing whether positive facial expressions reduce consumers’ understanding of the mandated health warning. A content analysis of a sample of DTC commercials reveals that positive facial expressions are more prevalent during the verbal warning act of the commercials than during the other acts. An eye-tracking experiment conducted with specially produced DTC commercials, which vary the valence of characters’ facial expressions during the health warning, provides evidence that happy faces reduce objective comprehension of the warning. PMID:29269979

"When diet and exercise are not enough": an examination of lifestyle change inefficacy claims in direct-to-consumer advertising.

PubMed

Byrne, Sahara; Niederdeppe, Jeff; Avery, Rosemary J; Cantor, Jonathan

2013-01-01

Previous research suggests that direct-to-consumer (DTC) advertisements for pharmaceutical drugs have the potential to influence consumers' perceptions of whether symptoms should be treated medically and/or through behavior change. However, the relative frequency of messages emphasizing these approaches in pharmaceutical advertising remains largely unknown. A content analysis of print and television advertisements for cholesterol management medication between 1994 and 2005 (for print) and between 1999 and 2007 (for television) was conducted. First, the extent to which established theoretical constructs drawn from health communication scholarship are depicted in the content of DTC cholesterol advertisements is quantified. Second, specific claims about behavior change inefficacy when a pharmaceutical alternative is available are identified. Findings indicate that DTC ads offer many mixed messages about the efficacy of diet and exercise in reducing cholesterol and risk of heart disease. Theoretical and practical implications of this work are discussed.

Pharmacy students' knowledge, attitudes, and evaluation of direct-to-consumer advertising.

PubMed

Naik, Rupali K; Borrego, Matthew E; Gupchup, Gireesh V; Dodd, Melanie; Sather, Mike R

2007-10-15

To assess pharmacy students' knowledge, attitudes, and evaluation of direct-to-consumer advertising (DTCA). A cross sectional, self-administered, 106-item survey instrument was used to assess first, second, and third professional year pharmacy students' knowledge about DTCA regulations, attitudes toward DTCA, and evaluation of DTC advertisements with different brief summary formats (professional labeling and patient labeling) and in different media sources (print and television). One hundred twenty (51.3%) of the 234 students enrolled participated in the study. The mean percentage knowledge score was 48.7% +/- 12.5%. Based on the mean scores per item, pharmacy students had an overall negative attitude toward DTC advertisements. Students had an overall negative attitude toward television and print advertisements using the professional labeling format but an overall positive attitude toward the print advertisement using the patient labeling format. Lectures discussing DTC advertising should be included in the pharmacy curriculum.

"Be ready against cancer, now": direct-to-consumer advertising for genetic testing.

PubMed

William-Jones, Bryn

2006-04-01

A recent addition to the debate about the benefits and harms of direct-to-consumer (DTC) advertising of medicines and pharmaceuticals is a growing critique of DTC marketing and sale of genetic tests. Academic and policy literatures exploring this issue have, however, tended to focus on the sale of genetic tests, paying rather less attention to the particular implications of advertising. The globalization of broadcast media and ever increasing access to the Internet mean that public exposure to advertising for medical technologies is a reality that national regulatory bodies will be hard pressed to constrain. Working through a case study detailing Myriad Genetics' 2002 pilot advertising campaign for their BRACAnalysis genetic susceptibility test for hereditary breast and ovarian cancer, this paper highlights some of the diverse and often overlooked and unregulated approaches to DTC advertising, and the associated social, ethical and policy implications.

Pharmacy Students' Knowledge, Attitudes, and Evaluation of Direct-to-Consumer Advertising

PubMed Central

Borrego, Matthew E.; Gupchup, Gireesh V.; Dodd, Melanie; Sather, Mike R.

2007-01-01

Objectives To assess pharmacy students' knowledge, attitudes, and evaluation of direct-to-consumer advertising (DTCA). Methods A cross sectional, self-administered, 106-item survey instrument was used to assess first, second, and third professional year pharmacy students' knowledge about DTCA regulations, attitudes toward DTCA, and evaluation of DTC advertisements with different brief summary formats (professional labeling and patient labeling) and in different media sources (print and television). Results One hundred twenty (51.3%) of the 234 students enrolled participated in the study. The mean percentage knowledge score was 48.7% ± 12.5%. Based on the mean scores per item, pharmacy students had an overall negative attitude toward DTC advertisements. Students had an overall negative attitude toward television and print advertisements using the professional labeling format but an overall positive attitude toward the print advertisement using the patient labeling format. Conclusions Lectures discussing DTC advertising should be included in the pharmacy curriculum. PMID:17998983

A Randomized Controlled Trial for the Effectiveness of Aromatherapy in Decreasing Salivary Gland Damage following Radioactive Iodine Therapy for Differentiated Thyroid Cancer.

PubMed

Nakayama, Michihiro; Okizaki, Atsutaka; Takahashi, Koji

2016-01-01

Objective. The aim of this study was to investigate effects of aromatherapy in decreasing salivary gland damage for patients undergoing radioactive iodine (RAI) therapy with differentiated thyroid cancer (DTC). Materials and Methods. The subjects were 71 patients with DTC. They were divided into aromatherapy group (group A, n = 35) and a control group (group B, n = 36). We blended 1.0 mL of lemon and 0.5 mL of ginger essential oils. The patients in the inhalation aromatherapy group inhaled this blend oil and those in the control group inhaled distilled water as placebo for 10 min during admission. We statistically compared salivary gland function before and after treatment between groups A and B. Results. In comparison with group B, the rate of change of the accumulation rate was significantly higher in the parotid glands and submandibular glands of group A ( P < 0.05). In comparison with group B, a significant increase in rate of secretion change before and after treatment was noted in the bilateral parotid glands in group A ( P < 0.05). Conclusion. Because an amelioration of salivary gland function was observed in the present study, our results suggest the efficacy of aromatherapy in the prevention of treatment-related salivary gland disorder. This trial is registered with UMIN Clinical Trial Registry: UMIN000013968.

A Randomized Controlled Trial for the Effectiveness of Aromatherapy in Decreasing Salivary Gland Damage following Radioactive Iodine Therapy for Differentiated Thyroid Cancer

PubMed Central

Okizaki, Atsutaka; Takahashi, Koji

2016-01-01

Objective. The aim of this study was to investigate effects of aromatherapy in decreasing salivary gland damage for patients undergoing radioactive iodine (RAI) therapy with differentiated thyroid cancer (DTC). Materials and Methods. The subjects were 71 patients with DTC. They were divided into aromatherapy group (group A, n = 35) and a control group (group B, n = 36). We blended 1.0 mL of lemon and 0.5 mL of ginger essential oils. The patients in the inhalation aromatherapy group inhaled this blend oil and those in the control group inhaled distilled water as placebo for 10 min during admission. We statistically compared salivary gland function before and after treatment between groups A and B. Results. In comparison with group B, the rate of change of the accumulation rate was significantly higher in the parotid glands and submandibular glands of group A (P < 0.05). In comparison with group B, a significant increase in rate of secretion change before and after treatment was noted in the bilateral parotid glands in group A (P < 0.05). Conclusion. Because an amelioration of salivary gland function was observed in the present study, our results suggest the efficacy of aromatherapy in the prevention of treatment-related salivary gland disorder. This trial is registered with UMIN Clinical Trial Registry: UMIN000013968. PMID:28042578

A Novel Design of an Automatic Lighting Control System for a Wireless Sensor Network with Increased Sensor Lifetime and Reduced Sensor Numbers

PubMed Central

Mohamaddoust, Reza; Haghighat, Abolfazl Toroghi; Sharif, Mohamad Javad Motahari; Capanni, Niccolo

2011-01-01

Wireless sensor networks (WSN) are currently being applied to energy conservation applications such as light control. We propose a design for such a system called a Lighting Automatic Control System (LACS). The LACS system contains a centralized or distributed architecture determined by application requirements and space usage. The system optimizes the calculations and communications for lighting intensity, incorporates user illumination requirements according to their activities and performs adjustments based on external lighting effects in external sensor and external sensor-less architectures. Methods are proposed for reducing the number of sensors required and increasing the lifetime of those used, for considerably reduced energy consumption. Additionally we suggest methods for improving uniformity of illuminance distribution on a workplane’s surface, which improves user satisfaction. Finally simulation results are presented to verify the effectiveness of our design. PMID:22164114

A novel design of an automatic lighting control system for a wireless sensor network with increased sensor lifetime and reduced sensor numbers.

PubMed

Mohamaddoust, Reza; Haghighat, Abolfazl Toroghi; Sharif, Mohamad Javad Motahari; Capanni, Niccolo

2011-01-01

Wireless sensor networks (WSN) are currently being applied to energy conservation applications such as light control. We propose a design for such a system called a lighting automatic control system (LACS). The LACS system contains a centralized or distributed architecture determined by application requirements and space usage. The system optimizes the calculations and communications for lighting intensity, incorporates user illumination requirements according to their activities and performs adjustments based on external lighting effects in external sensor and external sensor-less architectures. Methods are proposed for reducing the number of sensors required and increasing the lifetime of those used, for considerably reduced energy consumption. Additionally we suggest methods for improving uniformity of illuminance distribution on a workplane's surface, which improves user satisfaction. Finally simulation results are presented to verify the effectiveness of our design.

Choice, Transparency, Coordination, and Quality Among Direct-to-Consumer Telemedicine Websites and Apps Treating Skin Disease.

PubMed

Resneck, Jack S; Abrouk, Michael; Steuer, Meredith; Tam, Andrew; Yen, Adam; Lee, Ivy; Kovarik, Carrie L; Edison, Karen E

2016-07-01

Evidence supports use of teleconsultation for improving patient access to dermatology. However, little is known about the quality of rapidly expanding direct-to-consumer (DTC) telemedicine websites and smartphone apps diagnosing and treating skin disease. To assess the performance of DTC teledermatology services. Simulated patients submitted a series of structured dermatologic cases with photographs, including neoplastic, inflammatory, and infectious conditions, using regional and national DTC telemedicine websites and smartphone apps offering services to California residents. Choice of clinician, transparency of credentials, clinician location, demographic and medical data requested, diagnoses given, treatments recommended or prescribed, adverse effects discussed, care coordination. We received responses for 62 clinical encounters from 16 DTC telemedicine websites from February 4 to March 11, 2016. None asked for identification or raised concerns about pseudonym use or falsified photographs. During most encounters (42 [68%]), patients were assigned a clinician without any choice. Only 16 (26%) disclosed information about clinician licensure, and some used internationally based physicians without California licenses. Few collected the name of an existing primary care physician (14 [23%]) or offered to send records (6 [10%]). A diagnosis or likely diagnosis was proffered in 48 encounters (77%). Prescription medications were ordered in 31 of 48 diagnosed cases (65%), and relevant adverse effects or pregnancy risks were disclosed in a minority (10 of 31 [32%] and 6 of 14 [43%], respectively). Websites made several correct diagnoses in clinical scenarios where photographs alone were adequate, but when basic additional history elements (eg, fever, hypertrichosis, oligomenorrhea) were important, they regularly failed to ask simple relevant questions and diagnostic performance was poor. Major diagnoses were repeatedly missed, including secondary syphilis, eczema herpeticum, gram-negative folliculitis, and polycystic ovarian syndrome. Regardless of the diagnoses given, treatments prescribed were sometimes at odds with existing guidelines. Telemedicine has potential to expand access to high-value health care. Our findings, however, raise concerns about the quality of skin disease diagnosis and treatment provided by many DTC telemedicine websites. Ongoing expansion of health plan coverage of these services may be premature. Until improvements are made, patients risk using health care services that lack transparency, choice, thoroughness, diagnostic and therapeutic quality, and care coordination. We offer several suggestions to improve the quality of DTC telemedicine websites and apps and avoid further growth of fragmented, low-quality care.

Prosthetic design directives: Low-cost hands within reach.

PubMed

Jones, G K; Rosendo, A; Stopforth, R

2017-07-01

Although three million people around the world suffer from the lack of one or both upper limbs 80% of this number is located within developing countries. While prosthetic prices soar with technology 3D printing and low cost electronics present a sensible solution for those that cannot afford expensive prosthetics. The electronic and control design of a low-cost prosthetic hand, the Touch Hand II, is discussed. This paper shows that sensorless techniques can be used to reduce design complexities, costs, and provide easier access to the electronics. A closing and opening finite state machine (COFSM) was developed to handle the actuated digit joint control state and a supervisory switching control scheme, used for speed and grip strength control. Three torque and speed settings were created to be preset for specific grasps. The hand was able to replicate ten frequently used grasps and grip some common objects. Future work is necessary to enable a user to control it with myoelectric signals (MESs) and to solve operational problems related to electromagnetic interference (EMI).

Direct-to-consumer online genetic testing and the four principles: an analysis of the ethical issues.

PubMed

Wasson, Katherine; Cook, E David; Helzlsouer, Kathy

2006-01-01

The development of genetic tests marketed and sold direct-to-consumers (DTC) via the internet raises moral concerns and debate about their appropriateness and ethical and clinical significance. These tests are offered for a wide range of diseases and conditions, and the mutations have variable penetrance and associated risk. A number of these tests lack data on their accuracy and reliability, making interpretation of results difficult. DTC genetic testing is undertaken outside the context of the physician-patient relationship and may lack appropriate individual and family genetic counseling, leaving the consumer vulnerable to potential harms, such as misinterpretation of results, including false positive or false reassurance, with limited or no benefits. Beauchamp and Childress's four principles of biomedical ethics provide a framework for analyzing the ethical issues raised by DTC genetic testing. We argue that the potential harms outweigh the potential benefits of such tests, that respect for autonomy should be limited in light of potential harm from DTC testing, and that the availability of genetic testing over the internet may be considered unfair and unjust and affect resource allocation by placing an unfair burden on primary care physicians. In light of the moral issues posed by these tests, practical responses are suggested in the areas of consumer education, medical education, and interaction with commercial companies.

Direct-to-consumer prescription drug advertising and the public.

PubMed

Bell, R A; Kravitz, R L; Wilkes, M S

1999-11-01

Drug manufacturers are intensely promoting their products directly to consumers, but the impact has not been widely studied. Consumers' awareness and understanding of, attitudes toward, and susceptibility to direct-to-consumer (DTC) drug advertising were examined. Random-digit dialing telephone survey with a random household member selection procedure (completion and response rates, 58% and 69%, respectively). Respondents were interviewed while they were at their residences. Complete data were obtained from 329 adults in Sacramento County, California. Outcome measures included awareness of advertisements for 10 selected drugs, misconceptions about DTC advertising, attitudes toward DTC ads, and behavioral responses to such promotions. The influence of demographic characteristics, health status, attitudes, beliefs, and media exposure on awareness and behaviors was examined. On average, respondents were aware of advertisements for 3.7 of the 10 drugs; awareness varied from 8% for Buspar (buspirone) to 72% for Claritin (loratadine). Awareness was associated with prescription drug use, media exposure, positive attitudes toward DTC advertising, poorer health, and insurance status. Substantial misconceptions were revealed; e.g., 43% thought that only "completely safe" drugs could be advertised. Direct-to-consumer advertisements had led one third of respondents to ask their physicians for drug information and one fifth to request a prescription. Direct-to-consumer advertisements are reaching the public, but selectively so, and affecting their behaviors. Implications for public policy are examined.

Lack of HER-2 gene amplification and association with pathological and clinical characteristics of differentiated thyroid cancer.

PubMed

Mdah, Wahid; Mzalbat, Raneen; Gilbey, Peter; Stein, Moshe; Sharabi, Adi; Zidan, Jamal

2014-11-01

Human epidermal growth factor receptor 2 (HER-2) is a well recognized prognostic and predictive factor in breast cancer. However, the role of HER-2 in thyroid cancer remains controversial. The aim of this study was to evaluate HER-2 expression in differentiated thyroid cancer (DTC) and determine whether there is an association with other clinical and pathological characteristics. A total of 69 patients with DTC were investigated, 58 of whom had papillary and 11 follicular carcinomas. HER-2 was detected by immunohistochemical examination on sections from formalin-fixed, paraffin-embedded tumor tissues. Tumors with HER-2 expression classed as +1 and +2 were retested with chromogenic in situ hybridization. Clinicopathological data were retrieved from the hospital records of the patients. HER-2 overexpression was found in 4 (6.9%) of the 58 patients with papillary carcinoma, whereas there was no HER-2 overexpression in any of the 11 cases of follicular carcinoma. There was no association of HER-2 expression with tumor size, pathological grade and cervical lymph node metastasis. In conclusion, there were no HER-2 positive cases of follicular carcinoma and the incidence of HER-2 overexpression in papillary carcinoma was very low. Thus, HER-2 cannot be used routinely as a prognostic or predictive factor in DTC. The expression of other epidermal growth factor receptors in DTC merits further investigation.

Radiation dose rates of differentiated thyroid cancer patients after 131I therapy.

PubMed

Jin, Pingyan; Feng, Huijuan; Ouyang, Wei; Wu, Juqing; Chen, Pan; Wang, Jing; Sun, Yungang; Xian, Jialang; Huang, Liuhua

2018-05-01

Postoperative 131 I treatment for differentiated thyroid cancer (DTC) can create a radiation hazard for nearby persons. The present prospective study aimed to investigate radiation dose rates in 131 I-treated DTC patients to provide references for radiation protection. A total of 141 131 I-treated DTC patients were enrolled, and grouped into a singular treatment (ST) group and a repeated treatment (RT) group. The radiation dose rate of 131 I-treated patients was measured. The rate of achieving discharge compliance and restricted contact time were analyzed based on Chinese regulations. Multivariate logistic regression analysis was used to analyze the independent factors associated with the clearance of radioiodine. The rate of achieving discharge compliance ( 131 I retention < 400 MBq) was 79.8 and 93.7% at day 2 (D2) for the ST and RT groups, respectively, and reached 100% at D7 and D4, respectively. The restricted contact time with 131 I-treated patients at 0.5 m for medical staff, caregivers, family members, and the general public ranged from 4 to 7 days. Multivariate logistic regression analysis showed that the 24-h iodine uptake rate was the only significant factor associated with radioiodine clearance. For the radiation safety of 131 I-treated DTC patients, the present results can provide radiometric data for radiation protection.

Characterization of mitochondrial dicarboxylate/tricarboxylate transporters from grape berries.

PubMed

Regalado, Ana; Pierri, Ciro Leonardo; Bitetto, Maria; Laera, Valentina Liliana; Pimentel, Catarina; Francisco, Rita; Passarinho, José; Chaves, Maria M; Agrimi, Gennaro

2013-03-01

Grape berries (Vitis vinifera L fruit) exhibit a double-sigmoid pattern of development that results from two successive periods of vacuolar swelling during which the nature of accumulated solutes changes significantly. Throughout the first period, called green or herbaceous stage, berries accumulate high levels of organic acids, mainly malate and tartrate. At the cellular level fruit acidity comprises both metabolism and vacuolar storage. Malic acid compartmentation is critical for optimal functioning of cytosolic enzymes. Therefore, the identification and characterization of the carriers involved in malate transport across sub-cellular compartments is of great importance. The decrease in acid content during grape berry ripening has been mainly associated to mitochondrial malate oxidation. However, no Vitis vinifera mitochondrial carrier involved in malate transport has been reported to date. Here we describe the identification of three V. vinifera mitochondrial dicarboxylate/tricarboxylate carriers (VvDTC1-3) putatively involved in mitochondrial malate, citrate and other di/tricarboxylates transport. The three VvDTCs are very similar, sharing a percentage of identical residues of at least 83 %. Expression analysis of the encoding VvDTC genes in grape berries shows that they are differentially regulated exhibiting a developmental pattern of expression. The simultaneous high expression of both VvDTC2 and VvDTC3 in grape berry mesocarp close to the onset of ripening suggests that these carriers might be involved in the transport of malate into mitochondria.

Direct-to-Consumer Prescription Drug Advertising and the Public

PubMed Central

Bell, Robert A; Kravitz, Richard L; Wilkes, Michael S

1999-01-01

OBJECTIVE Drug manufacturers are intensely promoting their products directly to consumers, but the impact has not been widely studied. Consumers' awareness and understanding of, attitudes toward, and susceptibility to direct-to-consumer (DTC) drug advertising were examined. DESIGN Random-digit dialing telephone survey with a random household member selection procedure (completion and response rates, 58% and 69%, respectively). SETTING Respondents were interviewed while they were at their residences. PARTICIPANTS Complete data were obtained from 329 adults in Sacramento County, California. MEASUREMENTS AND MAIN RESULTS Outcome measures included awareness of advertisements for 10 selected drugs, misconceptions about DTC advertising, attitudes toward DTC ads, and behavioral responses to such promotions. The influence of demographic characteristics, health status, attitudes, beliefs, and media exposure on awareness and behaviors was examined. On average, respondents were aware of advertisements for 3.7 of the 10 drugs; awareness varied from 8% for Buspar (buspirone) to 72% for Claritin (loratadine). Awareness was associated with prescription drug use, media exposure, positive attitudes toward DTC advertising, poorer health, and insurance status. Substantial misconceptions were revealed; e.g., 43% thought that only “completely safe” drugs could be advertised. Direct-to-consumer advertisements had led one third of respondents to ask their physicians for drug information and one fifth to request a prescription. CONCLUSIONS Direct-to-consumer advertisements are reaching the public, but selectively so, and affecting their behaviors. Implications for public policy are examined. PMID:10571712

Research 2.0: social networking and direct-to-consumer (DTC) genomics.

PubMed

Lee, Sandra Soo-Jin; Crawley, LaVera

2009-01-01

The convergence of increasingly efficient high throughput sequencing technology and ubiquitous Internet use by the public has fueled the proliferation of companies that provide personal genetic information (PGI) direct-to-consumers. Companies such as 23andme (Mountain View, CA) and Navigenics (Foster City, CA) are emblematic of a growing market for PGI that some argue represents a paradigm shift in how the public values this information and incorporates it into how they behave and plan for their futures. This new class of social networking business ventures that market the science of the personal genome illustrates the new trend in collaborative science. In addition to fostering a consumer empowerment movement, it promotes the trend of democratizing information--openly sharing of data with all interested parties, not just the biomedical researcher--for the purposes of pooling data (increasing statistical power) and escalating the innovation process. This target article discusses the need for new approaches to studying DTC genomics using social network analysis to identify the impact of obtaining, sharing, and using PGI. As a locus of biosociality, DTC personal genomics forges social relationships based on beliefs of common genetic susceptibility that links risk, disease, and group identity. Ethical issues related to the reframing of DTC personal genomic consumers as advocates and research subjects and the creation of new social formations around health research may be identified through social network analysis.

All-digital pulse-expansion-based CMOS digital-to-time converter.

PubMed

Chen, Chun-Chi; Chu, Che-Hsun

2017-02-01

This paper presents a new all-digital CMOS digital-to-time converter (DTC) based on pulse expansion. Pulse expansion is achieved using an all-digital pulse-mixing scheme that can effectively improve the timing resolution and enable the DTC to be concise. Without requiring the Vernier principle or a costly digital-to-analog converter, the DTC comprises a pulse generator for generating a pulse, a pulse-expanding circuit (PEC) for programming timing generation, and a time subtractor for removing the time width of the pulse. The PEC comprises only a delay chain composed of proposed pulse-expanding units and a multiplexer. For accuracy enhancement, a pulse neutralization technique is presented to eliminate undesirable pulse variation. A 4-bit converter was fabricated in a 0.35-μm Taiwan Semiconductor Manufacturing Company CMOS process and had a small area of nearly 0.045 mm 2 . Six chips were tested, all of which exhibited an improved resolution (approximately 16 ps) and low integral nonlinearity (less than ±0.4 least significant bit). The power consumption was 0.2 mW when the sample rate was 1M samples/s and the voltage supply was 3.3 V. The proposed DTC not only has favorable cost and power but also achieves an acceptable resolution without requiring an advanced CMOS process. This study is the first to use pulse expansion in digital-to-time conversion.

All-digital pulse-expansion-based CMOS digital-to-time converter

NASA Astrophysics Data System (ADS)

Chen, Chun-Chi; Chu, Che-Hsun

2017-02-01

This paper presents a new all-digital CMOS digital-to-time converter (DTC) based on pulse expansion. Pulse expansion is achieved using an all-digital pulse-mixing scheme that can effectively improve the timing resolution and enable the DTC to be concise. Without requiring the Vernier principle or a costly digital-to-analog converter, the DTC comprises a pulse generator for generating a pulse, a pulse-expanding circuit (PEC) for programming timing generation, and a time subtractor for removing the time width of the pulse. The PEC comprises only a delay chain composed of proposed pulse-expanding units and a multiplexer. For accuracy enhancement, a pulse neutralization technique is presented to eliminate undesirable pulse variation. A 4-bit converter was fabricated in a 0.35-μ m Taiwan Semiconductor Manufacturing Company CMOS process and had a small area of nearly 0.045 mm2. Six chips were tested, all of which exhibited an improved resolution (approximately 16 ps) and low integral nonlinearity (less than ±0.4 least significant bit). The power consumption was 0.2 mW when the sample rate was 1M samples/s and the voltage supply was 3.3 V. The proposed DTC not only has favorable cost and power but also achieves an acceptable resolution without requiring an advanced CMOS process. This study is the first to use pulse expansion in digital-to-time conversion.

Supporting Operational Data Assimilation Capabilities to the Research Community

NASA Astrophysics Data System (ADS)

Shao, H.; Hu, M.; Stark, D. R.; Zhou, C.; Beck, J.; Ge, G.

2017-12-01

The Developmental Testbed Center (DTC), in partnership with the National Centers for Environmental Prediction (NCEP) and other operational and research institutions, provides operational data assimilation capabilities to the research community and helps transition research advances to operations. The primary data assimilation system supported currently by the DTC is the Gridpoint Statistical Interpolation (GSI) system and the National Oceanic and Atmospheric Administration (NOAA) Ensemble Kalman Filter (EnKF) system. GSI is a variational based system being used for daily operations at NOAA, NCEP, the National Aeronautics and Space Administration, and other operational agencies. Recently, GSI has evolved into a four-dimensional EnVar system. Since 2009, the DTC has been releasing the GSI code to the research community annually and providing user support. In addition to GSI, the DTC, in 2015, began supporting the ensemble based EnKF data assimilation system. EnKF shares the observation operator with GSI and therefore, just as GSI, can assimilate both conventional and non-conventional data (e.g., satellite radiance). Currently, EnKF is being implemented as part of the GSI based hybrid EnVar system for NCEP Global Forecast System operations. This paper will summarize the current code management and support framework for these two systems. Following that is a description of available community services and facilities. Also presented is the pathway for researchers to contribute their development to the daily operations of these data assimilation systems.

Joint Measurement Operations Controller (JMOC)

DTIC Science & Technology

2011-01-01

This work included evaluation of electronic paper and handwriting recognition software. Neither of these technologies was sufficiently robust to...is header information saying this is the Dynamic Targeting Cell set of questions. <Module webEnabled="false" appName="DTC" displayGlobalPre="true...translation of their handwriting captures. The one exception is Logitech, which provides its own software but is also compatible with MyScript Notes

The usefulness of fluorine-18 fluorodeoxyglucose PET in the detection of recurrence in patients with differentiated thyroid cancer with elevated thyroglobulin and negative radioiodine whole-body scan.

PubMed

Stangierski, Adam; Kaznowski, Jaroslaw; Wolinski, Kosma; Jodlowska, Elzbieta; Michaliszyn, Piotr; Kubiak, Katarzyna; Czepczynski, Rafal; Ruchala, Marek

2016-09-01

PET/computed tomography (CT) using fluorine-18 fluorodeoxyglucose (F-FDG) has been used in the diagnosis of recurrence and metastases of differentiated thyroid cancer (DTC) in cases of negative whole-body scan (WBS) despite elevated concentrations of stimulated thyroglobulin (Tg). To assess the utility of PET/CT in the detection of recurrence among patients with DTC with increased Tg levels and negative results of WBS. PET/CT results were retrospectively analyzed in patients with DTC with increased Tg and negative results of WBS as well as negative cervical ultrasonography and chest radiography. PET-CT was performed 1-2 weeks after recent diagnostics under conditions of endogenous or exogenous thyroid-stimulating hormone stimulation. PET/CT was performed using a Discovery ST scanner 1 h after an intravenously F-FDG injection (activity 4-5 MBq/kg). To determine the cutoff value of Tg, receiver operating characteristic curves were analyzed. Sixty-nine patients with DTC (48 women, 21 men) aged 22-83 years (mean 50.9±17.5 years) were qualified. In 44 patients (63.8%), PET/CT indicated lesions of DTC. Thirty (43.5%) patients had F-FDG positive findings. In the remaining 14 patients (20.3%), lesions were found in CT only. Patients with a positive PET/CT scan had significantly higher Tg values than patients with a negative PET/CT (mean 143.8 vs. 26.5 ng/ml, P=0.03). The cutoff value of Tg concentration measured with the receiver operating characteristic analysis was 32.9 ng/ml. PET/CT is a useful tool in the detection of recurrence among thyroid cancer patients in cases of conflicting results of standard procedures, particularly for those with high Tg levels and negative WBS. The probability of obtaining a positive PET-CT result increases with the level of Tg.

Inhibition of miR-146b expression increases radioiodine-sensitivity in poorly differential thyroid carcinoma via positively regulating NIS expression

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

Li, Luchuan; Lv, Bin; Chen, Bo

2015-07-10

Dedifferentiated thyroid carcinoma (DTC) with the loss of radioiodine uptake (RAIU) is often observed in clinical practice under radioiodine therapy, indicating the challenge for poor prognosis. MicroRNA (miRNA) has emerged as a promising therapeutic target in many diseases; yet, the role of miRNAs in RAIU has not been generally investigated. Based on recent studies about miRNA expression in papillary or follicular thyroid carcinomas, the expression profiles of several thyroid relative miRNAs were investigated in one DTC cell line, derived from normal DTC cells by radioiodine treatment. The top candidate miR-146b, with the most significant overexpression profiles in dedifferentiated cells, wasmore » picked up. Further research found that miR-146b could be negatively regulated by histone deacetylase 3 (HDAC3) in normal cells, indicating the correlation between miR-146b and Na{sup +}/I{sup −} symporter (NIS)-mediated RAIU. Fortunately, it was confirmed that miR-146b could regulate NIS expression/activity; what is more important, miR-146b interference would contribute to the recovery of radioiodine-sensitivity in dedifferentiated cells via positively regulating NIS. In the present study, it was concluded that NIS-mediated RAIU could be modulated by miR-146b; accordingly, miR-146b might serve as one of targets to enhance efficacy of radioactive therapy against poorly differential thyroid carcinoma (PDTC). - Highlights: • Significant upregulated miR-146b was picked up from thyroid relative miRNAs in DTC. • MiR-146b was negatively regulated by HDAC3 in normal thyroid carcinoma cells. • NIS activity and expression could be regulated by miR-146b in thyroid carcinoma. • MiR-146b inhibition could recover the decreased radioiodine-sensitivity of DTC cells.« less

Factors influencing the shift of patients from one proton pump inhibitor to another: the effect of direct-to-consumer advertising.

PubMed

Hansen, Richard A; Shaheen, Nicholas J; Schommer, Jon C

2005-09-01

Switching from one proton pump inhibitor (PPI) to another is common, and may be related to factors other than efficacy and tolerability. The purposes of this study were to describe the incidence of therapeutic switching among PPI users, quantify direct ambulatory medical costs of switching, and characterize the relationship between product switching and variables hypothesized to influence a switch (eg, direct-to-consumer [DTC] advertising, structure of insurance coverage, disease diagnosis). This was a retrospective cohort study of health plans using 1998 data. The subjects were employees and dependents with employer-sponsored health insurance contributing to the Medstat Market-Scan administrative dataset. Using a commercially available database to quantify DTC advertising by marketing area, market-specific expenditures were matched to eligible subjects. Among PPI users, we identified those who switched from one product to another (switchers) and compared their utilization and spending with nonswitchers. We then evaluated the relationship between drug use and variables hypothesized to affect switching: DTC advertising, insurance characteristics, patient diagnosis, diagnostic procedures, comorbidities, age, and sex. The analysis used data for 396,500 individuals from 47 unique markets that were geographically well distributed, with population density similar to that of the United States overall. The sample was also comparable with US census estimates for age and sex among working adults and their dependents. Only 620 (6.3%) of PPI users switched products during the 1998 calendar year. Annual diagnostic and drug costs were >US $400 higher for switchers than nonswitchers. Subjects in areas with high levels of DTC advertising were 43% more likely to switch from lansoprazole to omeprazole than those in the low-expenditure areas. Additionally, patients paying prescription drug copayments >US $5 were 12% less likely to switch from lansoprazole to omeprazole than patients paying lower copayments. In these privately insured patients using PPIs, product switching was associated with increased treatment costs. DTC advertising and patient cost-sharing were important predictors of product switching.

How sensitive (second-generation) thyroglobulin measurement is changing paradigms for monitoring patients with differentiated thyroid cancer, in the absence or presence of thyroglobulin autoantibodies

PubMed Central

Spencer, Carole; LoPresti, Jonathan; Fatemi, Shireen

2014-01-01

Purpose of review To discuss new insights regarding how sensitive (second-generation) thyroglobulin immunometric assays (Tg2GIMAs), (functional sensitivities ≤0.10 μg/L) necessitate different approaches for postoperative thyroglobulin monitoring of patients with differentiated thyroid cancer (DTC), depending on the presence of thyroglobulin autoantibodies (TgAbs). Recent findings Reliable low-range serum thyroglobulin measurement has both enhanced clinical utility and economic advantages, provided TgAb is absent (∼75% DTC patients). Basal [nonthyroid-stimulating hormone (TSH) stimulated] Tg2GIMA measurement obviates the need for recombinant human TSH stimulation because basal Tg2GIMA below 0.20 μg/L has comparable negative predictive value (>95%) to recombinant human TSH-stimulated thyroglobulin values below the cutoff of 2 μg/L. Now that radioiodine remnant ablation is no longer considered necessary to treat low-risk DTC, the trend and doubling time of low basal thyroglobulin values arising from postsurgical thyroid remnants have recognized prognostic significance. The major limitation of Tg2GIMA testing is interference by TgAb (∼25% DTC patients), causing Tg2GIMA underestimation that can mask disease. When TgAb is present, the trend in TgAb concentrations (measured by the same method) can serve as the primary (surrogate) tumor-marker and be augmented by thyroglobulin measured by a TgAb-resistant class of method (radioimmunoassay or liquid chromatography-tandem mass spectrometry). Summary The growing use of Tg2GIMA measurement is changing paradigms for postoperative DTC monitoring. When TgAb is absent, it is optimal to monitor the basal Tg2GIMA trend and doubling time (using the same method) in preference to recombinant human TSH-stimulated thyroglobulin testing. When TgAb is present, interference renders Tg2GIMA testing unreliable and the trend in serum TgAb concentrations per se (same method) can serve as a (surrogate) tumor-marker. PMID:25122493

Presenting efficacy information in direct-to-consumer prescription drug advertisements.

PubMed

O'Donoghue, Amie C; Sullivan, Helen W; Aikin, Kathryn J; Chowdhury, Dhuly; Moultrie, Rebecca R; Rupert, Douglas J

2014-05-01

We evaluated whether presenting prescription drug efficacy information in direct-to-consumer (DTC) advertising helps individuals accurately report a drug's benefits and, if so, which numerical format is most helpful. We conducted a randomized, controlled study of individuals diagnosed with high cholesterol (n=2807) who viewed fictitious prescription drug print or television ads containing either no drug efficacy information or efficacy information in one of five numerical formats. We measured drug efficacy recall, drug perceptions and attitudes, behavioral intentions, and drug risk recall. Individuals who viewed absolute frequency and/or percentage information more accurately reported drug efficacy than participants who viewed no efficacy information. Participants who viewed relative frequency information generally reported drug efficacy less accurately than participants who viewed other numerical formats. Adding efficacy information to DTC ads-both in print and on television-may potentially increase an individual's knowledge of a drug's efficacy, which may improve patient-provider communication and promote more informed decisions. Providing quantitative efficacy information in a combination of formats (e.g., absolute frequency and percent) may help patients remember information and make decisions about prescription drugs. Published by Elsevier Ireland Ltd.

Sliding mode based fault detection, reconstruction and fault tolerant control scheme for motor systems.

PubMed

Mekki, Hemza; Benzineb, Omar; Boukhetala, Djamel; Tadjine, Mohamed; Benbouzid, Mohamed

2015-07-01

The fault-tolerant control problem belongs to the domain of complex control systems in which inter-control-disciplinary information and expertise are required. This paper proposes an improved faults detection, reconstruction and fault-tolerant control (FTC) scheme for motor systems (MS) with typical faults. For this purpose, a sliding mode controller (SMC) with an integral sliding surface is adopted. This controller can make the output of system to track the desired position reference signal in finite-time and obtain a better dynamic response and anti-disturbance performance. But this controller cannot deal directly with total system failures. However an appropriate combination of the adopted SMC and sliding mode observer (SMO), later it is designed to on-line detect and reconstruct the faults and also to give a sensorless control strategy which can achieve tolerance to a wide class of total additive failures. The closed-loop stability is proved, using the Lyapunov stability theory. Simulation results in healthy and faulty conditions confirm the reliability of the suggested framework. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

Costs of current antihypertensive therapy in Switzerland: an economic evaluation of 3,489 patients in primary care.

PubMed

Schäfer, Hans Hendrik; Scheunert, Uta

2013-10-25

Due to greater life expectancy, costs of medication have increased within the last decade. This investigation assesses health care expenditures needed to manage the current state of blood pressure (BP) control in Switzerland. a) average day therapy costs (DTC) of substances, b) actual DTC of currently prescribed antihypertensive therapy, c) monetary differences of treatment regimens within different BP-groups and different high risk patients, d) estimated compliance-related financial loss/annum and adjusted costs/annum. Single-pill-combinations appear to be useful to increase patient's compliance, to reduce side effects and to bring more patients to their blood pressure goal. Costs were identified based on data from the Swiss department of health. We calculated DTC for each patient using prices of the largest available tablet box. The average antihypertensive therapy in Switzerland currently costs CHF 1.198 ± 0.732 per day. On average beta blockers were the cheapest substances, followed by angiotensin converting enzyme inhibitors (ARBs), calcium channel blockers and diuretics. The widest price ranges were observed within the class of ARBs. Most expensive were patients with impaired renal function. Throughout all stages, single-pill-combinations appeared to be significantly cheaper than dual-free-combinations. Stage-II-hypertension yielded the highest costs for dual free combination drug use. The actual costs for all patients observed in this analysis added up to CHF 1,525,962. Based on a compliance model, only treatment amounting to CHF 921,353 is expected to be actually taken. A disproportionately high healthcare cost is expected due to compliance reasons. The prescription of mono-therapies appears to be a major cost factor, thus, the use of single-pill-combination therapy can be considered as a suitable approach to saving costs throughout all BP- stages.

Long-term surveillance of papillary thyroid cancer patients who do not undergo postoperative radioiodine remnant ablation: is there a role for serum thyroglobulin measurement?

PubMed

Durante, Cosimo; Montesano, Teresa; Attard, Marco; Torlontano, Massimo; Monzani, Fabio; Costante, Giuseppe; Meringolo, Domenico; Ferdeghini, Marco; Tumino, Salvatore; Lamartina, Livia; Paciaroni, Alessandra; Massa, Michela; Giacomelli, Laura; Ronga, Giuseppe; Filetti, Sebastiano

2012-08-01

Serum thyroglobulin (Tg) assays are considered fundamental in postoperative surveillance of differentiated thyroid cancer (DTC) patients. However, the postsurgical profile of Tg levels has never been specifically investigated in patients who do not undergo radioiodine remnant ablation (RRA). Our objective was to explore the evolution of Tg levels over time in DTC patients treated with total or near-total thyroidectomy without RRA. We retrospectively analyzed 290 consecutively diagnosed cases of low-risk (American Thyroid Association criteria) DTC treated with thyroidectomy alone and followed yearly with neck ultrasonography and serum Tg assays. We compared final Tg values in this group and a matched group of 495 RRA-positive patients. Temporal trends of serial Tg levels were also analyzed in 78 of the RRA-negative patients monitored with a high-sensitivity immunoradiometric assay. After follow-up of 2.5-22 yr (median 5 yr), final Tg levels were undetectable (<1 ng/ml) in 274 of 290 RRA-negative patients (95%) and 492 of 495 RRA-positive controls (99%). In the subset of 78 RRA-negative patients, undetectable Tg levels (<0.2 ng/ml) were recorded in 60% at the first postoperative evaluation (3-12 months) and in 79% after 5 yr. Tg levels increased in the single patient who experienced disease recurrence during the observation period. In most RRA-negative patients, postoperative serum Tg values spontaneously drop to undetectable levels within 5-7 yr after thyroidectomy. Thus, in later phases, Tg assays may be a valuable tool for follow-up even in patients who do not undergo RRA.

Fusion of Tracks with Road Constraints

DTIC Science & Technology

2008-06-12

of orthogonality, the projec- tion error vector »¡ »D is orthogonal to D, i.e., each and every basis of it: h»¡ »D, dii = h»¡DTc, dii = dTi (»¡DTc) = 0, i... Electrical Engineers, 2004. [13] M. Ulmke and W. Koch Multi hypothesis track extraction and maintenance of GMTI sensor data. In Proceedings of the 8th...in Annapolis, MD (2000) and in Philadelphia, PA (2005), respectively. Dr. Yang is also an Adjunct Professor of Electrical and Computer Engineering at

Effects of emotional tone and visual complexity on processing health information in prescription drug advertising.

PubMed

Norris, Rebecca L; Bailey, Rachel L; Bolls, Paul D; Wise, Kevin R

2012-01-01

This experiment explored how the emotional tone and visual complexity of direct-to-consumer (DTC) drug advertisements affect the encoding and storage of specific risk and benefit statements about each of the drugs in question. Results are interpreted under the limited capacity model of motivated mediated message processing framework. Findings suggest that DTC drug ads should be pleasantly toned and high in visual complexity in order to maximize encoding and storage of risk and benefit information.

Influence of Patients’ Requests for Directly Advertised Antidepressants: A Randomized Controlled Trial

PubMed Central

Kravitz, Richard L.; Epstein, Ronald; Feldman, Mitchell D.; Franz, Carol E.; Azari, Rahman; Wilkes, Michael S.; Hinton, Ladson; Franks, Peter

2011-01-01

Context Direct-to-consumer (DTC) advertising of prescription drugs in the United States is both ubiquitous and controversial. Critics charge that DTC advertising leads to over-prescribing, while proponents counter that it helps avert under-use of effective treatments, especially for conditions such as depression that are poorly recognized or stigmatized. Objective To ascertain the effects of patients’ DTC-related requests on physicians’ initial treatment decisions (prescribing, referral, and follow-up) in patients with depressive symptoms. Design Randomized trial using Standardized Patients (SPs). Six SP roles (experimental cells) were created by crossing two conditions (major depression or adjustment disorder) with three request types (brand-specific, general, or none). Setting Offices of primary care physicians in Sacramento, CA; San Francisco, CA; and Rochester, NY. Participants 152 family physicians and general internists recruited from solo and group practices and health maintenance organizations; cooperation rates ranged from 53% to 61%. Interventions SPs were randomly assigned to make 298 unannounced visits, with assignments constrained so physicians saw 1 SP with major depression and 1 with adjustment disorder (approximately 50 visits per experimental cell). Main Outcome Measures Data on prescribing, mental health referral, and primary care follow-up were obtained from SP written reports, visit audio-recordings, chart review, and analysis of written prescriptions and drug samples. The effects of request type on prescribing were evaluated using contingency tables and confirmed in generalized linear mixed models that accounted for clustering and adjusted for site, physician, and visit characteristics. Results SP role fidelity was excellent, and the detection rate was 12%. In major depression, rates of antidepressant prescribing were 53%, 76%, and 31% for SPs making brand-specific requests, general requests, and no requests, respectively (p<.0001). In adjustment disorder, antidepressant prescribing was 55%, 39%, and 10%, respectively (p<.0001). The results were confirmed in multivariate models. “Minimally acceptable initial care” (any combination of an antidepressant, mental health referral, or follow-up within two weeks) in the major depression role was offered to 98% of SPs making a general request, 90% of those making a brand-specific request, and 56% of those making no request (p<0.001). Conclusions Patients’ requests have a profound effect on physician prescribing in major depression and adjustment disorder. DTC advertising may have competing effects on quality, potentially both averting under-use and promoting over-use. PMID:15855433

Long-Term Quality of Life in Adult Survivors of Pediatric Differentiated Thyroid Carcinoma.

PubMed

Nies, Marloes; Klein Hesselink, Mariëlle S; Huizinga, Gea A; Sulkers, Esther; Brouwers, Adrienne H; Burgerhof, Johannes G M; van Dam, Eveline W C M; Havekes, Bas; van den Heuvel-Eibrink, Marry M; Corssmit, Eleonora P M; Kremer, Leontien C M; Netea-Maier, Romana T; van der Pal, Heleen J H; Peeters, Robin P; Plukker, John T M; Ronckers, Cécile M; van Santen, Hanneke M; Tissing, Wim J E; Links, Thera P; Bocca, Gianni

2017-04-01

Little is known about long-term quality of life (QoL) of survivors of pediatric differentiated thyroid carcinoma. Therefore, this study aimed to evaluate generic health-related QoL (HRQoL), fatigue, anxiety, and depression in these survivors compared with matched controls, and to evaluate thyroid cancer-specific HRQoL in survivors only. Survivors diagnosed between 1970 and 2013 at age ≤18 years, were included. Exclusion criteria were a follow-up <5 years, attained age <18 years, or diagnosis of DTC as a second malignant neoplasm (SMN). Controls were matched by age, sex, and socioeconomic status. Survivors and controls were asked to complete 3 questionnaires [Short-Form 36 (HRQoL), Multidimensional Fatigue Inventory 20 (fatigue), and Hospital Anxiety and Depression Scale (anxiety/depression)]. Survivors completed a thyroid cancer-specific HRQoL questionnaire. Sixty-seven survivors and 56 controls. Median age of survivors at evaluation was 34.2 years (range, 18.8 to 61.7). Median follow-up was 17.8 years (range, 5.0 to 44.7). On most QoL subscales, scores of survivors and controls did not differ significantly. However, survivors had more physical problems (P = 0.031), role limitations due to physical problems (P = 0.021), and mental fatigue (P = 0.016) than controls. Some thyroid cancer-specific complaints (e.g., sensory complaints and chilliness) were present in survivors. Unemployment and more extensive disease or treatment characteristics were most frequently associated with worse QoL. Overall, long-term QoL in survivors of pediatric DTC was normal. Survivors experienced mild impairment of QoL in some domains (physical problems, mental fatigue, and various thyroid cancer-specific complaints). Factors possibly affecting QoL need further exploration. Copyright © 2017 Endocrine Society

A study of the web as DTC drug marketing agent.

PubMed

Lorence, Daniel; Churchill, Rick

2007-12-01

The growth of direct-to-consumer (DTC) marketing of pharmaceuticals in the USA has spawned the generation of web sites for consumer information and discussion, related to specific medical conditions and the efficacy of specific drugs. In such an environment consumers often find and act upon health information of variable quality, with little input from health professionals. Some health policy analysts argue that the emergence of such consumer "drug networks" will lead to unnecessary expenditure of money on prescription drugs, as consumers see ads and then demand that their providers prescribe that drug. Others say that an intelligent consumer will be able to research the information and narrow down a drug that will likely work for them personally, rather than having the provider "experiment" with different medications. There exist few cross-disciplinary evaluative frameworks for assessing such health information, especially within commercial search engines. This study serves as an exploratory technology assessment that examines the prevalence of web-based DTC for a popular prescription drug and the impact on healthcare consumers.

Informed Choice in Direct-to-Consumer Genetic Testing for Alzheimer and Other Diseases: Lessons from Two Cases

PubMed Central

Messner, Donna A.

2011-01-01

Health-related direct-to-consumer (DTC) genetic testing has been a controversial practice. Especially problematic is predictive testing for Alzheimer disease (AD), since the disease is incurable, prevention is inconclusive, and testing does not definitively predict an individual’s future disease status. In this paper, I examine two contrasting cases of subjects who learn through genetic testing that they have an elevated risk of developing AD later in life. In these cases, the subject’s emotional response to the result is related to how well prepared she was for the real-life personal implications of possible test results. Analysis leads to the conclusion that when groups of health-related genetic tests are offered as packages by DTC companies, informed consumer choice is rendered impossible. Moreover, I argue, this marketing approach contravenes U.S. Federal Trade Commission policies for non-deceptive commercial communications. I conclude by suggesting ways to improve the prospects for informed consumer choice in DTC testing. PMID:21603253

Molybdenum Carbamate Nanosheets as a New Class of Potential Phase Change Materials.

PubMed

Zhukovskyi, Maksym; Plashnitsa, Vladimir; Petchsang, Nattasamon; Ruth, Anthony; Bajpai, Anshumaan; Vietmeyer, Felix; Wang, Yuanxing; Brennan, Michael; Pang, Yunsong; Werellapatha, Kalpani; Bunker, Bruce; Chattopadhyay, Soma; Luo, Tengfei; Janko, Boldizsar; Fay, Patrick; Kuno, Masaru

2017-06-14

We report for the first time the synthesis of large, free-standing, Mo 2 O 2 (μ-S) 2 (Et 2 dtc) 2 (MoDTC) nanosheets (NSs), which exhibit an electron-beam induced crystalline-to-amorphous phase transition. Both electron beam ionization and femtosecond (fs) optical excitation induce the phase transition, which is size-, morphology-, and composition-preserving. Resulting NSs are the largest, free-standing regularly shaped two-dimensional amorphous nanostructures made to date. More importantly, amorphization is accompanied by dramatic changes to the NS electrical and optical response wherein resulting amorphous species exhibit room-temperature conductivities 5 orders of magnitude larger than those of their crystalline counterparts. This enhancement likely stems from the amorphization-induced formation of sulfur vacancy-related defects and is supported by temperature-dependent transport measurements, which reveal efficient variable range hopping. MoDTC NSs represent one instance of a broader class of transition metal carbamates likely having applications because of their intriguing electrical properties as well as demonstrated ability to toggle metal oxidation states.

Genetic Testing Integration Panels (GTIPs): A novel approach for considering integration of direct-to-consumer and other new genetic tests into patient care

PubMed Central

Uhlmann, Wendy R.; Sharp, Richard R.

2014-01-01

There has been a dramatic increase in the number of genetic tests available but few tests have practice guidelines. In addition, many tests have become available outside of genetics clinics through direct-to-consumer (DTC) companies and several offer tests not considered standard of care. To address several practical challenges associated with the rapid introduction of clinical and DTC genetic tests, we propose that genetic counselors and geneticists organize expert panels in their institutions to discuss the integration of new tests into patient care. We propose the establishment of Genetic Testing Integration Panels (GTIPs) to bring together local experts in medical genetics, genetic counseling, bioethics and law, health communication and clinical laboratory genetics. We describe key features of this approach and consider some of the potential advantages and limitations of using a GTIP to address the many clinical challenges raised by rapidly emerging clinical and DTC genetic tests. PMID:22246561

Public reaction to direct-to-consumer online genetic tests: Comparing attitudes, trust and intentions across commercial and conventional providers.

PubMed

Critchley, Christine; Nicol, Dianne; Otlowski, Margaret; Chalmers, Don

2015-08-01

The success of personalised medicine depends upon the public's embracing genetic tests. Tests that claim to predict an individual's future health can now be accessed via online companies outside of conventional health regulations. This research assessed the extent to which the public embrace direct-to-consumer (DTC) genetic tests relative to those obtained by a conventional medical practitioner (MP). It also examined the reasons for differences across providers using a randomised experimental telephone survey of 1000 Australians. Results suggest that people were significantly less likely to approve of, and order a DTC genetic test administered by a company compared to a MP because they were less trusting of companies' being able to protect their privacy and provide them with access to genetic expertise and counselling. Markets for DTC genetic tests provided by companies would therefore significantly increase if trust in privacy protection and access to expertise are enhanced through regulation. © The Author(s) 2014.

Production of novel cell-associated tannase from newly isolated Serratia ficaria DTC.

PubMed

Belur, Prasanna D; Gopal, Mugeraya; Nirmala, K R; Basavaraj, N

2010-04-01

Five strains of tannic acid degrading bacteria were isolated and identified by phenotypic characterization. All the five isolates showed cell-associated activity, where as only three showed extracellular activity. Serratia ficaria DTC showing highest cell-associated activity (0.29 U/l) was selected for further shake flask studies. Tannase synthesis was growth associated and reached the peak in the late stationary phase of growth. Organic nitrogen sources enhanced the tannase production. Peak tannase production of 0.56 U/l was recorded in the medium having the initial pH of 6. The pH and temperature optima of the enzyme were found to be 8.9 and 35 degrees , respectively. This is the first report of cell-associated activity in case of bacterial tannase. Cell-associated tannase of Serratia ficaria DTC could be industrially important from the perspective of its activity at broad temperature and pH range, its unusually high activity at pH 8.9.

Direct-to-Consumer Genetic Testing and Orphan Drug Development.

PubMed

Mason, Matthew; Levenson, James; Quillin, John

2017-08-01

Since the introduction of the Orphan Drug Act (ODA) in 1983, orphan drug approvals in the United States have jumped from <100 per decade to over 200 per year. This growth is widely attributed to the financial incentives the ODA gives to companies that develop these medicines, and it is likely to continue for a unique reason: partnerships between pharmaceutical firms and direct-to-consumer (DTC) genetic testing companies. This emerging trend is the subject of this article, which begins by considering how rare-disease drugs are regulated and the rising interest in nonclinical genetic testing. It then outlines how DTC companies analyze DNA and how their techniques benefit researchers and drug developers. Then, after an overview of the current partnerships between DTCs and drug developers, it examines concerns about privacy and cost brought up by these partnerships. The article concludes by contrasting the enormous positive potential of DTC-pharma relationships and their concomitant dangers, especially to consumer privacy and cost to the healthcare system.

The impact of Relative Prevalence on dual-target search for threat items from airport X-ray screening.

PubMed

Godwin, Hayward J; Menneer, Tamaryn; Cave, Kyle R; Helman, Shaun; Way, Rachael L; Donnelly, Nick

2010-05-01

The probability of target presentation in visual search tasks influences target detection performance: this is known as the prevalence effect (Wolfe et al., 2005). Additionally, searching for several targets simultaneously reduces search performance: this is known as the dual-target cost (DTC: Menneer et al., 2007). The interaction between the DTC and prevalence effect was investigated in a single study by presenting one target in dual-target search at a higher level of prevalence than the other target (Target A: 45% Prevalence; Target B: 5% Prevalence). An overall DTC was found for both RTs and response accuracy. Furthermore, there was an effect of target prevalence in dual-target search, suggesting that, when one target is presented at a higher level of prevalence than the other, both the dual-target cost and the prevalence effect contribute to decrements in performance. The implications for airport X-ray screening are discussed. Copyright 2010 Elsevier B.V. All rights reserved.

Dithiocarbamate Self-Assembled Monolayers as Efficient Surface Modifiers for Low Work Function Noble Metals

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

Meyer, Dominik; Schäfer, Tobias; Schulz, Philip

2016-09-06

Tuning the work function of the electrode is one of the crucial steps to improve charge extraction in organic electronic devices. Here, we show that N,N-dialkyl dithiocarbamates (DTC) can be effectively employed to produce low work function noble metal electrodes. Work functions between 3.1 and 3.5 eV are observed for all metals investigated (Cu, Ag, and Au). Ultraviolet photoemission spectroscopy (UPS) reveals a maximum decrease in work function by 2.1 eV as compared to the bare metal surface. Electronic structure calculations elucidate how the complex interplay between intrinsic dipoles and dipoles induced by bond formation generates such large work functionmore » shifts. Subsequently, we quantify the improvement in contact resistance of organic thin film transistor devices with DTC coated source and drain electrodes. These findings demonstrate that DTC molecules can be employed as universal surface modifiers to produce stable electrodes for electron injection in high performance hybrid organic optoelectronics.« less

Retrospective imaging study on the diagnosis of pathological false positive iodine-131 scans in patients with thyroid cancer.

PubMed

Jia, Qiang; Meng, Zhaowei; Tan, Jian; Zhang, Guizhi; He, Yajing; Sun, Haoran; Yu, Chunshui; Li, Dong; Zheng, Wei; Wang, Renfei; Wang, Shen; Li, Xue; Zhang, Jianping; Hu, Tianpeng; Liu, N A; Upadhyaya, Arun

2015-11-01

Iodine-131 (I-131) therapy and post-therapy I-131 scanning are essential in the management of differentiated thyroid cancer (DTC). However, pathological false positive I-131 scans can lead to misdiagnosis and inappropriate I-131 treatment. This retrospective study aimed to investigate the best imaging modality for the diagnosis of pathological false positive I-131 scans in a DTC patient cohort, and to determine its incidence. DTC patient data archived from January 2008 to January 2010 was retrieved. Post-therapeutic I-131 scans were conducted and interpreted. The imaging modalities of magnetic resonance imaging (MRI), computed tomography and ultrasonography were applied and compared to check all suspected lesions. Biopsy or needle aspiration was conducted for patients who consented to the acquisition of histopathological confirmation. Data for 156 DTC patients were retrieved. Only 6 cases of pathological false-positives were found among these (incidence, 3.85%), which included 3 cases of thymic hyperplasia in the mediastinum, 1 case of pleomorphic adenoma in the parapharyngeal space and 1 case of thyroglossal duct cyst in the neck. MRI was demonstrated as the best imaging modality for diagnosis due to its superior soft tissue resolution. However, no imaging modality was able to identify the abdominal false positive-lesions observed in 2 cases, one of whom also had thymic hyperplasia. In conclusion, pathological false positive I-131 scans occurred with an incidence of 3.85%. MRI was the best imaging modality for diagnosing these pathological false-positives.

Impact of direct-to-consumer advertising for hereditary breast cancer testing on genetic services at a managed care organization: a naturally-occurring experiment.

PubMed

Mouchawar, Judy; Hensley-Alford, Sharon; Laurion, Suzanne; Ellis, Jennifer; Kulchak-Rahm, Alanna; Finucane, Melissa L; Meenan, Richard; Axell, Lisen; Pollack, Rebecca; Ritzwoller, Debra

2005-03-01

To describe the impact of Myriad Genetics, Inc.'s direct-to-consumer advertising (DTC-ad) campaign on cancer genetic services within two Managed Care Organizations, Kaiser Permanente Colorado (KPCO), Denver, Colorado, where the ad campaign occurred, and Henry Ford Health System (HFHS), Detroit, Michigan, where there were no advertisements. The main outcome measures were the changes in number and pretest mutation probability of referrals approved for cancer genetic services at KPCO and HFHS during the campaign versus the year prior, and mutation probability of those undergoing testing. At KPCO, referrals increased 244% during the DTC-ad compared to the same time period a year earlier (P value<0.001). The proportion of referrals at high pretest probability of a mutation (10% or greater) dropped from 69% the previous year to 48% during the campaign (P value<0.001). There was no significant change in pretest mutation probability among women who underwent testing between the two time periods. HFHS reported no significant change between the two time periods for numbers or mutation probability of referrals, or for mutation probability of women tested. The DTC-ad caused significant increase in demand for cancer genetic services. In the face of potential future DTC-ad for inherited cancer risk, providers and payers need to consider the delivery of genetic services and genetic education for persons of all risk levels.

Health literacy knowledge among direct-to-consumer pharmaceutical advertising professionals.

PubMed

Mackert, Michael

2011-09-01

While direct-to-consumer (DTC) prescription drug advertising has been the subject of ongoing debate, to this point the perspective of the advertising professionals engaged in creating these ads has been absent from the discussion. This study, consisting of in-depth interviews with advertising professionals (N = 22), was an initial investigation focused on these individuals. The primary purpose of this study was to explore advertising professionals' understanding of health literacy-consumers' ability to obtain, process, and act on health information; with that context in place, participants' views on the role of DTC advertising, industry regulations, and the future of the industry were also investigated. While some participants knew nothing about health literacy or had a relatively simple conceptualization (e.g., grade level of written materials), others exhibited more nuanced understanding of health literacy (e.g., the need to pair relevant images with text to enhance understanding). Participants spoke of the potential public health benefit of DTC advertising in educating consumers about health issues, but were realistic that such efforts on the part of pharmaceutical companies were driven primarily by business concerns-educational messages need to be tied directly to an advertised medication and its benefits. These professionals spoke of industry regulations as presenting additional barriers to effective communication and suggested that industry trends toward more niche products will necessitate more patient education about less well-known health issues. Directions for future research are considered, as more investigation of this understudied group is necessary to enrich the DTC prescription drug advertising debate.

Changes in step-width during dual-task walking predicts falls.

PubMed

Nordin, E; Moe-Nilssen, R; Ramnemark, A; Lundin-Olsson, L

2010-05-01

The aim was to evaluate whether gait pattern changes between single- and dual-task conditions were associated with risk of falling in older people. Dual-task cost (DTC) of 230 community living, physically independent people, 75 years or older, was determined with an electronic walkway. Participants were followed up each month for 1 year to record falls. Mean and variability measures of gait characteristics for 5 dual-task conditions were compared to single-task walking for each participant. Almost half (48%) of the participants fell at least once during follow-up. Risk of falling increased in individuals where DTC for performing a subtraction task demonstrated change in mean step-width compared to single-task walking. Risk of falling decreased in individuals where DTC for carrying a cup and saucer demonstrated change compared to single-task walking in mean step-width, mean step-time, and step-length variability. Degree of change in gait characteristics related to a change in risk of falling differed between measures. Prognostic guidance for fall risk was found for the above DTCs in mean step-width with a negative likelihood ratio of 0.5 and a positive likelihood ratio of 2.3, respectively. Findings suggest that changes in step-width, step-time, and step-length with dual tasking may be related to future risk of falling. Depending on the nature of the second task, DTC may indicate either an increased risk of falling, or a protective strategy to avoid falling. Copyright 2010. Published by Elsevier B.V.

Prognostic indicators of outcomes in patients with lung metastases from differentiated thyroid carcinoma during long-term follow-up.

PubMed

Sohn, Seo Young; Kim, Hye In; Kim, Young Nam; Kim, Tae Hyuk; Kim, Sun Wook; Chung, Jae Hoon

2018-02-01

Distant metastases, although uncommon, represent maximum disease-related mortality in differentiated thyroid carcinoma (DTC). Lungs are the most frequent sites of metastases. We aimed to evaluate long-term outcomes and identify prognostic factors in metastatic DTC limited to the lungs. This retrospective study included 89 patients with DTC and metastases limited to the lungs, who were treated between 1996 and 2012 at Samsung Medical Center. Progression-free survival (PFS) and cancer-specific survival (CSS) rates were evaluated according to clinicopathologic factors. Cox regression analysis was used to identify independent factors associated with structural progressive disease (PD) and cancer-specific death. With a median follow-up of 84 months, the 5- and 10-year CSS rates were 78% and 73%, respectively. Older age at diagnosis (≥55 years), radioactive iodine (RAI) nonavidity, preoperative or late diagnosis of metastasis and macro-nodular metastasis (≥1 cm) were predictive of decreased PFS and CSS. Multivariate analysis identified older age (P = .002), RAI nonavidity (P = .045) and preoperative (P = .030) or late diagnosis (P = .026) as independent predictors of structural PD. RAI avidity was also independent predictor of cancer-specific death (P = .025). Patients with DTC and metastatic disease limited to the lungs had favourable long-term outcomes. Age, RAI avidity and timing of metastasis were found to be major factors for predicting prognosis. © 2017 John Wiley & Sons Ltd.

Shape memory alloy wire for self-sensing servo actuation

NASA Astrophysics Data System (ADS)

Josephine Selvarani Ruth, D.; Dhanalakshmi, K.

2017-01-01

This paper reports on the development of a straightforward approach to realise self-sensing shape memory alloy (SMA) wire actuated control. A differential electrical resistance measurement circuit (the sensorless signal conditioning (SSC) circuit) is designed; this sensing signal is directly used as the feedback for control. Antagonistic SMA wire actuators designed for servo actuation is realized in self-sensing actuation (SSA) mode for direct control with the differential electrical resistance feedback. The self-sensing scheme is established on a 1-DOF manipulator with the discrete time sliding mode controls which demonstrates good control performance, whatever be the disturbance and loading conditions. The uniqueness of this work is the design of the generic electronic SSC circuit for SMA actuated system, for measurement and control. With a concern to the implementation of self-sensing technique in SMA, this scheme retains the systematic control architecture by using the sensing signal (self-sensed, electrical resistance corresponding to the system position) for feedback, without requiring any processing as that of the methods adopted and reported previously for SSA techniques of SMA.

The educational potential of direct-to-consumer prescription drug advertising.

PubMed

Kaphingst, Kimberly A; DeJong, William

2004-01-01

Food and Drug Administration (FDA) regulations for direct-to-consumer (DTC) prescription drug advertising allow broadcast advertisements with incomplete risk information if the ads refer consumers to physicians, pharmacists, and supplemental information sources. New research reveals several problems with both television advertisements and supplemental text materials that might compromise their ability to meet the FDA's requirement for "fair balance" in the presentation of risks and benefits. In response, we make several recommendations to improve the educational quality of DTC advertising, which can be implemented through either voluntary agreements or revised FDA regulations.

Sensorless FOC Performance Improved with On-Line Speed and Rotor Resistance Estimator Based on an Artificial Neural Network for an Induction Motor Drive

PubMed Central

Gutierrez-Villalobos, Jose M.; Rodriguez-Resendiz, Juvenal; Rivas-Araiza, Edgar A.; Martínez-Hernández, Moisés A.

2015-01-01

Three-phase induction motor drive requires high accuracy in high performance processes in industrial applications. Field oriented control, which is one of the most employed control schemes for induction motors, bases its function on the electrical parameter estimation coming from the motor. These parameters make an electrical machine driver work improperly, since these electrical parameter values change at low speeds, temperature changes, and especially with load and duty changes. The focus of this paper is the real-time and on-line electrical parameters with a CMAC-ADALINE block added in the standard FOC scheme to improve the IM driver performance and endure the driver and the induction motor lifetime. Two kinds of neural network structures are used; one to estimate rotor speed and the other one to estimate rotor resistance of an induction motor. PMID:26131677

Sensorless FOC Performance Improved with On-Line Speed and Rotor Resistance Estimator Based on an Artificial Neural Network for an Induction Motor Drive.

PubMed

Gutierrez-Villalobos, Jose M; Rodriguez-Resendiz, Juvenal; Rivas-Araiza, Edgar A; Martínez-Hernández, Moisés A

2015-06-29

Three-phase induction motor drive requires high accuracy in high performance processes in industrial applications. Field oriented control, which is one of the most employed control schemes for induction motors, bases its function on the electrical parameter estimation coming from the motor. These parameters make an electrical machine driver work improperly, since these electrical parameter values change at low speeds, temperature changes, and especially with load and duty changes. The focus of this paper is the real-time and on-line electrical parameters with a CMAC-ADALINE block added in the standard FOC scheme to improve the IM driver performance and endure the driver and the induction motor lifetime. Two kinds of neural network structures are used; one to estimate rotor speed and the other one to estimate rotor resistance of an induction motor.

Acute and chronic hypothyroidism are associated with similar left ventricular diastolic dysfunction relative to the euthyroid state: results of doppler echocardiographic comparisons.

PubMed

Gauna, A; Messuti, H; Papadopulos, G; Benchuga, G; Viale, F; Marlowe, R J; Silva Croome, M C

2011-10-01

How the duration of hypothyroidism affects left ventricular diastolic function is not well-characterized. We sought to compare left ventricular diastolic function in acutely vs chronically hypothyroid patients vs euthyroid controls, and within individuals while on vs off T4. We prospectively performed such comparisons measuring pulsed-wave and color M-mode Doppler echocardiographic variables: early or late mitral peak velocities (E wave or A wave, respectively), E wave/A wave ratio, E wave deceleration time, isovolumic relaxation time (IVRT), mitral flow propagation velocity (Vp), E wave/Vp ratio. Subjects comprised the acute HYPO group, 10 patients undergoing T4 withdrawal ≥ 6 months post-primary treatment for differentiated thyroid cancer (DTC); the chronic HYPO group, 23 treatment-naïve Hashimoto thyroiditis patients; and 21 healthy euthyroid controls. Subjects were adults aged ≤ 60 yr, predominantly female, with sinus rhythm; exclusion criteria were cardiovascular or thyroid disorder besides DTC (Hashimoto thyroiditis) in acute (chronic) HYPO patients or medication (besides thyroid hormone) affecting cardiac or thyroid function. Mean IVRT was significantly delayed and mean Vp, significantly slowed in both HYPO groups vs controls (p<0.0005), but did not differ between HYPO groups. These variables also were significantly impaired (p<0.05) within individuals when off vs on T4 (no.=8 acute, 10 chronic HYPO patients). Both HYPO groups had elevated mean E wave/Vp ratios vs controls, but the elevation reached significance (p<0.05) only in the larger chronic HYPO group. Left ventricular diastolic dysfunction is largely similar in acutely or chronically hypothyroid patients off T4 vs healthy controls or the same patients on T4.

Germline Polymorphisms of the VEGF Pathway Predict Recurrence in Nonadvanced Differentiated Thyroid Cancer.

PubMed

Marotta, Vincenzo; Sciammarella, Concetta; Capasso, Mario; Testori, Alessandro; Pivonello, Claudia; Chiofalo, Maria Grazia; Gambardella, Claudio; Grasso, Marica; Antonino, Antonio; Annunziata, Annamaria; Macchia, Paolo Emidio; Pivonello, Rosario; Santini, Luigi; Botti, Gerardo; Losito, Simona; Pezzullo, Luciano; Colao, Annamaria; Faggiano, Antongiulio

2017-02-01

Tumor angiogenesis is determined by host genetic background rather than environment. Germline single nucleotide polymorphisms (SNPs) of the vascular endothelial growth factor (VEGF) pathway have demonstrated prognostic value in different tumors. Our main objective was to test the prognostic value of germline SNPs of the VEGF pathway in nonadvanced differentiated thyroid cancer (DTC). Secondarily, we sought to correlate analyzed SNPs with microvessel density (MVD). Multicenter, retrospective, observational study. Four referral centers. Blood samples were obtained from consecutive DTC patients. Genotyping was performed according to the TaqMan protocol, including 4 VEGF-A (-2578C>A, -460T>C, +405G>C, and +936C>T) and 2 VEGFR-2 (+1192 C>T and +1719 T>A) SNPs. MVD was estimated by means of CD34 staining. Rate of recurrent structural disease/disease-free survival (DFS). Difference in MVD between tumors from patients with different genotype. Two hundred four patients with stage I-II DTC (mean follow-up, 73 ± 64 months) and 240 patients with low- to intermediate-risk DTC (mean follow-up, 70 ± 60 months) were enrolled. Two "risk" genotypes were identified by combining VEGF-A SNPs -2578 C>A, -460 T>C, and +405 G>C. The ACG homozygous genotype was protective in both stage I-II (odds ratio [OR], 0.08; 95% confidence interval [CI], 0.01 to 1.43; P = 0.018) and low- to intermediate-risk (OR, 0.14; 95% CI, 0.01 to 1.13; P = 0.035) patients. The CTG homozygous genotype was significantly associated with recurrence in stage I-II (OR, 5.47; 95% CI, 1.15 to 26.04; P = 0.018) and was slightly deleterious in low- to intermediate-risk (OR, 3.39; 95% CI, 0.8 to 14.33; P = 0.079) patients. MVD of primary tumors from patients harboring a protective genotype was significantly lower (median MVD, 76.5 ± 12.7 and 86.7 ± 27.9, respectively; P = 0.024). Analysis of germline VEGF-A SNPs could empower a prognostic approach to DTC. Copyright © 2017 by the Endocrine Society

Direct-to-consumer promotion of prescription drugs. Economic implications for patients, payers and providers.

PubMed

Findlay, S D

2001-01-01

Spending on outpatient prescription drugs in the US is accelerating rapidly. Although numerous factors are driving this trend, attention has recently focused on the role played by the marketing, promotion and advertising of pharmaceuticals, in particular direct-to-consumer (DTC) advertising. In 1997, the US Food and Drug Administration (FDA) issued a 'guidance' on such mass media promotion. The guidance altered existing FDA rules and effectively permitted pharmaceutical companies to promote prescription drugs on television and radio without giving detailed or even summary information on indications, efficacy or potential adverse effects. Since then, television commercials, in particular, and print advertisements in consumer magazines and newspapers have proliferated rapidly. Pharmaceutical companies spent $US1.8 billion on DTC advertising in 1999, a 40% increase over 1998. This spending in 1999 was heavily concentrated on about 50 drugs. Evidence is growing that DTC promotion of prescription drugs is: (i) alerting consumers to the existence of new drugs and the conditions they treat; (ii) increasing consumer demand for many drugs; (iii) contributing increasingly to the recent sharp increase in the number of prescriptions being dispensed; (iv) raising sales revenues; and, thus, (v) contributing to the higher pharmaceutical costs of health insurers, government and consumers. The public policy issues surrounding DTC advertisements centre on the following questions: (i) are the advertisements leading to the inappropriate clinical use of some drugs? (ii) are the advertisements inducing both consumers and physicians to choose more costly new brand-name drugs over less expensive, but equally effective, older brand or generic drugs? (iii) do television advertisements for prescription drugs contain a balanced amount of information on benefits versus potential adverse effects? and (iv) will the revenue benefits generated by DTC advertising cause pharmaceutical companies to focus more on developing products to treat prevalent but not life-threatening conditions, such as baldness, sexual dysfunction or memory loss? These questions are just beginning to be probed despite prescription drug spending, insurance coverage and payment policies having become major political issues in the US.

Nonanaplastic follicular cell-derived thyroid carcinoma: mitosis and necrosis in long-term follow-up.

PubMed

Skansing, Daniel Bräuner; Londero, Stefano Christian; Asschenfeldt, Pia; Larsen, Stine Rosenkilde; Godballe, Christian

2017-06-01

Nonanaplastic follicular cell-derived thyroid carcinoma (NAFCTC) includes differentiated- (DTC) and poorly differentiated thyroid carcinoma (PDTC). DTC has an excellent prognosis, while PDTC is situated between DTC and anaplastic carcinomas. Short-term studies suggest that PDTC patients diagnosed only on tumor necrosis and/or mitosis have a prognosis similar to those diagnosed according to the TURIN proposal. The purpose of this study was to evaluate prognosis for NAFCTC based on long-term follow-up illuminating the significance of tumor necrosis and mitosis. A cohort of 225 patients with NAFCTC was followed more than 20 years. Age, sex, distant metastasis, histology, tumor size, extrathyroidal invasion, lymph node metastasis, tumor necrosis and mitosis were examined as possible prognostic factors. Median follow-up time for patients alive was 28 years (range 20-43 years). Age, distant metastasis, extrathyroidal invasion, tumor size, tumor necrosis and mitosis were independent prognostic factors in multivariate analysis for overall survival (OS). In disease specific survival (DSS) age was not significant. Using only necrosis and/or mitosis as criteria for PDTC the 5-, 10- and 20-year OS for DTC was 87, 79 and 69%, respectively. In DSS it was 95, 92 and 90%. For PDTC the 5-, 10- and 20-year OS was 57, 40 and 25%, respectively. In DSS it was 71, 55 and 48%. Tumor necrosis and mitosis are highly significant prognostic indicators in analysis of long time survival of nonanaplastic follicular cell-derived thyroid carcinoma indicating that a simplification of the actually used criteria for poorly differentiated carcinomas may be justified.

High level of distress in long-term survivors of thyroid carcinoma: results of rapid screening using the distress thermometer.

PubMed

Roerink, Sean H P P; de Ridder, Mischa; Prins, Judith; Huijbers, Angelique; de Wilt, Hans J H; Marres, Henri; Repping-Wuts, Han; Stikkelbroeck, Nike M M L; Timmers, Henri J; Hermus, Ad R M M; Netea-Maier, Romana T

2013-01-01

Cancer patients are at increased risk for distress. The Distress Thermometer (DT) and problem list (PL) are short-tools validated and recommended for distress screening in cancer patients. To investigate the level of distress and problems experienced by survivors of differentiated non-medullary thyroid carcinoma (DTC), using the DT and PL and whether this correlates with clinical and demographical variables. All 205 DTC patients, under follow-up at the outpatient clinic of our university hospital, were asked to fill in the DT and PL, hospital anxiety and depression scale (HADS), illness cognition questionnaire (ICQ) and an ad hoc questionnaire. Receiver Operator Characteristic analysis (ROC) was used to establish the optimal DT cut-off score according to HADS. Correlations of questionnaires scores with data on diagnosis, treatment and follow-up collected from medical records were analyzed. Of the 159 respondents, 145 agreed to participate [118 in remission, median follow-up 7.2 years (range 3 months-41 years)]. Of these, 34.3% rated their distress score ≥5, indicating clinically relevant distress according to ROC analysis. Patients reported physical (86%) over emotional problems (76%) as sources of distress. DT scores correlated with HADS scores and ICQ subscales. No significant correlations were found between DT scores and clinical or demographical characteristics except for employment status. Prevalence of distress is high among patients with DTC even after long-term remission and cannot be predicted by clinical and demographical characteristics. DT and PL are useful screening instruments for distress in DTC patients and could easily be incorporated into daily practice.

Anaplastic transformation of follicular thyroid carcinoma in a metastatic skeletal lesion presenting with paraneoplastic leukocytosis.

PubMed

Nakayama, Robert; Horiuchi, Keisuke; Susa, Michiro; Hosaka, Seiichi; Hayashi, Yuichiro; Kameyama, Kaori; Suzuki, Yoshihisa; Yabe, Hiroo; Toyama, Yoshiaki; Morioka, Hideo

2012-02-01

Anaplastic transformation of differentiated thyroid carcinoma (DTC) is a rare event with a poor clinical outcome. It usually occurs in the primary site or in regional lymph nodes, but rarely in distant metastatic lesions. A 55-year-old woman with persistent pain in the left hip joint visited our hospital. She had a history of DTC that had been surgically removed 12 years earlier. Clinical images showed a tumorous mass in the left pelvis, indicative of bone metastasis. The patient underwent surgery to remove the tumor and remained stable until local recurrence was found 5 weeks after the surgery. The patient subsequently underwent radiation therapy; however, she died of respiratory failure due to lung metastases 2 months after the surgery for the recurrent lesion. The surgical specimens were diagnosed as anaplastic thyroid carcinoma, indicating that anaplastic transformation of thyroid follicular carcinoma occurred in the metastatic skeletal lesion. In addition, the patient had an unusually high white blood cell count throughout the course. Based on elevated serum granulocyte colony-stimulating factor (G-CSF) levels and positive immunostaining for G-CSF in the surgical specimens, the patient was diagnosed with paraneoplastic leukocytosis. To our knowledge, this is the first case of anaplastic transformation of DTC arising in a metastatic bone lesion described in the literature. In addition, the present case also exhibited severe leukocytosis accompanied by elevated serum G-CSF levels. Clinicians should be aware of the possibility of this occurring in their patients with DTC, as this development calls for a rapid change from observational follow-up to aggressive treatment.

Stabilization of high-valent Fe(IV)S6-cores by dithiocarbamate(1-) and 1,2-dithiolate(2-) ligands in octahedral [Fe(IV)(Et2dtc)(3-n)(mnt)(n)]((n-1)-) complexes (n=0, 1, 2, 3): a spectroscopic and density functional theory computational study.

PubMed

Milsmann, Carsten; Sproules, Stephen; Bill, Eckhard; Weyhermüller, Thomas; George, Serena DeBeer; Wieghardt, Karl

2010-03-22

A detailed spectroscopic and quantum chemical analysis is presented to elucidate the electronic structures of the octahedral complexes [Fe(Et(2)dtc)(3-n)(mnt)(n)](n-) (1-4, n=3, 2, 1, 0) and their one-electron oxidized analogues [Fe(Et(2)dtc)(3-n)(mnt)(n)]((n-1)-) (1(ox)-4(ox)); (mnt)(2-) represents maleonitriledithiolate(2-) and (Et(2)dtc)(1-) is the diethyldithiocarbamato(1-) ligand. By using X-ray crystallography, Mössbauer spectroscopy, and Fe and S K-edge X-ray absorption spectroscopy (XAS) it is convincingly shown that, in contrast to our previous studies on [Fe(cyclam)(mnt)](1+) (cyclam=1,4,8,11-tetraazacyclotetradecane), the oxidation of 1-4 is metal-centered yielding the genuine Fe(IV) complexes 1(ox)-4(ox). For the latter complexes, a spin ground state of S=1 has been established by magnetic susceptibility measurements, which indicates a low-spin d(4) configuration. DFT calculations at the B3LYP level support this electronic structure and exclude the presence of a ligand pi radical coordinated to an intermediate-spin ferric ion. Mössbauer parameters and XAS spectra have been calculated to calibrate our computational results against the experiment. Finally, a simple ligand-field approach is presented to correlate the structural features obtained from X-ray crystallography (100 K) with the spectroscopic data.

A Qualitative and Quantitative Comparative Analysis of Commercial and Independent Online Information for Hip Surgery: A Bias in Online Information Targeting Patients?

PubMed

Kelly, Martin J; Feeley, Iain H; O'Byrne, John M

2016-10-01

Direct to consumer (DTC) advertising, targeting the public over the physician, is an increasingly pervasive presence in medical clinics. It is trending toward a format of online interaction rather than that of traditional print and television advertising. We analyze patient-focused Web pages from the top 5 companies supplying prostheses for total hip arthroplasties, comparing them to the top 10 independent medical websites. Quantitative comparison is performed using the Journal of American Medical Association benchmark and DISCERN criteria, and for comparative readability, we use the Flesch-Kincaid grade level, the Flesch reading ease, and the Gunning fog index. Content is analyzed for information on type of surgery and surgical approach. There is a statistically significant difference between the independent and DTC websites in both the mean DISCERN score (independent 74.6, standard deviation [SD] = 4.77; DTC 32.2, SD = 10.28; P = .0022) and the mean Journal of American Medical Association score (Independent 3.45, SD = 0.49; DTC 1.9, SD = 0.74; P = .004). The difference between the readability scores is not statistically significantly. The commercial content is found to be heavily biased in favor of the direct anterior approach and minimally invasive surgical techniques. We demonstrate that the quality of information on commercial websites is inferior to that of the independent sites. The advocacy of surgical approaches by industry to the patient group is a concern. This study underlines the importance of future regulation of commercial patient education Web pages. Copyright © 2016 Elsevier Inc. All rights reserved.

Evaluating the educational content of direct-to-consumer fulfillment materials.

PubMed

Chao, Blenda A

2005-03-15

The educational content of direct-to-consumer (DTC) fulfillment materials was evaluated. A list of prescription drug products advertised to consumers via broadcast media from August 1997 through April 20, 2002, was obtained from the Food and Drug Administration (FDA). The prescription products were categorized by disease state on the basis of their FDA-approved indications. Eight disease states were selected for analysis purposes and included acne, allergic rhinitis, depression, diabetes, hypercholesterolemia, migraine, overactive bladder, and osteoporosis. A total of 31 products were advertised directly to consumers for the eight targeted disease states, 26 of which met the inclusion criteria. The educational content of the advertisements for these 26 products was assessed by analyzing the materials' consistency, instructiveness, and consumer orientation. Two of the 26 materials analyzed contained claims that potentially broadened a drug's indication from that listed in the FDA-approved labeling. The majority of materials listed the condition name (92%), symptom information (77%), the drug's mechanism of action (65%), the drug's time to onset of action (54%), and supportive behaviors (62%). Twenty of 24 DTC fulfillment materials (83%) were not written at the reading level of eighth grade or lower. Fifteen of the 26 mailings contained educational diagrams, 52% of which met the criteria for necessity, and a greater percentage met the criteria for suitability (90%), familiarity (86%), overall layout (88%), single concept (86%), and lack of distracting elements (100%). DTC fulfillment materials appear to have more educational content than DTC print advertisements but are still overwhelmingly deficient in meeting the recommended sixth to eighth-grade reading level.

Differences in serum thyroglobulin measurements by 3 commercial immunoradiometric assay kits and laboratory standardization using Certified Reference Material 457 (CRM-457).

PubMed

Lee, Ji In; Kim, Ji Young; Choi, Joon Young; Kim, Hee Kyung; Jang, Hye Won; Hur, Kyu Yeon; Kim, Jae Hyeon; Kim, Kwang-Won; Chung, Jae Hoon; Kim, Sun Wook

2010-09-01

Serum thyroglobulin (Tg) is essential in the follow-up of patients with differentiated thyroid carcinoma (DTC). However, interchangeability and standardization between Tg assays have not yet been achieved, even with the development of an international Tg standard (Certified Reference Material 457 [CRM-457]). Serum Tg from 30 DTC patients and serially diluted CRM-457 were measured using 3 different immunoradiometric assays (IRMA-1, IRMA-2, IRMA-3). The intraclass correlation coefficient (ICC) method was used to describe the concordance of each IRMA to CRM-457. The serum Tg measured by 3 different IRMAs correlated well (r > .85, p < .0001), but clinically relevant discrepancies were found in 13.3% of patients. IRMA-3, which claims to be standardized to CRM-457, showed the best ICC (p(1) = .98) for the CRM-457. Hospitals caring for patients with DTC should either set their own cutoffs for IRMAs for Tg based on their patient pools, or adopt IRMAs standardized to CRM-457 and calibrate their laboratory using CRM-457.

Are the kids really all right? Direct-to-consumer genetic testing in children: are company policies clashing with professional norms?

PubMed

Howard, Heidi Carmen; Avard, Denise; Borry, Pascal

2011-11-01

The genetic testing of minors within the direct-to-consumer (DTC) genetic testing (GT) context has been given relatively little attention. The issue of testing healthy children for diseases that would only develop in adulthood raises many important ethical, legal and social issues. As genetic testing is now available outside of the traditional health care system, often without even the intermediate of a health care professional, we surveyed 37 DTC GT companies regarding their policies for testing in children. Although the response rate is relatively low (35%, 13/37), our findings reveal that a clear majority of companies do perform genetic testing in minors. As such, companies testing for adult onset diseases are acting in contradiction of established professional guidelines, which state, among others, that, for predictive genetic testing, the availability of therapeutic or preventive measures is necessary for testing to be performed in asymptomatic minors. The community of stakeholders in children's health care and genetic testing should, therefore, decide which standards need to be upheld by DTC GT companies and ensure that these are met.

Field of Genes: An Investigation of Sports-Related Genetic Testing

PubMed Central

Wagner, Jennifer K.; Royal, Charmaine D.

2012-01-01

Sports-related genetic testing is a sector of the diverse direct-to-consumer (DTC) industry that has not yet been examined thoroughly by academic scholars. A systematic search was used to identify companies in this sector and content analysis of online information was performed. More than a dozen companies were identified. Marketing practices observed generally did not target parents for child testing, and marketing images were mild compared to images used in popular media. Information was provided at a high reading level (industry-wide Flesh-Kincaid Grade Levels > 11). While ~75% of companies provide privacy policies and terms of service prior to purchase and ~40% provide scientific citations for their tests, <25% reported using American Association of Blood Banks (AABB) accredited or the Clinical Laboratory Improvement Amendments of 1988 (CLIA) certified laboratories. Tests ranged considerably in price (~$100–$1,100) and were substantively diverse. These findings highlight the need to appreciate nuances and avoid broad generalizations of this and other DTC sectors. Utilization of consumer protections available for e-commerce generally may adequately protect DTC genetics consumers without new federal legislation or regulation. PMID:25562204

Thyroid Carcinoma

PubMed

Ahmed, Najeeb; Niyaz, Kashif; Borakati, Aditya; Marafi, Fahad; Birk, Rubinder; Usmani, Sharjeel

2018-02-26

Differentiated thyroid cancer (DTC) has a good prognosis overall; however, lifelong follow-up is required for many cases. Radioiodine planar imaging with iodine-123 (I-123) or radioiodine-131 (I-131) remains the standard in the follow-up after initial surgery and ablation of residual thyroid tissue using I-131 therapy. Radioiodine imaging is also used in risk-stratifying and for staging of thyroid cancer, and in long-term follow-up. Unfortunately, the lack of anatomical detail on planar gamma camera imaging and superimposition of areas presenting with increased radioiodine uptake can make accurate diagnosis and localization of radioiodine-avid metastatic disease challenging, leading to false positive results and potentially to over-treatment of patients. Hybrid SPECT/CT allows precise anatomical localization and superior characterization of foci of increased tracer uptake when compared to planar imaging. This, in turn, allows the differentiation of pathological and physiological uptake, increasing the accuracy of image interpretation and ultimately improving the accuracy of DTC staging and subsequent patient management. In this review, we look at the unique and emerging role that SPECT/CT plays in the management of DTC, illustrated by examples from our own clinical practice. Creative Commons Attribution License

Myths, misconceptions and myopia: searching for clarity in the debate about the regulation of consumer genetics.

PubMed

Hogarth, S

2010-01-01

The new wave of companies offering genome scans direct-to-consumer (DTC) has prompted commentary from scientists, clinicians, bioethicists and those interested in the ethical, legal and social issues arising from genomics. It has thus brought a far wider range of actors into a longstanding debate about the regulation of genetic tests. However, some of the recent discussion is characterised by misunderstanding of the regulatory landscape, a failure to grasp the lessons of the past and lack of clarity of thought. In this commentary I challenge a series of myths and misconceptions which plague current academic and policy discussion: the conflation of regulation and proscription; the failure to recognise that DTC companies are gatekeepers; the assumption that requiring a medical intermediary for testing is paternalistic; the belief that online services cannot be regulated; the presumption that we must avoid genetic exceptionalism; the idea that policy is lagging behind science or that it is too soon to act; and finally, the view that DTC genetics is a reality we have to adapt to.

Myths, Misconceptions and Myopia: Searching for Clarity in the Debate about the Regulation of Consumer Genetics

PubMed Central

Hogarth, S.

2010-01-01

The new wave of companies offering genome scans direct-to-consumer (DTC) has prompted commentary from scientists, clinicians, bioethicists and those interested in the ethical, legal and social issues arising from genomics. It has thus brought a far wider range of actors into a longstanding debate about the regulation of genetic tests. However, some of the recent discussion is characterised by misunderstanding of the regulatory landscape, a failure to grasp the lessons of the past and lack of clarity of thought. In this commentary I challenge a series of myths and misconceptions which plague current academic and policy discussion: the conflation of regulation and proscription; the failure to recognise that DTC companies are gatekeepers; the assumption that requiring a medical intermediary for testing is paternalistic; the belief that online services cannot be regulated; the presumption that we must avoid genetic exceptionalism; the idea that policy is lagging behind science or that it is too soon to act; and finally, the view that DTC genetics is a reality we have to adapt to. PMID:20588076

Bend it like Beckham! The Ethics of Genetically Testing Children for Athletic Potential

PubMed Central

Camporesi, Silvia

2016-01-01

The recent boom of direct-to-consumer (DTC) genetic tests, aimed at measuring children’s athletic potential, is the latest wave in the ‘pre-professionalization’ of children that has characterized, especially but not exclusively, the USA in the last 15 years or so. In this paper, I analyse the use of DTC genetic tests, sometimes coupled with more traditional methods of ‘talent scouting’, to assess a child’s predisposition to athletic performance. I first discuss the scientific evidence at the basis of these tests, and the parental decision in terms of education, and of investing in the children’s future, taken on the basis of the results of the tests. I then discuss how these parental practices impact on the children’s right to an open future, and on their developing sense of autonomy. I also consider the meaning and role of sports in childhood, and conclude that the use of DTC genetic tests to measure children’s athletic potential should be seen as a ‘wake up’ call for other problematic parental attitudes aimed at scouting and developing children’s talent. PMID:27996058

[Rational and emotional appeals in prescription drug advertising: study of a weight loss drug].

PubMed

Huertas, Melby Karina Zuniga; Campomar, Marcos Cortez

2008-04-01

The Direct-to-Consumer (DTC) advertising of medicines encourages people to ask doctors for certain medicines and treatments that require medical prescription. In order to enhance their persuasive power, advertising models recommend matching the appeals (rational and/or emotional) to the consumer's attitude (cognitive and/ or affective) towards the product. This recommendation leads to controversies in the context of DTC advertising. Emotional appeals, although frequently used, would always be inadequate in that kind of advertising. In absence of empiric evidence of the consumer's perspective, a descriptive research was undertaken with the objective of evaluating: i) the components of the attitude toward medicines; ii) attitude and behavioral intentions in response to DTC ads (one appealing to reason and the other appealing to emotion). A prescription weight loss drug was chosen for this purpose. The results revealed a predominantly cognitive attitude toward the product and an attitude and behavioral intention more favorable to the rational ad. Negative cognition about the product played an outstanding role canceling the persuasive power of emotional appeals.

CCDC-55 is required for larval development and distal tip cell migration in Caenorhabditis elegans.

PubMed

Kovacevic, Ismar; Ho, Richard; Cram, Erin J

2012-01-01

The Caenorhabditis elegans distal tip cells (DTCs) are an in vivo model for the study of developmentally regulated cell migration. In this study, we characterize a novel role for CCDC-55, a conserved coiled-coil domain containing protein, in DTC migration and larval development in C. elegans. Although animals homozygous for a probable null allele, ccdc-55(ok2851), display an early larval arrest, RNAi depletion experiments allow the analysis of later phenotypes and suggest that CCDC-55 is needed within the DTC for migration to cease at the end of larval morphogenesis. The ccdc-55 gene is found in an operon with rnf-121 and rnf-5, E3 ubiquitin ligases that target cell migration genes such as the β-integrin PAT-3. Genetic interaction studies using RNAi depletion and the deletion alleles rnf-121(ok848) and rnf-5(tm794) indicate that CCDC-55 and the RNF genes act at least partially in parallel to promote termination of cell migration in the adult DTC. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

CCDC-55 is required for larval development and distal tip cell migration in C. elegans

PubMed Central

Kovacevic, Ismar; Ho, Richard; Cram, Erin J.

2012-01-01

The C. elegans distal tip cells (DTCs) are an in vivo model for the study of developmentally regulated cell migration. In this study we characterize a novel role for CCDC-55, a conserved coiled-coil domain containing protein, in DTC migration and larval development in C. elegans. Although animals homozygous for a probable null allele, ccdc-55(ok2851), display an early larval arrest, RNAi depletion experiments allow the analysis of later phenotypes and suggest that CCDC-55 is needed within the DTC for migration to cease at the end of larval morphogenesis. The ccdc-55 gene is found in an operon with rnf-121 and rnf-5, E3 ubiquitin ligases that target cell migration genes such as the β-integrin PAT-3. Genetic interaction studies using RNAi depletion and the deletion alleles rnf-121(ok848) and rnf-5(tm794) indicate that CCDC-55 and the RNF genes act at least partially in parallel to promote termination of cell migration in the adult DTC. PMID:22285439

[Protective factors for anxiety and depression in thyroid cancer patients].

PubMed

Tagay, Sefik; Senf, Wolfgang; Schöpper, Nicole; Mewes, Ricarda; Bockisch, Andreas; Görges, Rainer

2007-01-01

Depression and anxiety are the most common mental symptoms in patients with thyroid cancer (DTC) and have an important influence on the quality of life. The aim of the current study was to identify protective factors of depression and anxiety in DTC patients. In a cross-sectional study 230 DTC patients were examined with Hospital Anxiety and Depression Scale (HADS-D), the Sense of Coherence Scale (SOC-13) and the Questionnaire of Social Support (F-SOZU). Depression correlated highly significantly with anxiety (r = .633, p = 0,001). Social support and sense of coherence correlated highly significantly negative with depression as well as with anxiety (both p < or = 0,001). Although still significant, the correlation between age and anxiety was lower (r = -.19; p < or = 0,005). The TSH level as an indicator of hypothyreodism did not correlate with depression or with anxiety on a significant statistical level. Furthermore, variables such as education, religiosity and elapsed time interval since initial diagnosis were not correlated with depression and anxiety. Our results support the thesis that low social support and low sense of coherence enhance vulnerability to depressive and anxiety symptoms.

Conflicting accountabilities: Doctor's dilemma in TB control in rural India.

PubMed

Fochsen, Grethe; Deshpande, Kirti; Ringsberg, Karin C; Thorson, Anna

2009-02-01

The aim of this study was to analyse how the implementation strategy of direct observed treatment short course (DOTS) has shaped and influenced patient-provider encounters in a district tuberculosis centre (DTC) in a rural district of India. Qualitative methods, combining observations and interviews, were carried out in a DTC focusing on the medical encounters between a TB doctor and his patients. The findings showed that the TB doctor seemed to be working with a dilemma, defined as conflicting accountabilities, in the medical encounters. In an organization perceived as inefficient and resource-constrained, the doctor struggled to find a balance between meeting the obligations of the DOTS programme and meeting the needs and expectations of the patients. Strategies to deal with these conflicting accountabilities were identified as limiting patients' involvement, struggling to maintain authority, and transferring responsibility. Professional involvement and patient participation were seen as part of a linked process in this study, and the importance of empowering doctors and health care workers who are implementing DOTS is emphasized. The development of DOTS guidelines needs to be based on the actual process of health care delivery, and staff empowering efforts should also include strengthening of public health care infrastructure.

The effect of qualifying language on perceptions of drug appeal, drug experience, and estimates of side-effect incidence in DTC advertising.

PubMed

Davis, Joel

2007-01-01

This study examined how the use of qualifying language in direct-to-consumer (DTC) pharmaceutical advertising affects consumers' perceptions of drug appeal, anticipated pleasantness of drug usage, and the expected incidence of side-effect occurrence. A sample of 669 individuals participated in a 2 x 8 complete factorial design. The design manipulated the number of side effects associated with drug use and the type of qualifying language used to describe the side effects. The eight experimental qualifying language cells represented one control condition (no qualifying language), three cells where each of three types of qualifying language were presented individually, and four cells where qualifying language was combined. The results indicate that qualifying language has a profound effect on drug perceptions, especially when used in combination. Drug appeal and the anticipated drug-using experience almost always were more positive in the presence of qualifying language. Qualifying language appears to exert its influence by causing individuals to reduce their estimate of the likelihood of experiencing individual side effects. Policy implications of the research, particularly for evaluation of "fair balance" and the reporting of side effects, are presented.

Examining the FDA's oversight of direct-to-consumer advertising.

PubMed

Gahart, Martin T; Duhamel, Louise M; Dievler, Anne; Price, Roseanne

2003-01-01

Our analysis examined the effects of the Food and Drug Administration's (FDA's) 1997 draft guidance regarding advertisements for prescription drugs broadcast directly to consumers. We found that although direct-to-consumer (DTC) advertising spending by pharmaceutical companies has increased, more than 80 percent of their promotional spending is directed to physicians. DTC advertising appears to increase the use of prescription drugs among consumers. The FDA's oversight has not prevented companies from making misleading claims in subsequent advertisements, and a recent policy change has lengthened the FDA's review process, raising the possibility that some misleading campaigns could run their course before review.

Consumers' preferences for the communication of risk information in drug advertising.

PubMed

Davis, Joel J

2007-01-01

Research was conducted to identify consumers' preferences regarding the form, content, and placement of drug side-effect information in direct-to-consumer (DTC) advertising. Specific questions explored preferences for the presence or absence of numeric information, the use of placebo and discontinuation groups as a context for understanding drug risk, the sequence in which side effects are presented, and the placement of side-effect statements on DTC Web sites. Consumers prefer detailed, readily accessible risk information--preferences that are a major departure from current advertiser practices and from what current and proposed Food and Drug Administration (FDA) regulations require.

“Better Not to Know?”: Justifiable Limits on the Right to Information in the Realm of DTC Genetic Testing. An Analysis of the European and Spanish Legal Framework.

PubMed

Martínez Otero, Juan María

2017-04-01

The rapid advance of genetics increases the availability in the market of different genetic tests, which can be acquired directly by consumers without the intermediation of a healthcare professional. Both the European and the Spanish legal framework have restricted the access to these direct-to-consumer (DTC) genetic tests on the grounds of different reasons, such as the protection of consumers or the preservation of public health. The present article discusses these legal restrictions under the light of the right to information.

The directed migration of gonadal distal tip cells in Caenorhabditis elegans requires NGAT-1, a ß1,4-N-acetylgalactosaminyltransferase enzyme

PubMed Central

Veyhl, Joseph; Dunn, Robert J.; Johnston, Wendy L.; Bennett, Alexa; Zhang, Lijia W.; Dennis, James W.; Schachter, Harry

2017-01-01

Glycoproteins such as growth factor receptors and extracellular matrix have well-known functions in development and cancer progression, however, the glycans at sites of modification are often heterogeneous molecular populations which makes their functional characterization challenging. Here we provide evidence for a specific, discrete, well-defined glycan modification and regulation of a stage-specific cell migration in Caenorhabditis elegans. We show that a chain-terminating, putative null mutation in the gene encoding a predicted β1,4-N-acetylgalactosaminyltransferase, named ngat-1, causes a maternally rescued temperature sensitive (ts) defect in the second phase of the three phase migration pattern of the posterior, but not the anterior, hermaphrodite Distal Tip Cell (DTC). An amino-terminal partial deletion of ngat-1 causes a similar but lower penetrance ts phenotype. The existence of multiple ts alleles with distinctly different molecular DNA lesions, neither of which is likely to encode a ts protein, indicates that NGAT-1 normally prevents innate temperature sensitivity for phase 2 DTC pathfinding. Temperature shift analyses indicate that the ts period for the ngat-1 mutant defect ends by the beginning of post-embryonic development–nearly 3 full larval stages prior to the defective phase 2 migration affected by ngat-1 mutations. NGAT-1 homologs generate glycan-terminal GalNAc-β1-4GlcNAc, referred to as LacdiNAc modifications, on glycoproteins and glycolipids. We also found that the absence of the GnT1/Mgat1 activity [UDP-N-acetyl-D-glucosamine:α-3-D-mannoside β-1,2-N-acetylglucosaminyltransferase 1 (encoded by C. elegans gly-12, gly-13, and gly-14 and homologous to vertebrate GnT1/Mgat1)], causes a similar spectrum of DTC phenotypes as ngat-1 mutations–primarily affecting posterior DTC phase 2 migration and preventing manifestation of the same innate ts period as ngat-1. GnT1/Mgat1 is a medial Golgi enzyme known to modify mannose residues and initiate N-glycan branching, an essential step in the biosynthesis of hybrid, paucimannose and complex-type N-glycans. Quadruple mutant animals bearing putative null mutations in ngat-1 and the three GnT genes (gly-12, gly-13, gly-14) were not enhanced for DTC migration defects, suggesting NGAT-1 and GnT1 act in the same pathway. These findings suggest that GnTI generates an N-glycan substrate for NGAT-1 modification, which is required at restrictive temperature (25°C) to prevent, stabilize, reverse or compensate a perinatal thermo-labile process (or structure) causing late larval stage DTC phase 2 migration errors. PMID:28817611

Sensorless battery temperature measurements based on electrochemical impedance spectroscopy

NASA Astrophysics Data System (ADS)

Raijmakers, L. H. J.; Danilov, D. L.; van Lammeren, J. P. M.; Lammers, M. J. G.; Notten, P. H. L.

2014-02-01

A new method is proposed to measure the internal temperature of (Li-ion) batteries. Based on electrochemical impedance spectroscopy measurements, an intercept frequency (f0) can be determined which is exclusively related to the internal battery temperature. The intercept frequency is defined as the frequency at which the imaginary part of the impedance is zero (Zim = 0), i.e. where the phase shift between the battery current and voltage is absent. The advantage of the proposed method is twofold: (i) no hardware temperature sensors are required anymore to monitor the battery temperature and (ii) the method does not suffer from heat transfer delays. Mathematical analysis of the equivalent electrical-circuit, representing the battery performance, confirms that the intercept frequency decreases with rising temperatures. Impedance measurements on rechargeable Li-ion cells of various chemistries were conducted to verify the proposed method. These experiments reveal that the intercept frequency is clearly dependent on the temperature and does not depend on State-of-Charge (SoC) and aging. These impedance-based sensorless temperature measurements are therefore simple and convenient for application in a wide range of stationary, mobile and high-power devices, such as hybrid- and full electric vehicles.

Lens-based wavefront sensorless adaptive optics swept source OCT

NASA Astrophysics Data System (ADS)

Jian, Yifan; Lee, Sujin; Ju, Myeong Jin; Heisler, Morgan; Ding, Weiguang; Zawadzki, Robert J.; Bonora, Stefano; Sarunic, Marinko V.

2016-06-01

Optical coherence tomography (OCT) has revolutionized modern ophthalmology, providing depth resolved images of the retinal layers in a system that is suited to a clinical environment. Although the axial resolution of OCT system, which is a function of the light source bandwidth, is sufficient to resolve retinal features at a micrometer scale, the lateral resolution is dependent on the delivery optics and is limited by ocular aberrations. Through the combination of wavefront sensorless adaptive optics and the use of dual deformable transmissive optical elements, we present a compact lens-based OCT system at an imaging wavelength of 1060 nm for high resolution retinal imaging. We utilized a commercially available variable focal length lens to correct for a wide range of defocus commonly found in patient’s eyes, and a novel multi-actuator adaptive lens for aberration correction to achieve near diffraction limited imaging performance at the retina. With a parallel processing computational platform, high resolution cross-sectional and en face retinal image acquisition and display was performed in real time. In order to demonstrate the system functionality and clinical utility, we present images of the photoreceptor cone mosaic and other retinal layers acquired in vivo from research subjects.

The River EdenDTC Project: A National Demonstration Test Catchment

NASA Astrophysics Data System (ADS)

Benskin, C.; Surridge, B.; Deasy, C.; Woods, C.; Rimmer, D.; Lees, E.; Owens, G.; Jonczyk, J.; Quinton, J.; Wilkinson, M.; Perks, M.; Quinn, P.; Barker, P.; Haygarth, P.; Burke, S.; Reaney, S.; Watson, N.

2012-04-01

Our environment is a complex system of interactions between natural process and anthropogenic activities that disrupt them. It is crucial to manage the balance for continued food production whilst maintaining the quality of the environment. The challenges we face include managing the impact of agricultural land use on aquatic quality and biodiversity as an integral system, rather than as separate issues. In order to do this, it is critical to understand how the different components are linked - how does land use affect our water courses and ground water, and their associated ecosystems, and how can the impact of agricultural land use on these systems be minimised? Regulating farm nutrient management through measures that minimise sources, their exposure to mobilisation, and reduce drainage pathways to water courses are all fundamental to the UK's approach to meeting the Water Framework Directive objective of achieving 'good ecological status' in all surface and groundwater bodies by 2015. The EdenDTC project is part of a 5-year national Demonstration Test Catchments (DTC) environmental scheme, aiming to understand the above issues through combining scientific research with local knowledge and experience from multiple stakeholders. The DTC project is a 5-year initiative by Defra, Welsh Assembly Government and the Environment Agency, which encompasses a research platform covering three distinct river catchments: the Eden in Cumbria; the Wensum in Norfolk; and the Avon in Hampshire. Within the EdenDTC, the impact and effects of multiple diffuse pollutants on ecosystems and sustainable food production are being studied on a river catchment scale. Three 10 km2 focus catchments, selected to represent the different farming practices and geologies observed across the Eden, have been instrumented to record the dynamics of agricultural diffuse pollution at multiple scales. Within each focus catchment, two sub-catchments were selected: one control and one mitigation, in which a number of existing and novel mitigation measures will be tested. A number of on-farm measures, aimed at reducing agricultural diffuse pollution, will be evaluated by monitoring their effect on water quality and associated biodiversity. In order to achieve this, state of the art hydro-meteorological logging systems have been installed. The outlets of the focus catchments each have a 'high-tech' multi-parameter station that will provide data for total P, soluble reactive P, nitrate, ammonium, temperature, conductivity, dissolved oxygen, turbidity, pH and flow. At the sub-catchment scale are 10 sub-stations, which provide a record of turbidity and water level. All are continuously sampling at 15 minute intervals and are telemetered. The goal is to give an abundance of high quality, multi-scale continuous data provided in real time. Additional storm sampling is being performed at all stations using automatic water samplers, and monthly spot samples are also analysed for each site. The information gathered at these different scales is hoped to improve the effectiveness/efficiency of schemes such as the England Catchment Sensitive Farming Delivery Initiative (ECSFDI). It is also hoped that many of the mitigation features will be multipurpose, having positive effects on flooding, carbon sequestration, habitat creation and biodiversity.

Header: Do adult DTC programs prevent child maltreatment? Parental criminal justice involvement and children’s involvement with child protective services: Do adult drug treatment courts prevent child maltreatment?

PubMed Central

Eldred, Lindsey M.; Sloan, Frank A.; Evans, Kelly E.

2016-01-01

Background In light of evidence showing reduced criminal recidivism and cost savings, adult drug treatment courts have grown in popularity. However, the potential spillover benefits to family members are understudied. Objectives To examine: 1) the overlap between parents who were convicted of a substance-related offense and their children’s involvement with child protective services (CPS); and 2) whether parental participation in an adult drug treatment court program reduces children’s risk for CPS involvement. Methods Administrative data from North Carolina courts, birth records, and social services were linked at the child level. First, children of parents convicted of a substance-related offense were matched to (a) children of parents convicted of a non-substance-related offense and (b) those not convicted of any offense. Second, we compared children of parents who completed a DTC program with children of parents who were referred but did not enroll, who enrolled for <90 days but did not complete, and who enrolled for 90+ days but did not complete. Multivariate logistic regression was used to model group differences in the odds of being reported to CPS in the one to three years following parental criminal conviction or, alternatively, being referred to a DTC program. Results Children of parents convicted of a substance-related offense were at greater risk of CPS involvement than children whose parents were not convicted of any charge, but DTC participation did not mitigate this risk. Conclusion/Importance The role of specialty courts as a strategy for reducing children’s risk of maltreatment should be further explored. PMID:26789656

A study of the time of hospital discharge of differentiated thyroid cancer patients after receiving iodine-131 for thyroid remnant ablation treatment.

PubMed

Azizmohammadi, Zahra; Tabei, Faraj; Shafiei, Babak; Babaei, Ali Akbar; Jukandan, Seyed Mohsen Qutbi; Naghshine, Reza; Javadi, Hamid; Nabipour, Iraj; Assadi, Majid; Asli, Isa Neshandar

2013-01-01

The aim of this study was to measure the radiation exposure rate from differentiated thyroid carcinoma (DTC) patients who had received iodine-131 ((131)I) treatment, and to evaluate hospital discharge planning in relation to three different sets of regulations. We studied 100 patients, 78 females and 22 males, aged 13 to 79 years (mean 44.40±15.83 years) with DTC, in three Groups who were treated with 3.7, 5.5 or 7.4GBq of (131)I, respectively. The external whole-body dose rates following oral administration of (131)I were measured after each one of the first three hospitalization days. A multivariant linear analysis was performed, considering exposure rates as dependent variables to the administered dose for treatment, age, gender, regional and/or distant metastases, thyroglobulin (Tg), antibodies to Tg and thyroid remnant in the three dose groups. We found that the exposure rates after each of the three first days of hospitalization were 30, 50 and 70μSvh-1 at 1m. All our DTC patients had an acceptable dose rate on days 2 and 3 that allowed their hospital discharge. After only 1 day of hospitalization, just 3/11 cases showed not permissible exposure rates above 70μSvh-1. In conclusion, it is the opinion of the authors that after measuring the exposure rates, most treated, DTC patients could be discharged after only one day of hospitalization, even some of those treated with high doses of (131)I (7.4GBq). Patients, who received the higher doses of (131)I, should not be released before their individual exposure rate is measured.

Comprehension and Data-Sharing Behavior of Direct-To-Consumer Genetic Test Customers.

PubMed

McGrath, Scott P; Coleman, Jason; Najjar, Lotfollah; Fruhling, Ann; Bastola, Dhundy R

2016-01-01

The aim of this study was to evaluate current direct-to-consumer (DTC) genetic customers' ability to interpret and comprehend test results and to determine if honest brokers are needed. One hundred and twenty-two customers of the DTC genetic testing company 23andMe were polled in an online survey. The subjects were asked about their personal test results and to interpret the results of two mock test cases (type 2 diabetes and multiple sclerosis), where results were translated into disease probability for an individual compared to the public. When asked to evaluate the risk, 72.1% correctly assessed the first case and 77% were correct on the second case. Only 23.8% of those surveyed were able to interpret both cases correctly. x03C7;2 and logistic regression were used to interpret the results. Participants who took the time to read the DTC test-provided supplemental material were 3.93 times (p = 0.040) more likely to correctly interpret the test results than those who did not. The odds for correctly interpreting the test cases were 3.289 times (p = 0.011) higher for those who made more than USD 50,000 than those who made less. Survey results were compared to the Health Information National Trends Survey (HINTS) phase 4 cycle 3 data to evaluate national trends. Most of the subjects were able to correctly interpret the test cases, yet a majority did not share their results with a health-care professional. As the market for DTC genetic testing grows, test comprehension will become more critical. Involving more health professionals in this process may be necessary to ensure proper interpretations. © 2016 S. Karger AG, Basel.

Sociodemographic Disparities in Differentiated Thyroid Cancer Survival Among Adolescents and Young Adults in California

PubMed Central

Grogan, Raymon H.; Parsons, Helen M.; Tao, Li; White, Michael G.; Onel, Kenan; Horn-Ross, Pamela L.

2015-01-01

Background: Few studies have focused on prognostic factors among adolescents and young adults (AYAs) 15 to 39 years of age when diagnosed with differentiated thyroid cancer (DTC). Our study expands upon prior work by including an evaluation of survival among AYA men and by neighborhood socioeconomic status, health insurance, and clinical factors to identify subgroups of young DTC patients at higher risk of mortality. Methods: Data for 16,827 AYA DTC patients diagnosed between 1988 and 2010 were obtained from the California Cancer Registry. Survival, through 2010, by sociodemographic and clinical factors was analyzed using Cox proportional hazards regression. Results: Of the 2.1% of AYAs who died, 16.7% died from thyroid cancer and 21.4% died from a subsequent cancer. In multivariate analyses, older AYAs 35 to 39 year of age (versus 15- to 29-year-olds), men (hazard ratio [HR] 2.77, 95% confidence interval [CI] 1.62–4.72), and AYAs of African American or Hispanic race/ethnicity (versus non-Hispanic whites) had worse thyroid cancer specific survival. In addition, residing in low socioeconomic status neighborhoods (HR 3.11 [CI 1.28–7.56]) and nonmetropolitan areas (HR 5.53 [CI 2.07–14.78]) was associated with worse thyroid cancer–specific survival among AYA men, but not AYA women. Conclusions: Despite the generally good prognosis among AYAs with DTC, we identified subgroups of AYA patients at risk for poor outcomes. Further study of the factors underlying these associations, including possible barriers to receiving high-quality treatment and follow-up care, as well as lifestyle factors, are critical to reducing these disparities. PMID:25778795

Clinical factors related to the efficacy of tyrosine kinase inhibitor therapy in radioactive iodine refractory recurrent differentiated thyroid cancer patients.

PubMed

Sugino, Kiminori; Nagahama, Mitsuji; Kitagawa, Wataru; Ohkuwa, Keiko; Uruno, Takashi; Matsuzu, Kenichi; Suzuki, Akifumi; Masaki, Chie; Akaishi, Junko; Hames, Kiyomi Y; Tomoda, Chisato; Ogimi, Yuna; Ito, Koichi

2018-03-28

New insights in thyroid cancer biology propelled the development of targeted therapies as salvage treatment for radioiodine-refractory differentiated thyroid cancer (RR-DTC), and the tyrosine kinase inhibitor (TKI) lenvatinib has recently become available as a new line of therapy for RR-DTC. The aim of this study is to investigate clinical factors related to the efficacy of TKI therapy in recurrent RR-DTC patients and identify the optimal timing for the start of TKI therapy. The subjects consisted of 29 patients with progressive RR-DTC, 9 males and 20 females, median age 66 years. A univariate analysis was conducted in relation to progression free survival (PFS) and overall survival (OS) by the Kaplan-Meier method for the following variables: age, sex, histology of the primary tumor, thyroglobulin doubling time before the start of lenvatinib therapy, site of the target lesions, presence of a tumor-mediated symptom at the start of lenvatinib therapy, and baseline tumor size of the target lesions. Median duration of lenvatinib therapy was 14.7 months and median drug intensity was 9.5 mg. At the time of the data cut-off for the analysis, 9 patients (31.0%) have died of their disease (DOD), and a PR (partial response), SD (stable disease), and PD (progressive disease) were observed in 20 patients (69%), 6 patients (20.7%), 3 patients (10.3%), respectively. Univariate analyses showed that the presence of a symptom was the only factor significantly related to poorer PFS and OS. Clinical benefit of TKI therapy will be possibly limited when the therapy starts after tumor-mediated symptoms appear.

Trends in Imaging after Thyroid Cancer Diagnosis

PubMed Central

Banerjee, Mousumi; Muenz, Daniel G.; Worden, Francis P.; Haymart, Megan R.

2015-01-01

Background The largest growth in differentiated thyroid cancer (DTC) diagnosis is in low-risk cancers. Trends in imaging after DTC diagnosis are understudied. Hypothesizing a reduction in imaging utilization due to rising low-risk disease, we evaluated post-diagnosis imaging patterns over time and patient characteristics that are associated with likelihood of imaging. Methods Using the Surveillance Epidemiology and End Results-Medicare database, we identified patients diagnosed with localized, regional or distant DTC between 1991 and 2009. We reviewed Medicare claims for neck ultrasound, I-131 scan, or PET scan within 3 years post-diagnosis. Using regression analyses we evaluated trends of imaging utilization. Multivariable logistic regression was used to estimate the likelihood of imaging based on patient characteristics. Results 23,669 patients were included. Patients diagnosed during 2001-2009, compared to 1991-2000, were more likely to have localized disease (p<0.001) and tumors less than 1cm (p<0.001). Use of neck ultrasound and I-131 scan increased in patients with localized disease (p=<0.001 and p=0.003, respectively), regional disease (p<0.001 and p<0.001), and distant metastasis (p=0.001 and p=0.015). Patients diagnosed after 2000 were more likely to undergo neck ultrasound (OR 2.15, 95% CI 2.02-2.28) and I-131 scan (OR 1.44, 95% CI 1.35-1.54). PET scan use from 2005-2009, compared to 1996-2004, increased 32.4-fold (p=<0.001) in localized patients, 13.1-fold (p<0.001) in regional disease patients, and 33.4-fold (p<0.001) in patients with distant DTC. Conclusion Despite a rise in low-risk disease, the use of post-diagnosis imaging increased in all stages of disease. The largest growth was in use of PET scan after 2004. PMID:25565063

Pre-operative role of BRAF in the guidance of the surgical approach and prognosis of differentiated thyroid carcinoma.

PubMed

Danilovic, Debora L S; Lima, Erika U; Domingues, Regina B; Brandão, Lenine G; Hoff, Ana O; Marui, Suemi

2014-04-01

The p.V600E BRAF and RAS mutations are found in 30-80% of differentiated thyroid carcinoma (DTC). BRAF mutation has been associated with poor prognosis. This study investigated the role of molecular studies in preoperative diagnosis of DTC and the association of p.V600E mutation with prognostic factors. Prospective study. A total of 202 patients with cytological diagnosis of Bethesda III-VI underwent preoperative molecular studies and subsequent thyroidectomy. p.V600E and RAS mutations were studied in the cytology smears, using real-time PCR genotyping technique. The BRAF mutation (BRAF(+) or BRAF(-)) was correlated with histological and clinical findings. Molecular study of 172 nodules with Bethesda III-V cytology improved negative predictive value and accuracy of Bethesda III and IV diagnosis. BRAF mutation was present in 65% of 94 DTC and p.Q61R NRAS in one. Except for age, BRAF(+) and BRAF(-) did not differ in sex, tumor size, histological subtype, multifocality, vascular invasion, extrathyroidal extension, or prognostic staging. Among papillary carcinomas, lymph node (LN) metastasis was diagnosed in 23% BRAF(+) and 37% BRAF(-). Distant metastasis occurred in four BRAF(-). Recurrent or persistent disease was more frequent in BRAF(-) (26.7 vs 3.3% BRAF(+), P=0.002) along follow-up of 29.8±10 months. BRAF(+) patients without LN metastasis by pre-operative evaluation submitted to thyroidectomy with central neck dissection (CND) had more frequent LN metastasis (45 vs 5% no CND, P=0.002), but no difference in clinical outcome was observed. Pre-operative identification of BRAF mutation improved cytological diagnosis of DTC, but it was not associated with poor prognostic factors. Prophylactic CND did not guarantee better outcome in BRAF(+) patients.

Elucidating the role of surface passivating ligand structural parameters in hole wave function delocalization in semiconductor cluster molecules.

PubMed

Teunis, Meghan B; Nagaraju, Mulpuri; Dutta, Poulami; Pu, Jingzhi; Muhoberac, Barry B; Sardar, Rajesh; Agarwal, Mangilal

2017-09-28

This article describes the mechanisms underlying electronic interactions between surface passivating ligands and (CdSe) 34 semiconductor cluster molecules (SCMs) that facilitate band-gap engineering through the delocalization of hole wave functions without altering their inorganic core. We show here both experimentally and through density functional theory calculations that the expansion of the hole wave function beyond the SCM boundary into the ligand monolayer depends not only on the pre-binding energetic alignment of interfacial orbitals between the SCM and surface passivating ligands but is also strongly influenced by definable ligand structural parameters such as the extent of their π-conjugation [π-delocalization energy; pyrene (Py), anthracene (Anth), naphthalene (Naph), and phenyl (Ph)], binding mode [dithiocarbamate (DTC, -NH-CS 2 - ), carboxylate (-COO - ), and amine (-NH 2 )], and binding head group [-SH, -SeH, and -TeH]. We observe an unprecedentedly large ∼650 meV red-shift in the lowest energy optical absorption band of (CdSe) 34 SCMs upon passivating their surface with Py-DTC ligands and the trend is found to be Ph- < Naph- < Anth- < Py-DTC. This shift is reversible upon removal of Py-DTC by triethylphosphine gold(i) chloride treatment at room temperature. Furthermore, we performed temperature-dependent (80-300 K) photoluminescence lifetime measurements, which show longer lifetime at lower temperature, suggesting a strong influence of hole wave function delocalization rather than carrier trapping and/or phonon-mediated relaxation. Taken together, knowledge of how ligands electronically interact with the SCM surface is crucial to semiconductor nanomaterial research in general because it allows the tuning of electronic properties of nanomaterials for better charge separation and enhanced charge transfer, which in turn will increase optoelectronic device and photocatalytic efficiencies.

Testing Cross-Sectional and Prospective Mediators of Internalized Heterosexism on Heavy Drinking, Alcohol Problems, and Psychological Distress Among Heavy Drinking Men Who Have Sex With Men.

PubMed

Kuerbis, Alexis; Mereish, Ethan H; Hayes, Marie; Davis, Christine M; Shao, Sijing; Morgenstern, Jon

2017-01-01

Minority stress theory is one of the primary theories used to understand substance use among lesbian, gay, and bisexual populations. This study tested whether drinking to cope with stress (DTC), loneliness, and gay community participation (GCP) mediated the relationship between one type of minority stress (i.e., internalized heterosexism) and behavioral health outcomes. Using secondary data analysis and the PROCESS procedure, relationships between internalized heterosexism, the mediators (DTC, loneliness, and GCP), and outcomes (heavy drinking, alcohol problems, and psychological distress) were explored, both cross-sectionally and in a lagged manner, among both treatment-seeking and non-treatment-seeking problem drinking men who have sex with men. Problem drinkers (N = 187) were assessed, provided brief normative feedback about their drinking, given the choice to receive brief alcohol use disorder treatment or change on their own, and then followed for 9 months. Cross-sectional findings revealed that internalized heterosexism was significantly associated with heavy drinking, alcohol problems, and psychological distress. DTC emerged as a significant mediator of internalized heterosexism for all the health outcomes. Loneliness and GCP were significant mediators of internalized heterosexism for alcohol problems and psychological distress. Multiple mediation models reveal that all three mediators significantly contribute to internalized heterosexism's effect on health outcomes. Lagged analyses did not yield any significant indirect effects. DTC, loneliness, and GCP all play an integral, mediational role in the relationship between internalized heterosexism and alcohol problems and psychological distress. Findings underscore the necessity of addressing internalized heterosexism in psychosocial interventions along with coping skills training, emphasizing culturally relevant social support and loneliness.

Lenvatinib in Advanced Radioiodine-Refractory Thyroid Cancer - A Retrospective Analysis of the Swiss Lenvatinib Named Patient Program.

PubMed

Balmelli, Catharina; Railic, Nikola; Siano, Marco; Feuerlein, Kristin; Cathomas, Richard; Cristina, Valerie; Güthner, Christiane; Zimmermann, Stefan; Weidner, Sabine; Pless, Miklos; Stenner, Frank; Rothschild, Sacha I

2018-01-01

Purpose: Differentiated thyroid cancer (DTC) accounts for approximately 95% of thyroid carcinomas. In the metastatic RAI-refractory disease, chemotherapy has very limited efficacy and is associated with substantial toxicity. With increasing knowledge of the molecular pathogenesis of DTC, novel targeted therapies have been developed. Lenvatinib is a tyrosine kinase inhibitor (TKI) with promising clinical activity based on the randomized phase III SELECT trial. In Switzerland, a Named Patient Program (NPP) was installed to bridge the time gap to Swissmedic approval. Here, we report the results from the Swiss Lenvatinib NPP including patients with metastatic RAI-refractory DTC. Methods: Main inclusion criteria for the Swiss NPP were RAI-refractory DTC, documented disease progression, Eastern Cooperative Oncology Group (ECOG) performance status 0-3. The number of previous therapies was not limited. The Swiss Lenvatinib NPP was initiated in June 2014 and was closed in October 2015 with the approval of the drug. Results: Between June 2014 and October 2015, 13 patients with a median age of 72 years have been enrolled. Most patients (69%) had at least one prior systemic therapy, mainly sorafenib. 31% of patients showed a PR and 31% SD. Median progression free survival was 7.2 months and the median overall survival was 22.7 months. Dose reduction due to adverse events was necessary in 7 patients (53%). At the time of analysis 6 patients (47%) were still on treatment with a median time on treatment of 9.98 months. Conclusions: Our results show that lenvatinib has reasonable clinical activity in unselected patients with RAI-refractory thyroid cancer with nearly two-third of patients showing clinical benefit. The toxicity profile of lenvatinib is manageable.

Lenvatinib in Advanced Radioiodine-Refractory Thyroid Cancer - A Retrospective Analysis of the Swiss Lenvatinib Named Patient Program

PubMed Central

Balmelli, Catharina; Railic, Nikola; Siano, Marco; Feuerlein, Kristin; Cathomas, Richard; Cristina, Valerie; Güthner, Christiane; Zimmermann, Stefan; Weidner, Sabine; Pless, Miklos; Stenner, Frank; Rothschild, Sacha I.

2018-01-01

Purpose:Differentiated thyroid cancer (DTC) accounts for approximately 95% of thyroid carcinomas. In the metastatic RAI-refractory disease, chemotherapy has very limited efficacy and is associated with substantial toxicity. With increasing knowledge of the molecular pathogenesis of DTC, novel targeted therapies have been developed. Lenvatinib is a tyrosine kinase inhibitor (TKI) with promising clinical activity based on the randomized phase III SELECT trial. In Switzerland, a Named Patient Program (NPP) was installed to bridge the time gap to Swissmedic approval. Here, we report the results from the Swiss Lenvatinib NPP including patients with metastatic RAI-refractory DTC. Methods:Main inclusion criteria for the Swiss NPP were RAI-refractory DTC, documented disease progression, Eastern Cooperative Oncology Group (ECOG) performance status 0-3. The number of previous therapies was not limited. The Swiss Lenvatinib NPP was initiated in June 2014 and was closed in October 2015 with the approval of the drug. Results:Between June 2014 and October 2015, 13 patients with a median age of 72 years have been enrolled. Most patients (69%) had at least one prior systemic therapy, mainly sorafenib. 31% of patients showed a PR and 31% SD. Median progression free survival was 7.2 months and the median overall survival was 22.7 months. Dose reduction due to adverse events was necessary in 7 patients (53%). At the time of analysis 6 patients (47%) were still on treatment with a median time on treatment of 9.98 months. Conclusions:Our results show that lenvatinib has reasonable clinical activity in unselected patients with RAI-refractory thyroid cancer with nearly two-third of patients showing clinical benefit. The toxicity profile of lenvatinib is manageable. PMID:29344270

The evaluation of protective and mitigating effects of vitamin C against side effects induced by radioiodine therapy.

PubMed

Jafari, Esmail; Alavi, Mehrosadat; Zal, Fatemeh

2018-06-02

The goal of this study was to evaluate the protective and mitigative effect of vitamin C on oxidative stress in differentiated thyroid cancer (DTC) patients ablated with radioiodine. 58 DTC patients selected for radioactive iodine therapy (RAIT) with 5550 MBq 131 Iodine were divided into four groups. Group 1 (control group) consisted of patients who underwent RAIT routinely. Other patients received 1500 mg vitamin C daily 2 days after (group 2), 2 days before to 2 days after (group 3) and 2 days before RAIT (group 4). Serum oxidative stress markers including malondialdehyde (MDA), glutathione (GSH), catalase (CAT), and superoxide dismutase (SOD) were measured immediately before and 2 days after RAIT. A significant increase in MDA after RAIT was observed in all groups (p < 0.05). The concentrations of MDA were significantly higher in the control group compared to the intervention groups (p < 0.05). A significant decrease in the control group (p < 0.05) and increase in group 4 (p < 0.05) were observed in GSH level after RAIT (p < 0.05). Mean variation of GSH was significant between control group with groups 3 (p < 0.01) and 4 (p < 0.01). The results indicate that activity of SOD remained unchanged in all groups (p > 0.05). A significant increase was observed in CAT activity after RAIT in all groups (p < 0.05), which was higher in control group than intervention groups. In groups 3 (p < 0.05) and 4 (p < 0.05), this increase in CAT activity was significantly lower than the control group. RAIT causes serum oxidative stress, which can be ameliorated using vitamin C as an antioxidant. These results indicate that radioprotective effect of vitamin C is preferable to its mitigative effect.

Photophysics of aggregated 9-methylthiacarbocyanine bound to polyanions

NASA Astrophysics Data System (ADS)

Chibisov, Alexander K.; Görner, Helmut

2002-05-01

The photophysical properties of 3,3 '-diethyl-9-methylthiacarbocyanine (DTC) were studied in the presence of polystyrene sulfonate (PSS), polyacrylic acid (PAA) and polymethacrylic acid (PMA). The absorption spectra reflect a monomer/dimer equilibrium in neat aqueous solution and a shift towards bound H-aggregates, bound dimers and bound monomers on increasing the ratio of polyanion residue to dye concentrations ( r). These equilibria also determine the photodeactivation modes of DTC. The fluorescence intensity is reduced, when dimers and aggregates are present and strongly enhanced for low dye loading ( r=10 4). In contrast, the quantum yield of intersystem crossing is enhanced for bound dimers ( r=10 3).

Educational content and health literacy issues in direct-to-consumer advertising of pharmaceuticals.

PubMed

Mackert, Michael; Love, Brad

2011-01-01

Direct-to-consumer (DTC) pharmaceutical advertisements have been analyzed in many ways, but richer conceptualizations of health literacy have been largely absent from this research. With approximately half of U.S. adults struggling to understand health information, it is important to consider consumers' health literacy when analyzing DTC advertisements. This project, framed by the health belief model, analyzed 82 advertisements. Advertisements provided some kinds of educational content (e.g., drugs' medical benefits) but typically failed to offer other useful information (e.g., other strategies for dealing with conditions). Issues likely to be barriers to low health literate consumers, such as nonstandard text formatting, are common.

Diagnostic value of Tg and TgAb for metastasis following ablation in patients with differentiated thyroid carcinoma coexistent with Hashimoto thyroiditis.

PubMed

Chai, Hong; Zhu, Zhao-Jin; Chen, Ze-Quan; Yu, Yong-Li

2016-08-01

This study was designed to investigate the clinical value of serum thyroglobulin (Tg) and antithyroglobulin antibody (TgAb) measurements and the cutoff value after ablation in differentiated thyroid carcinoma (DTC) complicated by Hashimoto thyroiditis (HT) with metastasis. We measured serum Tg and TgAb levels and evaluated the disease status in 164 cases of DTC coexistent with HT in pathologically confirmed patients after surgery and post-remnant ablation during a 3-year follow-up. All Tg and TgAb levels were assessed by chemiluminescent immunoassay (IMA). Receiver operating characteristic (ROC) curve analysis was used to evaluate the prognostic value of Tg and TgAb for disease metastasis. The relationship between Tg and TgAb was analyzed using the scatter diagram distribution method. We found that the cutoff values of Tg and TgAb were 1.48 µg/L and 45 kIU/L, respectively. The area under the ROC curve (AUC) of Tg and TgAb was 0.907 and 0.650, respectively. In DTC coexistent with HT patients, the optimal cutoff value correlated with metastasis in Tg and TgAb was 1.48 µg/L and 45 kIU/L, respectively.

Radioactive Iodine Administration Is Associated with Persistent Related Symptoms in Patients with Differentiated Thyroid Cancer

PubMed Central

Droppelmann, Nicolás

2016-01-01

Context. Radioiodine (RAI) administration has adverse effects in patients treated for thyroid cancer (DTC), but there is scarce information regarding their intensity and duration. Objective. To evaluate frequency and intensity of early and late RAI-related symptoms in patients with DTC. Design. Observational prospective study. Patients. DTC patients who underwent thyroidectomy, with or without RAI. Measurements. Patients answered 2 surveys: (1) from 0 to 6 months and (2) between 6 and 18 months after initial treatment. Results. 110 patients answered the first survey and 61 both. Nearly 80 percent received RAI. Among early symptoms, periorbital edema, excessive tearing, salivary gland disturbances, dry mouth, taste disorders, and nausea were more frequent and intense among RAI patients. Regarding late symptoms, periorbital edema, salivary gland pain and swelling, and dry mouth were more frequent and intense in RAI patients. Frequency and intensity of adverse effects were not different between low and high RAI doses (50 versus ≥100 mCi). Conclusion. RAI-related symptoms are frequent and usually persist after 6 months of administration, even when low doses are given. This finding must be considered when deciding RAI administration, especially in low risk patients, among whom RAI benefit is controversial. PMID:27867395

Radioactive Iodine Administration Is Associated with Persistent Related Symptoms in Patients with Differentiated Thyroid Cancer.

PubMed

Florenzano, Pablo; Guarda, Francisco J; Jaimovich, Rodrigo; Droppelmann, Nicolás; González, Hernán; Domínguez, José M

2016-01-01

Context . Radioiodine (RAI) administration has adverse effects in patients treated for thyroid cancer (DTC), but there is scarce information regarding their intensity and duration. Objective . To evaluate frequency and intensity of early and late RAI-related symptoms in patients with DTC. Design . Observational prospective study. Patients . DTC patients who underwent thyroidectomy, with or without RAI. Measurements . Patients answered 2 surveys: (1) from 0 to 6 months and (2) between 6 and 18 months after initial treatment. Results . 110 patients answered the first survey and 61 both. Nearly 80 percent received RAI. Among early symptoms, periorbital edema, excessive tearing, salivary gland disturbances, dry mouth, taste disorders, and nausea were more frequent and intense among RAI patients. Regarding late symptoms, periorbital edema, salivary gland pain and swelling, and dry mouth were more frequent and intense in RAI patients. Frequency and intensity of adverse effects were not different between low and high RAI doses (50 versus ≥100 mCi). Conclusion . RAI-related symptoms are frequent and usually persist after 6 months of administration, even when low doses are given. This finding must be considered when deciding RAI administration, especially in low risk patients, among whom RAI benefit is controversial.

Optical and electrochemical characteristics of Ir(III) complexes with metalated 4-(4-bromophenyl)-2-methyl-1,3-thiazole and isocyanide, ethylenediamine, and diethyldithiocarbamate ligands

NASA Astrophysics Data System (ADS)

Katlenok, E. A.; Kinzhalov, M. A.; Eremina, A. A.; Balashev, K. P.

2017-05-01

The influence of donor-acceptor properties of tert-butyl-, 2.6-dimethylphenyl-, and 4-bromophenyl-isocyanides (BuNC, XylNC, BpNC), ethylenediamine (En), and diethyldithiocarbamate ions (Dtc-) on the 1H and 13C NMR, IR, optical, and electrochemical characteristics of Ir(III) complexes with metalated 4-(4-bromophenyl)-2-methyl-1,3-thiazole is studied. Enhancement of the donor properties of BpNC, XylNC, BuNC, En, and Dtc- ligands leads to a bathochromic shift of metal-to-ligand charge transfer (MLCT) bands and to a decrease in the difference between the one-electron oxidation and reduction potentials of complexes. The bathochromic shift of the low-temperature phosphorescence of complexes in frozen (77 K) solutions with increasing donor properties of BpNC, XylNC, BuNC, En, and Dtc-ligands is caused by a decrease in the admixture of MLCT to the intraligand excited state of {Ir(bptz)2}. Quenching of the phosphorescence of complexes in liquid solutions is attributed to the thermally-induced population of excited d- d* states with subsequent nonradiative deactivation.

Limitations of direct-to-consumer advertising for clinical genetic testing.

PubMed

Gollust, Sarah E; Hull, Sara Chandros; Wilfond, Benjamin S

2002-10-09

Although direct-to-consumer (DTC) advertisements for pharmaceuticals have been appearing in the mass media for 20 years, DTC advertisements for genetic testing have only recently appeared. Advertisements for genetic testing can provide both consumers and physicians with information about test availability in an expanding market. However, 3 factors limit the value and appropriateness of advertisements: complex information, a complicated social context surrounding genetics, and a lack of consensus about the clinical utility of some tests. Consideration of several advertisements suggests that they overstate the value of genetic testing for consumers' clinical care. Furthermore, advertisements may provide misinformation about genetics, exaggerate consumers' risks, endorse a deterministic relationship between genes and disease, and reinforce associations between diseases and ethnic groups. Advertising motivated by factors other than evidence of the clinical value of genetic tests can manipulate consumers' behavior by exploiting their fears and worries. At this time, DTC advertisements are inappropriate, given the public's limited sophistication regarding genetics and the lack of comprehensive premarket review of tests or oversight of advertisement content. Existing Federal Trade Commission and Food and Drug Administration regulations for other types of health-related advertising should be applied to advertisements for genetic tests.

Postoperative radioactive iodine-131 ablation is not necessary among patients with intermediate-risk differentiated thyroid carcinoma: a population-based study.

PubMed

Zhang, Hong; Cai, Yuechang; Zheng, Li; Zhang, Zhanlei; Jiang, Ningyi

2017-01-01

To assess the effectiveness of radioactive iodine (RAI) ablation among patients with intermediate-risk differentiated thyroid cancer (DTC) following surgery. This population based study obtained information from the Surveillance, Epidemiology, and End Results (SEER) Program Research Data (1973-2013). National Cancer Institute, DCCPS, Surveillance Research Programme, Surveillance Systems Branch, released April 2016, based on the November 2015 submission. A total of 93,530 patients with primary thyroid cancer were identified in the SEER database during the period of 2004-2013 and focused on patients with DTC post-operatively treated or not treated with radioactive iodine (RAI). From these 9,127 patients were selected who had intermediate-risk DTC. A total of 8,601 patients were included in this study. For the overall population, the mean age of the population was 47.3 years and the majority were female (70.5%). Kaplan-Meier analysis found the mean overall survival time (os) for subjects with no radiation therapy which was 112.9 months and 114.9 months for those who received RAI ablation treatment (P<0.001). However, thyroid cancer-specific survival was not significantly different between treatment groups (117.7 vs. 118.0 months, log-rank test P=0.164). Overall survival and thyroid cancer-specific 1 year, 5 years, and 10-years survival rates were ≥89.8% and were similar between both treated groups. Multivariate analysis found age, gender, histologic type, and degree of lymph node metastases to be associated with OS, and age, gender, degree of lymph node metastasis and extra-thyroid tumor spread were independent factors for cancer-specific survival. In DTC patients with intermediate cancer risk multivariate analysis found that RAI was associated with a reduced risk of mortality compared with no radiation therapy (HR=0.710, 95% CI: 0.562-0.897, P=0.004) but no significant difference was seen in cancer-specific survival, either based on whole study population or on tumor size category. In DTC patients with intermediate cancer risk although postoperative RAI ablation following surgery showed a benefit in overall survival, no significant difference was seen in cancer-specific survival, either based on whole study population or on tumor size category.

Beyond recidivism: changes in health and social service involvement following exposure to drug treatment court.

PubMed

Rezansoff, Stefanie N; Moniruzzaman, Akm; Clark, Elenore; Somers, Julian M

2015-10-31

The majority of Drug Treatment Court (DTC) research has examined the impact of DTCs on criminal recidivism. Comparatively little research has addressed the association between DTC participation and engagement with community-based health and social services. The present study investigated changes in participant involvement with outpatient healthcare and income assistance within a DTC cohort. We hypothesized that involvement with community-based (outpatient) health and social services would increase post-DTC participation, and that service levels would be higher among program graduates and offenders with histories of co-occurring mental and substance use disorders. Participants were 631 offenders at the DTC in Vancouver, Canada (DTCV). Administrative data representing hospital, outpatient medical care, and income assistance were examined one-year pre/post program to assess differences over time. Generalized estimating equations were used to investigate the association between changes in service use and program involvement. We also examined the relationship between level of service use and offender characteristics. Members of the cohort were disproportionately Aboriginal (33 %), had been sentenced 2.7 times in the 2 years preceding their index offence, and 50 % had been diagnosed with a non substance-related mental disorder in the five years preceding the index offence. The mean number of outpatient services post DTCV was 51, and the mean amount of social assistance paid was $5,897. Outpatient service use increased following exposure to DTCV (Adjusted Rate Ratio (ARR) = 1.45) and was significantly higher among women (ARR = 1.47), program graduation (ARR = 1.23), and those previously diagnosed with concurrent substance use and mental disorders (ARR = 4.92). Overall, hospital admissions did not increase post-program, although rates were significantly higher among women (ARR = 1.76) and those with concurrent disorders (ARR = 2.71). Income assistance increased significantly post program (ARR = 1.16), and was significantly higher among women (ARR = 1.03), and those diagnosed with substance use disorders (ARR = 1.42) and concurrent disorders (ARR = 1.72). These findings suggest that the DTCV was a catalyst for increased participant engagement with community health and social supports, and that rates of service use were consistently higher among women and individuals with concurrent disorders. Research is needed to investigate the potential link between health and social support and reductions in recidivism associated with DTCs.

Advertising for AIDS drugs: it's everywhere lately, but is it helpful?

PubMed

Mirken, B

1998-07-01

The recent proliferation of direct to consumer (DTC) advertisements for prescription drugs, including HIV/AIDS drugs, can present a confusing and unrealistic picture of treatment options and outcomes; however, supporters claim that it stimulates awareness of treatment options and encourages dialogue between doctors and patients. The Food and Drug Administration (FDA), which regulates DTC advertising, requires that manufacturers disclose a complete description of benefits and adverse effects, similar to the information on the product's label. This balance of information applies to the written portion of the ad, but not to the visual message, which is arguably the most powerful part of the advertisement. Many of the visuals in the AIDS drugs advertisements misconstrue the effect of the virus on the patients. However, the FDA has not yet developed restrictions to more accurately control the visual component of advertisements, in order to depict the downside of disease. Additionally, manufacturers whose advertisements match the wording on their labels have an easier time getting acceptance from the FDA, but use more technical language than the typical lay person can understand. Reliance on the FDA- approved label description, restricts the drug companies from promoting off-label uses of their products, and also does not allow for the constantly changing information of a drug's effectiveness.

Impact of Animated Spokes-Characters in Print Direct-to-Consumer Prescription Drug Advertising: An Elaboration Likelihood Model Approach.

PubMed

Bhutada, Nilesh S; Rollins, Brent L; Perri, Matthew

2017-04-01

A randomized, posttest-only online survey study of adult U.S. consumers determined the advertising effectiveness (attitude toward ad, brand, company, spokes-characters, attention paid to the ad, drug inquiry intention, and perceived product risk) of animated spokes-characters in print direct-to-consumer (DTC) advertising of prescription drugs and the moderating effects of consumers' involvement. Consumers' responses (n = 490) were recorded for animated versus nonanimated (human) spokes-characters in a fictitious DTC ad. Guided by the elaboration likelihood model, data were analyzed using a 2 (spokes-character type: animated/human) × 2 (involvement: high/low) factorial multivariate analysis of covariance (MANCOVA). The MANCOVA indicated significant main effects of spokes-character type and involvement on the dependent variables after controlling for covariate effects. Of the several ad effectiveness variables, consumers only differed on their attitude toward the spokes-characters between the two spokes-character types (specifically, more favorable attitudes toward the human spokes-character). Apart from perceived product risk, high-involvement consumers reacted more favorably to the remaining ad effectiveness variables compared to the low-involvement consumers, and exhibited significantly stronger drug inquiry intentions during their next doctor visit. Further, the moderating effect of consumers' involvement was not observed (nonsignificant interaction effect between spokes-character type and involvement).

Does the walking task matter? Influence of different walking conditions on dual-task performances in young and older persons.

PubMed

Beurskens, Rainer; Bock, Otmar

2013-12-01

Previous literature suggests that age-related deficits of dual-task walking are particularly pronounced with second tasks that require continuous visual processing. Here we evaluate whether the difficulty of the walking task matters as well. To this end, participants were asked to walk along a straight pathway of 20m length in four different walking conditions: (a) wide path and preferred pace; (b) narrow path and preferred pace, (c) wide path and fast pace, (d) obstacled wide path and preferred pace. Each condition was performed concurrently with a task requiring visual processing or fine motor control, and all tasks were also performed alone which allowed us to calculate the dual-task costs (DTC). Results showed that the age-related increase of DTC is substantially larger with the visually demanding than with the motor-demanding task, more so when walking on a narrow or obstacled path. We attribute these observations to the fact that visual scanning of the environment becomes more crucial when walking in difficult terrains: the higher visual demand of those conditions accentuates the age-related deficits in coordinating them with a visual non-walking task. Copyright © 2013 The Authors. Published by Elsevier B.V. All rights reserved.

Spin your science into gold: direct to consumer marketing within social media platforms.

PubMed

Egilman, David; Druar, Nicholas M

2012-01-01

We describe the emerging issues related to warnings with respect to pharmaceutical company use of the internet as a vehicle for direct-to-consumer marketing (DTC) and market research. We describe the various techniques pharmaceutical companies have used to exploit this new communications medium which permits two way exchange of information. The Food and Drug Administration (FDA) has not issued any specific regulations to control internet based misbranding. We describe some examples of the FDA's application of historic regulations to pharmaceutical company use of this new medium and suggest.

Optical coherence tomography with a 2.8-mm beam diameter and sensorless defocus and astigmatism correction

NASA Astrophysics Data System (ADS)

Reddikumar, Maddipatla; Tanabe, Ayano; Hashimoto, Nobuyuki; Cense, Barry

2017-02-01

An optical coherence tomography (OCT) system with a 2.8-mm beam diameter is presented. Sensorless defocus correction can be performed with a Badal optometer and astigmatism correction with a liquid crystal device. OCT B-scans were used in an image-based optimization algorithm for aberration correction. Defocus can be corrected from -4.3 D to +4.3 D and vertical and oblique astigmatism from -2.5 D to +2.5 D. A contrast gain of 6.9 times was measured after aberration correction. In comparison with a 1.3-mm beam diameter OCT system, this concept achieved a 3.7-dB gain in dynamic range on a model retina. Both systems were used to image the retina of a human subject. As the correction of the liquid crystal device can take more than 60 s, the subject's spectacle prescription was adopted instead. This resulted in a 2.5 times smaller speckle size compared with the standard OCT system. The liquid crystal device for astigmatism correction does not need a high-voltage amplifier and can be operated at 5 V. The correction device is small (9 mm×30 mm×38 mm) and can easily be implemented in existing designs for OCT.

Multiscale sensorless adaptive optics OCT angiography system for in vivo human retinal imaging.

PubMed

Ju, Myeong Jin; Heisler, Morgan; Wahl, Daniel; Jian, Yifan; Sarunic, Marinko V

2017-11-01

We present a multiscale sensorless adaptive optics (SAO) OCT system capable of imaging retinal structure and vasculature with various fields-of-view (FOV) and resolutions. Using a single deformable mirror and exploiting the polarization properties of light, the SAO-OCT-A was implemented in a compact and easy to operate system. With the ability to adjust the beam diameter at the pupil, retinal imaging was demonstrated at two different numerical apertures with the same system. The general morphological structure and retinal vasculature could be observed with a few tens of micrometer-scale lateral resolution with conventional OCT and OCT-A scanning protocols with a 1.7-mm-diameter beam incident at the pupil and a large FOV (15 deg× 15 deg). Changing the system to a higher numerical aperture with a 5.0-mm-diameter beam incident at the pupil and the SAO aberration correction, the FOV was reduced to 3 deg× 3 deg for fine detailed imaging of morphological structure and microvasculature such as the photoreceptor mosaic and capillaries. Multiscale functional SAO-OCT imaging was performed on four healthy subjects, demonstrating its functionality and potential for clinical utility. (2017) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE).

Direct-to-consumer advertising of predictive genetic tests: a health belief model based examination of consumer response.

PubMed

Rollins, Brent L; Ramakrishnan, Shravanan; Perri, Matthew

2014-01-01

Direct-to-consumer (DTC) advertising of predictive genetic tests (PGTs) has added a new dimension to health advertising. This study used an online survey based on the health belief model framework to examine and more fully understand consumers' responses and behavioral intentions in response to a PGT DTC advertisement. Overall, consumers reported moderate intentions to talk with their doctor and seek more information about PGTs after advertisement exposure, though consumers did not seem ready to take the advertised test or engage in active information search. Those who perceived greater threat from the disease, however, had significantly greater behavioral intentions and information search behavior.

Health care providers and direct-to-consumer access and advertising of genetic testing in the United States

PubMed Central

2011-01-01

Marketing pressures, regulatory policies, clinical guidelines, and consumer demand all affect health care providers' knowledge and use of health-related genetic tests that are sold and/or advertised to consumers. In addition, clinical guidelines, regulatory policies, and educational efforts are needed to promote the informed use of genetic tests that are sold and advertised to consumers and health care providers. A shift in culture regarding the regulation of genetic tests that are sold directly to consumers is suggested: by recent actions taken by the US Food and Drug Administration (FDA), including letters sent to direct-to-consumer (DTC) genetic testing companies stating that their tests meet the definition of medical devices; by public meetings held by the FDA to discuss laboratory developed tests; and by the convening of the Molecular and Clinical Genetics Panel to gather input on scientific issues concerning DTC genetic tests that make medical claims. This review provides a brief overview of DTC advertising and the regulation of pharmaceuticals and genetic tests in the United States. It highlights recent changes in the regulatory culture regarding genetic tests that are sold to consumers, and discusses the impact on health care providers of selling and advertising genetic tests directly to consumers. PMID:22204616

Content Analysis of Informed Consent for Whole Genome Sequencing Offered by Direct-to-Consumer Genetic Testing Companies.

PubMed

Niemiec, Emilia; Borry, Pascal; Pinxten, Wim; Howard, Heidi Carmen

2016-12-01

Whole exome sequencing (WES) and whole genome sequencing (WGS) have become increasingly available in the research and clinical settings and are now also being offered by direct-to-consumer (DTC) genetic testing (GT) companies. This offer can be perceived as amplifying the already identified concerns regarding adequacy of informed consent (IC) for both WES/WGS and the DTC GT context. We performed a qualitative content analysis of Websites of four companies offering WES/WGS DTC regarding the following elements of IC: pre-test counseling, benefits and risks, and incidental findings (IFs). The analysis revealed concerns, including the potential lack of pre-test counseling in three of the companies studied, missing relevant information in the risks and benefits sections, and potentially misleading information for consumers. Regarding IFs, only one company, which provides opportunistic screening, provides basic information about their management. In conclusion, some of the information (and related practices) present on the companies' Web pages salient to the consent process are not adequate in reference to recommendations for IC for WGS or WES in the clinical context. Requisite resources should be allocated to ensure that commercial companies are offering high-throughput sequencing under responsible conditions, including an adequate consent process. © 2016 WILEY PERIODICALS, INC.

The Origin and Coupling Mechanism of the Magnetoelectric Effect in TM Cl 2 -4SC(NH 2 ) 2 ( TM = Ni and Co)

DOE PAGES

Mun, Eundeok; Wilcox, Jason; Manson, Jamie L.; ...

2014-01-01

Most research on multiferroics and magnetoelectric effects to date has focused on inorganic oxides. Molecule-based materials are a relatively new field in which to search for magnetoelectric multiferroics and to explore new coupling mechanisms between electric and magnetic order. We present magnetoelectric behavior in NiCl 2 -4SC(NH 2 ) 2 (DTN) and CoCl 2 -4SC(NH 2 ) 2 (DTC). These compounds form tetragonal structures where the transition metal ion (Ni or Co) is surrounded by four electrically polar thiourea molecules [SC(NH 2 ) 2 ]. By tracking the magnetic and electric properties of these compounds as a function of magneticmore » field, we gain insights into the coupling mechanism by observing that, in DTN, the electric polarization tracks the magnetic ordering, whereas in DTC it does not. For DTN, all electrically polar thiourea molecules tilt in the same direction along the c -axis, breaking spatial-inversion symmetry, whereas, for DTC, two thiourea molecules tilt up and two tilt down with respect to c -axis, perfectly canceling the net electrical polarization. Thus, the magnetoelectric coupling mechanism in DTN is likely a magnetostrictive adjustment of the thiourea molecule orientation in response to magnetic order.« less

Health care providers and direct-to-consumer access and advertising of genetic testing in the United States.

PubMed

Myers, Melanie F

2011-12-28

Marketing pressures, regulatory policies, clinical guidelines, and consumer demand all affect health care providers' knowledge and use of health-related genetic tests that are sold and/or advertised to consumers. In addition, clinical guidelines, regulatory policies, and educational efforts are needed to promote the informed use of genetic tests that are sold and advertised to consumers and health care providers. A shift in culture regarding the regulation of genetic tests that are sold directly to consumers is suggested: by recent actions taken by the US Food and Drug Administration (FDA), including letters sent to direct-to-consumer (DTC) genetic testing companies stating that their tests meet the definition of medical devices; by public meetings held by the FDA to discuss laboratory developed tests; and by the convening of the Molecular and Clinical Genetics Panel to gather input on scientific issues concerning DTC genetic tests that make medical claims. This review provides a brief overview of DTC advertising and the regulation of pharmaceuticals and genetic tests in the United States. It highlights recent changes in the regulatory culture regarding genetic tests that are sold to consumers, and discusses the impact on health care providers of selling and advertising genetic tests directly to consumers.

News media coverage of direct-to-consumer pharmaceutical advertising: implications for countervailing powers theory.

PubMed

Hartley, Heather; Coleman, Cynthia-Lou

2008-01-01

Since a 1997 regulatory shift on the part of the US Food and Drug Administration (FDA), there has been an explosion of televised direct-to-consumer (DTC) pharmaceutical advertising in the United States. The introduction and growth of this form of advertising, as well as other recent evolutions in the health care arena, have altered relationships among key countervailing powers in the health care system, suggesting the need to recast countervailing powers theory so as to account for these changes. Coming from the perspective that the news media play an important role in reflecting the balance of power among the various countervailing powers, the paper advances this theoretical framework through an empirical assessment of the relative prominence of those entities in print news media coverage of the DTC advertising phenomenon. The study finds that ;corporate sellers' (pharmaceutical industry) are accorded more prominence in news coverage than are providers, consumers, corporate purchasers, or state players and that DTC critics, in particular, have minimal representation. In addition, the findings point toward two modifications for countervailing powers theory: (1) an incorporation of the role of academic/research organizations, and (2) a consideration of the universe of possibilities with respect to each of the countervailing powers.

Communicating efficacy information based on composite scores in direct-to-consumer prescription drug advertising.

PubMed

Williams, Pamela A; O'Donoghue, Amie C; Sullivan, Helen W; Willoughby, Jessica Fitts; Squire, Claudia; Parvanta, Sarah; Betts, Kevin R

2016-04-01

Drug efficacy can be measured by composite scores, which consist of two or more symptoms or other clinical components of a disease. We evaluated how individuals interpret composite scores in direct-to-consumer (DTC) prescription drug advertising. We conducted an experimental study of seasonal allergy sufferers (n=1967) who viewed a fictitious print DTC ad that varied by the type of information featured (general indication, list of symptoms, or definition of composite scores) and the presence or absence of an educational intervention about composite scores. We measured composite score recognition and comprehension, and perceived drug efficacy and risk. Ads that featured either (1) the composite score definition alone or (2) the list of symptoms or general indication information along with the educational intervention improved composite score comprehension. Ads that included the composite score definition or the educational intervention led to lower confidence in the drug's benefits. The composite score definition improved composite score recognition and lowered drug risk perceptions. Adding composite score information to DTC print ads may improve individuals' comprehension of composite scores and affect their perceptions of the drug. Providing composite score information may lead to more informed patient-provider prescription drug decisions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Time dependent-density functional theory (TD-DFT) and experimental studies of UV-Visible spectra and cyclic voltammetry for Cu(II) complex with Et2DTC

NASA Astrophysics Data System (ADS)

Valle, Eliana Maira A.; Maltarollo, Vinicius Gonçalves; Almeida, Michell O.; Honorio, Kathia Maria; dos Santos, Mauro Coelho; Cerchiaro, Giselle

2018-04-01

In this work, we studied the complexation mode between copper(II) ion and the specific ligand investigated as carriers of metals though biological membranes, diethyldithiocarbamate (Et2DTC). It is important to understand how this occurs because it is an important intracellular chelator with potential therapeutic applications. Theoretical and experimental UV visible studies were performed to investigate the complexation mode between copper and the ligand. Electrochemical studies were also performed to complement the spectroscopic analyses. According to the theoretical calculations, using TD-DFT (Time dependent density functional theory), with B3LYP functional and DGDVZP basis set, implemented in Gaussian 03 package, it was observed that the formation of the complex [Cu(Et2DTC)2] is favorable with higher electron density over the sulfur atoms of the ligand. UV/Vis spectra have a charge transfer band at 450 nm, with the DMSO-d6 band shift from 800 to 650 nm. The electrochemical experiments showed the formation of a new redox process, referring to the complex, where the reduction peak potential of copper is displaced to less positive region. Therefore, the results obtained from this study give important insights on possible mechanisms involved in several biological processes related to the studied system.

Clinical determinants of fluorodeoxyglucose positron emission tomography/computed tomography in differentiated thyroid cancer patients with elevated thyroglobulin and negative (131)iodine whole body scans after (131)iodine therapy.

PubMed

Shamim, Syed Ejaz; Nang, Lee Boon; Shuaib, Ibrahim Lutfi; Muhamad, Nor Asiah

2014-05-01

A cross-sectional prospective study has been conducted on differentiated thyroid cancer (DTC) patients using negative (131)Iodine ((131)I) whole body scans and elevated thyroglobulin (Tg) levels. The main objective of this research was to determine the prevalence of the conversion of differentiated to dedifferentiated thyroid cancer patients during follow up at the Hospital Kuala Lumpur. It has been demonstrated that fluorodeoxyglucose (FDG) uptake is inversely proportional to the iodine concentration and to differentiation of the cells. Thirty-five patients with histologically proven DTC that have undergone total or near total thyroidectomy, and post (131)I radioactive iodine ablation therapy, were selected and prospectively analysed. The patients also had to show at least one negative whole body scan and Tg levels of 10 μg/L and above. The results of the FDG-Positron Emission Tomography/Computed Tomography (PET/CT) were then studied to determine the association and the predictors influencing the outcome by using univariable and multivariable analyses. Out of the thirty-five patients, 60% of them (twenty-one) showed positive results and 40% (fourteen) showed negative. Age, gender, and type of histopathology (HPE) showed significant associations with the positive results of the FDG-PET/CT. The results also showed no correlations observed between the Tg levels and standardised uptake value (SUV)max in the DTC patients with positive disease findings in the FDG-PET/CT. The predictor for this study was age. The prevalence of the conversion of differentiated to dedifferentiated thyroid cancer among patients with negative (131)I and elevated Tg was 60%, with age as the predictor. DTC patients aged 45 year-old and older were seven times more likely to have positive results of FDG-PET/CT imaging.

Age-related differences in dual task performance: A cross-sectional study on women.

PubMed

Brustio, Paolo R; Magistro, Daniele; Rabaglietti, Emanuela; Liubicich, Monica E

2017-02-01

Simultaneous performances of motor and attention-demanding tasks are common in activities of everyday life. The present cross-sectional study examined the changes and age-related differences on mobility performance with an additional cognitive or motor task, and evaluated the relative dual-task cost (DTC) on the motor performance in young, middle-aged and older women. A total of 30 young (mean age 25.12 ± 3.00 years), 30 middle-aged (mean age 47.82 ± 5.06 years) and 30 older women (mean age 72.74 ± 5.95 years) were recruited. Participants carried out: (i) single task: Timed Up & Go Test; (ii) cognitive dual-task: Timed Up & Go Test while counting backwards by three; (iii) manual dual-task: Timed Up & Go Test while carrying a glass of water. A repeated measures anova with between-factor as age groups and within-factor as tasks was carried out to assess the effect of aging on the performance of mobility tasks. DTC was calculated as ([performance in single-task - performance in dual-task] / performance in single task) × 100%. One-way ancova were carried out to compare the DTC among the three age groups. A significant interaction between age groups and task (F 4,172  = 6.716, P < 0.001, partial η 2  = 0.135) was observed. Specifically, older women showed a worse mobility performance under dual-task condition compared with young and middle-aged groups. Furthermore, DTC differences in cognitive task were observed in older women compared with younger and middle-aged women (F 2,86  = 7.649, P < 0.001, partial η 2  = 0.151), but not in manual task. Dual-task conditions might affect mobility performance differently across the lifespan, and could be particularly challenging in older women. Geriatr Gerontol Int 2017; 17: 315-321. © 2015 Japan Geriatrics Society.

LYMPHOCYTIC THYROIDITIS IS ASSOCIATED WITH INCREASED NUMBER OF BENIGN CERVICAL NODES AND FEWER CENTRAL NECK COMPARTMENT METASTATIC LYMPH NODES IN PATIENTS WITH DIFFERENTIATED THYROID CANCER.

PubMed

Donangelo, Ines; Walts, Ann E; Bresee, Catherine; Braunstein, Glenn D

2016-10-01

Whether or not autoimmune thyroid disease influences the progression of differentiated thyroid cancer (DTC) remains controversial. Findings of previous studies are influenced by lead time bias and/or procedure bias selection. These biases can be reduced by studying a single-institution patient population that underwent a similar extent of surgical resection. From a cohort of 660 patients with DTC who underwent thyroidectomy, we retrospectively studied 357 patients who underwent total thyroidectomy and central compartment node dissection (CCND) for DTC between 2003 and 2013. Forty-one percent (140/345) of study patients had lymphocytic thyroiditis (LT), and 30% (91/301) had serum positive for thyroglobulin antibody (TgAb). LT was reported in 78% of the TgAb-positive cases. Sixty percent (213/357) of cases had metastatic thyroid carcinoma in 1 or more neck lymph nodes (55% [198/357] central compartment, and 22% [77/356] lateral compartment). Patients with LT had fewer metastatic cervical lymph nodes than those with no LT (2.7 ± 4.7 vs 3.5 ± 4.8, respectively, P = .0285). Patients with positive TgAb and thyroiditis had a larger number of benign cervical lymph nodes removed than those with negative TgAb or no LT. No significant difference was observed in age, tumor size, multifocality, extrathyroidal extension, vascular invasion, or frequency of cervical lymph node metastasis between TgAb-negative and -positive cases or between cases with and without LT. Lymphocytic thyroiditis is associated with fewer central neck compartment metastatic lymph nodes and a larger number of excised reactive benign cervical lymph nodes. Whether this association indicates a protective role of thyroid autoimmunity in lymph node spreading remains unclear. CCND = central compartment node dissection DTC = differentiated thyroid cancer HT = Hashimoto thyroiditis LT = lymphocytic thyroiditis TgAb = thyroglobulin antibody TPO = thyroid peroxidase.

Deceleration time of left ventricular outflow tract flow as a simple surrogate marker for central haemodynamics at rest and as well as during exercise.

PubMed

Cho, In-Jeong; Shim, Chi Young; Moon, Sun-Ha; Lee, Hyun-Jin; Hong, Geu-Ru; Chung, Namsik; Ha, Jong-Won

2017-05-01

The shape and duration of left ventricular outflow tract (LVOT) flow has not been applied to assess the central haemodynamics, although LVOT flow is confronted with afterload of arterial system during systole. The aim of this study was to evaluate whether the LVOT flow parameters are related with central systolic blood pressure (BP) and arterial compliance at rest and as well as during exercise. We studied 258 subjects (175 females, age 61 ± 11 years) with normal left ventricular (LV) systolic function who underwent supine bicycle stress echocardiography and arterial tonometry simultaneously at rest and at peak exercise. Deceleration time (DT) of LVOT flow and RR interval were measured and deceleration time corrected for heart rate (DTc) was calculated. Peripheral and central haemodynamic parameters including systolic and diastolic BP, and augmentation index at a heart rate of 75 (AIx@75) were assessed using radial artery tonometry. Carotid femoral pulse wave velocity (PWV) was measured. Deceleration time corrected for heart rate was independently associated with central systolic BP and AIx@75 at rest (P < 0.001 and 0.006). Similarly, it also showed significant independent correlations with central systolic BP and AIx@75 during peak exercise (P = 0.006 and P = 0.021). In addition, DTc which measured both at rest and at peak exercise demonstrated significant positive correlations with PWV, suggesting association of prolonged DTc with arterial stiffening (P = 0.023 and P = 0.005). Prolongation of LVOT flow DTc represents raised central systolic BP and increased arterial stiffness not only at rest but also during exercise. Therefore, central aortic pressures and arterial stiffness influence the DT of LVOT flow at rest as well as during exercise in individuals with normal LV systolic function. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

Clinical Determinants of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Differentiated Thyroid Cancer Patients with Elevated Thyroglobulin and Negative 131Iodine Whole Body Scans after 131Iodine Therapy

PubMed Central

SHAMIM, Syed Ejaz; NANG, Lee Boon; SHUAIB, Ibrahim Lutfi; MUHAMAD, Nor Asiah

2014-01-01

Background: A cross-sectional prospective study has been conducted on differentiated thyroid cancer (DTC) patients using negative 131Iodine (131I) whole body scans and elevated thyroglobulin (Tg) levels. The main objective of this research was to determine the prevalence of the conversion of differentiated to dedifferentiated thyroid cancer patients during follow up at the Hospital Kuala Lumpur. It has been demonstrated that fluorodeoxyglucose (FDG) uptake is inversely proportional to the iodine concentration and to differentiation of the cells. Methods: Thirty-five patients with histologically proven DTC that have undergone total or near total thyroidectomy, and post 131I radioactive iodine ablation therapy, were selected and prospectively analysed. The patients also had to show at least one negative whole body scan and Tg levels of 10 μg/L and above. The results of the FDG-Positron Emission Tomography/Computed Tomography (PET/CT) were then studied to determine the association and the predictors influencing the outcome by using univariable and multivariable analyses. Results: Out of the thirty-five patients, 60% of them (twenty-one) showed positive results and 40% (fourteen) showed negative. Age, gender, and type of histopathology (HPE) showed significant associations with the positive results of the FDG-PET/CT. The results also showed no correlations observed between the Tg levels and standardised uptake value (SUV)max in the DTC patients with positive disease findings in the FDG-PET/CT. The predictor for this study was age. Conclusion: The prevalence of the conversion of differentiated to dedifferentiated thyroid cancer among patients with negative 131I and elevated Tg was 60%, with age as the predictor. DTC patients aged 45 year-old and older were seven times more likely to have positive results of FDG-PET/CT imaging. PMID:25246834

Multicentre clinical evaluation of the new highly sensitive Elecsys® thyroglobulin II assay in patients with differentiated thyroid carcinoma.

PubMed

Trimboli, P; Imperiali, M; Piccardo, A; CampennÌ, A; Giordani, I; Ruggeri, R M; Baldari, S; Orlandi, F; Giovanella, L

2018-02-01

A highly sensitive thyroglobulin assay (Elecsys® Tg II, Roche Diagnostics, Penzberg, Germany) has become available for monitoring patients with differentiated thyroid cancer (DTC). Here, we evaluated the clinical performance of Elecsys® Tg II assay in a multicentre patients series and compare it with the established Access® Tg assay (Beckman Coulter, Brea, CA, USA). Retrospective analysis on prospectively selected patients in four thyroid cancer referral centres with uniform DTC management. All DTC cases diagnosed, treated and followed up in four tertiary referral centres for thyroid cancer since January 2005 (n = 1456) were retrieved, and predefined selection criteria were applied to prevent relevant enrolment biases. A series of 204 patients was finally selected for this study. Samples had been stored at -80°C. Tg was measured by fully automated immunometric Elecsys® Tg II and Access® Tg assays in a centralized laboratory. Two hundred and four DTC were finally included. Of these, 10.8% had structural recurrence (sREC), and 81.4% showed no evidence of disease (NED) at the end of follow-up. There was a significant analytical bias between methods that cannot be used interchangeably. Using ROC curve analysis, the best basal and rhTSH-stimulated Tg cut-offs to detect sREC were 0.41 μg/L and 1.82 μg/L for Elecsys® and 0.36 μg/L and 1.62 μg/L for Access® assay, respectively. Using Cox proportional hazard regression, Tg was the only independent predictor of cancer relapse. Using appropriate assay-specific cut-offs, the clinical performance of the Elecsys® Tg II assay was comparable to that provided by the well-established Access® Tg assay. © 2017 John Wiley & Sons Ltd.

Acknowledging gray areas: 2015 vs. 2009 American Thyroid Association differentiated thyroid cancer guidelines on ablating putatively low-intermediate-risk patients.

PubMed

Frangos, Savvas; Iakovou, Ioannis P; Marlowe, Robert J; Eftychiou, Nicolaos; Patsali, Loukia; Vanezi, Anna; Savva, Androulla; Mpalaris, Vassilis; Giannoula, Evanthia I

2017-02-01

Typically formulated by investigators from "world centres of excellence," differentiated thyroid carcinoma (DTC) management guidelines may have more limited applicability in settings of less expert care and fewer resources. Arguably the world's leading DTC guidelines are those of the American Thyroid Association, revised in 2009 ("ATA 2009") and 2015 ("ATA 2015"). To further explore the issue of "real-world applicability" of DTC guidelines, we retrospectively compared indications for ablation using ATA 2015 versus ATA 2009 in a two-centre cohort of ablated T1-2, M0 DTC patients (N = 336). Based on TNM status and histology, these patients were low-intermediate risk, but many ultimately had other characteristics suggesting elevated or uncertain risk. Working by consensus, two experienced nuclear medicine physicians considered patient and treatment characteristics to classify each case as having "no indication," a "possible indication," or a "clear indication" for ablation according to ATA 2009 or ATA 2015. The physicians also identified reasons for classification changes between ATA 2015 versus ATA 2009. Classification was unblinded, but the physicians had cared for only 138/336 patients, and the charts encompassed September 2010-October 2013, several years before the classification was performed. One hundred of 336 patients (29.8 %) changed classification regarding indication for ablation using ATA 2015 versus ATA 2009. Most reclassified patients (70/100) moved from "no indication" or "clear indication" to "possible indication." Reflecting this phenomenon, "possible indication" became the largest category according to the ATA 2015 classification (141/336, 42.0 %, versus 96/336, 28.6 %, according to ATA 2009). Many reclassifications were attributable to multiple clinicopathological characteristics, most commonly, stimulated thyroglobulin or anti-thyroglobulin antibody levels, multifocality, bilateral involvement, or capsular/nodal invasion. Regarding indications for ablation, ATA 2015 appears to better "acknowledge grey areas," i.e., patients with ambiguous or unavailable data requiring individualised, nuanced decision-making, than does ATA 2009.

Axitinib treatment in advanced RAI-resistant differentiated thyroid cancer (DTC) and refractory medullary thyroid cancer (MTC).

PubMed

Capdevila, Jaume; Trigo, José Manuel; Aller, Javier; Manzano, José Luís; Adrián, Silvia García; Llopis, Carles Zafón; Reig, Òscar; Bohn, Uriel; Cajal, Teresa Ramón Y; Duran-Poveda, Manuel; Astorga, Beatriz González; López-Alfonso, Ana; Martínez, Javier Medina; Porras, Ignacio; Reina, Juan Jose; Palacios, Nuria; Grande, Enrique; Cillán, Elena; Matos, Ignacio; Grau, Juan Jose

2017-10-01

Axitinib, an antiangiogenic multikinase inhibitor (MKI), was evaluated in the compassionate use programme (CUP) in Spain (October 2012-November 2014). 47 patients with advanced radioactive iodine (RAI)-refractory differentiated thyroid cancer (DTC, n  = 34) or medullary thyroid cancer (MTC, n  = 13) with documented disease progression were treated with axitinib 5 mg b.i.d. The primary efficacy endpoint was objective response rate (ORR) by Response Evaluation Criteria In Solid Tumors (RECIST) v1.1. Progression-free survival (PFS) and adverse events (AEs) were secondary objectives. Regulatory authorities validated the CUP, and all patients signed informed consent form. Axitinib was administered as first-line therapy in 17 patients (36.2%), as second-line in 18 patients (38.3%) and as third/fourth-line in 12 patients (25.5%). With a median follow-up of 11.5 months (0-24.3), ORR was 27.7% (DTC: 29.4% and MTC: 23.1%) and median PFS was 8.1 months (95% CI: 4.1-12.2) (DTC: 7.4 months (95% CI: 3.1-11.8) and MTC: 9.4 months (95% CI: 4.8-13.9)). Better outcomes were reported with first-line axitinib, with an ORR of 53% and a median PFS of 13.6 months compared with 16.7% and 10.6 months as second-line treatment. Twelve (25.5%) patients required dose reduction to 3 mg b.i.d. All-grade AEs included asthenia (53.2%), diarrhoea (36.2%), hypertension (31.9%) and mucositis (29.8%); grade 3/4 AEs included anorexia (6.4%), diarrhoea (4.3%) and cardiac toxicity (4.3%). Axitinib had a tolerable safety profile and clinically meaningful activity in refractory and progressive thyroid cancer regardless of histology as first-line therapy. To our knowledge, this is the first time that cross-resistance between MKIs is suggested in thyroid cancer, highlighting the importance of prospective sequential clinical studies. © 2017 European Society of Endocrinology.

High-resolution monitoring of catchment nutrient response to the end of the 2011-2012 drought in England, captured by the demonstration test catchments

NASA Astrophysics Data System (ADS)

Outram, F. N.; Lloyd, C.; Jonczyk, J.; Benskin, C. McW. H.; Grant, F.; Dorling, S. R.; Steele, C. J.; Collins, A. L.; Freer, J.; Haygarth, P. M.; Hiscock, K. M.; Johnes, P. J.; Lovett, A. L.

2013-12-01

The Demonstration Test Catchments (DTC) project is a UK Government funded initiative to test the effectiveness of on-farm mitigation measures designed to reduce agricultural pollution without compromising farm productivity. Three distinct catchments in England have been chosen to test the efficacy of mitigation measures on working farms in small tributary sub-catchments equipped with continuous water quality monitoring stations. The Hampshire Avon in the south is a mixed livestock and arable farming catchment, the River Wensum in the east is a lowland catchment with predominantly arable farming and land use in the River Eden catchment in the north-west is predominantly livestock farming. One of the many strengths of the DTC as a national research platform is that it provides the ability to investigate catchment hydrology and biogeochemical response across different landscapes and geoclimatic characteristics, with a range of differing flow behaviours, geochemistries and nutrient chemistries. Although numerous authors present studies of individual catchment responses to storms, no studies exist of multiple catchment responses to the same rainfall event captured with in situ high-resolution nutrient monitoring at a national scale. This paper brings together findings from all three DTC research groups to compare the response of the catchments to a major storm event in April 2012. This was one of the first weather fronts to track across the country following a prolonged drought period affecting much of the UK through 2011-2012, marking an unusual meteorological transition when a rapid shift from drought to flood risk occurred. The effects of the weather front on discharge and water chemistry parameters, including nitrogen species (NO3-N and NH4-N) and phosphorus fractions (total P (TP) and total reactive P (TRP)), measured at a half-hourly time step are examined. When considered in the context of one hydrological year, flow and concentration duration curves reveal that the weather fronts resulted in extreme flow, nitrate and TP concentrations in all three catchments but with distinct differences in both hydrographs and chemographs. Hysteresis loops constructed from high resolution data are used to highlight an array of potential pollutant sources and delivery pathways. In the Hampshire Avon DTC, transport was dominated by sub-surface processes, where phosphorus, largely in the soluble form, was found to be transport-limited. In the Wensum DTC, transport was largely dominated by rapid sub-surface movement due to the presence of under-drainage, which mobilised large quantities of nitrate during the storm. In the Eden DTC, transport was found to be initially dominated by surface runoff, which switched to subsurface delivery on the falling limb of the hydrograph, with the surface delivery transporting large amounts of particulate phosphorus to the river, with a transport-limited response. The lack of exhaustion of nutrient delivery in response to such extreme flow generation indicates the size of the nutrient pools stored in these catchments, and highlights the scale of the challenges faced by environmental managers when designing mitigation measures to reduce the flux of nutrients to UK river systems from diffuse agricultural sources.

MTPA control of mechanical sensorless IPMSM based on adaptive nonlinear control.

PubMed

Najjar-Khodabakhsh, Abbas; Soltani, Jafar

2016-03-01

In this paper, an adaptive nonlinear control scheme has been proposed for implementing maximum torque per ampere (MTPA) control strategy corresponding to interior permanent magnet synchronous motor (IPMSM) drive. This control scheme is developed in the rotor d-q axis reference frame using adaptive input-output state feedback linearization (AIOFL) method. The drive system control stability is supported by Lyapunov theory. The motor inductances are online estimated by an estimation law obtained by AIOFL. The estimation errors of these parameters are proved to be asymptotically converged to zero. Based on minimizing the motor current amplitude, the MTPA control strategy is performed by using the nonlinear optimization technique while considering the online reference torque. The motor reference torque is generated by a conventional rotor speed PI controller. By performing MTPA control strategy, the generated online motor d-q reference currents were used in AIOFL controller to obtain the SV-PWM reference voltages and the online estimation of the motor d-q inductances. In addition, the stator resistance is online estimated using a conventional PI controller. Moreover, the rotor position is detected using the online estimation of the stator flux and online estimation of the motor q-axis inductance. Simulation and experimental results obtained prove the effectiveness and the capability of the proposed control method. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

Nematode cholinergic pharmacology

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

Segerberg, M.A.

1989-01-01

Nematode acetylcholine (ACh) receptors were characterized using both biochemical and electrophysiological techniques, including: (1) receptor binding studies in crude homogenates of the free-living nematode Caenorhabditis elegans and the parasitic nematode Ascaris lumbricoides with the high-affinity probe ({sup 3}H)N-methylscopolamine (({sup 3}H)NMS) which binds to muscarinic receptors in many vertebrate and invertebrate tissues (2) measurement of depolarization and contraction induced by a variety of cholinergic agents, including N-methylscopolamine (NMS), in an innervated dorsal muscle strip preparation of Ascaris; (3) examination of the antagonistic actions of d-tubocurarine (dTC) and NMS at dorsal neuromuscular junction; (4) measurement of input resistance changes in Ascaris commissuralmore » motorneurons induced by ACh, dTC, NMS, pilocarpine and other cholinergic drugs.« less

Hidden in plain sight marketing prescription drugs to consumers in the twentieth century.

PubMed

Greene, Jeremy A; Herzberg, David

2010-05-01

Although the public health impact of direct-to-consumer (DTC) pharmaceutical advertising remains a subject of great controversy, such promotion is typically understood as a recent phenomenon permitted only by changes in federal regulation of print and broadcast advertising over the past two decades. But today's omnipresent ads are only the most recent chapter in a longer history of DTC pharmaceutical promotion (including the ghostwriting of popular articles, organization of public-relations events, and implicit advertising of products to consumers) stretching back over the twentieth century. We use trade literature and archival materials to examine the continuity of efforts to promote prescription drugs to consumers and to better grapple with the public health significance of contemporary pharmaceutical marketing practices.

HIDDEN in PLAIN SIGHT Marketing Prescription Drugs to Consumers in the Twentieth Century

PubMed Central

Herzberg, David

2010-01-01

Although the public health impact of direct-to-consumer (DTC) pharmaceutical advertising remains a subject of great controversy, such promotion is typically understood as a recent phenomenon permitted only by changes in federal regulation of print and broadcast advertising over the past two decades. But today's omnipresent ads are only the most recent chapter in a longer history of DTC pharmaceutical promotion (including the ghostwriting of popular articles, organization of public-relations events, and implicit advertising of products to consumers) stretching back over the twentieth century. We use trade literature and archival materials to examine the continuity of efforts to promote prescription drugs to consumers and to better grapple with the public health significance of contemporary pharmaceutical marketing practices. PMID:20299640

Signal injection as a fault detection technique.

PubMed

Cusidó, Jordi; Romeral, Luis; Ortega, Juan Antonio; Garcia, Antoni; Riba, Jordi

2011-01-01

Double frequency tests are used for evaluating stator windings and analyzing the temperature. Likewise, signal injection on induction machines is used on sensorless motor control fields to find out the rotor position. Motor Current Signature Analysis (MCSA), which focuses on the spectral analysis of stator current, is the most widely used method for identifying faults in induction motors. Motor faults such as broken rotor bars, bearing damage and eccentricity of the rotor axis can be detected. However, the method presents some problems at low speed and low torque, mainly due to the proximity between the frequencies to be detected and the small amplitude of the resulting harmonics. This paper proposes the injection of an additional voltage into the machine being tested at a frequency different from the fundamental one, and then studying the resulting harmonics around the new frequencies appearing due to the composition between injected and main frequencies.

Signal Injection as a Fault Detection Technique

PubMed Central

Cusidó, Jordi; Romeral, Luis; Ortega, Juan Antonio; Garcia, Antoni; Riba, Jordi

2011-01-01

Double frequency tests are used for evaluating stator windings and analyzing the temperature. Likewise, signal injection on induction machines is used on sensorless motor control fields to find out the rotor position. Motor Current Signature Analysis (MCSA), which focuses on the spectral analysis of stator current, is the most widely used method for identifying faults in induction motors. Motor faults such as broken rotor bars, bearing damage and eccentricity of the rotor axis can be detected. However, the method presents some problems at low speed and low torque, mainly due to the proximity between the frequencies to be detected and the small amplitude of the resulting harmonics. This paper proposes the injection of an additional voltage into the machine being tested at a frequency different from the fundamental one, and then studying the resulting harmonics around the new frequencies appearing due to the composition between injected and main frequencies. PMID:22163801

Aircraft panel with sensorless active sound power reduction capabilities through virtual mechanical impedances

NASA Astrophysics Data System (ADS)

Boulandet, R.; Michau, M.; Micheau, P.; Berry, A.

2016-01-01

This paper deals with an active structural acoustic control approach to reduce the transmission of tonal noise in aircraft cabins. The focus is on the practical implementation of the virtual mechanical impedances method by using sensoriactuators instead of conventional control units composed of separate sensors and actuators. The experimental setup includes two sensoriactuators developed from the electrodynamic inertial exciter and distributed over an aircraft trim panel which is subject to a time-harmonic diffuse sound field. The target mechanical impedances are first defined by solving a linear optimization problem from sound power measurements before being applied to the test panel using a complex envelope controller. Measured data are compared to results obtained with sensor-actuator pairs consisting of an accelerometer and an inertial exciter, particularly as regards sound power reduction. It is shown that the two types of control unit provide similar performance, and that here virtual impedance control stands apart from conventional active damping. In particular, it is clear from this study that extra vibrational energy must be provided by the actuators for optimal sound power reduction, mainly due to the high structural damping in the aircraft trim panel. Concluding remarks on the benefits of using these electrodynamic sensoriactuators to control tonal disturbances are also provided.

Generalized predictive control for a coupled four tank MIMO system using a continuous-discrete time observer.

PubMed

Gouta, Houssemeddine; Hadj Saïd, Salim; Barhoumi, Nabil; M'Sahli, Faouzi

2017-03-01

This paper deals with the problem of the observer based control design for a coupled four-tank liquid level system. For this MIMO system's dynamics, motivated by a desire to provide precise and sensorless liquid level control, a nonlinear predictive controller based on a continuous-discrete observer is presented. First, an analytical solution from the model predictive control (MPC) technique is developed for a particular class of nonlinear MIMO systems and its corresponding exponential stability is proven. Then, a high gain observer that runs in continuous-time with an output error correction time that is updated in a mixed continuous-discrete fashion is designed in order to estimate the liquid levels in the two upper tanks. The effectiveness of the designed control schemes are validated by two tests; The first one is maintaining a constant level in the first bottom tank while making the level in the second bottom tank to follow a sinusoidal reference signal. The second test is more difficult and it is made using two trapezoidal reference signals in order to see the decoupling performance of the system's outputs. Simulation and experimental results validate the objective of the paper. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

Robust control for a biaxial servo with time delay system based on adaptive tuning technique.

PubMed

Chen, Tien-Chi; Yu, Chih-Hsien

2009-07-01

A robust control method for synchronizing a biaxial servo system motion is proposed in this paper. A new network based cross-coupled control and adaptive tuning techniques are used together to cancel out the skew error. The conventional fixed gain PID cross-coupled controller (CCC) is replaced with the adaptive cross-coupled controller (ACCC) in the proposed control scheme to maintain biaxial servo system synchronization motion. Adaptive-tuning PID (APID) position and velocity controllers provide the necessary control actions to maintain synchronization while following a variable command trajectory. A delay-time compensator (DTC) with an adaptive controller was augmented to set the time delay element, effectively moving it outside the closed loop, enhancing the stability of the robust controlled system. This scheme provides strong robustness with respect to uncertain dynamics and disturbances. The simulation and experimental results reveal that the proposed control structure adapts to a wide range of operating conditions and provides promising results under parameter variations and load changes.

Caffeine prevents cognitive impairment induced by chronic psychosocial stress and/or high fat-high carbohydrate diet.

PubMed

Alzoubi, K H; Abdul-Razzak, K K; Khabour, O F; Al-Tuweiq, G M; Alzubi, M A; Alkadhi, K A

2013-01-15

Caffeine alleviates cognitive impairment associated with a variety of health conditions. In this study, we examined the effect of caffeine treatment on chronic stress- and/or high fat-high carbohydrate Western diet (WD)-induced impairment of learning and memory in rats. Chronic psychosocial stress, WD and caffeine (0.3 g/L in drinking water) were simultaneously administered for 3 months to adult male Wistar rats. At the conclusion of the 3 months, and while the previous treatments continued, rats were tested in the radial arm water maze (RAWM) for learning, short-term and long-term memory. This procedure was applied on a daily basis to all animals for 5 consecutive days or until the animal reaches days to criterion (DTC) in the 12th learning trial and memory tests. DTC is the number of days that the animal takes to make zero error in two consecutive days. Chronic stress and/or WD groups caused impaired learning, which was prevented by chronic caffeine administration. In the memory tests, chronic caffeine administration also prevented memory impairment during chronic stress conditions and/or WD. Furthermore, DTC value for caffeine treated stress, WD, and stress/WD groups indicated that caffeine normalizes memory impairment in these groups. These results showed that chronic caffeine administration prevented stress and/or WD-induced impairment of spatial learning and memory. Copyright © 2012 Elsevier B.V. All rights reserved.