Controlling percolation with limited resources.

PubMed

Schröder, Malte; Araújo, Nuno A M; Sornette, Didier; Nagler, Jan

2017-12-01

Connectivity, or the lack thereof, is crucial for the function of many man-made systems, from financial and economic networks over epidemic spreading in social networks to technical infrastructure. Often, connections are deliberately established or removed to induce, maintain, or destroy global connectivity. Thus, there has been a great interest in understanding how to control percolation, the transition to large-scale connectivity. Previous work, however, studied control strategies assuming unlimited resources. Here, we depart from this unrealistic assumption and consider the effect of limited resources on the effectiveness of control. We show that, even for scarce resources, percolation can be controlled with an efficient intervention strategy. We derive such an efficient strategy and study its implications, revealing a discontinuous transition as an unintended side effect of optimal control.

Controlling percolation with limited resources

NASA Astrophysics Data System (ADS)

Schröder, Malte; Araújo, Nuno A. M.; Sornette, Didier; Nagler, Jan

2017-12-01

Connectivity, or the lack thereof, is crucial for the function of many man-made systems, from financial and economic networks over epidemic spreading in social networks to technical infrastructure. Often, connections are deliberately established or removed to induce, maintain, or destroy global connectivity. Thus, there has been a great interest in understanding how to control percolation, the transition to large-scale connectivity. Previous work, however, studied control strategies assuming unlimited resources. Here, we depart from this unrealistic assumption and consider the effect of limited resources on the effectiveness of control. We show that, even for scarce resources, percolation can be controlled with an efficient intervention strategy. We derive such an efficient strategy and study its implications, revealing a discontinuous transition as an unintended side effect of optimal control.

Cerebral Economics: Resource Competition within but not Between Hemispheres.

DTIC Science & Technology

1981-06-01

the Office of Naval Research and by the Air Force Office of Scientific Research. 19. KEY WORDS (Continue on reveree side ifneceset, and Identify by...consistent RVF advantage on the naming task when it LI 6 was performed alone, the effect of adding the memory load made left hemisphere resources so...might be argued that the equivalent tradeoff effects we found when comparing the complete with the partial overlap situation might be evidence for some

One-sided truncated sequential t-test: application to natural resource sampling

Treesearch

Gary W. Fowler; William G. O' Regan

1974-01-01

A new procedure for constructing one-sided truncated sequential t-tests and its application to natural resource sampling are described. Monte Carlo procedures were used to develop a series of one-sided truncated sequential t-tests and the associated approximations to the operating characteristic and average sample number functions. Different truncation points and...

D-Side: A Facility and Workforce Planning Group Multi-criteria Decision Support System for Johnson Space Center

NASA Technical Reports Server (NTRS)

Tavana, Madjid

2005-01-01

"To understand and protect our home planet, to explore the universe and search for life, and to inspire the next generation of explorers" is NASA's mission. The Systems Management Office at Johnson Space Center (JSC) is searching for methods to effectively manage the Center's resources to meet NASA's mission. D-Side is a group multi-criteria decision support system (GMDSS) developed to support facility decisions at JSC. D-Side uses a series of sequential and structured processes to plot facilities in a three-dimensional (3-D) graph on the basis of each facility alignment with NASA's mission and goals, the extent to which other facilities are dependent on the facility, and the dollar value of capital investments that have been postponed at the facility relative to the facility replacement value. A similarity factor rank orders facilities based on their Euclidean distance from Ideal and Nadir points. These similarity factors are then used to allocate capital improvement resources across facilities. We also present a parallel model that can be used to support decisions concerning allocation of human resources investments across workforce units. Finally, we present results from a pilot study where 12 experienced facility managers from NASA used D-Side and the organization's current approach to rank order and allocate funds for capital improvement across 20 facilities. Users evaluated D-Side favorably in terms of ease of use, the quality of the decision-making process, decision quality, and overall value-added. Their evaluations of D-Side were significantly more favorable than their evaluations of the current approach. Keywords: NASA, Multi-Criteria Decision Making, Decision Support System, AHP, Euclidean Distance, 3-D Modeling, Facility Planning, Workforce Planning.

Evaluating Complementary and Alternative Therapies

MedlinePlus

... t Work Drug Information Resources Side Effects Dating, Sex, and Reproduction Advanced Cancer For Children For Teens For Young Adults For Older Adults Prevention and Healthy Living Cancer.Net Videos Coping With Cancer Research and Advocacy Survivorship Blog ...

The Association between Insomnia and Insomnia Treatment Side Effects on Health Status, Work Productivity, and Healthcare Resource Use

PubMed Central

DiBonaventura, Marco; Richard, Lance; Kumar, Maya; Forsythe, Anna; Flores, Natalia M.; Moline, Margaret

2015-01-01

The aims of this study were (1) to compare health outcomes (i.e., health-related quality of life [HRQoL], productivity at work, and healthcare resource use visits) between those with insomnia and non-insomnia controls, (2) to compare health outcomes between those treated for insomnia and non-insomnia controls, and (3) to assess the prevalence of side effects of insomnia medications and their relationship with health outcomes. Data from the 2013 US (N = 75,000) and 5EU (N = 62,000) National Health and Wellness Survey (NHWS) were used. The NHWS is a patient-reported survey administered to a demographically representative sample of adults. Those who met DSM-V criteria for insomnia and, separately, those treated for insomnia were compared with equivalently sized control groups who were identified using a propensity score matching method. Outcomes included HRQoL (Short Form 36v2), productivity at work (Work Productivity and Activity Impairment—General Health questionnaire), and healthcare resource use visits in the past 6 months and were analyzed using one-way ANOVAs. Among those with treated insomnia, those with and without side effects were compared on health outcomes using general linear models controlling for confounding variables. Patients with insomnia (n = 4147) and treated insomnia (n = 2860) in the 5EU reported significantly worse HRQoL than controls (health utilities: 0.60 vs. 0.74; 0.60 vs. 0.74, respectively), greater overall work impairment (38.74% vs. 14.86%; 39.50% vs. 15.66%), and more physician visits in the past 6 months (9.10 vs. 4.08; 9.58 vs. 4.11). Similar findings were observed in the US. Among those treated for insomnia, 13.56% and 24.55% in the US and 5EU, respectively, were non-adherent due to side effects. In the US, non-adherence was associated with significantly worse HRQoL (health utilities: 0.60 vs. 0.64, p <.05) and greater overall work impairment (37.71% vs. 29.08%, p <.05), among other significant differences. These relationships were not significant in the 5EU. A significant burden of insomnia was observed in both the US and 5EU, and the association remained even after treatment. Non-adherence due to side effects was common and, in the case of the US, associated with significantly poorer health outcomes. PMID:26426805

Safety of stavudine in the treatment of HIV infection with a special focus on resource-limited settings.

PubMed

Makinson, Alain; Moing, Vincent Le; Kouanfack, Charles; Laurent, Christian; Delaporte, Eric

2008-05-01

Western randomized trials and prospective cohorts in resource-limited settings have proven virological success with stavudine-based highly active antiretroviral therapy. However, stavudine is no longer recommended in first-line treatments in these two settings due to its intrinsic toxicities and side effects. Yet it remains a cornerstone of treatment in resource-limited settings, due to lack of alternatives and its availability in generic fixed-dose combinations. To review the toxic effects of stavudine and their prevention and management strategies, especially in resource-limited settings. Data from clinical and pharmacological trials in Western countries, as well as prospective cohorts in resource-limited settings, were reviewed. Initiating or switching to less toxic nucleoside analogues whenever possible, or lowering stavudine doses to 30 mg b.i.d., is strongly recommended.

On the Water-Food Nexus: an Optimization Approach for Water and Food Security

NASA Astrophysics Data System (ADS)

Mortada, Sarah; Abou Najm, Majdi; Yassine, Ali; Alameddine, Ibrahim; El-Fadel, Mutasem

2016-04-01

Water and food security is facing increased challenges with population increase, climate and land use change, as well as resource depletion coupled with pollution and unsustainable practices. Coordinated and effective management of limited natural resources have become an imperative to meet these challenges by optimizing the usage of resources under various constraints. In this study, an optimization model is developed for optimal resource allocation towards sustainable water and food security under nutritional, socio-economic, agricultural, environmental, and natural resources constraints. The core objective of this model is to maximize the composite water-food security status by recommending an optimal water and agricultural strategy. The model balances between the healthy nutritional demand side and the constrained supply side while considering the supply chain in between. It equally ensures that the population achieves recommended nutritional guidelines and population food-preferences by quantifying an optimum agricultural and water policy through transforming optimum food demands into optimum cropping policy given the water and land footprints of each crop or agricultural product. Through this process, water and food security are optimized considering factors that include crop-food transformation (food processing), water footprints, crop yields, climate, blue and green water resources, irrigation efficiency, arable land resources, soil texture, and economic policies. The model performance regarding agricultural practices and sustainable food and water security was successfully tested and verified both at a hypothetical and pilot scale levels.

Exploring Tradeoffs in Demand-side and Supply-side Management of Urban Water Resources using Agent-based Modeling and Evolutionary Computation

NASA Astrophysics Data System (ADS)

Kanta, L.; Berglund, E. Z.

2015-12-01

Urban water supply systems may be managed through supply-side and demand-side strategies, which focus on water source expansion and demand reductions, respectively. Supply-side strategies bear infrastructure and energy costs, while demand-side strategies bear costs of implementation and inconvenience to consumers. To evaluate the performance of demand-side strategies, the participation and water use adaptations of consumers should be simulated. In this study, a Complex Adaptive Systems (CAS) framework is developed to simulate consumer agents that change their consumption to affect the withdrawal from the water supply system, which, in turn influences operational policies and long-term resource planning. Agent-based models are encoded to represent consumers and a policy maker agent and are coupled with water resources system simulation models. The CAS framework is coupled with an evolutionary computation-based multi-objective methodology to explore tradeoffs in cost, inconvenience to consumers, and environmental impacts for both supply-side and demand-side strategies. Decisions are identified to specify storage levels in a reservoir that trigger (1) increases in the volume of water pumped through inter-basin transfers from an external reservoir and (2) drought stages, which restrict the volume of water that is allowed for residential outdoor uses. The proposed methodology is demonstrated for Arlington, Texas, water supply system to identify non-dominated strategies for an historic drought decade. Results demonstrate that pumping costs associated with maximizing environmental reliability exceed pumping costs associated with minimizing restrictions on consumer water use.

Open Educational Resources: American Ideals, Global Questions

ERIC Educational Resources Information Center

Weiland, Steven

2015-01-01

Educational relations between societies and cultures that begin with benevolent intentions can come to be seen as threats to national autonomy and local preferences. Indeed, side by side with the growth since the first years of this century of Open Educational Resources (OER) there has been worry about their impact on global educational…

Stressors of caregivers of school-age children with epilepsy and use of community resources.

PubMed

Saburi, Gladys

2011-06-01

Childhood epilepsy causes multiple stressors, difficulty in adjustment, and disruptions in family relations. This study sought to identify stressors of caregivers of school-age children and to assess whether use of community resources alleviates or contributes to caregiver stress. Stressors refer to concern about the child, communication with healthcare providers, changes in family relationships, interaction with school, and support within the community. A caregiver refers to the person who had looked after the child for the past 6-12 months. Support groups, religious or worship groups, counseling services, and traditional and spiritual faith healers were the community resources that were addressed. Face-to-face interviews were conducted on a convenience sample of 46 caregivers. A three-part structured interview schedule was used to describe demographic data, stressors of caregivers, and use of community resources. The top 6 stressors were the inability to get antiepileptic drugs, the deep pain or sadness caused by the child's seizures, caregiving (which was predominantly by mothers), limited help from the extended family, inadequate information on side effects of drugs, and inadequate information on seizures. The most commonly used community resource was religious or worship groups, with epilepsy support groups being least used. To alleviate caregiver stress, it is important that healthcare providers routinely assess the effect of seizures on caregivers and refer those requiring counseling, advocate for more male and extended family involvement in caregiving and provide adequate information on side effects of drugs and on seizures as standard practice. Nurses in developed countries should incorporate religious activities among complementary and alternative medicine interventions to reduce caregiver stress. Spiritual faith healers should be encouraged to refer clients with epilepsy for drug therapy and counseling.

Input and output constraints affecting irrigation development

NASA Astrophysics Data System (ADS)

Schramm, G.

1981-05-01

In many of the developing countries the expansion of irrigated agriculture is used as a major development tool for bringing about increases in agricultural output, rural economic growth and income distribution. Apart from constraints imposed by water availability, the major limitations considered to any acceleration of such programs are usually thought to be those of costs and financial resources. However, as is shown on the basis of empirical data drawn from Mexico, in reality the feasibility and effectiveness of such development programs is even more constrained by the lack of specialized physical and human factors on the input and market limitations on the output side. On the input side, the limited availability of complementary factors such as, for example, truly functioning credit systems for small-scale farmers or effective agricultural extension services impose long-term constraints on development. On the output side the limited availability, high risk, and relatively slow growth of markets for high-value crops sharply reduce the usually hoped-for and projected profitable crop mix that would warrant the frequently high costs of irrigation investments. Three conclusions are drawn: (1) Factors in limited supply have to be shadow-priced to reflect their high opportunity costs in alternative uses. (2) Re-allocation of financial resources from immediate construction of projects to longer-term increase in the supply of scarce, highly-trained manpower resources are necessary in order to optimize development over time. (3) Inclusion of high-value, high-income producing crops in the benefit-cost analysis of new projects is inappropriate if these crops could potentially be grown in already existing projects.

Assessment of the effectiveness of supply-side cost-containment measures

PubMed Central

Garrison, Louis P.

1992-01-01

This article assesses the arguments and evidence concerning the likely effectiveness of four supply-side cost-containment measures. The health planning efforts of the 1970s, particularly certificate-of-need regulations, had very limited success in containing costs. The new and related tools of technology assessment and practice guidelines hold some promise for refining benefit packages, but they are inadequate for micromanaging complex medical practices. Payment policies, such as hospital ratesetting, have enjoyed some success in limiting hospital cost growth but are less effective at controlling total costs. None of these measures alone is likely to address fully the fundamental issues of equity and efficiency in health care resource allocation that underlie the problem of rising costs. PMID:25372721

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

Riggs, J.B.

An experimental test model, which is dynamically similar to an actual UCC (Underground Coal Conversion) system, was used to determine fluid-flow patterns and local heat transfer that occur in the UCC burn cavity. This study was designed to provide insight into the little understood mechanisms (i.e., heat transfer and oxygen transport to the cavity walls) that control maximum cavity width, and therefore resource recovery during UCC. The experimental studies will be designed to study the effects of a growing cavity upon the transport to the side walls of a UCG cavity. The flow model will be used to study themore » effects of rubble pile shape changes upon the transport to the side walls.« less

Features of effective medical knowledge resources to support point of care learning: a focus group study.

PubMed

Cook, David A; Sorensen, Kristi J; Hersh, William; Berger, Richard A; Wilkinson, John M

2013-01-01

Health care professionals access various information sources to quickly answer questions that arise in clinical practice. The features that favorably influence the selection and use of knowledge resources remain unclear. We sought to better understand how clinicians select among the various knowledge resources available to them, and from this to derive a model for an effective knowledge resource. We conducted 11 focus groups at an academic medical center and outlying community sites. We included a purposive sample of 50 primary care and subspecialist internal medicine and family medicine physicians. We transcribed focus group discussions and analyzed these using a constant comparative approach to inductively identify features that influence the selection of knowledge resources. We identified nine features that influence users' selection of knowledge resources, namely efficiency (with sub-features of comprehensiveness, searchability, and brevity), integration with clinical workflow, credibility, user familiarity, capacity to identify a human expert, reflection of local care processes, optimization for the clinical question (e.g., diagnosis, treatment options, drug side effect), currency, and ability to support patient education. No single existing resource exemplifies all of these features. The influential features identified in this study will inform the development of knowledge resources, and could serve as a framework for future research in this field.

Features of Effective Medical Knowledge Resources to Support Point of Care Learning: A Focus Group Study

PubMed Central

Cook, David A.; Sorensen, Kristi J.; Hersh, William; Berger, Richard A.; Wilkinson, John M.

2013-01-01

Objective Health care professionals access various information sources to quickly answer questions that arise in clinical practice. The features that favorably influence the selection and use of knowledge resources remain unclear. We sought to better understand how clinicians select among the various knowledge resources available to them, and from this to derive a model for an effective knowledge resource. Methods We conducted 11 focus groups at an academic medical center and outlying community sites. We included a purposive sample of 50 primary care and subspecialist internal medicine and family medicine physicians. We transcribed focus group discussions and analyzed these using a constant comparative approach to inductively identify features that influence the selection of knowledge resources. Results We identified nine features that influence users' selection of knowledge resources, namely efficiency (with sub-features of comprehensiveness, searchability, and brevity), integration with clinical workflow, credibility, user familiarity, capacity to identify a human expert, reflection of local care processes, optimization for the clinical question (e.g., diagnosis, treatment options, drug side effect), currency, and ability to support patient education. No single existing resource exemplifies all of these features. Conclusion The influential features identified in this study will inform the development of knowledge resources, and could serve as a framework for future research in this field. PMID:24282535

Human resources for health policies: a critical component in health policies

PubMed Central

Dussault, Gilles; Dubois, Carl-Ardy

2003-01-01

In the last few years, increasing attention has been paid to the development of health policies. But side by side with the presumed benefits of policy, many analysts share the opinion that a major drawback of health policies is their failure to make room for issues of human resources. Current approaches in human resources suggest a number of weaknesses: a reactive, ad hoc attitude towards problems of human resources; dispersal of accountability within human resources management (HRM); a limited notion of personnel administration that fails to encompass all aspects of HRM; and finally the short-term perspective of HRM. There are three broad arguments for modernizing the ways in which human resources for health are managed: • the central role of the workforce in the health sector; • the various challenges thrown up by health system reforms; • the need to anticipate the effect on the health workforce (and consequently on service provision) arising from various macroscopic social trends impinging on health systems. The absence of appropriate human resources policies is responsible, in many countries, for a chronic imbalance with multifaceted effects on the health workforce: quantitative mismatch, qualitative disparity, unequal distribution and a lack of coordination between HRM actions and health policy needs. Four proposals have been put forward to modernize how the policy process is conducted in the development of human resources for health (HRH): • to move beyond the traditional approach of personnel administration to a more global concept of HRM; • to give more weight to the integrated, interdependent and systemic nature of the different components of HRM when preparing and implementing policy; • to foster a more proactive attitude among human resources (HR) policy-makers and managers; • to promote the full commitment of all professionals and sectors in all phases of the process. The development of explicit human resources policies is a crucial link in health policies and is needed both to address the imbalances of the health workforce and to foster implementation of the health services reforms. PMID:12904254

Human resources for health policies: a critical component in health policies.

PubMed

Dussault, Gilles; Dubois, Carl-Ardy

2003-04-14

In the last few years, increasing attention has been paid to the development of health policies. But side by side with the presumed benefits of policy, many analysts share the opinion that a major drawback of health policies is their failure to make room for issues of human resources. Current approaches in human resources suggest a number of weaknesses: a reactive, ad hoc attitude towards problems of human resources; dispersal of accountability within human resources management (HRM); a limited notion of personnel administration that fails to encompass all aspects of HRM; and finally the short-term perspective of HRM.There are three broad arguments for modernizing the ways in which human resources for health are managed:bullet; the central role of the workforce in the health sector;bullet; the various challenges thrown up by health system reforms;bullet; the need to anticipate the effect on the health workforce (and consequently on service provision) arising from various macroscopic social trends impinging on health systems.The absence of appropriate human resources policies is responsible, in many countries, for a chronic imbalance with multifaceted effects on the health workforce: quantitative mismatch, qualitative disparity, unequal distribution and a lack of coordination between HRM actions and health policy needs.Four proposals have been put forward to modernize how the policy process is conducted in the development of human resources for health (HRH):bullet; to move beyond the traditional approach of personnel administration to a more global concept of HRM;bullet; to give more weight to the integrated, interdependent and systemic nature of the different components of HRM when preparing and implementing policy;bullet; to foster a more proactive attitude among human resources (HR) policy-makers and managers;bullet; to promote the full commitment of all professionals and sectors in all phases of the process.The development of explicit human resources policies is a crucial link in health policies and is needed both to address the imbalances of the health workforce and to foster implementation of the health services reforms.

National Conference on Integrated Resource Planning: Proceedings

NASA Astrophysics Data System (ADS)

Until recently, state regulators have focused most of their attention on the development of least-cost or integrated resource planning (IRP) processes for electric utilities. A number of commissions are beginning to scrutinize the planning processes of local gas distribution companies (LDCs) because of the increased control that LDCs have over their purchased gas costs (as well as the associated risks) and because of questions surrounding the role and potential of gas end-use efficiency options. Traditionally, resource planning (LDCs) has concentrated on options for purchasing and storing gas. Integrated resource planning involves the creation of a process in which supply-side and demand-side options are integrated to create a resource mix that reliably satisfies customers' short-term and long-term energy service needs at the lowest cost. As applied to gas utilities, an integrated resource plan seeks to balance cost and reliability, and should not be interpreted simply as the search for lowest commodity costs. The National Association of Regulatory Utility Commissioners' (NARUC) Energy Conservation committee asked Lawrence Berkeley Laboratory (LBL) to survey state PUCs to determine the extent to which they have undertaken least cost planning for gas utilities. The survey included the following topics: status of state PUC least-cost planning regulations and practices for gas utilities; type and scope of natural gas DSM programs in effect, including fuel substitution; economic tests and analysis methods used to evaluate DSM programs; relationship between prudency reviews of gas utility purchasing practices and integrated resource planning; and key regulatory issues facing gas utilities during the next five years.

Risk-based water resources planning: Incorporating probabilistic nonstationary climate uncertainties

NASA Astrophysics Data System (ADS)

Borgomeo, Edoardo; Hall, Jim W.; Fung, Fai; Watts, Glenn; Colquhoun, Keith; Lambert, Chris

2014-08-01

We present a risk-based approach for incorporating nonstationary probabilistic climate projections into long-term water resources planning. The proposed methodology uses nonstationary synthetic time series of future climates obtained via a stochastic weather generator based on the UK Climate Projections (UKCP09) to construct a probability distribution of the frequency of water shortages in the future. The UKCP09 projections extend well beyond the range of current hydrological variability, providing the basis for testing the robustness of water resources management plans to future climate-related uncertainties. The nonstationary nature of the projections combined with the stochastic simulation approach allows for extensive sampling of climatic variability conditioned on climate model outputs. The probability of exceeding planned frequencies of water shortages of varying severity (defined as Levels of Service for the water supply utility company) is used as a risk metric for water resources planning. Different sources of uncertainty, including demand-side uncertainties, are considered simultaneously and their impact on the risk metric is evaluated. Supply-side and demand-side management strategies can be compared based on how cost-effective they are at reducing risks to acceptable levels. A case study based on a water supply system in London (UK) is presented to illustrate the methodology. Results indicate an increase in the probability of exceeding the planned Levels of Service across the planning horizon. Under a 1% per annum population growth scenario, the probability of exceeding the planned Levels of Service is as high as 0.5 by 2040. The case study also illustrates how a combination of supply and demand management options may be required to reduce the risk of water shortages.

Plasma separation

NASA Technical Reports Server (NTRS)

Steurer, Wolfgang

1992-01-01

This process employs a thermal plasma for the separation and production of oxygen and metals. It is a continuous process that requires no consumables and relies entirely on space resources. The almost complete absence of waste renders it relatively clean. It can be turned on or off without any undesirable side effects or residues. The prime disadvantage is its high power consumption.

Effects of fire and fuels management on water quality in eastern North America

Treesearch

R. K. Kolka

2012-01-01

Fuels management, especially prescribed fire, can have direct impacts on aquatic resources through deposition of ash to surface waters. On the terrestrial side, fuels management leads to changes in vegetative structure and potentially soil properties that affect ecosystem cycling of water and inorganic and organic constituents. Because surface water systems (streams,...

Effects of Text-Belief Consistency and Reading Task on the Strategic Validation of Multiple Texts

ERIC Educational Resources Information Center

Maier, Johanna; Richter, Tobias

2016-01-01

In the comprehension of multiple controversial scientific texts, readers with strong prior beliefs tend to construct a one-sided mental representation that is biased towards belief-consistent information. In the present study, we examined whether an argument in contrast to a summary task instruction can increase the resource allocation to and…

Leaving the Dark Side for the Light: Twelve Strategies for Effective Transition from Academic Administrator to Faculty Member

ERIC Educational Resources Information Center

Sale, Paul

2013-01-01

Copious literature is available to provide nascent administrators with guidelines and advice for being a successful administrator. Likewise, faculty new to academia have many available resources both from the literature and from campus-based support services, such as new faculty development programs, mentors, and special internal funding programs.…

Strategies to increase demand for maternal health services in resource-limited settings: challenges to be addressed.

PubMed

Elmusharaf, Khalifa; Byrne, Elaine; O'Donovan, Diarmuid

2015-09-08

Universal health access will not be achieved unless women are cared for in their own communities and are empowered to take decisions about their own health in a supportive environment. This will only be achieved by community-based demand side interventions for maternal health access. In this review article, we highlight three common strategies to increase demand-side barriers to maternal healthcare access and identify the main challenges that still need to be addressed for these strategies to be effective. Common demand side strategies can be grouped into three categories:(i) Financial incentives/subsidies; (ii) Enhancing patient transfer, and; (iii) Community involvement. The main challenges in assessing the effectiveness or efficacy of these interventions or strategies are the lack of quality evidence on their outcome and impact and interventions not integrated into existing health or community systems. However, what is highlighted in this review and overlooked in most of the published literature on this topic is the lack of knowledge about the context in which these strategies are to be implemented. We suggest three challenges that need to be addressed to create a supportive environment in which these demand-side strategies can effectively improve access to maternal health services. These include: addressing decision-making norms, engaging in intergenerational dialogue, and designing contextually appropriate communication strategies.

A Hierarchical Framework for Demand-Side Frequency Control

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

Moya, Christian; Zhang, Wei; Lian, Jianming

2014-06-02

With large-scale plans to integrate renewable generation, more resources will be needed to compensate for the uncertainty associated with intermittent generation resources. Under such conditions, performing frequency control using only supply-side resources become not only prohibitively expensive but also technically difficult. It is therefore important to explore how a sufficient proportion of the loads could assume a routine role in frequency control to maintain the stability of the system at an acceptable cost. In this paper, a novel hierarchical decentralized framework for frequency based load control is proposed. The framework involves two decision layers. The top decision layer determines themore » optimal droop gain required from the aggregated load response on each bus using a robust decentralized control approach. The second layer consists of a large number of devices, which switch probabilistically during contingencies so that the aggregated power change matches the desired droop amount according to the updated gains. The proposed framework is based on the classical nonlinear multi-machine power system model, and can deal with timevarying system operating conditions while respecting the physical constraints of individual devices. Realistic simulation results based on a 68-bus system are provided to demonstrate the effectiveness of the proposed strategy.« less

Resource Letter GrW-1: Gravitational Waves

NASA Technical Reports Server (NTRS)

White, Nicholas E. (Technical Monitor); Centrella, Joan M.

2003-01-01

The phenomenon of gravitational radiation was one of the first predictions of Einstein's general theory of relativity. Progress in understanding this radiation theoretically was slow at first, owing to the difficulty of the nonlinear field equations and the subtleties of their physical effects. The experimental side of this subject also has taken a long time to develop, with efforts at detection severely challenged by the extreme weakness of the waves impinging on the Earth. However, as the 21st century begins, observations of the gravitational waves from astrophysical sources such as black holes, neutron stars, and stellar collapse are expected to open a new window on the universe. Vigorous experimental programs centered on ground-based detectors are being carried out worldwide, and a space-based detector is in the planning stages. On the theoretical side, much effort is being expended to produce robust models of the astrophysical sources and accurate calculations of the waveforms they produce. In this Resource Letter, a set of basic references will be presented first, to provide a general introduction to and overview of the literature in this field. The focus then will shift to highlighting key resources in more specialized areas at the forefront of current research.

Co-Optimization of Electricity Transmission and Generation Resources for Planning and Policy Analysis: Review of Concepts and Modeling Approaches

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

Krishnan, Venkat; Ho, Jonathan; Hobbs, Benjamin F.

2016-05-01

The recognition of transmission's interaction with other resources has motivated the development of co-optimization methods to optimize transmission investment while simultaneously considering tradeoffs with investments in electricity supply, demand, and storage resources. For a given set of constraints, co-optimized planning models provide solutions that have lower costs than solutions obtained from decoupled optimization (transmission-only, generation-only, or iterations between them). This paper describes co-optimization and provides an overview of approaches to co-optimizing transmission options, supply-side resources, demand-side resources, and natural gas pipelines. In particular, the paper provides an up-to-date assessment of the present and potential capabilities of existing co-optimization tools, andmore » it discusses needs and challenges for developing advanced co-optimization models.« less

Numerical Approach for Goaf-Side Entry Layout and Yield Pillar Design in Fractured Ground Conditions

NASA Astrophysics Data System (ADS)

Jiang, Lishuai; Zhang, Peipeng; Chen, Lianjun; Hao, Zhen; Sainoki, Atsushi; Mitri, Hani S.; Wang, Qingbiao

2017-11-01

Entry driven along goaf-side (EDG), which is the development of an entry of the next longwall panel along the goaf-side and the isolation of the entry from the goaf with a small-width yield pillar, has been widely employed in China over the past several decades . The width of such a yield pillar has a crucial effect on EDG layout in terms of the ground control, isolation effect and resource recovery rate. Based on a case study, this paper presents an approach for evaluating, designing and optimizing EDG and yield pillar by considering the results from numerical simulations and field practice. To rigorously analyze the ground stability, the numerical study begins with the simulation of goaf-side stress and ground conditions. Four global models with identical conditions, except for the width of the yield pillar, are built, and the effect of pillar width on ground stability is investigated by comparing aspects of stress distribution, failure propagation, and displacement evolution during the entire service life of the entry. Based on simulation results, the isolation effect of the pillar acquired from field practice is also considered. The suggested optimal yield pillar design is validated using a field test in the same mine. Thus, the presented numerical approach provides references and can be utilized for the evaluation, design and optimization of EDG and yield pillars under similar geological and geotechnical circumstances.

Access to Routine Immunization: A Comparative Analysis of Supply-Side Disparities between Northern and Southern Nigeria

PubMed Central

Eboreime, Ejemai; Abimbola, Seye; Bozzani, Fiammetta

2015-01-01

Background The available data on routine immunization in Nigeria show a disparity in coverage between Northern and Southern Nigeria, with the former performing worse. The effect of socio-cultural differences on health-seeking behaviour has been identified in the literature as the main cause of the disparity. Our study analyses the role of supply-side determinants, particularly access to services, in causing these disparities. Methods Using routine government data, we compared supply-side determinants of access in two Northern states with two Southern states. The states were identified using criteria-based purposive selection such that the comparisons were made between a low-coverage state in the South and a low-coverage state in the North as well as between a high-coverage state in the South and a high-coverage state in the North. Results Human resources and commodities at routine immunization service delivery points were generally insufficient for service delivery in both geographical regions. While disparities were evident between individual states irrespective of regional location, compared to the South, residents in Northern Nigeria were more likely to have vaccination service delivery points located within a 5km radius of their settlements. Conclusion Our findings suggest that regional supply-side disparities are not apparent, reinforcing the earlier reported socio-cultural explanations for disparities in routine immunization service uptake between Northern and Southern Nigeria. Nonetheless, improving routine immunisation coverage services require that there are available human resources and that health facilities are equitably distributed. PMID:26692215

Access to Routine Immunization: A Comparative Analysis of Supply-Side Disparities between Northern and Southern Nigeria.

PubMed

Eboreime, Ejemai; Abimbola, Seye; Bozzani, Fiammetta

2015-01-01

The available data on routine immunization in Nigeria show a disparity in coverage between Northern and Southern Nigeria, with the former performing worse. The effect of socio-cultural differences on health-seeking behaviour has been identified in the literature as the main cause of the disparity. Our study analyses the role of supply-side determinants, particularly access to services, in causing these disparities. Using routine government data, we compared supply-side determinants of access in two Northern states with two Southern states. The states were identified using criteria-based purposive selection such that the comparisons were made between a low-coverage state in the South and a low-coverage state in the North as well as between a high-coverage state in the South and a high-coverage state in the North. Human resources and commodities at routine immunization service delivery points were generally insufficient for service delivery in both geographical regions. While disparities were evident between individual states irrespective of regional location, compared to the South, residents in Northern Nigeria were more likely to have vaccination service delivery points located within a 5 km radius of their settlements. Our findings suggest that regional supply-side disparities are not apparent, reinforcing the earlier reported socio-cultural explanations for disparities in routine immunization service uptake between Northern and Southern Nigeria. Nonetheless, improving routine immunisation coverage services require that there are available human resources and that health facilities are equitably distributed.

Opportunities and Challenges Within the Veterans Administration

PubMed Central

Schafer, Paul W.

1981-01-01

Because the Veterans Administration operates the largest health care delivery system in the nation under the aegis of a single administration, having 172 medical centers and the third largest federal agency budget, it should assume a logical role at the forefront of automated health care application development. During the past three years, two quite different approaches to the development of medical application software have proceeded side-by-side within the Veterans Administration. One approach employed modern methods and techniques, requiring only a minimum amount of personnel and equipment resources and using local facility funds. It has produced a bounty of cost-effective automated health care application systems that are now in active use at a number of VA Medical Centers (VAMCs) nationwide. The other approach followed methods and techniques known to be unproductive, and used all of the centrally administered funds, personnel and equipment resources available. It has produced nothing of value; on the contrary, it has delayed the implementation of automated systems that could be providing important clinical services to veterans.

Cancer-related terminology: glossaries for compounded pharmacists and their clients.

PubMed

Williams, Lavonn A

2008-01-01

Webster's dictionary defines cancer as a "pernicious, spreading evil...", a definition that is hard to debate. Cancer is a life-changing disease for both the patient with cancer and the family members. Compounding pharmacists have the resources to assist patients in reducing their pain, nausea, and other symptoms of cancer and the side effects of their cancer treatments. By providing a glossary of terms for clients affected by cancer, compounding pharmacists also can reduce at least a small part of their frustration. The International Journal of Pharmaceutical Compounding, Inc., has published many formulations and articles dealing with cancer-related symptoms and treatment side effects, and is working hard to get more formulations online so we can participate in the challenge and victory of defeating the pain and suffering of patients with cancer.

Enabling Healthcare IT Governance: Human Task Management Service for Administering Emergency Department's Resources for Efficient Patient Flow.

PubMed

Rodriguez, Salvador; Aziz, Ayesha; Chatwin, Chris

2014-01-01

The use of Health Information Technology (HIT) to improve healthcare service delivery is constantly increasing due to research advances in medical science and information systems. Having a fully automated process solution for a Healthcare Organization (HCO) requires a combination of organizational strategies along with a selection of technologies that facilitate the goal of improving clinical outcomes. HCOs, requires dynamic management of care capability to realize the full potential of HIT. Business Process Management (BPM) is being increasingly adopted to streamline the healthcare service delivery and management processes. Emergency Departments (EDs) provide a case in point, which require multidisciplinary resources and services to deliver effective clinical outcomes. Managed care involves the coordination of a range of services in an ED. Although fully automated processes in emergency care provide a cutting edge example of service delivery, there are many situations that require human interactions with the computerized systems; e.g. Medication Approvals, care transfer, acute patient care. This requires a coordination mechanism for all the resources, computer and human, to work side by side to provide the best care. To ensure evidence-based medical practice in ED, we have designed a Human Task Management service to model the process of coordination of ED resources based on the UK's NICE Clinical guideline for managing the care of acutely ill patients. This functionality is implemented using Java Business process Management (jBPM).

The fundamental closed-form solution of control-related states of kth order S3PR system with left-side non-sharing resource places of Petri nets

NASA Astrophysics Data System (ADS)

Chao, Daniel Yuh; Yu, Tsung Hsien

2016-01-01

Due to the state explosion problem, it has been unimaginable to enumerate reachable states for Petri nets. Chao broke the barrier earlier by developing the very first closed-form solution of the number of reachable and other states for marked graphs and the kth order system. Instead of using first-met bad marking, we propose 'the moment to launch resource allocation' (MLR) as a partial deadlock avoidance policy for a large, real-time dynamic resource allocation system. Presently, we can use the future deadlock ratio of the current state as the indicator of MLR due to which the ratio can be obtained real-time by a closed-form formula. This paper progresses the application of an MLR concept one step further on Gen-Left kth order systems (one non-sharing resource place in any position of the left-side process), which is also the most fundamental asymmetric net structure, by the construction of the system's closed-form solution of the control-related states (reachable, forbidden, live and deadlock states) with a formula depending on the parameters of k and the location of the non-sharing resource. Here, we kick off a new era of real-time, dynamic resource allocation decisions by constructing a generalisation formula of kth order systems (Gen-Left) with r* on the left side but at arbitrary locations.

A geographically-referenced multiple-resource data management system for the oak savannas of the Malpai Borderland Region

Treesearch

Hui Chen; Cody L. Stropki; Peter F. Ffolliott; Gerald J. Gottfried

2009-01-01

Twelve watersheds in the oak savannas on the eastern side of the Peloncillo Mountains in the Southwestern Borderlands Region of New Mexico are being monitored to document the ecological and hydrologic characteristics, and to determine the effects of burning treatments on this ecosystem. Ecological components monitored include tree overstories, loadings of fuel...

Students Today, Teachers Tomorrow? Identifying Constraints on the Provision of Education. Policy Research Working Paper 5674

ERIC Educational Resources Information Center

Andrabi, Tahir; Das, Jishnu; Khwaja, Asim Ijaz

2011-01-01

With an estimated 115 million children not attending primary school in the developing world, increasing access to education is critical. Resource constraints limit the effectiveness of demand-based subsidies. This paper focuses on the importance of a supply-side factor--the availability of low-cost teachers--and the resulting ability of the market…

The Effects of Gender of Private Sports Establishment Administrators on Job Satisfaction: A Case of Istanbul

ERIC Educational Resources Information Center

Erol, Mustafa

2015-01-01

This study aims to indicate whether work satisfaction varies according to gender, the job itself and factors of human resources. To evaluate reassurence related with their jobs, a short version of "Minnesota Jobs Satisfaction'' survey was carried out with 32 men and 18 women who work at private sporting establishments in Anatolian side of…

Introduction. [usefulness of modern remote sensing techniques for studying components of California water resources

NASA Technical Reports Server (NTRS)

Colwell, R. N.

1973-01-01

Since May 1970, personnel on several campuses of the University of California have been conducting investigations which seek to determine the usefulness of modern remote sensing techniques for studying various components of California's earth resources complex. Emphasis has been given to California's water resources as exemplified by the Feather River project and other aspects of the California Water Plan. This study is designed to consider in detail the supply, demand, and impact relationships. The specific geographic areas studied are the Feather River drainage in northern California, the Chino-Riverside Basin and Imperial Valley areas in southern California, and selected portions of the west side of San Joaquin Valley in central California. An analysis is also given on how an effective benefit-cost study of remote sensing in relation to California's water resources might best be made.

MOUNT HOOD WILDERNESS AND ADJACENT AREAS, OREGON.

USGS Publications Warehouse

Keith, T.E.C.; Causey, J.D.

1984-01-01

A mineral survey of the Mount Hood Wilderness, Oregon, was conducted. Geochemical data indicate two areas of substantiated mineral-resource potential containing weak epithermal mineralization: an area of the north side of Zigzag Mountain where vein-type lead-zinc-silver deposits occur and an area of the south side of Zigzag Mountain, where the upper part of a quartz diorite pluton has propylitic alteration associated with mineralization of copper, gold, silver, lead, and zinc in discontinuous veins. Geothermal-resource potential for low- to intermediate-temperature (less than 248 degree F) hot-water systems in the wilderness is probable in these areas. Part of the wilderness is classified as a Known Geothermal Resource Area (KGRA), which is considered to have probable geothermal-resource potential, and two parts of the wilderness have been included in geothermal lease areas.

Neural Correlates of Opposing Effects of Emotional Distraction on Perception and Episodic Memory: An Event-Related fMRI Investigation

PubMed Central

Shafer, Andrea T.; Dolcos, Florin

2012-01-01

A main question in emotion and memory literature concerns the relationship between the immediate impact of emotional distraction on perception and the long-term impact of emotion on memory. While previous research shows both automatic and resource-mediated mechanisms to be involved in initial emotion processing and memory, it remains unclear what the exact relationship between the immediate and long-term effects is, and how this relationship may change as a function of manipulations at perception favoring the engagement of either more automatic or mediated mechanisms. Using event-related functional magnetic resonance imaging, we varied the degree of resource availability for processing task-irrelevant emotional information, to determine how the initial (impairing) impact of emotional distraction related to the long-term (enhancing) impact of emotion on memory. Results showed that a direct relationship between emotional distraction and memory was dependent on automatic mechanisms, as this was found only under conditions of limited resource availability and engagement of amygdala (AMY)-hippocampal (HC) mechanisms to both impairing and enhancing effects. A hemispheric disassociation was also identified in AMY-HC, where while both sides were associated with emotional distraction and left AMY and anterior HC were linked to emotional memory, functional asymmetry was only identified in the posterior HC, with only the left side contributing to emotional memory. Finally, areas dissociating between the two opposing effects included the medial frontal, precentral, superior temporal, and middle occipital gyri (linked to emotional distraction), and the superior parietal cortex (linked to emotional memory). These findings demonstrate the relationship between emotional distraction and memory is context dependent and that specific brain regions may be more or less susceptible to the direction of emotional modulation (increased or decreased), depending on the task manipulation, and processes investigated. PMID:23049502

Mineral resource potential map of the Selway-Bitterroot Wilderness, Idaho County, Idaho, and Missoula and Ravalli counties, Montana

USGS Publications Warehouse

Toth, Margo I.; Coxe, Berton W.; Zilka, Nicholas T.; Hamilton, Michael M.

1983-01-01

Mineral resource studies by the U.S. Bureau of Mines and the U.S, Geological Survey indicate that five areas within the Selway-Bitterroot Wilderness have mineral resource potential. Regional studies suggest that three granitic plutons within the wildemess, the Running Creek pluton on the southwestern border of the wildemess, the Painted Rocks pluton on the southern border of the wildemess, and the Whistling Pig pluton in the west-central portion of the wildemess, have low potential for molybdenite deposits, but detailed surface investigations failed to recognize a deposit. Placer deposits in the Elk Summit area on the north side of the wildemess contain subeconomic resources of niobium- (columbium-) bearing ilmenite. A vein on the northeast side of the wildemess at t~e Cliff mine at Saint Joseph Peak contains subeconomic silver-copper-lead resources. The wilderness has no known potential for oil and gas, coal, geothermal resources, or other energy-related commodities.

Intermittent Renewable Management Pilot Phase 2

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

Kiliccote, Sila; Homan, Gregory; Anderson, Robert

The Intermittent Renewable Management Pilot - Phase 2 (IRM2) was designed to study the feasibility of demand-side resources to participate into the California Independent System Operator (CAISO) wholesale market as proxy demand resources (PDR). The pilot study focused on understanding the issues related with direct participation of third-parties and customers including customer acceptance; market transformation challenges (wholesale market, technology); technical and operational feasibility; and value to the rate payers, DR resource owners and the utility on providing an enabling mechanism for DR resources into the wholesale markets. The customer had the option of committing to either three contiguous hour blocksmore » for 24 days or six contiguous hours for 12 days a month with day-ahead notification that aligned with the CAISO integrated forward market. As a result of their being available, the customer was paid $10/ kilowatt (kW)-month for capacity in addition to CAISO energy settlements. The participants were limited to no more than a 2 megawatt (MW) capacity with a six-month commitment. Four participants successfully engaged in the pilot. In this report, we provide the description of the pilot, participant performance results, costs and value to participants as well as outline some of the issues encountered through the pilot. Results show that participants chose to participate with storage and the value of CAISO settlements were significantly lower than the capacity payments provided by the utility as incentive payments. In addition, this pilot revealed issues both on the participant side and system operations side. These issues are summarized in the report.The Intermittent Renewable Management Pilot - Phase 2 (IRM2) was designed to study the feasibility of demand-side resources to participate into the California Independent System Operator (CAISO) wholesale market as proxy demand resources (PDR). The pilot study focused on understanding the issues related with direct participation of third-parties and customers including customer acceptance; market transformation challenges (wholesale market, technology); technical and operational feasibility; and value to the rate payers, DR resource owners and the utility on providing an enabling mechanism for DR resources into the wholesale markets.« less

A fuel cycle assessment guide for utility and state energy planners

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

Not Available

1994-07-01

This guide, one in a series of documents designed to help assess fuel cycles, is a framework for setting parameters, collecting data, and analyzing fuel cycles for supply-side and demand-side management. It provides an automated tool for entering comparative fuel cycle data that are meaningful to state and utility integrated resource planning, collaborative, and regional energy planning activities. It outlines an extensive range of energy technology characteristics and environmental, social, and economic considerations within each stage of a fuel cycle. The guide permits users to focus on specific stages or effects that are relevant to the technology being evaluated andmore » that meet the user`s planning requirements.« less

Net Resource Assessment (NetRA): A Collaborative Effort Between USGS Science and Decisions Center, the Science Impact Laboratory for Policy and Economics (University of New Mexico) and Sandia National Laboratory

NASA Astrophysics Data System (ADS)

Brookshire, D.; Bernknopf, R.; Adhikari, D. R.; Babis, C.; Broadbent, C. D.; Tidwell, V. C.

2015-12-01

Department of Interior Secretarial Order No. 3330, "… establishes a Department-wide mitigation strategy that will ensure consistency and efficiency in the review and permitting of infrastructure development projects and in conserving our Nation's valuable natural and cultural resources." The USGS Organic Act authorizes resource assessments to estimate the in-place potential capacity of energy, mineral, hydrologic, and biologic resources (20 Stat. 394; 43 U.S.C. 31) and later amendments. These two statements form the basis for the development of the Net Resources Assessment (NetRA) framework. NetRA is a policy-relevant, interdisciplinary approach to assessing natural resources availability in examining the regional-scale interrelationships between energy or mineral extraction and impact on ecosystem services. The systems dynamics approach (SD) emphasizes the interdependence of natural resource development and its effect on collocated ecosystem services over space and time. The example of the NetRA that will be presented focuses on tradeoffs associated with land management decisions in the West. The Piceance Basin, CO example that will be discussed involves development of a continuous gas deposit and its impact on Mule Deer and water quality. The SD is the hub for generating a range of simulated landscape outcomes. The probabilistic model provides an economic indicator as to the expected net societal benefit of economic development and biophysical indicators for ecosystem services affected in the region. Both natural and economic indicators are associated with each outcome via a tradeoff analysis the can be used for risk analysis. The NetRA also retains map attributes for before and after map comparisons to specific alternatives for an existing baseline. The model has three stages: map-based scenario development with slider bars (choice variables), side-by-side extraction and ecosystem services sub-models, and integrated multiple resource trade-off outcomes.

Diagnosing the Causes and Severity of One-sided Message Contention

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

Tallent, Nathan R.; Vishnu, Abhinav; van Dam, Hubertus

Two trends suggest network contention for one-sided messages is poised to become a performance problem that concerns application developers: an increased interest in one-sided programming models and a rising ratio of hardware threads to network injection bandwidth. Unfortunately, it is difficult to reason about network contention and one-sided messages because one-sided tasks can either decrease or increase contention. We present effective and portable techniques for diagnosing the causes and severity of one-sided message contention. To detect that a message is affected by contention, we maintain statistics representing instantaneous (non-local) network resource demand. Using lightweight measurement and modeling, we identify themore » portion of a message's latency that is due to contention and whether contention occurs at the initiator or target. We attribute these metrics to program statements in their full static and dynamic context. We characterize contention for an important computational chemistry benchmark on InfiniBand, Cray Aries, and IBM Blue Gene/Q interconnects. We pinpoint the sources of contention, estimate their severity, and show that when message delivery time deviates from an ideal model, there are other messages contending for the same network links. With a small change to the benchmark, we reduce contention up to 50% and improve total runtime as much as 20%.« less

Future directions: Integrated resource planning

NASA Astrophysics Data System (ADS)

Bauer, D. C.; Eto, J.

Integrated resource planning or IRP is the process for integrating supply- and demand-side resources to provide energy services at a cost that balances the interests of all stakeholders. It now is the resource planning process used by electric utilities in over 30 states. The goals of IRP have evolved from least cost planning and encouragement of demand-side management to broader, more complex issues including core competitive business activity, risk management and sharing, accounting for externalities, and fuel switching between gas and electricity. IRP processes are being extended to other interior regions of the country, to non-investor owned utilities, and to regional (rather than individual utility) planning bases, and to other fuels (natural gas). The comprehensive, multi-valued, and public reasoning characteristics of IRP could be extended to applications beyond energy, e.g., transportation, surface water management, and health care in ways suggested.

The United States’ Vulnerability to Coercion by China in the Rare Earths Market

DTIC Science & Technology

2012-12-14

a computer, is assembled in a third country. This has brought down the total cost of such products which has had very positive effects on the...world’s economy. When materials or resources can be obtained from multiple sources around the world, costs of procurement and manufacture are lower, which...results in the total cost of goods being overall less expensive. Sometimes there is the possibility of a very dangerous side effect from relying 2

Parental divorce, sibship size, family resources, and children's academic performance.

PubMed

Sun, Yongmin; Li, Yuanzhang

2009-09-01

Using data from 19,839 adolescents from the National Education Longitudinal Study, this study investigates whether the effects of parental divorce on adolescents' academic test performance vary by sibship size. Analyses show that the negative effect of divorce on adolescent performance attenuates as sibship size increases. On the other side of the interaction, the inverse relationship between sibship size and test performance is weaker in disrupted than in two-biological-parent families. Trends of such interactions are evident when sibship size is examined either as a continuous or a categorical measure. Finally, the observed interactions on adolescents' academic performance are completely explained by variations in parental financial, human, cultural, and social resources. In sum, this study underlines the importance of treating the effect of parental divorce as a variable and calls for more research to identify child and family features that may change the magnitude of such an effect.

Economic study on the impact of side effects in patients taking oxycodone controlled-release for noncancer pain.

PubMed

Anastassopoulos, Kathryn P; Chow, Wing; Tapia, Crisanta I; Baik, Rebecca; Ackerman, Stacey J; Biondi, David; Kim, Myoung S

2012-10-01

Chronic pain is a prevalent condition in the United States. Musculoskeletal pain, including joint and back pain, is the most common type of chronic pain, and many patients with back pain have a neuropathic component. Pain has direct economic consequences. While oxycodone controlled-release (CR) is one of the most widely used oral long-acting opioids for pain, including pain with a neuropathic component, it is often associated with bothersome side effects, resulting in additional medical resource use (MRU) and costs. To examine the impact on MRU and costs to payers of side effects in patients taking oxycodone CR alone or in combination with other pain medications for noncancer pain (including those with neuropathic pain symptoms). A nationwide convenience sample of adults in the United States, who participated in a survey research panel and reported current use of oxycodone CR for noncancer pain, completed an online survey between November 2, 2010, and December 13, 2010. Respondents were excluded if they reported current use of other extended-release or long-acting opioid prescription medications. The survey consisted of questions on demographics, clinical characteristics, pain characteristics, experience with pain medication, and MRU associated with side effects. Payer costs were calculated based on the MRU reported by the respondents multiplied by Medicare reimbursement rates for hospitalizations and outpatient visits and average wholesale price (AWP) minus 20% for medications. A subgroup of patients who reported neuropathic pain symptoms also was examined. After applying the exclusion criteria, 432 respondents completed the survey. Approximately half of the respondents (n = 219; 50.7%) reported neuropathic pain symptoms. The majority of respondents were Caucasian (88.4%) and female (63.7%) with an average age of 41.8 years (14.89). Respondents most frequently reported low back pain (41.2%), followed by osteoarthritis/rheumatoid arthritis (20.4%), neuropathic pain (10.6%), and fibromyalgia (9.0%). Respondents reported having their pain condition for an average of 5.4 (7.42) years. On days when taken, respondents reported a mean oxycodone CR daily dose of 83.3 mg (126.93) taken in an average of 2 doses. Most respondents (82.4%) reported experiencing at least 1 side effect with 77.5% being bothered by at least 1 side effect. The most frequently reported side effects ( greater than 25%) were drowsiness (41.4%), constipation (37.0%), fatigue or daytime sleepiness (36.6%), and dizziness (27.1%). Among respondents who reported being bothered by one or more side effects in the previous month, MRU associated with side effects was reported by 39.1% of respondents and significantly increased as the level of side-effect bother increased from 19.8% among those "A little bit bothered" to 38.4% among those "Bothered" to 61.0% among those "Extremely bothered" (P less than 0.001). Additionally, total average payer costs (in 2010 dollars) per respondent in the previous month associated with side effects were $238 ($1,159) and also significantly increased as the level of side-effect bother increased from $61 ($512) among those "A little bit bothered" to $238 ($1,160) among those "Bothered" to $425 ($1,561) among those "Extremely bothered" (P less than 0.001). Results reported in the neuropathic pain subgroup were similar to results reported in the total study sample. Among adults taking oxycodone CR for chronic noncancer pain (with or without a neuropathic pain component), over three-fourths reported being bothered by side effects. Respondents who reported higher levels of side-effect bother also reported greater MRU, resulting in increased payer costs. The results of this study provide further support of the econo-mic burden to payers associated with opioid-related side effects in patients with chronic noncancer pain, with and without neuropathic pain.

Electricity decision-making: New techniques for calculating statewide economic impacts from new power supply and demand-side management programs

NASA Astrophysics Data System (ADS)

Tegen, Suzanne Isabel Helmholz

This dissertation introduces new techniques for calculating and comparing statewide economic impacts from new coal, natural gas and wind power plants, as well as from demand-side management programs. The impetus for this work was two-fold. First, reviews of current literature and projects revealed that there was no standard way to estimate statewide economic impacts from new supply- and demand-side electricity options. Second, decision-makers who were interviewed stated that they were overwhelmed with data in general, but also lacked enough specific information about economic development impacts to their states from electricity, to make informed choices. This dissertation includes chapters on electricity decision-making and on economic impacts from supply and demand. The supply chapter compares different electricity options in three states which vary in natural resource content: Arizona, Colorado and Michigan. To account for differing capacity factors, resources are compared on a per-megawatt-hour basis. The calculations of economic impacts from new supply include: materials and labor for construction, operations, maintenance, fuel extraction, fuel transport, as well as property tax, financing and landowner revenues. The demand-side chapter compares residential, commercial and industrial programs in Iowa. Impact calculations include: incremental labor and materials for program planning, installation and operations, as well as sales taxes and electricity saved. Results from supply-side calculations in the three states analyzed indicate that adding new wind power can have a greater impact to a state's economy than adding new gas or coal power due to resource location, taxes and infrastructure. Additionally, demand-side management programs have a higher relative percentage of in-state dollar flow than supply-side solutions, though demand-side programs typically involve fewer MWh and dollars than supply-side generation. Methods for this dissertation include researching existing models and data, gathering new data and interviews with industry representatives and policy makers. The new techniques are important for decision-makers, utilities, energy advocates and others who are concerned with economic development and in-state dollar flows from new electricity decisions.

Functional Requirements for Information Resource Provenance on the Web

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

McCusker, James P.; Lebo, Timothy; Graves, Alvaro

We provide a means to formally explain the relationship between HTTP URLs and the representations returned when they are requested. According to existing World Wide Web architecture, the URL serves as an identier for a semiotic referent while the document returned via HTTP serves as a representation of the same referent. This begins with two sides of a semiotic triangle; the third side is the relationship between the URL and the representation received. We complete this description by extending the library science resource model Functional Requirements for Bibliographic Resources (FRBR) with cryptographic message and content digests to create a Functionalmore » Requirements for Information Resources (FRIR). We show how applying the FRIR model to HTTP GET and POST transactions disambiguates the many relationships between a given URL and all representations received from its request, provides fine-grained explanations that are complementary to existing explanations of web resources, and integrates easily into the emerging W3C provenance standard.« less

Development of mobile platform integrated with existing electronic medical records.

PubMed

Kim, YoungAh; Kim, Sung Soo; Kang, Simon; Kim, Kyungduk; Kim, Jun

2014-07-01

This paper describes a mobile Electronic Medical Record (EMR) platform designed to manage and utilize the existing EMR and mobile application with optimized resources. We structured the mEMR to reuse services of retrieval and storage in mobile app environments that have already proven to have no problem working with EMRs. A new mobile architecture-based mobile solution was developed in four steps: the construction of a server and its architecture; screen layout and storyboard making; screen user interface design and development; and a pilot test and step-by-step deployment. This mobile architecture consists of two parts, the server-side area and the client-side area. In the server-side area, it performs the roles of service management for EMR and documents and for information exchange. Furthermore, it performs menu allocation depending on user permission and automatic clinical document architecture document conversion. Currently, Severance Hospital operates an iOS-compatible mobile solution based on this mobile architecture and provides stable service without additional resources, dealing with dynamic changes of EMR templates. The proposed mobile solution should go hand in hand with the existing EMR system, and it can be a cost-effective solution if a quality EMR system is operated steadily with this solution. Thus, we expect this example to be shared with hospitals that currently plan to deploy mobile solutions.

Development of Mobile Platform Integrated with Existing Electronic Medical Records

PubMed Central

Kim, YoungAh; Kang, Simon; Kim, Kyungduk; Kim, Jun

2014-01-01

Objectives This paper describes a mobile Electronic Medical Record (EMR) platform designed to manage and utilize the existing EMR and mobile application with optimized resources. Methods We structured the mEMR to reuse services of retrieval and storage in mobile app environments that have already proven to have no problem working with EMRs. A new mobile architecture-based mobile solution was developed in four steps: the construction of a server and its architecture; screen layout and storyboard making; screen user interface design and development; and a pilot test and step-by-step deployment. This mobile architecture consists of two parts, the server-side area and the client-side area. In the server-side area, it performs the roles of service management for EMR and documents and for information exchange. Furthermore, it performs menu allocation depending on user permission and automatic clinical document architecture document conversion. Results Currently, Severance Hospital operates an iOS-compatible mobile solution based on this mobile architecture and provides stable service without additional resources, dealing with dynamic changes of EMR templates. Conclusions The proposed mobile solution should go hand in hand with the existing EMR system, and it can be a cost-effective solution if a quality EMR system is operated steadily with this solution. Thus, we expect this example to be shared with hospitals that currently plan to deploy mobile solutions. PMID:25152837

Cattle and cultivators: A study of competition over natural resources in north Senegal

USGS Publications Warehouse

Freudenberger, Karen Schoonmaker; Wood, Eric

1998-01-01

This study presents an analysis of the interaction of humans and their environment in the arid Sahel ian zone of northern Senegal. It compares a pastoral community which lives primarily from the production of livestock and a farming community whose activities have traditionally centered on crop production. Living side by side but following different strategies for securing their livelihoods, these groups find themselves in increasing conflict over how the diminishing resources of the area should be used. The pastoral livelihood system, as practiced in the case study community of Maka Ndandary, is essentially conservationist in its approach to natural resources. It regulates the activities of community members toward the environment and employs diverse strategies to protect local resources against incursion by outsiders. The agricultural village, represented by the case study of Teud Bitty, takes a much more extractive approach to its resources. As resources have diminished over time, the villagers have become even more aggressive in their attempts to exploit what remains, whether soils or trees ... both within and outside their territory.

Effect of thermal cycling ramp rate on CSP assembly reliability

NASA Technical Reports Server (NTRS)

Ghaffarian, R.

2001-01-01

A JPL-led chip scale package consortium of enterprises recently joined together to pool in-kind resources for developing the quality and reliability of chip scale packages for a variety of projects. The experience of the consortium in building more than 150 test vehicle assemblies, single and double sided multilayer PWBs, and the environmental test results has now been published as a chip scale package guidelines document.

Groundwater: the processes and global significance of aquifer degradation.

PubMed Central

Foster, S S D; Chilton, P J

2003-01-01

The exploitation of groundwater resources for human use dates from the earliest civilizations, but massive resource development has been largely restricted to the past 50 years. Although global in scope, the emphasis of this paper is on groundwater-based economies in a developing nation context, where accelerated resource development has brought major social and economic benefits over the past 20 years. This results from groundwater's significant role in urban water supply and in rural livelihoods, including irrigated agriculture. However, little of the economic benefit of resource development has been reinvested in groundwater management, and concerns about aquifer degradation and resource sustainability began to arise. A general review, for a broad-based audience, is given of the mechanisms and significance of three semi-independent facets of aquifer degradation. These are (i) depletion of aquifer storage and its effects on groundwater availability, terrestrial and aquatic ecosystems; (ii) groundwater salinization arising from various different processes of induced hydraulic disturbance and soil fractionation; and (iii) vulnerability of aquifers to pollution from land-use and effluent discharge practices related to both urban development and agricultural intensification. Globally, data with which to assess the status of aquifer degradation are of questionable reliability, inadequate coverage and poor compilation. Recourse has to be made to 'type examples' and assumptions about the extension of similar hydrogeological settings likely to be experiencing similar conditions of groundwater demand and subsurface contaminant load. It is concluded that (i) aquifer degradation is much more than a localized problem because the sustainability of the resource base for much of the rapid socio-economic development of the second half of the twentieth century is threatened on quite a widespread geographical basis; and (ii) major (and long overdue) investments in groundwater resource and quality protection are urgently needed. These investments include appropriate institutional provisions, demand-side management, supply-side enhancement and pollution control. PMID:14728791

18 CFR 430.13 - Protected area permits for new withdrawals.

Code of Federal Regulations, 2010 CFR

2010-04-01

... space heating or cooling that are subsequently used for commercial or industrial water supply purposes... against significant leaks of refrigerant, all ground water heat pump systems shall be equipped with an... resource requirements; evaluate supply-side and demand-side alternatives to meet water withdrawal needs...

Performance evaluation of a health insurance in Nigeria using optimal resource use: health care providers perspectives

PubMed Central

2014-01-01

Background Performance measures are often neglected during the transition period of national health insurance scheme implementation in many low and middle income countries. These measurements evaluate the extent to which various aspects of the schemes meet their key objectives. This study assesses the implementation of a health insurance scheme using optimal resource use domains and examines possible factors that influence each domain, according to providers’ perspectives. Methods A retrospective, cross-sectional survey was done between August and December 2010 in Kaduna state, and 466 health care provider personnel were interviewed. Optimal-resource-use was defined in four domains: provider payment mechanism (capitation and fee-for-service payment methods), benefit package, administrative efficiency, and active monitoring mechanism. Logistic regression analysis was used to identify provider factors that may influence each domain. Results In the provider payment mechanism domain, capitation payment method (95%) performed better than fee-for-service payment method (62%). Benefit package domain performed strongly (97%), while active monitoring mechanism performed weakly (37%). In the administrative efficiency domain, both promptness of referral system (80%) and prompt arrival of funds (93%) performed well. At the individual level, providers with fewer enrolees encountered difficulties with reimbursement. Other factors significantly influenced each of the optimal-resource-use domains. Conclusions Fee-for-service payment method and claims review, in the provider payment and active monitoring mechanisms, respectively, performed weakly according to the providers’ (at individual-level) perspectives. A short-fall on the supply-side of health insurance could lead to a direct or indirect adverse effect on the demand-side of the scheme. Capitation payment per enrolees should be revised to conform to economic circumstances. Performance indicators and providers’ characteristics and experiences associated with resource use can assist policy makers to monitor and evaluate health insurance implementation. PMID:24628889

Increasing the demand for childhood vaccination in developing countries: a systematic review

PubMed Central

2009-01-01

Background Attempts to maintain or increase vaccination coverage almost all focus on supply side interventions: improving availability and delivery of vaccines. The effectiveness and cost-effectiveness of efforts to increase demand is uncertain. Methods We performed a systematic review of studies that provided quantitative estimates of the impact of demand side interventions on uptake of routine childhood vaccination. We retrieved studies published up to Sept 2008. Results The initial search retrieved 468 potentially eligible studies, including four systematic reviews and eight original studies of the impact of interventions to increase demand for vaccination. We identified only two randomised controlled trials. Interventions with an impact on vaccination uptake included knowledge translation (KT) (mass media, village resource rooms and community discussions) and non-KT initiatives (incentives, economic empowerment, household visits by extension workers). Most claimed to increase vaccine coverage by 20 to 30%. Estimates of the cost per vaccinated child varied considerably with several in the range of $10-20 per vaccinated child. Conclusion Most studies reviewed here represented a low level of evidence. Mass media campaigns may be effective, but the impact depends on access to media and may be costly if run at a local level. The persistence of positive effects has not been investigated. The economics of demand side interventions have not been adequately assessed, but available data suggest that some may be very cost-effective. PMID:19828063

Spatial access to residential care resources in Beijing, China

PubMed Central

2012-01-01

Background As the population is ageing rapidly in Beijing, the residential care sector is in a fast expansion process with the support of the municipal government. Understanding spatial accessibility to residential care resources by older people supports the need for rational allocation of care resources in future planning. Methods Based on population data and data on residential care resources, this study uses two Geographic Information System (GIS) based methods – shortest path analysis and a two-step floating catchment area (2SFCA) method to analyse spatial accessibility to residential care resources. Results Spatial accessibility varies as the methods and considered factors change. When only time distance is considered, residential care resources are more accessible in the central city than in suburban and exurban areas. If care resources are considered in addition to time distance, spatial accessibility is relatively poor in the central city compared to the northeast to southeast side of the suburban and exurban areas. The resources in the northwest to southwest side of the city are the least accessible, even though several hotspots of residential care resources are located in these areas. Conclusions For policy making, it may require combining various methods for a comprehensive analysis. The methods used in this study provide tools for identifying underserved areas in order to improve equity in access to and efficiency in allocation of residential care resources in future planning. PMID:22877360

A Literature and Records Search on the Cultural Resources of the Portage, Wisconsin Area

DTIC Science & Technology

1980-08-01

brother , A.W. English) of Wyocena. Mr. English, a high. school teacher, appeared to have been the most active...north side of the highway to Dekorra, on both banks of Rocky Run Creek Investigator/Year: Brown, 1937 Report/Reference: Brown Manuscripts, 9/19/37...sides of the creek . On the east side, a limited amount of material was recovered. However, across the creek , a larger number of artifacts were

Nurses' exhaustion: the role of flow at work between job demands and job resources.

PubMed

Zito, Margherita; Cortese, Claudio G; Colombo, Lara

2016-01-01

In the light of the job demands-resources model, this study aimed to detect the mediating role of flow at work between job demands and job resources on one side, and exhaustion on the other. In a historical period where it is necessary to reduce the abandonment of nursing profession, flow is a useful tool to investigate the factors that can promote work motivation and prevent psychological distress. A cross-sectional study was conducted in a hospital, and 279 nurses completed a questionnaire. Analyses conducted are descriptive statistics, alphas, correlations and a structural equations model that considers the mediating role of flow at work. Findings show both the central role of job resources in determining flow at work, and the mediating role of flow at work in decreasing exhaustion, starting from job resources, and in decreasing the effect of job demands on exhaustion. Moreover, flow at work directly decreases exhaustion. Results show the relevance of containing job demands and provide job resources to promote positive experiences at work. To promote flow at work, organizations should offer specific resources, such as supervisors' support, job autonomy, and psychological support to manage the emotional charge. © 2015 John Wiley & Sons Ltd.

Benchmarking Discount Rate in Natural Resource Damage Assessment with Risk Aversion.

PubMed

Wu, Desheng; Chen, Shuzhen

2017-08-01

Benchmarking a credible discount rate is of crucial importance in natural resource damage assessment (NRDA) and restoration evaluation. This article integrates a holistic framework of NRDA with prevailing low discount rate theory, and proposes a discount rate benchmarking decision support system based on service-specific risk aversion. The proposed approach has the flexibility of choosing appropriate discount rates for gauging long-term services, as opposed to decisions based simply on duration. It improves injury identification in NRDA since potential damages and side-effects to ecosystem services are revealed within the service-specific framework. A real embankment case study demonstrates valid implementation of the method. © 2017 Society for Risk Analysis.

Hypoglycaemia: an overview.

PubMed

Graveling, Alex J; Frier, Brian M

2009-08-01

Hypoglycaemia is a frequent side-effect of treatment with insulin and sulfonylureas for people with diabetes, threatening potentially serious morbidity and preventing optimal glycaemic control. Fear of hypoglycaemia and development of syndromes such as impaired awareness and counterregulatory deficiency provide additional hazards for intensification of treatment. Rapid lowering of HbA1c may be potentially dangerous in type 2 diabetes because of the adverse cardiovascular effects induced by hypoglycaemia. Hypoglycaemia can disrupt many everyday activities such as driving, work performance and recreational pursuits. Measures to reduce the risk of hypoglycaemia are labour-intensive and require substantial resources.

Environmental geology: Our professional public responsibility

USGS Publications Warehouse

Gerhard, L.C.; Brady, L.L.

1999-01-01

Conflicts between different interest groups for use of natural resources is one area where state geological surveys can provide assistance. A state geological survey working within the scientific constraints of specific issues can remain objective in its presentations and maintain the faith of both the conflicting interest groups and the public. One cannot vary from the objective view or you will quickly be criticized. Criticism can still occur from one side of a natural resource issue as your data might counter their views. However, the final decisions are almost always made in some legislators, or regulators, area of responsibility. The responsibility of the state geological survey is to provide the important data that will assist in making correct decisions. Should one party in the conflict become extreme in their demands, a potential compromise that is beneficial to both sides can be lost. In Kansas, the classical natural resource problem of resource/recreation in a populated area is presented as a case study. The state geological survey presented data on sand resources in the Kansas River and its valley in northeast Kansas. That information was important to both recreation and dredging interests where the political problem is a conflict of sand use as a construction material resource versus use of the alluvial river as an important recreation area, especially for canoeing. However, when a reasonable compromise was near completion in the Kansas Legislature one side, in a bold move to develop an advantage, ruined that potential for compromise.Conflicts between different interest groups for use of natural resources is one area where state geological surveys can provide assistance. A state geological survey working within the scientific constraints of specific issues can remain objective in its presentations and maintain the faith of both the conflicting interest groups and the public. In Kansas, the classical natural resource problem of resource/recreation in a populated area is presented as a case study. The state geological survey presented data on sand resources in the Kansas River and its valley in northeast Kansas. That information was important to both recreation and dredging interests.

Integrating long-term stewardship goals into the remediation process: natural resource damages and the Department of Energy.

PubMed

Burger, Joanna; Gochfeld, Michael; Powers, Charles W

2007-01-01

The United States and other developed countries are faced with restoring and managing degraded ecosystems. Evaluations of the degradation of ecological resources can be used for determining ecological risk, making remediation or restoration decisions, aiding stakeholders with future land use decisions, and assessing natural resource damages. Department of Energy (DOE) lands provide a useful case study for examining degradation of ecological resources in light of past or present land uses and natural resource damage assessment (NRDA). We suggest that past site history should be incorporated into the cleanup and restoration phase to reduce the ultimate NRDA costs, and hasten resource recovery. The lands that DOE purchased over 50 years ago ranged from relatively undisturbed to heavily impacted farmland, and the impact that occurred from DOE occupation varies from regeneration of natural ecosystems (benefits) to increased exposure to several stressors (negative effects). During the time of the DOE releases, other changes occurred on the lands, including recovery from the disturbance effects of farming, grazing, and residential occupation, and the cessation of human disturbance. Thus, the injury to natural resources that occurred as a result of chemical and radiological releases occurred on top of recovery of already degraded systems. Both spatial (size and dispersion of patch types) and temporal (past/present/future land use and ecological condition) components are critical aspects of resource evaluation, restoration, and NRDA. For many DOE sites, integrating natural resource restoration with remediation to reduce or eliminate the need for NRDA could be a win-win situation for both responsible parties and natural resource trustees by eliminating costly NRDAs by both sides, and by restoring natural resources to a level that satisfies the trustees, while being cost-effective for the responsible parties. It requires integration of remediation, restoration, and end-state planning to a greater degree than is currently done at most DOE sites.

Asymmetric abstraction and allocation: the Israeli-Palestinian water pumping record.

PubMed

Zeitoun, Mark; Messerschmid, Clemens; Attili, Shaddad

2009-01-01

The increased attention given to international transboundary aquifers may be nowhere more pressing than on the western bank of the Jordan River. Hydropolitical analysis of six decades of Israeli and Palestinian pumping records reveals how ground water abstraction rates are as asymmetrical as are water allocations. The particular hydrogeology of the region, notably the variability in depth to ground water, variations in ground water quality, and the vulnerability of the aquifer, also affect the outcome. The records confirm previously drawn conclusions of the influence of the agricultural lobby in maintaining a supply-side water management paradigm. Comparison of water consumption rates divulges that water consumed by all sectors of the farming-based Palestinian economy is less than half of Israeli domestic consumption. The overwhelming majority of "reserve" flows from wet years are sold at subsidized rates to the Israeli agricultural sector, while very minor amounts are sold at normal rates to the Palestinian side for drinking water. An apparent coevolution of water resource variability and politics serves to explain increased Israeli pumping prior to negotiations in the early 1990s. The abstraction record from the Western Aquifer Basin discloses that the effective limit set by the terms of the 1995 Oslo II Agreement is regularly violated by the Israeli side, thereby putting the aquifer at risk. The picture that emerges is one of a transboundary water regime that is much more exploitative than cooperative and that risks spoiling the resource as it poisons international relations.

Impact of ranolazine on clinical outcomes and healthcare resource utilization in patients with refractory angina pectoris.

PubMed

Ling, Hua; Packard, Kathleen A; Burns, Tammy L; Hilleman, Daniel E

2013-12-01

Ranolazine is a novel antianginal medication approved for the treatment of chronic angina. There are only limited data concerning the efficacy of ranolazine in reducing healthcare resource utilization in patients with refractory angina pectoris. The primary objective of this analysis was to evaluate the efficacy and safety of ranolazine in refractory angina pectoris. In addition, the impact of ranolazine on healthcare resource utilization was assessed. Consecutive patients with refractory angina pectoris treated with ranolazine at two cardiology practices in the state of Nebraska were included in this analysis. The Canadian Cardiovascular Society (CCS) angina class and frequency and type of healthcare resource consumption were determined during the 12 months prior to and the 12 months after initiation of ranolazine. A total of 150 pts (64 % men) with a mean age of 66 ± 12 years were included in this analysis. All patients had previously undergone coronary revascularization. Nitrates, β-adrenoceptor antagonists (β-blockers), and calcium antagonists (calcium channel blockers) were being used in 83, 97, and 75 % of patients, respectively. During ranolazine treatment, a significant improvement in CCS angina class was observed, with 23 patients improving by one class and no patient experiencing a deterioration in functional class (p = 0.025). A total of 53 side effects occurred in 28 (19 %) patients receiving ranolazine. Of those patients with side effects, four required dose reduction and seven required drug discontinuation. The frequency of clinic visits and emergency room visits was lower during ranolazine treatment, but the differences in frequency were not significant. The number of patients hospitalized and the number of hospitalizations were significantly lower during ranolazine therapy than in the pre-ranolazine study period (p = 0.002). Ranolazine improved the CCS angina class and reduced hospitalizations over a 12-month follow-up period in a group of patients with difficult-to-treat refractory angina pectoris.

Energy resources - cornucopia or empty barrel?

USGS Publications Warehouse

McCabe, P.J.

1998-01-01

Over the last 25 yr, considerable debate has continued about the future supply of fossil fuel. On one side are those who believe we are rapidly depleting resources and that the resulting shortages will have a profound impact on society. On the other side are those who see no impending crisis because long-term trends are for cheaper prices despite rising production. The concepts of resources and reserves have historically created considerable misunderstanding in the minds of many nongeologists. Hubbert-type predictions of energy production assume that there is a finite supply of energy that is measurable; however, estimates of resources and reserves are inventories of the amounts of a fossil fuel perceived to be available over some future period of time. As those resources/reserves are depleted over time, additional amounts of fossil fuels are inventoried. Throughout most of this century, for example, crude oil reserves in the United States have represented a 10-14-yr supply. For the last 50 yr, resource crude oil estimates have represented about a 60-70-yr supply for the United States. Division of reserve or resource estimates by current or projected annual consumption therefore is circular in reasoning and can lead to highly erroneous conclusions. Production histories of fossil fuels are driven more by demand than by the geologic abundance of the resource. Examination of some energy resources with well-documented histories leads to two conceptual models that relate production to price. The closed-market model assumes that there is only one source of energy available. Although the price initially may fall because of economies of scale long term, prices rise as the energy source is depleted and it becomes progressively more expensive to extract. By contrast, the open-market model assumes that there is a variety of available energy sources and that competition among them leads to long-term stable or falling prices. At the moment, the United States and the world approximate the open-market model, but in the long run the supply of fossil fuel is finite, and prices inevitably will rise unless alternate energy sources substitute for fossil energy supplies; however, there appears little reason to suspect that long-term price trends will rise significantly over the next few decades.Over the last 25 years, considerable debate has continued about the future supply of fossil fuel. On one side are those who believe that resources are rapidly depleting and that the resulting shortages will have a profound impact on society. On the other side are those who see no impending crisis because longterm trends are for cheaper prices despite rising production. This paper examines historic trends and clarify the foundations on which one may build one's predictions.

Integrating Demand-Side Resources into the Electric Grid: Economic and Environmental Considerations

NASA Astrophysics Data System (ADS)

Fisher, Michael J.

Demand-side resources are taking an increasingly prominent role in providing essential grid services once provided by thermal power plants. This thesis considers the economic feasibility and environmental effects of integrating demand-side resources into the electric grid with consideration given to the diversity of market and environmental conditions that can affect their behavior. Chapter 2 explores the private economics and system-level carbon dioxide reduction when using demand response for spinning reserve. Steady end uses like lighting are more than twice as profitable as seasonal end uses because spinning reserve is needed year-round. Avoided carbon emission damages from using demand response instead of fossil fuel generation for spinning reserve are sufficient to justify incentives for demand response resources. Chapter 3 quantifies the system-level net emissions rate and private economics of behind-the-meter energy storage. Net emission rates are lower than marginal emission rates for power plants and in-line with estimates of net emission rates from grid-level storage. The economics are favorable for many buildings in regions with high demand charges like California and New York, even without subsidies. Future penetration into regions with average charges like Pennsylvania will depend greatly on installation cost reductions and wholesale prices for ancillary services. Chapter 4 outlines a novel econometric model to quantify potential revenues from energy storage that reduces demand charges. The model is based on a novel predictive metric that is derived from the building's load profile. Normalized revenue estimates are independent of the power capacity of the battery holding other performance characteristics equal, which can be used to calculate the profit-maximizing storage size. Chapter 5 analyzes the economic feasibility of flow batteries in the commercial and industrial market. Flow batteries at a 4-hour duration must be less expensive on a dollar per installed kWh basis, often by 20-30%, to break even with shorter duration li-ion or lead-acid despite allowing for deeper depth of discharge and superior cycle life. These results are robust to assumptions of tariff rates, battery round-trip efficiencies, amount of solar generation and whether the battery can participate in the wholesale energy and ancillary services markets.

Stochastic simulation of power systems with integrated renewable and utility-scale storage resources

NASA Astrophysics Data System (ADS)

Degeilh, Yannick

The push for a more sustainable electric supply has led various countries to adopt policies advocating the integration of renewable yet variable energy resources, such as wind and solar, into the grid. The challenges of integrating such time-varying, intermittent resources has in turn sparked a growing interest in the implementation of utility-scale energy storage resources ( ESRs), with MWweek storage capability. Indeed, storage devices provide flexibility to facilitate the management of power system operations in the presence of uncertain, highly time-varying and intermittent renewable resources. The ability to exploit the potential synergies between renewable and ESRs hinges on developing appropriate models, methodologies, tools and policy initiatives. We report on the development of a comprehensive simulation methodology that provides the capability to quantify the impacts of integrated renewable and ESRs on the economics, reliability and emission variable effects of power systems operating in a market environment. We model the uncertainty in the demands, the available capacity of conventional generation resources and the time-varying, intermittent renewable resources, with their temporal and spatial correlations, as discrete-time random processes. We deploy models of the ESRs to emulate their scheduling and operations in the transmission-constrained hourly day-ahead markets. To this end, we formulate a scheduling optimization problem (SOP) whose solutions determine the operational schedule of the controllable ESRs in coordination with the demands and the conventional/renewable resources. As such, the SOP serves the dual purpose of emulating the clearing of the transmission-constrained day-ahead markets (DAMs ) and scheduling the energy storage resource operations. We also represent the need for system operators to impose stricter ramping requirements on the conventional generating units so as to maintain the system capability to perform "load following'', i.e., respond to quick variations in the loads and renewable resource outputs in a manner that maintains the power balance, by incorporating appropriate ramping requirement constraints in the formulation of the SOP. The simulation approach makes use of Monte Carlo simulation techniques to represent the impacts of the sources of uncertainty on the side-by-side power system and market operations. As such, we systematically sample the "input'' random processes -- namely the buyer demands, renewable resource outputs and conventional generation resource available capacities -- to generate the realizations, or sample paths, that we use in the emulation of the transmission-constrained day-ahead markets via SOP . As a result, we obtain realizations of the market outcomes and storage resource operations that we can use to approximate their statistics. The approach not only has the capability to emulate the side-by-side power system and energy market operations with the explicit representation of the chronology of time-dependent phenomena -- including storage cycles of charge/discharge -- and constraints imposed by the transmission network in terms of deliverability of the energy, but also to provide the figures of merit for all metrics to assess the economics, reliability and the environmental impacts of the performance of those operations. Our efforts to address the implementational aspects of the methodology so as to ensure computational tractability for large-scale systems over longer periods include relaxing the SOP, the use of a "warm-start'' technique as well as representative simulation periods, parallelization and variance reduction techniques. Our simulation approach is useful in power system planning, operations and investment analysis. There is a broad range of applications of the simulation methodology to resource planning studies, production costing issues, investment analysis, transmission utilization, reliability analysis, environmental assessments, policy formulation and to answer quantitatively various what-if questions. We demonstrate the capabilities of the simulation approach by carrying out various studies on modified IEEE 118- and WECC 240-bus systems. The results of our representative case studies effectively illustrate the synergies among wind and ESRs. Our investigations clearly indicate that energy storage and wind resources tend to complement each other in the reduction of wholesale purchase payments in the DAMs and the improvement of system reliability. In addition, we observe that CO2 emission impacts with energy storage depend on the resource mix characteristics. An important finding is that storage seems to attenuate the "diminishing returns'' associated with increased penetration of wind generation. Our studies also evidence the limited ability of integrated ESRs to enhance the wind resource capability to replace conventional resources from purely a system reliability perspective. Some useful insights into the siting of ESRs are obtained and they indicate the potentially significant impacts of such decisions on the network congestion patterns and, consequently, on the LMPs. Simulation results further indicate that the explicit representation of ramping requirements on the conventional units at the DAM level causes the expected total wholesale purchase payments to increase, thereby mitigating the benefits of wind integration. The stricter ramping requirements are also shown to impact the revenues of generators that do not even provide any ramp capability services.

[Between control and therapy: an evolutionary concept analysis of special observation in acute psychiatric wards].

PubMed

Zehnder, Ursina; Rabenschlag, Franziska; Panfil, Eva-Maria

2015-03-01

Special observation is a seriously invasive and resource intensive intervention. It is necessary to scientifically conceptualise this measure for further investigations and practice. Evolutionary concept analysis. The identified antecedents, attributes and consequences of special observation range between control and therapy as well as the safety of patients and the coverage of the professionals. Antecedents comprise of legitimisation (indication, assessment, prescription), resources (internal guidelines, architectural structures, information) as well as context factors (security needs, personal attitudes). The identified attitudes are organisation (qualification, shifting carers, length, place), intervention (relationship, re-assessment, transparency) as well as the field of tension between control and therapy. The consequences consist of side effects (patients, nurses, resources) and conflicts (ethical dilemmas, role conflicts). Society and discipline have influenced the concept over time and a distinction between the custodial and controlling pattern versus a therapeutic approach is recommended. © Georg Thieme Verlag KG Stuttgart · New York.

Performance evaluation of data center service localization based on virtual resource migration in software defined elastic optical network.

PubMed

Yang, Hui; Zhang, Jie; Ji, Yuefeng; Tan, Yuanlong; Lin, Yi; Han, Jianrui; Lee, Young

2015-09-07

Data center interconnection with elastic optical network is a promising scenario to meet the high burstiness and high-bandwidth requirements of data center services. In our previous work, we implemented cross stratum optimization of optical network and application stratums resources that allows to accommodate data center services. In view of this, this study extends the data center resources to user side to enhance the end-to-end quality of service. We propose a novel data center service localization (DCSL) architecture based on virtual resource migration in software defined elastic data center optical network. A migration evaluation scheme (MES) is introduced for DCSL based on the proposed architecture. The DCSL can enhance the responsiveness to the dynamic end-to-end data center demands, and effectively reduce the blocking probability to globally optimize optical network and application resources. The overall feasibility and efficiency of the proposed architecture are experimentally verified on the control plane of our OpenFlow-based enhanced SDN testbed. The performance of MES scheme under heavy traffic load scenario is also quantitatively evaluated based on DCSL architecture in terms of path blocking probability, provisioning latency and resource utilization, compared with other provisioning scheme.

Managing water with better institutions: Building flexibility, innovation and lessons of best practices

NASA Astrophysics Data System (ADS)

Msangi, S.

2014-12-01

Changing socio-economic conditions and global environmental change continue to put pressure on critical natural resources necessary for sustaining ecosystems and human well-being - including water. Increasing variability in water availability, deepening droughts and continuing demands and consumptive use have posed problems for resource managers and policy makers in many regions. While in some regions it is still possible to enhance supply, such as in under-exploited water basins in Africa - the majority of the world's heaviest water users are facing situations that call for more demand-side adjustments. This necessitates a change from engineering-focused solutions to more economic ones, especially where the costs of increasing supply (such as through de-salinization) are prohibitively expensive, or have unacceptable consequences for environmental sustainability. Despite many years and decades of studying water resource management problems, there is still too little guidance as to what institutional best-practices should be followed. Water resources tend to touch on a number of areas managed by different government departments and ministries (agriculture, aquaculture & fisheries, industry, natural resources, etc) - but there is still no common understanding of what the best governance arrangements are that lead to improved sectoral performance (however that is measured). Given the continuing efforts to invest in water resources management and development by major multi-lateral organizations such as the World Bank and the African Development Bank - this kind of institutional guidance is critical, if countries are to make the most of these investments. In this presentation, we review a number of cases in which previously supply-side oriented approaches have to be dealt with from the demand side, and why institutional flexibility and innovation is so important. We draw from examples of community-based groundwater management in India, groundwater overdraft management in China and the US, and try and synthesize some key priorities for further research and policy dialogue that are needed to enhance the sustainability of water resources in critical basins.

The Internet and the Humanities: The Human Side of Networking. The Future of Networking Technologies for Learning.

ERIC Educational Resources Information Center

Riel, Margaret

This paper focuses on the human side of networking in education, emphasizing that people working together can create new solutions to old problems. Discussion includes increased links to information through the Internet and new resources entering the classroom; team-teaching, cooperative learning, and learner-centered instruction; and distance…

Knowledge and perceptions of the intrauterine device among family planning providers in Nepal: a cross-sectional analysis by cadre and sector.

PubMed

Chakraborty, Nirali M; Murphy, Caitlin; Paudel, Mahesh; Sharma, Sriju

2015-01-28

Nepal has high unmet need for family planning and low use of intrauterine devices (IUDs). While clients' attitudes toward the IUD are known in a variety of contexts, little is known about providers' knowledge and perceptions of the IUD in developing countries. Nepal's liberal IUD service provision policies allow the opportunity to explore provider knowledge and perceptions across cadres and sectors. This research contributes to an understanding of providers' IUD perceptions in low-resource environments, and increases evidence for IUD task-sharing and private sector involvement. A questionnaire was administered to 345 nurses and auxiliary nurse midwives (ANMs) affiliated with the private Mahila Swastha Sewa (MSS) franchise, public sector, or private non-franchise sector. All providers had been trained in TCu 380A IUD insertion and removal. The questionnaire captured providers' IUD experience, knowledge, and perceived barriers to recommendation. Descriptive, multivariate linear, and multinomial logistic regression was conducted, comparing providers between cadre and sector. On average, providers answered 21.5 of 35 questions correctly, for a score of 61.4%. Providers scored the lowest on IUD medical eligibility, answering 5.9 of 14 questions correctly. Over 50% of providers were able to name the four side effects most frequently associated with the IUD; however, one-third of all providers found at least one of these side effects unacceptable. Adjusted results show that cadre does not significantly impact provider's IUD knowledge scores or side effect perceptions. Public sector affiliation was associated with higher knowledge scores regarding personal characteristic eligibility and more negative perceptions of two normal IUD side effects. IUD knowledge is significantly associated with provider's recent training and employment at multiple facilities, and side effect perceptions are significantly associated with client volume, range of family planning methods, and region. Provider knowledge and attitudes towards IUD provision are similar across cadre and sector, supporting WHO task-sharing guidelines and validating Nepal's family planning policies. However, overall provider knowledge is low. We recommend that providers need to receive further training and support to improve knowledge, manage side effects, and recognize women in periods of high unmet need--such as post-partum or post-abortion women--as suitable candidates for IUDs.

Phytoremediation of heavy metal polluted soils and water: Progresses and perspectives*

PubMed Central

Lone, Mohammad Iqbal; He, Zhen-li; Stoffella, Peter J.; Yang, Xiao-e

2008-01-01

Environmental pollution affects the quality of pedosphere, hydrosphere, atmosphere, lithosphere and biosphere. Great efforts have been made in the last two decades to reduce pollution sources and remedy the polluted soil and water resources. Phytoremediation, being more cost-effective and fewer side effects than physical and chemical approaches, has gained increasing popularity in both academic and practical circles. More than 400 plant species have been identified to have potential for soil and water remediation. Among them, Thlaspi, Brassica, Sedum alfredii H., and Arabidopsis species have been mostly studied. It is also expected that recent advances in biotechnology will play a promising role in the development of new hyperaccumulators by transferring metal hyperaccumulating genes from low biomass wild species to the higher biomass producing cultivated species in the times to come. This paper attempted to provide a brief review on recent progresses in research and practical applications of phytoremediation for soil and water resources. PMID:18357623

Treatment and disease management of multiple sclerosis patients: A review for nurse practitioners.

PubMed

Roman, Cortnee; Menning, Kara

2017-10-01

This review discusses the role of the nurse practitioner (NP) in evaluating the clinical effects, potential side effects, and monitoring requirements for treatment options in multiple sclerosis (MS) and provides guidance on how to help patients understand these issues. A literature search was conducted on PubMed to identify publications on monitoring and disease management of MS patients. Additional resources included drug information web sites and package inserts. NPs play an active role in the management of MS patients via effective monitoring and communication throughout the patient's treatment regimen and disease course. In the shared decision-making model of MS treatment, NPs ensure that patients understand the implications of their disease-modifying therapies (DMTs). As patients move through treatments during the course of their disease, the importance of this role increases, and it is critical that NPs follow the guidelines in each medication's product label and take into account any potential lingering effects of prior medications. It is critical for NPs to promote patient adherence, to ensure that patients understand treatment side effects and monitoring requirements, and to take sequencing and reversibility implications of DMTs into account when making clinical decisions. ©2017 American Association of Nurse Practitioners.

On-demand provisioning of HEP compute resources on cloud sites and shared HPC centers

NASA Astrophysics Data System (ADS)

Erli, G.; Fischer, F.; Fleig, G.; Giffels, M.; Hauth, T.; Quast, G.; Schnepf, M.; Heese, J.; Leppert, K.; Arnaez de Pedro, J.; Sträter, R.

2017-10-01

This contribution reports on solutions, experiences and recent developments with the dynamic, on-demand provisioning of remote computing resources for analysis and simulation workflows. Local resources of a physics institute are extended by private and commercial cloud sites, ranging from the inclusion of desktop clusters over institute clusters to HPC centers. Rather than relying on dedicated HEP computing centers, it is nowadays more reasonable and flexible to utilize remote computing capacity via virtualization techniques or container concepts. We report on recent experience from incorporating a remote HPC center (NEMO Cluster, Freiburg University) and resources dynamically requested from the commercial provider 1&1 Internet SE into our intitute’s computing infrastructure. The Freiburg HPC resources are requested via the standard batch system, allowing HPC and HEP applications to be executed simultaneously, such that regular batch jobs run side by side to virtual machines managed via OpenStack [1]. For the inclusion of the 1&1 commercial resources, a Python API and SDK as well as the possibility to upload images were available. Large scale tests prove the capability to serve the scientific use case in the European 1&1 datacenters. The described environment at the Institute of Experimental Nuclear Physics (IEKP) at KIT serves the needs of researchers participating in the CMS and Belle II experiments. In total, resources exceeding half a million CPU hours have been provided by remote sites.

[Hypnosis as a resource in palliative care. A qualitative study of the contribution of hypnosis to the care of oncology patients].

PubMed

Teike Luethi, Fabienne; Currat, Thierry; Spencer, Brenda; Jayet, Nicolas; Cantin, Boris

2012-09-01

Hypnosis is recognised in medicine as an effective complementary therapy. However, few qualitative data are available concerning the benefits it may bring. This qualitative exploratory study aimed to examine the contribution of hypnosis to the care of advanced cancer patients. Results demonstrate that hypnosis is an effective and efficient means of developing the resources of people suffering from serious illness. After an average of four hypnotherapy sessions, patients said they were able to locate previously unexploited resources within themselves and were able to become autonomous in the use of self-hypnosis. The major benefit reported concerned a reduction in anxiety. For patients experiencing anxiety about death, hypnosis allowed them, within a therapeutic environment perceived as safe, to explore different facets of their fears and to develop adaptive strategies. Aside from slight fatigue experienced during the sessions, no adverse side-effects were reported. In conclusion, this study exploring the effects of hypnosis allowed us to identify important benefits for patients suffering from advanced cancer. Consequently, replication on a larger scale is recommended in order to ascertain the extent to which it is possible to generalise from these results and in order better to define the characteristics of patients most likely to benefit from this therapy.

Hair Cosmetics: An Overview

PubMed Central

Gavazzoni Dias, Maria Fernanda Reis

2015-01-01

Hair cosmetics are an important tool that helps to increase patient's adhesion to alopecia and scalp treatments. This article reviews the formulations and the mode of action of hair cosmetics: Shampoos, conditioners, hair straightening products, hair dyes and henna; regarding their prescription and safetiness. The dermatologist's knowledge of hair care products, their use, and their possible side effects can extend to an understanding of cosmetic resources and help dermatologists to better treat hair and scalp conditions according to the diversity of hair types and ethnicity. PMID:25878443

Coping strategies used by hospitalized children with cancer undergoing chemotherapy.

PubMed

Sposito, Amanda Mota Pacciulio; Silva-Rodrigues, Fernanda Machado; Sparapani, Valéria de Cássia; Pfeifer, Luzia Iara; de Lima, Regina Aparecida Garcia; Nascimento, Lucila Castanheira

2015-03-01

To analyze coping strategies used by children with cancer undergoing chemotherapy during hospitalization. This was an exploratory study to analyze qualitative data using an inductive thematic analysis. Semistructured interviews using puppets were conducted with 10 children with cancer, between 7 and 12 years old, who were hospitalized and undergoing chemotherapy. The coping strategies to deal with chemotherapy were: understanding the need for chemotherapy; finding relief for the chemotherapy's side effects and pain; seeking pleasure in nourishment; engaging in entertaining activities and having fun; keeping the hope of cure alive; and finding support in religion. Children with cancer undergoing chemotherapy need to cope with hospitalizations, pain, medication side effects, idle time, and uncertainty regarding the success of treatment. These challenges motivated children to develop their own coping strategies, which were effective while undergoing chemotherapy. By gaining knowledge and further understanding about valid coping strategies during chemotherapy treatment, health professionals can mobilize personal and material resources from the children, health teams, and institutions aiming to potentiate the use of these strategies to make treatments the least traumatic. © 2015 Sigma Theta Tau International.

Amorfrutins are potent antidiabetic dietary natural products

PubMed Central

Weidner, Christopher; de Groot, Jens C.; Prasad, Aman; Freiwald, Anja; Quedenau, Claudia; Kliem, Magdalena; Witzke, Annabell; Kodelja, Vitam; Han, Chung-Ting; Giegold, Sascha; Baumann, Matthias; Klebl, Bert; Siems, Karsten; Müller-Kuhrt, Lutz; Schürmann, Annette; Schüler, Rita; Pfeiffer, Andreas F. H.; Schroeder, Frank C.; Büssow, Konrad; Sauer, Sascha

2012-01-01

Given worldwide increases in the incidence of obesity and type 2 diabetes, new strategies for preventing and treating metabolic diseases are needed. The nuclear receptor PPARγ (peroxisome proliferator-activated receptor gamma) plays a central role in lipid and glucose metabolism; however, current PPARγ-targeting drugs are characterized by undesirable side effects. Natural products from edible biomaterial provide a structurally diverse resource to alleviate complex disorders via tailored nutritional intervention. We identified a family of natural products, the amorfrutins, from edible parts of two legumes, Glycyrrhiza foetida and Amorpha fruticosa, as structurally new and powerful antidiabetics with unprecedented effects for a dietary molecule. Amorfrutins bind to and activate PPARγ, which results in selective gene expression and physiological profiles markedly different from activation by current synthetic PPARγ drugs. In diet-induced obese and db/db mice, amorfrutin treatment strongly improves insulin resistance and other metabolic and inflammatory parameters without concomitant increase of fat storage or other unwanted side effects such as hepatoxicity. These results show that selective PPARγ-activation by diet-derived ligands may constitute a promising approach to combat metabolic disease. PMID:22509006

Online Resource Sharing II. A Comparison of: OCLC, Incorporated, Research Libraries Information Network, and Washington Library Network.

ERIC Educational Resources Information Center

Jacobs, Mary Ellen; And Others

This comparative study of three major online bibliographic systems is designed to provide assistance to library administrators in the assessment of the potential impact of such systems upon the operations of their libraries. A side by side arrangement of the text allows an overview of any specific characteristic under consideration. These…

No Pain, No Gain? A Resource-Based Model of Work-to-Family Enrichment and Conflict

ERIC Educational Resources Information Center

Chen, Zheng; Powell, Gary N.

2012-01-01

Work-family scholars tend to work in two largely disconnected research streams, focusing on either work-family enrichment--the positive side of the work-family interface--or work-family conflict--the negative side of this interface. The purpose of this study is to suggest a reconciliation of the two research streams by proposing and testing a…

Geology based planning and the aggregate industry -Perspectives from opposite sides of the globe

USGS Publications Warehouse

Stephens, A.W.; Langer, W.H.

2005-01-01

In Australia and America, encroachment by conflicting land uses, zoning restrictions, and the "not in my backyard" syndrome make it increasingly difficult to access high-quality aggregate resources located near the market areas. Attempts by government agencies in America to protect aggregate resources for future development have met with varying degrees of success. The State of Queensland, Australia, designates aggregate resource areas as Key Resource Areas, which protect the resource and the routes to transport the resource, provide a separation area from incompatible land uses, and indicate the likelihood that the area is free from conflicting social or environmental issues. Copyright ?? 2005 by SME.

Geology-based planning and the aggregate industry - Perspectives from opposite sides of the globe

USGS Publications Warehouse

Stephens, A.W.; Langer, W.H.

2006-01-01

In Australia and in the United States, encroachment by conflicting land uses, zoning restrictions and the "not-in-my-backyard" syndrome make it increasingly difficult to access high-quality aggregate resources located near their market areas. Attempts by government agencies in the United States to protect aggregate resources for future development have met with varying degrees of success. The State of Queensland, Australia, designates aggregate resource areas as Key Resource Areas. These protect the resource and the routes to transport the resource, provide a separation area from incompatible land uses and indicate the likelihood that the area is free from conflicting social or environmental issues.

A security-awareness virtual machine management scheme based on Chinese wall policy in cloud computing.

PubMed

Yu, Si; Gui, Xiaolin; Lin, Jiancai; Tian, Feng; Zhao, Jianqiang; Dai, Min

2014-01-01

Cloud computing gets increasing attention for its capacity to leverage developers from infrastructure management tasks. However, recent works reveal that side channel attacks can lead to privacy leakage in the cloud. Enhancing isolation between users is an effective solution to eliminate the attack. In this paper, to eliminate side channel attacks, we investigate the isolation enhancement scheme from the aspect of virtual machine (VM) management. The security-awareness VMs management scheme (SVMS), a VMs isolation enhancement scheme to defend against side channel attacks, is proposed. First, we use the aggressive conflict of interest relation (ACIR) and aggressive in ally with relation (AIAR) to describe user constraint relations. Second, based on the Chinese wall policy, we put forward four isolation rules. Third, the VMs placement and migration algorithms are designed to enforce VMs isolation between the conflict users. Finally, based on the normal distribution, we conduct a series of experiments to evaluate SVMS. The experimental results show that SVMS is efficient in guaranteeing isolation between VMs owned by conflict users, while the resource utilization rate decreases but not by much.

A Security-Awareness Virtual Machine Management Scheme Based on Chinese Wall Policy in Cloud Computing

PubMed Central

Gui, Xiaolin; Lin, Jiancai; Tian, Feng; Zhao, Jianqiang; Dai, Min

2014-01-01

Cloud computing gets increasing attention for its capacity to leverage developers from infrastructure management tasks. However, recent works reveal that side channel attacks can lead to privacy leakage in the cloud. Enhancing isolation between users is an effective solution to eliminate the attack. In this paper, to eliminate side channel attacks, we investigate the isolation enhancement scheme from the aspect of virtual machine (VM) management. The security-awareness VMs management scheme (SVMS), a VMs isolation enhancement scheme to defend against side channel attacks, is proposed. First, we use the aggressive conflict of interest relation (ACIR) and aggressive in ally with relation (AIAR) to describe user constraint relations. Second, based on the Chinese wall policy, we put forward four isolation rules. Third, the VMs placement and migration algorithms are designed to enforce VMs isolation between the conflict users. Finally, based on the normal distribution, we conduct a series of experiments to evaluate SVMS. The experimental results show that SVMS is efficient in guaranteeing isolation between VMs owned by conflict users, while the resource utilization rate decreases but not by much. PMID:24688434

Contraceptive information on pregnancy resource center websites: a statewide content analysis.

PubMed

Swartzendruber, Andrea; Steiner, Riley J; Newton-Levinson, Anna

2018-04-24

Most pregnancy resource centers (PRCs) in the US are affiliated with national organizations that have policies against promoting or providing contraceptives, yet many provide information about contraception on their websites. In 2016, the state of Georgia passed a new law to publicly fund PRCs. This study sought to describe the contraceptive information on Georgia PRC websites. We systematically identified all accessible Georgia PRC websites April-June 2016. We downloaded entire websites and used defined protocols to code and thematically analyze content about contraceptives. Of the 64 websites reviewed, 20 (31%) presented information about contraceptives. Most of the content was dedicated to emergency contraception. Emphasis on risks and side effects was the most prominent theme. However, no site presented information about the frequency or prevalence of risks and side effects. Sites also emphasized contraceptive failure and minimized effectiveness. We found a high degree of inaccurate and misleading information about contraceptives. Georgia PRC websites presented skewed information that may undermine confidence in the safety and efficacy of contraceptive methods and discourage use. Public funding for PRCs, an increasing national trend, should be rigorously examined. Increased regulation is urgently needed to ensure that online information about contraceptives presented by publicly funded centers is unbiased, complete and accurate. We examined contraceptive information on Georgia PRC websites and found sites minimize benefits and emphasize barriers to use. They contain high levels of medically inaccurate and misleading information that may undermine public health goals. Public funding for PRCs should be rigorously examined; increased regulation is urgently needed. Copyright © 2018 Elsevier Inc. All rights reserved.

Encouraging the use of generic medicines: implications for transition economies.

PubMed

King, Derek R; Kanavos, Panos

2002-08-01

Generic drugs have a key role to play in the efficient allocation of financial resources for pharmaceutical medicines. Policies implemented in the countries with a high rate of generic drug use, such as Canada, Denmark, Germany, the Netherlands, the United Kingdom, and the United States, are reviewed, with consideration of the market structures that facilitate strong competition. Savings in these countries are realized through increases in the volume of generic drugs used and the frequently significant differences in the price between generic medicines and branded originator medicines. Their policy tools include the mix of supply-side measures and demand-side measures that are relevant for generic promotion and higher generic use. On the supply-side, key policy measures include generic drug marketing regulation that facilitates market entry soon after patent expiration, reference pricing, the pricing of branded originator products, and the degree of price competition in pharmaceutical markets. On the demand-side, measures typically encompass influencing prescribing and dispensing patterns as well as introducing a co-payment structure for consumers/patients that takes into consideration the difference in cost between branded and generic medicines. Quality of generic medicines is a pre-condition for all other measures discussed to take effect. The paper concludes by offering a list of policy options for decision-makers in Central and Eastern European economies in transition.

Mineral resources and land use in Stanislaus County, California

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

Higgins, C.T.; Dupras, D.L.; Chapman, R.H.

1993-04-01

Stanislaus County covers portions of 3 geologic provinces: Coast Ranges, Great Valley, and Sierra Nevada. Each has been exploited for a distinct set of mineral resources, which include sand and gravel, ball and fire clay, placer gold, manganese, chromite, magnesite, mercury, diatomite, building stone, and mineral pigment. Of these, sand and gravel, clay, and diatomite have been the most important commodities produced recently. Sand and gravel, particularly that along the Tuolumne River, is and will continue to be the county's main mineral product; other potentially important areas include alluvial fans along the west side of the Great Valley. Clay andmore » diatomite could resume importance in the future. There is also potential for quartz-rich specialty sands. Although the county is largely rural, it is undergoing one of the highest growth rates in California. Several new residential communities are being proposed in the county, which would have two major effects on mineral resources: (1) large sources of aggregate will be required for construction, and (2) development of residential areas may preclude mining of resources in those areas. Maps of mineral resources produced by this study, will assist decisions on such potential conflicts in land use.« less

An Integrated Approach to Functional Engineering: An Engineering Database for Harness, Avionics and Software

NASA Astrophysics Data System (ADS)

Piras, Annamaria; Malucchi, Giovanni

2012-08-01

In the design and development phase of a new program one of the critical aspects is the integration of all the functional requirements of the system and the control of the overall consistency between the identified needs on one side and the available resources on the other side, especially when both the required needs and available resources are not yet consolidated, but they are evolving as the program maturity increases.The Integrated Engineering Harness Avionics and Software database (IDEHAS) is a tool that has been developed to support this process in the frame of the Avionics and Software disciplines through the different phases of the program. The tool is in fact designed to allow an incremental build up of the avionics and software systems, from the description of the high level architectural data (available in the early stages of the program) to the definition of the pin to pin connectivity information (typically consolidated in the design finalization stages) and finally to the construction and validation of the detailed telemetry parameters and commands to be used in the test phases and in the Mission Control Centre. The key feature of this approach and of the associated tool is that it allows the definition and the maintenance / update of all these data in a single, consistent environment.On one side a system level and concurrent approach requires the feasibility to easily integrate and update the best data available since the early stages of a program in order to improve confidence in the consistency and to control the design information.On the other side, the amount of information of different typologies and the cross-relationships among the data imply highly consolidated structures requiring lot of checks to guarantee the data content consistency with negative effects on simplicity and flexibility and often limiting the attention to special needs and to the interfaces with other disciplines.

Character Matters: Using Newspapers To Teach Character. Strategies for Teachers, Activities for Parents. Newspaper in Education Resource Guide.

ERIC Educational Resources Information Center

DeRoche, Edward F.; Sullivan, Betty L.; Garrett, Sherrye Dee

One side of character education is to create schools and communities that are caring, civil, and challenging (both academically and behaviorally). The other side is to develop young citizens who are smart, decent, and responsible. This booklet illustrates how to use newspaper content at school and at home to teach eight specific values: respect,…

Traits and Resource Use of Co-Occurring Introduced and Native Trees in a Tropical Novel Forest

Treesearch

Jéssica Fonseca da Silva; Ernesto Medina; Ariel Lugo

2017-01-01

Novel forests are naturally regenerating forests that have established on degraded lands and have a species composition strongly influenced by introduced species. We studied ecophysiological traits of an introduced species (Castilla elastica Sessé) and several native species growing side by side in novel forests dominated by C. elastica ...

Identifying predictors for quality and quantity restorative character of wilderness: using events as an analysis unit

Treesearch

Chad D. Pierskalla; Jason M. Siniscalchi; William E. Hammitt; David A. Smaldone; Steven J. Storck

2007-01-01

The purpose of this research is to understand whether and how trail design and resource impacts influence the quality and quantity of restorative experiences. The focus of past research has been on understanding the quality-side (what happens). What is missing is a better understanding of the quantity-side of experiences (how much happens). Gibson's environmental...

No blank slates: Pre-existing schemas about pharmaceuticals predict memory for side effects.

PubMed

Heller, Monika K; Chapman, Sarah C E; Horne, Rob

2017-04-01

Attribution of symptoms as medication side effects is informed by pre-existing beliefs about medicines and perceptions of personal sensitivity to their effects (pharmaceutical schemas). We tested whether (1) pharmaceutical schemas were associated with memory (recall/recognition) for side effect information (2) memory explained the attribution of a common unrelated symptom as a side effect. In this analogue study participants saw the patient leaflet of a fictitious asthma drug listing eight side effects. We measured recall and recognition memory for side effects and used a vignette to test whether participants attributed an unlisted common symptom (headache) as a side effect. Participants who perceived pharmaceuticals as more harmful in general recalled fewer side effects correctly (r Correct Recall  = -.273), were less able to differentiate between listed and unlisted side effects (r Recognition Sensitivity  = -.256) and were more likely to attribute the unlisted headache symptom as a side effect (r side effect attribution  = .381, ps < .01). The effect of harm beliefs on side effect attribution was partially mediated by correct recall of side effects. Pharmaceutical schemas are associated with memory for side effect information. Memory may explain part of the association between pharmaceutical schemas and the attribution of unrelated symptoms as side effects.

Motives and Tensions in the Release of Open Educational Resources: The UKOER Program

ERIC Educational Resources Information Center

Falconer, Isobel; Littlejohn, Allison; McGill, Lou; Beetham, Helen

2016-01-01

Open educational resources (OER) have been promoted as a path to universal education, supporting economic development and intercultural dialogue. However, to realise these benefits requires greater understanding of the factors that influence both OER supply and use. This paper examines an aspect of the supply side of the OER lifecycle--the motives…

[Research strategies for feed additives and veterinary medicines from side products of Chinese medicine resources industrialization].

PubMed

Zhao, Ming; Duan, Jin-Ao; Zhang, Sen; Guo, Sheng; Su, Shu-Lan; Wu, Qi-Nan; Tang, Yu-Ping; Zeng, Jian-Guo

2017-09-01

The global antimicrobial resistance has been a big challenge to the human health for years. It has to make balance between the safety of animal products and the use of antimicrobials in animal husbandry. Any methods that can minimize or even phase out the use of antimicrobials in animal husbandry should be encouraged. We herein describe the research strategies for feed additives and veterinary medicines from the side products of Chinese medicine resources industrialization. Killing two birds with one stone-besides the major purposes, the rational utilization of non-medicinal parts and wastes of industrialization of Chinese herbal medicines is also achieved under the proposed strategies. Copyright© by the Chinese Pharmaceutical Association.

Modeling Framework and Validation of a Smart Grid and Demand Response System for Wind Power Integration

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

Broeer, Torsten; Fuller, Jason C.; Tuffner, Francis K.

2014-01-31

Electricity generation from wind power and other renewable energy sources is increasing, and their variability introduces new challenges to the power system. The emergence of smart grid technologies in recent years has seen a paradigm shift in redefining the electrical system of the future, in which controlled response of the demand side is used to balance fluctuations and intermittencies from the generation side. This paper presents a modeling framework for an integrated electricity system where loads become an additional resource. The agent-based model represents a smart grid power system integrating generators, transmission, distribution, loads and market. The model incorporates generatormore » and load controllers, allowing suppliers and demanders to bid into a Real-Time Pricing (RTP) electricity market. The modeling framework is applied to represent a physical demonstration project conducted on the Olympic Peninsula, Washington, USA, and validation simulations are performed using actual dynamic data. Wind power is then introduced into the power generation mix illustrating the potential of demand response to mitigate the impact of wind power variability, primarily through thermostatically controlled loads. The results also indicate that effective implementation of Demand Response (DR) to assist integration of variable renewable energy resources requires a diversity of loads to ensure functionality of the overall system.« less

Automatic Identification of Application I/O Signatures from Noisy Server-Side Traces

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

Liu, Yang; Gunasekaran, Raghul; Ma, Xiaosong

2014-01-01

Competing workloads on a shared storage system cause I/O resource contention and application performance vagaries. This problem is already evident in today s HPC storage systems and is likely to become acute at exascale. We need more interaction between application I/O requirements and system software tools to help alleviate the I/O bottleneck, moving towards I/O-aware job scheduling. However, this requires rich techniques to capture application I/O characteristics, which remain evasive in production systems. Traditionally, I/O characteristics have been obtained using client-side tracing tools, with drawbacks such as non-trivial instrumentation/development costs, large trace traffic, and inconsistent adoption. We present a novelmore » approach, I/O Signature Identifier (IOSI), to characterize the I/O behavior of data-intensive applications. IOSI extracts signatures from noisy, zero-overhead server-side I/O throughput logs that are already collected on today s supercomputers, without interfering with the compiling/execution of applications. We evaluated IOSI using the Spider storage system at Oak Ridge National Laboratory, the S3D turbulence application (running on 18,000 Titan nodes), and benchmark-based pseudo-applications. Through our ex- periments we confirmed that IOSI effectively extracts an application s I/O signature despite significant server-side noise. Compared to client-side tracing tools, IOSI is transparent, interface-agnostic, and incurs no overhead. Compared to alternative data alignment techniques (e.g., dynamic time warping), it offers higher signature accuracy and shorter processing time.« less

Water demand for electricity in deep decarbonisation scenarios: a multi-model assessment

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

Mouratiadou, I.; Bevione, M.; Bijl, D. L.

This study assesses the effects of deep electricity decarbonisation and shifts in the choice of power plant cooling technologies on global electricity water demand, using a suite of five integrated assessment models. We find that electricity sector decarbonisation results in co-benefits for water resources primarily due to the phase-out of water-intensive coal-based thermoelectric power generation, although these co-benefits vary substantially across decarbonisation scenarios. Wind and solar photovoltaic power represent a win-win option for both climate and water resources, but further expansion of nuclear or fossil- and biomass-fuelled power plants with carbon capture and storage may result in increased pressures onmore » the water environment. Further to these results, the paper provides insights on the most crucial factors of uncertainty with regards to future estimates of water demand. These estimates varied substantially across models in scenarios where the effects of decarbonisation on the electricity mix were less clear-cut. Future thermal and water efficiency improvements of power generation technologies and demand-side energy efficiency improvements were also identified to be important factors of uncertainty. We conclude that in order to ensure positive effects of decarbonisation on water resources, climate policy should be combined with technology-specific energy and/or water policies.« less

A generalized network flow model for the multi-mode resource-constrained project scheduling problem with discounted cash flows

NASA Astrophysics Data System (ADS)

Chen, Miawjane; Yan, Shangyao; Wang, Sin-Siang; Liu, Chiu-Lan

2015-02-01

An effective project schedule is essential for enterprises to increase their efficiency of project execution, to maximize profit, and to minimize wastage of resources. Heuristic algorithms have been developed to efficiently solve the complicated multi-mode resource-constrained project scheduling problem with discounted cash flows (MRCPSPDCF) that characterize real problems. However, the solutions obtained in past studies have been approximate and are difficult to evaluate in terms of optimality. In this study, a generalized network flow model, embedded in a time-precedence network, is proposed to formulate the MRCPSPDCF with the payment at activity completion times. Mathematically, the model is formulated as an integer network flow problem with side constraints, which can be efficiently solved for optimality, using existing mathematical programming software. To evaluate the model performance, numerical tests are performed. The test results indicate that the model could be a useful planning tool for project scheduling in the real world.

Improving Service Management in the Internet of Things

PubMed Central

Sammarco, Chiara; Iera, Antonio

2012-01-01

In the Internet of Things (IoT) research arena, many efforts are devoted to adapt the existing IP standards to emerging IoT nodes. This is the direction followed by three Internet Engineering Task Force (IETF) Working Groups, which paved the way for research on IP-based constrained networks. Through a simplification of the whole TCP/IP stack, resource constrained nodes become direct interlocutors of application level entities in every point of the network. In this paper we analyze some side effects of this solution, when in the presence of large amounts of data to transmit. In particular, we conduct a performance analysis of the Constrained Application Protocol (CoAP), a widely accepted web transfer protocol for the Internet of Things, and propose a service management enhancement that improves the exploitation of the network and node resources. This is specifically thought for constrained nodes in the abovementioned conditions and proves to be able to significantly improve the node energetic performance when in the presence of large resource representations (hence, large data transmissions).

The ethics of screening: is 'screeningitis' an incurable disease?

PubMed Central

Shickle, D; Chadwick, R

1994-01-01

Screening programmes are becoming increasingly popular since prevention is considered 'better than cure'. While earlier diagnosis may result in more effective treatment for some, there will be consequent harm for others due to anxiety, stigma, side-effects etc. A screening test cannot guarantee the detection of all 'abnormal' cases, therefore there will be false reassurance for some. A proper consideration of the potential benefit and harm arising from screening may lead to the conclusion that the programme should not be offered. A modified utilitarian approach may be used for allocation of scarce resources in health care. Ethics has an important role in this evaluation. PMID:8035433

Use of participatory modeling workshops in a water-stressed basin of northern Mexico to assess sustainable water resources management and conduct community outreach

NASA Astrophysics Data System (ADS)

Vivoni, E. R.; Mayer, A. S.; Halvorsen, K. E.; Robles-Morua, A.; Kossak, D.

2016-12-01

A series of iterative participatory modeling workshops were held in Sonora, México with the goal of developing water resources management strategies in a water-stressed basin subject to hydro-climatic variability and change. A model of the water resources system, consisting of watershed hydrology, water resources infrastructure, and groundwater models, was developed deliberatively in the workshops, along with scenarios of future climate and development. Participants used the final version of the water resources systems model to select from supply-side and demand-side water resources management strategies. The performance of the strategies was based on the reliability of meeting current and future demands at a daily time scale over a year's period. Pre- and post-workshop surveys were developed and administered. The survey questions focused on evaluation of participants' modeling capacity and the utility and accuracy of the models. The selected water resources strategies and the associated, expected reliability varied widely among participants. Most participants could be clustered into three groups with roughly equal numbers of participants that varied in terms of reliance on expanding infrastructure vs. demand modification; expectations of reliability; and perceptions of social, environmental, and economic impacts. The wide range of strategies chosen and associated reliabilities indicate that there is a substantial degree of uncertainty in how future water resources decisions could be made in the region. The pre- and post-survey results indicate that participants believed their modeling abilities increased and beliefs in the utility of models increased as a result of the workshops

A rapid, Web-based method for obtaining patient views on effects and side-effects of antidepressants.

PubMed

Rizo, Carlos; Deshpande, Amol; Ing, Alton; Seeman, Neil

2011-04-01

This project was undertaken to develop a rapid method for obtaining a widespread sample of patient views on the efficacy and side-effects of antidepressants. A Web-based method is described for rapidly and objectively obtaining patient views on the effects and side-effects of treatment with antidepressants. The method entails a systematized search of many URLs (Uniform Resource Locators, or Web page addresses), using keywords and phrases to extract the named drug and symptom that are reliably relevant to the medication being taken by the individual reporting the experience online. Unwanted medical conditions (e.g., cancer) are excluded. Three successive searches of thousands of Web pages revealed a cumulative total of 835 "mentions" of patient experience on duloxetine, 756 for venlafaxine, 637 for citalopram, 636 for sertraline, 559 for paroxetine, 457 for fluoxetine, 318 for desvenlafaxine, 289 for fluvoxamine, and 210 for mirtazapine, in association with various symptoms. A comparison of the associated symptoms for each of the antidepressants found that the prevalence of the combined factor of fatigue, drowsiness, tiredness or lethargy ranged from 6.4±0.8% down to 2.9±0.15% of the mentions, where the S.E. was derived from three repeats of the Web-based analysis. The prevalence of dizziness or vertigo ranged from 7.6±0.8% down to 1.9±0.3% of the mentions. Given the increasing number of patient narratives about drug experiences on open-access Web forums, this rapid novel method will have increasing utility in post-marketing surveillance and in comparing the effects of psychiatric medications. Copyright © 2010 Elsevier B.V. All rights reserved.

Alleviating Pressure on Water Resources: A new approach could be attempted

NASA Astrophysics Data System (ADS)

Sun, Shikun; Wang, Yubao; Wang, Feifei; Liu, Jing; Luan, Xiaobo; Li, Xiaolei; Zhou, Tianwa; Wu, Pute

2015-09-01

Water and food safety are two major challenges which the world faces today. Traditional water management focuses on the reduction of water use through improvements in water saving technologies. However, quantitative research is needed to evaluate the effects of changing food consumption patterns on water resources. Here we report the water saving effects of changing diet pattern of the major crops and animal products in mainland China. By using the concepts of water footprint (WF) per weight unit and per calorie unit, provided by 13 primary crop and animal products, the WFs of the 13 agricultural products in each province are compared, and their water/energy conversion efficiencies are analyzed. Then, impacts of different scenarios of changing diet pattern on water consumption were explored. Results show that there are obvious differences between the WF per weight and calorie unit provided by crop and animal products due to the nutritional properties of the agricultural products. Promoting water savings from the food consumption side could give a positive feedback on water consumption. Scenario analysis of adjustments to the diet pattern proves that it is potentially feasible to reach the objective of alleviating stress on water resources while guaranteeing nutritional value of the residents.

Living knowledge of the healing plants: ethno-phytotherapy in the Chepang communities from the Mid-Hills of Nepal.

PubMed

Rijal, Arun

2008-11-25

Contribution of indigenous knowledge in developing more effective drugs with minimum or no side effects helped to realise importance of study of indigenous remedies and the conservation of biological resources. This study analysed indigenous knowledge regarding medicinal plants use among the Chepang communities from ward number 3 and 4 of Shaktikhor Village Development Committee located in the central mid hills of Nepal. Data were collected in a one-year period and included interviews with traditional healers and elders. Chepangs are rich in knowledge regarding use of different plants and were using a total 219 plant parts from 115 species including one mushroom (belonging 55 families) for medicinal uses. Out of these, 75 species had 118 different new medicinal uses and 18 of them were not reported in any previous documents from Nepal as medicinal plants. Spiritual belief, economy and limitation of alternative health facilities were cause of continuity of people's dependency on traditional healers. Change in socio-economic activities not only threatened traditional knowledge but also resource base of the area. Enforcement of local institution in management of forest resources and legitimating traditional knowledge and practices could help to preserve indigenous knowledge.

Alleviating Pressure on Water Resources: A new approach could be attempted.

PubMed

Sun, Shikun; Wang, Yubao; Wang, Feifei; Liu, Jing; Luan, Xiaobo; Li, Xiaolei; Zhou, Tianwa; Wu, Pute

2015-09-14

Water and food safety are two major challenges which the world faces today. Traditional water management focuses on the reduction of water use through improvements in water saving technologies. However, quantitative research is needed to evaluate the effects of changing food consumption patterns on water resources. Here we report the water saving effects of changing diet pattern of the major crops and animal products in mainland China. By using the concepts of water footprint (WF) per weight unit and per calorie unit, provided by 13 primary crop and animal products, the WFs of the 13 agricultural products in each province are compared, and their water/energy conversion efficiencies are analyzed. Then, impacts of different scenarios of changing diet pattern on water consumption were explored. Results show that there are obvious differences between the WF per weight and calorie unit provided by crop and animal products due to the nutritional properties of the agricultural products. Promoting water savings from the food consumption side could give a positive feedback on water consumption. Scenario analysis of adjustments to the diet pattern proves that it is potentially feasible to reach the objective of alleviating stress on water resources while guaranteeing nutritional value of the residents.

Alleviating Pressure on Water Resources: A new approach could be attempted

PubMed Central

Sun, Shikun; Wang, Yubao; Wang, Feifei; Liu, Jing; Luan, Xiaobo; Li, Xiaolei; Zhou, Tianwa; Wu, Pute

2015-01-01

Water and food safety are two major challenges which the world faces today. Traditional water management focuses on the reduction of water use through improvements in water saving technologies. However, quantitative research is needed to evaluate the effects of changing food consumption patterns on water resources. Here we report the water saving effects of changing diet pattern of the major crops and animal products in mainland China. By using the concepts of water footprint (WF) per weight unit and per calorie unit, provided by 13 primary crop and animal products, the WFs of the 13 agricultural products in each province are compared, and their water/energy conversion efficiencies are analyzed. Then, impacts of different scenarios of changing diet pattern on water consumption were explored. Results show that there are obvious differences between the WF per weight and calorie unit provided by crop and animal products due to the nutritional properties of the agricultural products. Promoting water savings from the food consumption side could give a positive feedback on water consumption. Scenario analysis of adjustments to the diet pattern proves that it is potentially feasible to reach the objective of alleviating stress on water resources while guaranteeing nutritional value of the residents. PMID:26364756

Using info-Gap Decision Theory for Water Resources Planning Under Severe Uncertainty

NASA Astrophysics Data System (ADS)

Korteling, B.; Brazier, R.; Kapelan, Z.; Dessai, S.

2012-12-01

Water resource managers are required to develop comprehensive water resource plans based on severely uncertain information of the effects of climate change on local hydrology and future socio-economic changes on localised demand. In England and Wales, current water resource planning methodologies include a headroom estimation process that quantifies uncertainty based on only one point of an assumed range of deviations from the expected climate and projected demand 25 years into the future. There are many situations where there is not enough knowledge to be able to estimate a representative probability of occurrence, or to be confident that the tails of an assumed probability distribution will not exhibit unexpected skewness, or that the kurtosis of a distribution differs from the norm. These situations can be considered severely uncertain. Information-Gap decision theory offers a method to sample a wider range of uncertainty than with traditional methods, and as a result, compare the robustness of various water resource management options under conditions of severe uncertainty. A more robust management option is one that delivers the same level of performance as other options at higher levels of uncertainty. A case study is based on a Water Supply Area that encompasses the county of Cornwall in southwest England containing 17 reservoirs and 19 demand nodes. The performance success of management options are evaluated primarily by measures of water availability including a reservoir risk measure that tests the probability and magnitude that strategic reservoir storage levels fall below the drought management curve under adverse conditions and also a safety margin deficit that tests how quickly reservoir levels can return to optimum operating levels in favourable conditions. Multi-Criteria Decision Analysis (MCDA) is used to test the effectiveness of different management options with different weightings for metrics other than water availability including; capital and operating costs, costs to customers, carbon emissions, environmental impact and social acceptability. Findings show that beyond the uncertainty range explored with the traditional headroom method, preference reversals can occur, i.e. some management options that underperform at lower uncertainties, outperform at higher levels of uncertainty. This study also shows that when 50% or more of the population adopts demand side management, efficiency related measures and innovative options such as rainwater collection can perform equally well or better than some supply side options. The additional use of MCDA shifts the focus away from reservoir expansion options that perform best with respect to water availability, to combined strategies that include innovative demand side management actions of rainwater collection and greywater reuse as well as efficiency measures and additional regional transfers. This research illustrates how an Info-Gap based approach can offer a comprehensive picture of potential supply/demand futures and a rich variety of information to support adaptive management of water systems under severe uncertainty.

Thermoelectric energy converter for generation of electricity from low-grade heat

DOEpatents

Jayadev, T.S.; Benson, D.K.

1980-05-27

A thermoelectric energy conversion device which includes a plurality of thermoelectric elements is described. A hot liquid is supplied to one side of each element and a cold liquid is supplied to the other side of each element. The thermoelectric generator may be utilized to produce power from low-grade heat sources such as ocean thermal gradients, solar ponds, and low-grade geothermal resources. (WHK)

Triple Co-Administration of Ivermectin, Albendazole and Praziquantel in Zanzibar: A Safety Study

PubMed Central

Mohammed, Khalfan A.; Haji, Hamad J.; Gabrielli, Albis-Francesco; Mubila, Likezo; Biswas, Gautam; Chitsulo, Lester; Bradley, Mark H.; Engels, Dirk; Savioli, Lorenzo; Molyneux, David H.

2008-01-01

Background Public health interventions based on distribution of anthelminthic drugs against lymphatic filariasis (LF), onchocerciasis, soil-transmitted helminthiasis (STH) and schistosomiasis have been implemented separately to date. A better use of available resources might be facilitated by a more coordinated approach to control such infections, including the possibility of co-administering the three recommended anthelminthic drugs through a single, large-scale intervention. Methodology/Principal Findings Ivermectin, albendazole and praziquantel were co-administered to 5,055 children and adults living in areas endemic for LF, STH and schistosomiasis in Zanzibar, United Republic of Tanzania, during a pilot intervention aimed at elucidating and quantifying possible side-effects. Subsequently, these drugs were co-administered to about 700,000 individuals during a countrywide intervention targeting a large part of the total population of Zanzibar. Passive and active surveillance measures carried out during both interventions showed that side-effects attributable to the three drugs given at the same time were mild and self-limiting events. Conclusions/Significance Our data suggest that co-administration of ivermectin, albendazole and praziquantel is safe in areas where lymphatic filariasis, soil-transmitted helminthiasis and schistosomiasis are co-endemic and where several rounds of treatment with one or two drugs have been implemented in the past. Passive surveillance measures, however, should be continued and detection, management and reporting of possible side-effects should be considered a key component of any health intervention administering drugs. PMID:18235853

A unified frame of predicting side effects of drugs by using linear neighborhood similarity.

PubMed

Zhang, Wen; Yue, Xiang; Liu, Feng; Chen, Yanlin; Tu, Shikui; Zhang, Xining

2017-12-14

Drug side effects are one of main concerns in the drug discovery, which gains wide attentions. Investigating drug side effects is of great importance, and the computational prediction can help to guide wet experiments. As far as we known, a great number of computational methods have been proposed for the side effect predictions. The assumption that similar drugs may induce same side effects is usually employed for modeling, and how to calculate the drug-drug similarity is critical in the side effect predictions. In this paper, we present a novel measure of drug-drug similarity named "linear neighborhood similarity", which is calculated in a drug feature space by exploring linear neighborhood relationship. Then, we transfer the similarity from the feature space into the side effect space, and predict drug side effects by propagating known side effect information through a similarity-based graph. Under a unified frame based on the linear neighborhood similarity, we propose method "LNSM" and its extension "LNSM-SMI" to predict side effects of new drugs, and propose the method "LNSM-MSE" to predict unobserved side effect of approved drugs. We evaluate the performances of LNSM and LNSM-SMI in predicting side effects of new drugs, and evaluate the performances of LNSM-MSE in predicting missing side effects of approved drugs. The results demonstrate that the linear neighborhood similarity can improve the performances of side effect prediction, and the linear neighborhood similarity-based methods can outperform existing side effect prediction methods. More importantly, the proposed methods can predict side effects of new drugs as well as unobserved side effects of approved drugs under a unified frame.

Drug side effect extraction from clinical narratives of psychiatry and psychology patients

PubMed Central

Kocher, Jean-Pierre A; Chute, Christopher G; Savova, Guergana K

2011-01-01

Objective To extract physician-asserted drug side effects from electronic medical record clinical narratives. Materials and methods Pattern matching rules were manually developed through examining keywords and expression patterns of side effects to discover an individual side effect and causative drug relationship. A combination of machine learning (C4.5) using side effect keyword features and pattern matching rules was used to extract sentences that contain side effect and causative drug pairs, enabling the system to discover most side effect occurrences. Our system was implemented as a module within the clinical Text Analysis and Knowledge Extraction System. Results The system was tested in the domain of psychiatry and psychology. The rule-based system extracting side effects and causative drugs produced an F score of 0.80 (0.55 excluding allergy section). The hybrid system identifying side effect sentences had an F score of 0.75 (0.56 excluding allergy section) but covered more side effect and causative drug pairs than individual side effect extraction. Discussion The rule-based system was able to identify most side effects expressed by clear indication words. More sophisticated semantic processing is required to handle complex side effect descriptions in the narrative. We demonstrated that our system can be trained to identify sentences with complex side effect descriptions that can be submitted to a human expert for further abstraction. Conclusion Our system was able to extract most physician-asserted drug side effects. It can be used in either an automated mode for side effect extraction or semi-automated mode to identify side effect sentences that can significantly simplify abstraction by a human expert. PMID:21946242

What matters when judging intentionality-moral content or normative status? Testing the rational scientist model of the side-effect.

PubMed

Papadopoulos, C; Hayes, B K

2018-06-01

Previous work has demonstrated a "side-effect effect," such that intentionality is more likely to be attributed to agents who bring about negatively valenced as opposed to positively valenced side effects. The rational-scientist model explains this by suggesting that norm-violating side effects are more informative for inferring intentionality than norm-conforming side effects. In the present study we reexamined this account, addressing limitations of previous empirical tests (e.g., Uttich & Lombrozo, Cognition 116: 87-100, 2010). Side-effect valence and norm status were manipulated factorially, enabling an examination of the impact of norm status on intentionality judgments in both positively and negatively valenced side effects. Additionally, the impact of side-effect norm status on the perceived valences of side effects and agents was examined. Effects of norm status were found for both positive and negative side effects. Violation of an ostensibly neutral norm led to negative perceptions of the side effect. However, a norm status effect on intentionality judgments persisted when these effects were controlled. These results support the view that the side-effect effect is the result of the rational use of social-cognitive evidence.

Incidence and severity of self-reported chemotherapy side effects in routine care: A prospective cohort study

PubMed Central

Haas, Marion; Viney, Rosalie; Pearson, Sallie-Anne; Haywood, Philip; Brown, Chris; Ward, Robyn

2017-01-01

Aim Chemotherapy side effects are often reported in clinical trials; however, there is little evidence about their incidence in routine clinical care. The objective of this study was to describe the frequency and severity of patient-reported chemotherapy side effects in routine care across treatment centres in Australia. Methods We conducted a prospective cohort study of individuals with breast, lung or colorectal cancer undergoing chemotherapy. Side effects were identified by patient self-report. The frequency, prevalence and incidence rates of side effects were calculated by cancer type and grade, and cumulative incidence curves for each side effect computed. Frequencies of side effects were compared between demographic subgroups using chi-squared statistics. Results Side effect data were available for 449 eligible individuals, who had a median follow-up of 5.64 months. 86% of participants reported at least one side effect during the study period and 27% reported a grade IV side effect, most commonly fatigue or dyspnoea. Fatigue was the most common side effect overall (85%), followed by diarrhoea (74%) and constipation (74%). Prevalence and incidence rates were similar across side effects and cancer types. Age was the only demographic factor associated with the incidence of side effects, with older people less likely to report side effects. Conclusion This research has produced the first Australian estimates of self-reported incidence of chemotherapy side effects in routine clinical care. Chemotherapy side effects in routine care are common, continue throughout chemotherapy and can be serious. This work confirms the importance of observational data in providing clinical practice-relevant information to decision-makers. PMID:29016607

Incidence and severity of self-reported chemotherapy side effects in routine care: A prospective cohort study.

PubMed

Pearce, Alison; Haas, Marion; Viney, Rosalie; Pearson, Sallie-Anne; Haywood, Philip; Brown, Chris; Ward, Robyn

2017-01-01

Chemotherapy side effects are often reported in clinical trials; however, there is little evidence about their incidence in routine clinical care. The objective of this study was to describe the frequency and severity of patient-reported chemotherapy side effects in routine care across treatment centres in Australia. We conducted a prospective cohort study of individuals with breast, lung or colorectal cancer undergoing chemotherapy. Side effects were identified by patient self-report. The frequency, prevalence and incidence rates of side effects were calculated by cancer type and grade, and cumulative incidence curves for each side effect computed. Frequencies of side effects were compared between demographic subgroups using chi-squared statistics. Side effect data were available for 449 eligible individuals, who had a median follow-up of 5.64 months. 86% of participants reported at least one side effect during the study period and 27% reported a grade IV side effect, most commonly fatigue or dyspnoea. Fatigue was the most common side effect overall (85%), followed by diarrhoea (74%) and constipation (74%). Prevalence and incidence rates were similar across side effects and cancer types. Age was the only demographic factor associated with the incidence of side effects, with older people less likely to report side effects. This research has produced the first Australian estimates of self-reported incidence of chemotherapy side effects in routine clinical care. Chemotherapy side effects in routine care are common, continue throughout chemotherapy and can be serious. This work confirms the importance of observational data in providing clinical practice-relevant information to decision-makers.

Water resources management in a homogenizing world: Averting the Growth and Underinvestment trajectory

NASA Astrophysics Data System (ADS)

Mirchi, Ali; Watkins, David W.; Huckins, Casey J.; Madani, Kaveh; Hjorth, Peder

2014-09-01

Biotic homogenization, a de facto symptom of a global biodiversity crisis, underscores the urgency of reforming water resources management to focus on the health and viability of ecosystems. Global population and economic growth, coupled with inadequate investment in maintenance of ecological systems, threaten to degrade environmental integrity and ecosystem services that support the global socioeconomic system, indicative of a system governed by the Growth and Underinvestment (G&U) archetype. Water resources management is linked to biotic homogenization and degradation of system integrity through alteration of water systems, ecosystem dynamics, and composition of the biota. Consistent with the G&U archetype, water resources planning primarily treats ecological considerations as exogenous constraints rather than integral, dynamic, and responsive parts of the system. It is essential that the ecological considerations be made objectives of water resources development plans to facilitate the analysis of feedbacks and potential trade-offs between socioeconomic gains and ecological losses. We call for expediting a shift to ecosystem-based management of water resources, which requires a better understanding of the dynamics and links between water resources management actions, ecological side-effects, and associated long-term ramifications for sustainability. To address existing knowledge gaps, models that include dynamics and estimated thresholds for regime shifts or ecosystem degradation need to be developed. Policy levers for implementation of ecosystem-based water resources management include shifting away from growth-oriented supply management, better demand management, increased public awareness, and institutional reform that promotes adaptive and transdisciplinary management approaches.

Field-scale monitoring of the long-term impact and sustainability of drainage water reuse on the west side of California’s San Joaquin Valley

USDA-ARS?s Scientific Manuscript database

Diminishing freshwater resources have brought attention to the reuse of degraded water as a potential water resource rather than as a disposal problem. Drainage water from tile-drained, irrigated agricultural land is degraded water that is often in large supply, but the long-term impact and sustain...

Why Are Women Dying When They Reach Hospital on Time? A Systematic Review of the ‘Third Delay’

PubMed Central

Knight, Hannah E.; Self, Alice; Kennedy, Stephen H.

2013-01-01

Background The ‘three delays model’ attempts to explain delays in women accessing emergency obstetric care as the result of: 1) decision-making, 2) accessing services and 3) receipt of appropriate care once a health facility is reached. The third delay, although under-researched, is likely to be a source of considerable inequity in access to emergency obstetric care in developing countries. The aim of this systematic review was to identify and categorise specific facility-level barriers to the provision of evidence-based maternal health care in developing countries. Methods and Findings Five electronic databases were systematically searched using a 4-way strategy that combined search terms related to: 1) maternal health care; 2) maternity units; 3) barriers, and 4) developing countries. Forty-three original research articles were eligible to be included in the review. Thirty-two barriers to the receipt of timely and appropriate obstetric care at the facility level were identified and categorised into six emerging themes (Drugs and equipment; Policy and guidelines; Human resources; Facility infrastructure; Patient-related and Referral-related). Two investigators independently recorded the frequency with which barriers relating to the third delay were reported in the literature. The most commonly cited barriers were inadequate training/skills mix (86%); drug procurement/logistics problems (65%); staff shortages (60%); lack of equipment (51%) and low staff motivation (44%). Conclusions This review highlights how a focus on patient-side delays in the decision to seek care can conceal the fact that many health facilities in the developing world are still chronically under-resourced and unable to cope effectively with serious obstetric complications. We stress the importance of addressing supply-side barriers alongside demand-side factors if further reductions in maternal mortality are to be achieved. PMID:23704943

Distributed Energy Systems Integration and Demand Optimization for Autonomous Operations and Electric Grid Transactions

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

Ghatikar, Girish; Mashayekh, Salman; Stadler, Michael

Distributed power systems in the U.S. and globally are evolving to provide reliable and clean energy to consumers. In California, existing regulations require significant increases in renewable generation, as well as identification of customer-side distributed energy resources (DER) controls, communication technologies, and standards for interconnection with the electric grid systems. As DER deployment expands, customer-side DER control and optimization will be critical for system flexibility and demand response (DR) participation, which improves the economic viability of DER systems. Current DER systems integration and communication challenges include leveraging the existing DER and DR technology and systems infrastructure, and enabling optimized cost,more » energy and carbon choices for customers to deploy interoperable grid transactions and renewable energy systems at scale. Our paper presents a cost-effective solution to these challenges by exploring communication technologies and information models for DER system integration and interoperability. This system uses open standards and optimization models for resource planning based on dynamic-pricing notifications and autonomous operations within various domains of the smart grid energy system. It identifies architectures and customer engagement strategies in dynamic DR pricing transactions to generate feedback information models for load flexibility, load profiles, and participation schedules. The models are tested at a real site in California—Fort Hunter Liggett (FHL). Furthermore, our results for FHL show that the model fits within the existing and new DR business models and networked systems for transactive energy concepts. Integrated energy systems, communication networks, and modeling tools that coordinate supply-side networks and DER will enable electric grid system operators to use DER for grid transactions in an integrated system.« less

Unmet needs in asthma treatment in a resource-limited setting: findings from the survey of adult asthma patients and their physicians in Nigeria.

PubMed

Desalu, Olufemi Olumuyiwa; Onyedum, Cajetan Chigozie; Adeoti, Adekunle Olatayo; Ozoh, Obianuju Beatrice; Fadare, Joseph Olusesan; Salawu, Fatai Kunle; Danburam, Ali; Fawibe, Ademola Emmanuel; Adewole, Olanisun Olufemi

2013-01-01

The prevalence of asthma in our society is rising and there is need for better understanding of the asthma patients' perception and treatment practice of physicians. The study was aimed at determining asthma attitudes and treatment practices among adult physicians and patients in Nigeria, with the goal of identifying barriers to optimal management. To assess asthma attitudes, treatment practices and limitations among adult physicians and patients in Nigeria, a questionnaire survey was conducted among 150 patients and 70 physicians. Majority (66.7%) of the patients reported their asthma as moderate to severe, 42.7% had emergency room visit and 32% had admission due to asthma in the previous 12 months. Physicians and patients perceptions significantly differed in the time devoted to educational issues (31.4% vs.18.7%) and its contents: individual management plan (64.3% vs.33.3%), correct inhaler technique (84.0% vs.71.0%), medication side effects (80.0% vs.60.0%) and compliance 100% of time (5.7% vs. 18.7%). Patients reported that non-compliance with medication causes increased symptoms (67.0%), exacerbations (60.0%), bronchodilator use (56.0%), urgent physician visit (52.0%) and hospitalizations /ER visits (38.7%). Asthma medication in patients caused short term (10.7%) and long term side effects (20.0%). Due to side effects, 28.0% skipped and stopped their medications. Most physicians (85.7%) and patients (56.0%) agreed on the need for new medication options. The need for new medication in patients was strongly related to asthma severity, limitation of activities, side effects, cost and lack of satisfaction with current medication. With the exception of pulmonologists, physicians did not readily prescribe ICS and their prescriptions were not in line with treatment guidelines. This study has highlighted the gaps and barriers to asthma treatment which need to be addressed to improve the quality of care in Nigeria.

Side effects associated with anti-HIV drugs.

PubMed

Highleyman, L

1998-04-01

Many side effects are associated with the use of anti-HIV drugs, impacting the development of drug resistance and the quality of life for HIV-patients. Concern about side effects is a primary factor in deterring people from beginning HIV therapy. Frequency and severity of side effects vary greatly, but they are frequently more common and severe in people who are taking a new drug or who have advanced HIV disease. Information on side effects comes largely from clinical trials; however, many side effects are not discovered until the drug has been approved and used by larger numbers of people. Side effects vary from serious toxicities that require stopping treatment to uncomfortable or annoying side effects that interfere with daily life. A table categorizes the four major side effects (nausea, fever, skin rash, and fatigue) and divides them into grades that describe their intensity. A chart lists the side effects associated with specific anti-HIV drugs. Suggestions for managing side effects are included.

Mining relational paths in integrated biomedical data.

PubMed

He, Bing; Tang, Jie; Ding, Ying; Wang, Huijun; Sun, Yuyin; Shin, Jae Hong; Chen, Bin; Moorthy, Ganesh; Qiu, Judy; Desai, Pankaj; Wild, David J

2011-01-01

Much life science and biology research requires an understanding of complex relationships between biological entities (genes, compounds, pathways, diseases, and so on). There is a wealth of data on such relationships in publicly available datasets and publications, but these sources are overlapped and distributed so that finding pertinent relational data is increasingly difficult. Whilst most public datasets have associated tools for searching, there is a lack of searching methods that can cross data sources and that in particular search not only based on the biological entities themselves but also on the relationships between them. In this paper, we demonstrate how graph-theoretic algorithms for mining relational paths can be used together with a previous integrative data resource we developed called Chem2Bio2RDF to extract new biological insights about the relationships between such entities. In particular, we use these methods to investigate the genetic basis of side-effects of thiazolinedione drugs, and in particular make a hypothesis for the recently discovered cardiac side-effects of Rosiglitazone (Avandia) and a prediction for Pioglitazone which is backed up by recent clinical studies.

New Insights into the Mechanisms of Chinese Herbal Products on Diabetes: A Focus on the “Bacteria-Mucosal Immunity-Inflammation-Diabetes” Axis

PubMed Central

Wu, Xuemin; Zhao, Xuemin

2017-01-01

Diabetes, especially type 2, has been rapidly increasing all over the world. Although many drugs have been developed and used to treat diabetes, side effects and long-term efficacy are of great challenge. Therefore, natural health product and dietary supplements have been of increasing interest alternatively. In this regard, Chinese herbs and herbal products have been considered a rich resource of product development. Although increasing evidence has been produced from various scientific studies, the mechanisms of action are lacking. Here, we have proposed that many herbal monomers and formulae improve glucose homeostasis and diabetes through the BMID axis; B represents gut microbiota, M means mucosal immunity, I represents inflammation, and D represents diabetes. Chinese herbs have been traditionally used to treat diabetes, with minimal side and toxic effects. Here, we reviewed monomers such as berberine, ginsenoside, M. charantia extract, and curcumin and herbal formulae such as Gegen Qinlian Decoction, Danggui Liuhuang Decoction, and Huanglian Wendan Decoction. This review was intended to provide new perspectives and strategies for future diabetes research and product. PMID:29164155

Side Effect Perceptions and Their Impact on Treatment Decisions in Women.

PubMed

Waters, Erika A; Pachur, Thorsten; Colditz, Graham A

2017-04-01

Side effects prompt some patients to forego otherwise-beneficial therapies. This study explored which characteristics make side effects particularly aversive. We used a psychometric approach, originating from research on risk perception, to identify the factors (or components) underlying side effect perceptions. Women ( N = 149) aged 40 to 74 years were recruited from a patient registry to complete an online experiment. Participants were presented with hypothetical scenarios in which an effective and necessary medication conferred a small risk of a single side effect (e.g., nausea, dizziness). They rated a broad range of side effects on several characteristics (e.g., embarrassing, treatable). In addition, we collected 4 measures of aversiveness for each side effect: choosing to take the medication, willingness to pay to avoid the side effect (WTP), negative affective attitude associated with the side effect, and how each side effect ranks among others in terms of undesirability. A principal components analysis (PCA) was used to identify the components underlying side effect perceptions. Then, for each aversiveness measure separately, regression analyses were used to determine which components predicted differences in aversiveness among the side effects. The PCA revealed 4 components underlying side effect perceptions: affective challenge (e.g., frightening), social challenge (e.g., disfiguring), physical challenge (e.g., painful), and familiarity (e.g., common). Side effects perceived as affectively and physically challenging elicited the highest levels of aversiveness across all 4 measures. Understanding what side effect characteristics are most aversive may inform interventions to improve medical decisions and facilitate the translation of novel biomedical therapies into clinical practice.

Side Effect Perceptions and their Impact on Treatment Decisions in Women

PubMed Central

Waters, Erika A.; Pachur, Thorsten; Colditz, Graham A.

2016-01-01

Background Side effects prompt some patients to forego otherwise-beneficial therapies. This study explored which characteristics make side effects particularly aversive. Methods We used a psychometric approach, originating from research on risk perception, to identify the factors (or components) underlying side effect perceptions. Women (N=149) aged 40–74 were recruited from a patient registry to complete an online experiment. Participants were presented with hypothetical scenarios in which an effective and necessary medication conferred a small risk of a single side effect (e.g., nausea, dizziness). They rated a broad range of side effects on several characteristics (e.g., embarrassing, treatable). In addition, we collected four measures of aversiveness for each side effect: choosing to take the medication, willingness to pay to avoid the side effect (WTP), negative affective attitude associated with the side effect, and how each side effect ranks among others in terms of undesirability. A principle-components analysis (PCA) was used to identify the components underlying side effect perceptions. Then, for each aversiveness measure separately, regression analyses were used to determine which components predicted differences in aversiveness among the side effects. Results The PCA revealed four components underlying side effect perceptions: affective challenge (e.g., frightening), social challenge (e.g., disfiguring), physical challenge (e.g., painful), and familiarity (e.g., common). Side effects perceived as affectively and physically challenging elicited the highest levels of aversiveness across all four measures. Conclusions Understanding what side effect characteristics are most aversive may inform interventions to improve medical decisions and facilitate the translation of novel biomedical therapies into clinical practice. PMID:27216581

Cost-effectiveness of pharmacological and psychosocial interventions for schizophrenia.

PubMed

Phanthunane, Pudtan; Vos, Theo; Whiteford, Harvey; Bertram, Melanie

2011-05-13

Information on cost-effectiveness of interventions to treat schizophrenia can assist health policy decision making, particularly given the lack of health resources in developing countries like Thailand. This study aims to determine the optimal treatment package, including drug and non-drug interventions, for schizophrenia in Thailand. A Markov model was used to evaluate the cost-effectiveness of typical antipsychotics, generic risperidone, olanzapine, clozapine and family interventions. Health outcomes were measured in disability adjusted life years. We evaluated intervention benefit by estimating a change in disease severity, taking into account potential side effects. Intervention costs included outpatient treatment costs, hospitalization costs as well as time and travel costs of patients and families. Uncertainty was evaluated using Monte Carlo simulation. A sensitivity analysis of the expected range cost of generic risperidone was undertaken. Generic risperidone is more cost-effective than typicals if it can be produced for less than 10 baht per 2 mg tablet. Risperidone was the cheapest treatment with higher drug costs offset by lower hospital costs in comparison to typicals. The most cost-effective combination of treatments was a combination of risperidone (dominant intervention). Adding family intervention has an incremental cost-effectiveness ratio of 1,900 baht/DALY with a 100% probability of a result less than a threshold for very cost-effective interventions of one times GDP or 110,000 baht per DALY. Treating the most severe one third of patients with clozapine instead of risperidone had an incremental cost-effectiveness ratio of 320,000 baht/DALY with just over 50% probability of a result below three times GDP per capita. There are good economic arguments to recommend generic risperidone as first line treatment in combination with family intervention. As the uncertainty interval indicates the addition of clozapine may be dominated and there are serious side effects, treating severe patients with clozapine is advisable only for patients who do not respond to risperidone and only in the presence of a stricter side effect monitoring system than currently exists.

Effect of Communication Style on Perceptions of Medication Side Effect Risk among Pharmacy Students.

PubMed

Sawant, Ruta V; Beatty, Collin R; Sansgiry, Sujit S

2016-10-25

Objective. To assess the effect of communication style, and frequency and severity of medication side-effects, on pharmacy students' perception of risk of experiencing side effects. Methods. One hundred responses from pharmacy students were obtained using an online survey. Participants were presented with a drug information box containing drug name, drug usage, and one side-effect associated with the drug. Information on side-effect for each drug was presented in one of eight experimental conditions, in a 2 (side-effect frequency: low, high), X2 (side-effect severity: mild, severe) X2 (communication style: verbal, verbal + natural frequency) factorial design. Risk perception of experiencing side effects was measured. Results. Communication style was found to have a significant impact on risk perception depending on the context of frequency and severity associated with the side effect. Conclusion. Communication style plays a significant role in formulating risk perceptions of medication side effects. Training in pharmaceutical counseling should include special emphasis on effective language use.

A Resource Service Model in the Industrial IoT System Based on Transparent Computing.

PubMed

Li, Weimin; Wang, Bin; Sheng, Jinfang; Dong, Ke; Li, Zitong; Hu, Yixiang

2018-03-26

The Internet of Things (IoT) has received a lot of attention, especially in industrial scenarios. One of the typical applications is the intelligent mine, which actually constructs the Six-Hedge underground systems with IoT platforms. Based on a case study of the Six Systems in the underground metal mine, this paper summarizes the main challenges of industrial IoT from the aspects of heterogeneity in devices and resources, security, reliability, deployment and maintenance costs. Then, a novel resource service model for the industrial IoT applications based on Transparent Computing (TC) is presented, which supports centralized management of all resources including operating system (OS), programs and data on the server-side for the IoT devices, thus offering an effective, reliable, secure and cross-OS IoT service and reducing the costs of IoT system deployment and maintenance. The model has five layers: sensing layer, aggregation layer, network layer, service and storage layer and interface and management layer. We also present a detailed analysis on the system architecture and key technologies of the model. Finally, the efficiency of the model is shown by an experiment prototype system.

A Resource Service Model in the Industrial IoT System Based on Transparent Computing

PubMed Central

Wang, Bin; Sheng, Jinfang; Dong, Ke; Li, Zitong; Hu, Yixiang

2018-01-01

The Internet of Things (IoT) has received a lot of attention, especially in industrial scenarios. One of the typical applications is the intelligent mine, which actually constructs the Six-Hedge underground systems with IoT platforms. Based on a case study of the Six Systems in the underground metal mine, this paper summarizes the main challenges of industrial IoT from the aspects of heterogeneity in devices and resources, security, reliability, deployment and maintenance costs. Then, a novel resource service model for the industrial IoT applications based on Transparent Computing (TC) is presented, which supports centralized management of all resources including operating system (OS), programs and data on the server-side for the IoT devices, thus offering an effective, reliable, secure and cross-OS IoT service and reducing the costs of IoT system deployment and maintenance. The model has five layers: sensing layer, aggregation layer, network layer, service and storage layer and interface and management layer. We also present a detailed analysis on the system architecture and key technologies of the model. Finally, the efficiency of the model is shown by an experiment prototype system. PMID:29587450

Stress-Induced Tradeoffs in a Free-Living Lizard across a Variable Landscape: Consequences for Individuals and Populations

PubMed Central

Lucas, LeiLani D.; French, Susannah S.

2012-01-01

Current life history theory suggests that the allocation of energetic resources between competing physiological needs should be dictated by an individual’s longevity and pace of life. One key physiological pathway likely to contribute to the partitioning of resources is the vertebrate stress response. By increasing circulating glucocorticoids the stress response can exert a suite of physiological effects, such as altering immune function. We investigated the effects of stress physiology on individual immunity, reproduction and oxidative stress, across an urban landscape. We sampled populations in and around St. George, Utah, examining corticosterone in response to restraint stress, two innate immune measures, reproductive output, and the presence of both reactive oxygen metabolites and antioxidant binding capacity, in populations of common side-blotched lizards (Uta stansburiana) experiencing variable levels of environmental stress. Additionally, using capture-mark-recapture techniques, we examined the relationships between these physiological parameters and population-level differences. Our results reveal elevated physiological stress corresponds with suppressed immunity and increased oxidative stress. Interestingly, urban populations experiencing the most physiological stress also exhibited greater reproductive output and decreased survival relative to rural populations experiencing less physiological stress, demonstrating a tradeoff between reproduction and life maintenance processes. Our results suggest that environmental stress may augment life history strategy in this fast-paced species, and that shifts in life history strategy can in turn affect the population at large. Finally, the urban environment poses definite challenges for organisms, and while it appears that side-blotched lizards are adjusting physiologically, it is unknown what fitness costs these physiological adjustments accrue. PMID:23185478

Physical, social, and psychological consequences of treatment for hepatitis C : a community-based evaluation of patient-reported outcomes.

PubMed

Manos, M Michele; Ho, Chanda K; Murphy, Rosemary C; Shvachko, Valentina A

2013-01-01

Hepatitis C virus (HCV) antiviral therapy entails a long treatment course, as well as significant side effects that can lead to medication non-adherence and premature termination of treatment. Few large studies have comprehensively examined patient perspectives on the treatment experience, particularly the social and personal effects. We sought to understand how a diverse group of patients' lives were affected during HCV treatment, and to obtain suggestions about how to better support patients during treatment. On average, 13 months after therapy we interviewed by telephone a consecutive sample of 200 patients treated for hepatitis C with ribavirin and pegylated interferon in a comprehensive, integrated health plan in the years 2008-2010. Mixed (quantitative and qualitative) survey methods were used. The response rate was 68.9 %. Mean age at treatment was 51 years; 63.0 % were men; and Black, Hispanic, Asian, and White non-Hispanic racial/ethnic groups were similarly represented. Patients whose treatment was managed by nurses or clinical pharmacists (vs. physicians) were more likely to report their providers as being part of their support system (83.5 % vs. 58.9 %; p < 0.001). Most patients reported flu-like symptoms (93.5 %) and psychiatric problems (84.5 %), and 42.5 % reported side effects lasted up to 6 months after treatment. Black patients reported discontinuing treatment prematurely due to side effects more often than non-Blacks (29.4 % vs. 12.1 %; p < 0.001). Physical side effects (69.5 % of patients), psychiatric issues (43.5 %), and employment (27.4 %) were ranked among the three most difficult challenges. Patients desired help in anticipating and arranging work modifications during treatment. Most patients rated peer support, nutritional guidance, and weekly provider contact by telephone as potentially helpful resources for future patients undergoing HCV treatment. Patient perspectives can help formulate and refine HCV treatment support programs. Effective support programs for diverse populations are crucial as the complexities and costs of HCV treatment increase. The call for greater support from peers, providers, and employers demands new systems such as patient-centered care teams.

Health Related Quality of Life in Patients with Side-Effects after Antimuscarinic Treatment for Overactive Bladder.

PubMed

Kim, Aram; Lee, Kyu-Sung; Jung, Rangrhee; Na, Selee; Kim, Joon-Chul; Kim, Hyeong Gon; Choo, Myung-Soo

2017-09-01

Drug therapy is the mainstay of treatment for overactive bladder (OAB), but antimuscarinic agents possess side-effects. These side-effects decrease the patients' quality of life. We therefore assessed the impact of side-effects on health-related quality of life (HR-QoL) through an analysis of EQ-5D questionnaire. This study was designed to investigate the patients' satisfaction by quality weight of health status as affected by the side-effects of OAB medications. Patients who had OAB symptoms lasting longer than 3 months and have experienced side-effects after any antimuscarinic treatments filled in the EQ-5D questionnaire. The enrolled patients had two EQ-5D questionnaires for two different health statuses, i.e., presence or absence of side-effects. Quality weight was calculated using the ED-5D health status score with Korean tariff. One hundred patients were enrolled and completed the HR-QoL questionnaire. The most prevalent side-effect was dry mouth (61%) and 28% patients had dry mouth and constipation concurrently. Most of the patients with side-effects tried to endure and overcome these side-effects (79%), but 10% desired a change in medication, and 6% stopped medication altogether. The quality weight of EQ-5D without side-effects was 0.863, while the quality weight with side-effects was 0.666 (P < 0.001). The VAS score was 79 in patient without side-effects and 57 in those with side-effects, supporting the results of quality weight assessment. Overactive bladder patients may enjoy a better quality of life if side-effects associated with antimuscarinic therapy are fewer. © 2016 John Wiley & Sons Australia, Ltd.

WaterQualityWatch and water-quality information bookmark

USGS Publications Warehouse

Wilde, Franceska D.

2014-01-01

WaterQualityWatch is an online resource of the U.S. Geological Survey (USGS) that provides access to continuous real-time measurements of water temperature, specific electrical conductance, pH, dissolved oxygen, turbidity, and nitrate at selected data-collection stations throughout the Nation. Additional online resources of the USGS that pertain to various types of water-quality information are shown on the reverse side of this bookmark.

Metals and Ceramics Information Center.

DTIC Science & Technology

1981-07-01

Systems RESOURCE MANAGEMENT AND ECONOMIC ANALYSIS a Ordnance Technology a Space Systems and Applications a Biomass Resources 6 Business Planning • Economics ...r 19 KEY WORDS (Cwintince on reverse side 4 neressery and identify by block numnber) Technical Information Center Composites DoD Information Analysis ...The Metals and Ceramics Information Center (MCIC) is one of the technical Information Analysis Centers (IAC’s) chartered and sponsored by the

Living on Both Sides of the Fence: A Phenomenological Study of Human Resource Development Professionals as Downsizing Survivors and Strategic Human Resource Development Facilitators

ERIC Educational Resources Information Center

Nackoney, Claire Kostopulos

2012-01-01

This phenomenological study explored how HR professionals who identified themselves as facilitators of strategic HRD (SHRD) perceived the experience of being an organizational agent-downsizing survivor. Criterion and snowball sampling were used to recruit 15 participants for this study. A semi-structured interview guide was used to interview…

A maternal health voucher scheme: what have we learned from the demand-side financing scheme in Bangladesh?

PubMed

Ahmed, Shakil; Khan, M Mahmud

2011-01-01

It is now more than 2 years since the Ministry of Health and Family Welfare of the Government of Bangladesh implemented the Maternal Health Voucher Scheme, a specialized form of demand-side financing programme. To analyse the early lessons from the scheme, information was obtained through semi-structured interviews with stakeholders at the sub-district level. The analysis identified a number of factors affecting the efficiency and performance of the scheme in the program area: delay in the release of voucher funds, selection criteria used for enrolling pregnant women in the programme, incentives created by the reimbursement system, etc. One of the objectives of the scheme was to encourage market competition among health care providers, but it failed to increase market competitiveness in the area. The resources made available through the scheme did not attract any new providers into the market and public facilities remained the only eligible provider both before and after scheme implementation. However, incentives provided through the voucher system did motivate public providers to offer a higher level of services. The beneficiaries expressed their overall satisfaction with the scheme as well. Since the local facility was not technically ready to provide all types of maternal health care services, providing vouchers may not improve access to care for many pregnant women. To improve the performance of the demand-side strategy, it has become important to adopt some supply-side interventions. In poor developing countries, a demand-side strategy may not be very effective without significant expansion of the service delivery capacity of health facilities at the sub-district level.

Acupuncture for chronic prostatitis: A systematic review and meta-analysis protocol.

PubMed

Peng, Tianzhong; Cheng, Ying; Jin, Yuhao; Xu, Na; Guo, Taipin

2018-04-01

Chronic prostatitis (CP) is a prevalent genitourinary condition. Considering its safety profile, acupuncture can be an option treating CP symptoms. The aim of this review is to undertake a systematic review to estimate the effectiveness and safety of acupuncture on CP. We will search all randomized controlled trials for CP in August 2018 in the databases of MEDLINE, Cochrane Library, Web of Science, EMBASE, Springer, WHO International Clinical Trials Registry Platform (ICTRP), China National Knowledge Infrastructure (CNKI), Wan fang, Chinese Biomedical Literature Database (CBM), PsycInfo, Chinese Scientific Journal Database (VIP), and other available resources. Languages are limited as English and Chinese. Search terms used are will "acupuncture," and "chronic prostatitis," "non-bacterial prostatitis," "abacterial prostatitis." And duplicates will be screened. The primary outcomes consisted of improvement rate and pain relief evaluated by The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) index. Secondary outcomes include the recurrence rate and side effects, such as pneumothorax, discomforts, and infection. This study will demonstrate an evidence-based review of acupuncture for chronic prostatitis. The study will provide clear evidence to assess the effectiveness and side effects of acupuncture for chronic prostatitis. There is no requirement of ethical approval and it will be in print or disseminated by electronic copies. CRD42018088834.

Explanations for side effect aversion in preventive medical treatment decisions

PubMed Central

Waters, Erika A.; Weinstein, Neil D.; Colditz, Graham A.; Emmons, Karen

2008-01-01

Objective Many laypeople demonstrate excessive sensitivity to negative side effects of medical treatments, which may lead them to refuse beneficial therapies. This Internet-based experiment investigated three possible explanations for such “side effect aversion.” One was derived from mental accounting, one examined the mere presence of a side effect, and one focused on computational difficulties. Design Participants (N = 5,379) were presented with a hypothetical cancer preventive treatment situation that was or was not accompanied by one or two small side effects. The side effects were either beneficial or harmful. In all conditions the net absolute risk reduction associated with the treatment was 15%. Main Outcome Measures Participants indicated their willingness to accept treatment and their perceptions of the treatment’s effects on their overall cancer risk. Results Data were consistent only with the “mere presence” explanation of side effect aversion, the idea that side effects act as a strong negative cue that directly affects treatment appraisal. The number of negative side effects did not influence treatment willingness. Conclusion Side effect aversion is a challenge to informed decision making. Specific mechanisms that produce side effect aversion should be identified. PMID:19290712

Application of a COTS Resource Optimization Framework to the SSN Sensor Tasking Domain - Part I: Problem Definition

NASA Astrophysics Data System (ADS)

Tran, T.

With the onset of the SmallSat era, the RSO catalog is expected to see continuing growth in the near future. This presents a significant challenge to the current sensor tasking of the SSN. The Air Force is in need of a sensor tasking system that is robust, efficient, scalable, and able to respond in real-time to interruptive events that can change the tracking requirements of the RSOs. Furthermore, the system must be capable of using processed data from heterogeneous sensors to improve tasking efficiency. The SSN sensor tasking can be regarded as an economic problem of supply and demand: the amount of tracking data needed by each RSO represents the demand side while the SSN sensor tasking represents the supply side. As the number of RSOs to be tracked grows, demand exceeds supply. The decision-maker is faced with the problem of how to allocate resources in the most efficient manner. Braxton recently developed a framework called Multi-Objective Resource Optimization using Genetic Algorithm (MOROUGA) as one of its modern COTS software products. This optimization framework took advantage of the maturing technology of evolutionary computation in the last 15 years. This framework was applied successfully to address the resource allocation of an AFSCN-like problem. In any resource allocation problem, there are five key elements: (1) the resource pool, (2) the tasks using the resources, (3) a set of constraints on the tasks and the resources, (4) the objective functions to be optimized, and (5) the demand levied on the resources. In this paper we explain in detail how the design features of this optimization framework are directly applicable to address the SSN sensor tasking domain. We also discuss our validation effort as well as present the result of the AFSCN resource allocation domain using a prototype based on this optimization framework.

Industry Perspectives on Market Access of Innovative Drugs: The Relevance for Oncology Drugs.

PubMed

Pauwels, Kim; Huys, Isabelle; Casteels, Minne; Simoens, Steven

2016-01-01

Key Points - Representatives of the pharmaceutical industry call for a broader recognition of value within the assessment and appraisal of innovative drugs- Focus on value within the assessment and appraisal of drugs is jeopardized by financial drives as the side of industry and at the side of the payers- A well-considered value-framework, with attention for patient reported outcomes, societal preferences and dynamic approach on the drug life cycle, needs to be incorporated in assessment and appraisal at national and European level in order to coordinate the views of different stakeholders and allow efficient resource allocation This study presents industry perspectives on the challenges related to market access of innovative drugs in general and oncology drugs in specific. Fifteen interviews were conducted with representatives of pharmaceutical companies and industry associations. Interviewees call for a broader recognition of value within the assessment and appraisal of drugs. According to interviewees, focus on value is jeopardized by the lack of a common value definition across Europe, poor availability and validity of value measures and cost-saving measures such as external reference price setting and cost-effectiveness analysis at the side of the payers. Centralized assessment of relative-effectiveness at European level would provide a common value estimate across member states, independent of financial drivers. Empirical evidence on PRO and societal preferences is however essential in the development of a value definition. Furthermore, value-based pricing would imply a dynamic approach where the price is differentiated across indications and across the lifecycle of the drug, especially in fields such as oncology. Financial drivers however also threat the application of value-based pricing at the side of the industry, making value-based profitability a more appropriate term.

Supply-side barriers to maternity-care in India: a facility-based analysis.

PubMed

Kumar, Santosh; Dansereau, Emily

2014-01-01

Health facilities in many low- and middle-income countries face several types of barriers in delivering quality health services. Availability of resources at the facility may significantly affect the volume and quality of services provided. This study investigates the effect of supply-side determinants of maternity-care provision in India. Health facility data from the District-Level Household Survey collected in 2007-2008 were analyzed to explore the effects of supply-side factors on the volume of delivery care provided at Indian health facilities. A negative binomial regression model was applied to the data due to the count and over-dispersion property of the outcome variable (number of deliveries performed at the facility). Availability of a labor room (Incidence Rate Ratio [IRR]: 1.81; 95% Confidence Interval [CI]: 1.68-1.95) and facility opening hours (IRR: 1.43; CI: 1.35-1.51) were the most significant predictors of the volume of delivery care at the health facilities. Medical and paramedical staff were found to be positively associated with institutional deliveries. The volume of deliveries was also higher if adequate beds, essential obstetric drugs, medical equipment, electricity, and communication infrastructures were available at the facility. Findings were robust to the inclusion of facility's catchment area population and district-level education, health insurance coverage, religion, wealth, and fertility. Separate analyses were performed for facilities with and without a labor room and results were qualitatively similar across these two types of facilities. Our study highlights the importance of supply-side barriers to maternity-care India. To meet Millennium Development Goals 4 and 5, policymakers should make additional investments in improving the availability of medical drugs and equipment at primary health centers (PHCs) in India.

Supply-Side Barriers to Maternity-Care in India: A Facility-Based Analysis

PubMed Central

Kumar, Santosh; Dansereau, Emily

2014-01-01

Background Health facilities in many low- and middle-income countries face several types of barriers in delivering quality health services. Availability of resources at the facility may significantly affect the volume and quality of services provided. This study investigates the effect of supply-side determinants of maternity-care provision in India. Methods Health facility data from the District-Level Household Survey collected in 2007–2008 were analyzed to explore the effects of supply-side factors on the volume of delivery care provided at Indian health facilities. A negative binomial regression model was applied to the data due to the count and over-dispersion property of the outcome variable (number of deliveries performed at the facility). Results Availability of a labor room (Incidence Rate Ratio [IRR]: 1.81; 95% Confidence Interval [CI]: 1.68–1.95) and facility opening hours (IRR: 1.43; CI: 1.35–1.51) were the most significant predictors of the volume of delivery care at the health facilities. Medical and paramedical staff were found to be positively associated with institutional deliveries. The volume of deliveries was also higher if adequate beds, essential obstetric drugs, medical equipment, electricity, and communication infrastructures were available at the facility. Findings were robust to the inclusion of facility's catchment area population and district-level education, health insurance coverage, religion, wealth, and fertility. Separate analyses were performed for facilities with and without a labor room and results were qualitatively similar across these two types of facilities. Conclusions Our study highlights the importance of supply-side barriers to maternity-care India. To meet Millennium Development Goals 4 and 5, policymakers should make additional investments in improving the availability of medical drugs and equipment at primary health centers (PHCs) in India. PMID:25093729

MERRA/AS: The MERRA Analytic Services Project Interim Report

NASA Technical Reports Server (NTRS)

Schnase, John; Duffy, Dan; Tamkin, Glenn; Nadeau, Denis; Thompson, Hoot; Grieg, Cristina; Luczak, Ed; McInerney, Mark

2013-01-01

MERRA AS is a cyberinfrastructure resource that will combine iRODS-based Climate Data Server (CDS) capabilities with Coudera MapReduce to serve MERRA analytic products, store the MERRA reanalysis data collection in an HDFS to enable parallel, high-performance, storage-side data reductions, manage storage-side driver, mapper, reducer code sets and realized objects for users, and provide a library of commonly used spatiotemporal operations that can be composed to enable higher-order analyses.

Similkameen River Multipurpose Project Feasibility Study, Cultural Resource Reconnaissance

DTIC Science & Technology

1987-04-01

fill below the vicinity of Nighthawk. Soil survey data and well drilling logs suggest that a large block of ice occupied the western half of Palmer Lake...granodiorite on the south side of the river opposite the staging gauge at R.M. 15.3 (Rinehart and Fox 1972); the north side of the river does not...Utilized 7 Penetration Drilling Drill 1 Projectile Impact Projectile Point 10 Percussion Chopping Chopper 2 Flaking Complete Flake 84 Broken Flake 40

Subjective Report of Side Effects of Prescribed and Nonprescribed Psychostimulant Use in Young Adults.

PubMed

Smith, Tess E; Martel, Michelle M; DeSantis, Alan D

2017-03-21

Side effects of prescribed and nonprescribed psychostimulant use are understudied. The study examined side effects of prescribed and nonprescribed psychostimulant use in a college sample with attention to possible gender differences. 2716 undergraduates (1448 male) between the ages of 17 and 57 years (M = 19.43 years, SD = 1.7 years) completed an online survey that included questions about the subjective side effects of prescribed and nonprescribed psychostimulant use. Results suggested that prescribed users more frequently reported side effects, compared to nonprescribed users. For prescribed users, females more frequently reported appetite, somatic, and anxiety-related side effects compared to males. For nonprescribed users, while females reported more somatic and anxiety-related side effects, males more frequently reported loss of sex drive and sweating as side effects. Conclusions/Importance: These findings suggest prescribed users of psychostimulants more frequently report side effects with prominent gender differences in line with gender roles.

Sexual side effects associated with conventional and atypical antipsychotics.

PubMed

Compton, M T; Miller, A H

2001-01-01

The sexual side effects of psychotropic medications are becoming increasingly recognized in clinical psychiatry. The magnitude of the problem of sexual side effects associated with antipsychotic medications has yet to be fully elucidated, but a multitude of references in the literature demonstrate the importance of these side effects in both men and women. All currently used antipsychotic medications are associated with sexual side effects of various types. Although each antipsychotic medication may have a specific side effect profile determined by its various receptor affinities and by the degree to which it elevates serum prolactin, there is currently no evidence that specific side effects can be predicted. Sexual side effects can be categorized according to the phase of the sexual response cycle with which they interfere. Suggestions for clinical evaluation and treatment options are provided, including risk factor modification, dose reduction, switching agents, and addition of other agents. Sexual side effects associated with conventional and atypical antipsychotic medications represent an underestimated and understudied set of side effects that may diminish a patient's quality of life and lead to treatment noncompliance. Clinicians prescribing antipsychotic medications should be familiar with the classification, evaluation, and treatment of these side effects.

BUFFALO PEAKS WILDERNESS STUDY AREA, COLORADO.

USGS Publications Warehouse

Hedlund, D.C.; Wood, R.H.

1984-01-01

Field investigations were conducted to evaluate the mineral-resource potential of the Buffalo Peaks Wilderness Study Area, Colorado. On the basis of this study there is a probable mineral-resource potential for silver vein and bedding replacement deposits along the Weston Pass fault zone, for hydrothermal vein-type uranium deposits in the vicinity of the Parkdale iron pit, and for gold vein deposits in the parts of the Granite and Four Mile districts that are within the wilderness study area. A probable barite resource potential occurs at Rough and Tumbling Creek and near Spring Creek on the east side of the study area. There is little promise for the occurrence of energy resources.

Lewin's Theory of Planned Change as a strategic resource.

PubMed

Shirey, Maria R

2013-02-01

This department highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. With the goal of presenting practical approaches helpful to nurse leaders advancing organizational change, content includes evidence-based projects, tools, and resources that mobilize and sustain organizational change initiatives. In this article, the author explores the use of the Lewin's Theory of Planned Change as a strategic resource to mobilize the people side of change. An overview of the theory is provided along with a discussion of its strengths, limitations, and targeted application.

An Adaptive Priority Tuning System for Optimized Local CPU Scheduling using BOINC Clients

NASA Astrophysics Data System (ADS)

Mnaouer, Adel B.; Ragoonath, Colin

2010-11-01

Volunteer Computing (VC) is a Distributed Computing model which utilizes idle CPU cycles from computing resources donated by volunteers who are connected through the Internet to form a very large-scale, loosely coupled High Performance Computing environment. Distributed Volunteer Computing environments such as the BOINC framework is concerned mainly with the efficient scheduling of the available resources to the applications which require them. The BOINC framework thus contains a number of scheduling policies/algorithms both on the server-side and on the client which work together to maximize the available resources and to provide a degree of QoS in an environment which is highly volatile. This paper focuses on the BOINC client and introduces an adaptive priority tuning client side middleware application which improves the execution times of Work Units (WUs) while maintaining an acceptable Maximum Response Time (MRT) for the end user. We have conducted extensive experimentation of the proposed system and the results show clear speedup of BOINC applications using our optimized middleware as opposed to running using the original BOINC client.

Efavirenz-induced gynecomastia in a prepubertal girl with human immunodeficiency virus infection: a case report

PubMed Central

2013-01-01

Background Prepubertal gynecomastia is a rare condition and most frequently classified as idiopathic. In HIV-infected adults gynecomastia is a recognised but infrequent side-effect of antiretroviral treatment (ART) and mostly attributed to efavirenz use. Gynecomastia should be distinguished from pseudogynecomastia as part of the lipodystrophy syndrome caused by Nucleoside Reverse Transcriptase Inhibitors (NRTIs) to avoid incorrect substitution of drugs. In the medical literature only five cases of prepubertal gynecomastia in children taking ART are described and underlying pathogenesis was unknown. The occurrence of adverse effects of ART may interfere with therapy adherence and long-term prognosis and for that reason requires attention. We report the first case of prepubertal gynecomastia in a young girl attributed to efavirenz use. Case presentation A seven-year-old African girl presented with true gynecomastia four months after initiation on ART (abacavir, lamivudine, efavirenz). History, physical examination and laboratory tests excluded known causes of gynecomastia and efavirenz was considered as the most likely cause. Six weeks after withdrawal of efavirenz the breast enlargement had completely resolved. Conclusions Efavirenz-induced gynecomastia may occur in children as well as in adults. With the increasing access to ART, the possibility of efavirenz-exposure and the potential occurrence of its associated side-effects may be high. In resource-poor settings, empirical change from efavirenz to nevirapine may be considered, providing no other known or alarming cause is identified, as efavirenz-induced gynecomastia can resolve quickly after withdrawal of the drug. Timely recognition of gynecomastia as a side-effect of efavirenz is important in order to intervene while the condition may still be reversible, to sustain adherence to ART and to maintain the sociopsychological health of the child. PMID:23941256

Efavirenz-induced gynecomastia in a prepubertal girl with human immunodeficiency virus infection: a case report.

PubMed

van Ramshorst, Mette S; Kekana, Magdeline; Struthers, Helen E; McIntyre, James A; Peters, Remco P H

2013-08-13

Prepubertal gynecomastia is a rare condition and most frequently classified as idiopathic. In HIV-infected adults gynecomastia is a recognised but infrequent side-effect of antiretroviral treatment (ART) and mostly attributed to efavirenz use. Gynecomastia should be distinguished from pseudogynecomastia as part of the lipodystrophy syndrome caused by Nucleoside Reverse Transcriptase Inhibitors (NRTIs) to avoid incorrect substitution of drugs. In the medical literature only five cases of prepubertal gynecomastia in children taking ART are described and underlying pathogenesis was unknown. The occurrence of adverse effects of ART may interfere with therapy adherence and long-term prognosis and for that reason requires attention. We report the first case of prepubertal gynecomastia in a young girl attributed to efavirenz use. A seven-year-old African girl presented with true gynecomastia four months after initiation on ART (abacavir, lamivudine, efavirenz). History, physical examination and laboratory tests excluded known causes of gynecomastia and efavirenz was considered as the most likely cause. Six weeks after withdrawal of efavirenz the breast enlargement had completely resolved. Efavirenz-induced gynecomastia may occur in children as well as in adults. With the increasing access to ART, the possibility of efavirenz-exposure and the potential occurrence of its associated side-effects may be high. In resource-poor settings, empirical change from efavirenz to nevirapine may be considered, providing no other known or alarming cause is identified, as efavirenz-induced gynecomastia can resolve quickly after withdrawal of the drug. Timely recognition of gynecomastia as a side-effect of efavirenz is important in order to intervene while the condition may still be reversible, to sustain adherence to ART and to maintain the sociopsychological health of the child.

Gastrointestinal Side Effects of Antiarrhythmic Medications: A Review of Current Literature.

PubMed

Amjad, Waseem; Qureshi, Waqas; Farooq, Ali; Sohail, Umair; Khatoon, Salma; Pervaiz, Sarah; Narra, Pratyusha; Hasan, Syeda M; Ali, Farman; Ullah, Aman; Guttmann, Steven

2017-09-03

Antiarrhythmic drugs are commonly prescribed cardiac drugs. Due to their receptor mimicry with several of the gastrointestinal tract receptors, they can frequently lead to gastrointestinal side effects. These side effects are the most common reasons for discontinuation of these drugs by the patients. Knowledge of these side effects is important for clinicians that manage antiarrhythmic drugs. This review focuses on the gastrointestinal side effects of these drugs and provides a detailed up-to-date literature review of the side effects of these drugs. The review provides case reports reported in the literature as well as possible mechanisms that lead to gastrointestinal side effects.

Memory for Medication Side Effects in Younger and Older Adults: The Role of Subjective and Objective Importance

PubMed Central

Friedman, Michael C.; McGillivray, Shannon; Murayama, Kou; Castel, Alan D.

2014-01-01

Older adults often experience memory impairments, but can sometimes use selective processing and schematic support to remember important information. The current experiments investigate to what degree younger and healthy older adults remember medication side effects that were subjectively or objectively important to remember. Participants studied a list of common side effects, and rated how negative these effects were if they were to experience them, and were then given a free recall test. In Experiment 1, the severity of the side effects ranged from mild (e.g., itching) to severe (e.g., stroke), and in Experiment 2, certain side effects were indicated as critical to remember (i.e., “contact your doctor if you experience this”). There were no age differences in terms of free recall of the side effects, and older adults remembered more severe side effects relative to mild effects. However, older adults were less likely to recognize critical side effects on a later recognition test, relative to younger adults. The findings suggest that older adults can selectively remember medication side effects, but have difficulty identifying familiar but potentially critical side effects, and this has implications for monitoring medication use in older age. PMID:25331278

The development of water services and their interaction with water resources in European and Brazilian cities

NASA Astrophysics Data System (ADS)

Barraqué, B.; Formiga Johnsson, R. M.; Nogueira de Paiva Britto, A. L.

2008-08-01

The extension and complexity of large cities creates "urban water" and a related issue: public water services, including public water supply, sewage collection and treatment, and storm water control, had previously become a policy sector separate from water resource allocation issues thanks to water transport and treatment technologies. Large metropolitan areas today cannot take nature for granted anymore, and they need to protect water resources, if only to reduce the long term cost of transporting and treating water. In this paper, we compare the historical development of water services in European and Brazilian metropolitan areas, placing the technological developments in their geographic, socio-economic and political contexts. Our frame is to follow the successive contributions of civil engineering, sanitary engineering, and environmental engineering: the "quantity of water" and civil engineering paradigm allowed to mobilise water in and out of the city, and up the hills or the floors; in the "water quality" and chemical/sanitary engineering paradigm, water treatment gave more freedom to cities to take water from rivers closer to them, but also to reduce sewer discharge impacts; lastly, the environmental engineering paradigm proposes to overcome the supply side perspective, by introducing demand side management, water conservation, water allocation flexibilisation, and an integrated approach to water services, water resources management, and land use policies.

Programs in Renewable Energy

NASA Astrophysics Data System (ADS)

1990-01-01

Our nation faces significant challenges as we enter the 1990s: securing a reliable supply of competitively priced energy, improving the quality of our environment, and increasing our share of foreign markets for goods and services. The U.S. Department of Energy's (DOE) Programs in Renewable Energy are working toward meeting these challenges by developing the technologies that make use of our nation's largest energy resource: renewable energy. The sunlight, wind biomass, flowing water, ocean energy, and geothermal energy that make up the renewable energy resource can be found throughout our nation. These resources can provide all the forms of energy our nation needs: liquid fuels, electricity, and heating and cooling. Renewable energy meets about 10 percent of our need for these forms of energy today, yet the potential contribution is many times greater. DOE's Programs in Renewable Energy are working side-by-side with American industry to develop the technologies that convert renewable energy resources into practical, cost-competitive energy. After a decade of progress in research, several of these technologies are poised to make large contributions during the 1990s and beyond. This booklet provides an overview of the renewable energy programs and their plans for FY 1990. Sources of additional information are listed at the back of the booklet.

Need of the regulation for profit percentage investment by pharmaceutical companies in new drug discovery research from the various local traditional medicinal and plant systems.

PubMed

Bhattarai, M D

2012-01-01

In the modern medical systems the active pharmacological ingredients, effective against any disease is identified, purified and studied for its various effects and side-effects whereas it is not so in the traditional systems. Therefore, it is not surprising that safety concerns have often been raised about the traditional medical products. The major issue now, is to make appropriate situation with basic supports to bring all the available experts and resources together for the identification, purification, and study of efficacy and safety of the active molecules of the popular traditional medicines. Government and public sectors in the countries with such rich traditional medicinal and plant systems have related experts, but they also have much hurdle regarding recruitment and retention of expert human resources, getting fund, purchase and maintenance of equipment, bureaucratic formalities and others. The pharmaceutical companies have basic laboratories with related infrastructure and human resources as well as interest about bringing the drug molecules. To bridge the gap, there is a need of the regulation which will make the pharmaceutical companies to invest certain percentage of their profit in the field of research to identify new drug molecules and to study their effects. It is just not an issue of discovering the active molecule but also of creating the concept and culture of research, purity and quality of drugs, safety of people, and future direction of the human society.

Self-administration of medicine and older people.

PubMed

McGraw, C; Drennan, V

Non-adherence to medication regimens is a significant problem in older patients, which can lead to therapeutic failure and the wastage of resources. Common causes include poor patient memory, physical difficulties, unpleasant side effects and a lack of social support. Strategies such as careful labelling, self-administration of medicine programmes, simplifying drug regimens and the use of medication compliance devices can help to promote patient adherence. Some of these interventions will work for certain patients, however the authors recommend that a multidisciplinary assessment and a regular review of each patient's ability to adhere to medication should be undertaken.

Improving Resource Selection and Scheduling Using Predictions. Chapter 1

NASA Technical Reports Server (NTRS)

Smith, Warren

2003-01-01

The introduction of computational grids has resulted in several new problems in the area of scheduling that can be addressed using predictions. The first problem is selecting where to run an application on the many resources available in a grid. Our approach to help address this problem is to provide predictions of when an application would start to execute if submitted to specific scheduled computer systems. The second problem is gaining simultaneous access to multiple computer systems so that distributed applications can be executed. We help address this problem by investigating how to support advance reservations in local scheduling systems. Our approaches to both of these problems are based on predictions for the execution time of applications on space- shared parallel computers. As a side effect of this work, we also discuss how predictions of application run times can be used to improve scheduling performance.

The role of intrinsic motivations in attention allocation and shifting

PubMed Central

Di Nocera, Dario; Finzi, Alberto; Rossi, Silvia; Staffa, Mariacarla

2014-01-01

The concepts of attention and intrinsic motivations are of great interest within adaptive robotic systems, and can be exploited in order to guide, activate, and coordinate multiple concurrent behaviors. Attention allocation strategies represent key capabilities of human beings, which are strictly connected with action selection and execution mechanisms, while intrinsic motivations directly affect the allocation of attentional resources. In this paper we propose a model of Reinforcement Learning (RL), where both these capabilities are involved. RL is deployed to learn how to allocate attentional resources in a behavior-based robotic system, while action selection is obtained as a side effect of the resulting motivated attentional behaviors. Moreover, the influence of intrinsic motivations in attention orientation is obtained by introducing rewards associated with curiosity drives. In this way, the learning process is affected not only by goal-specific rewards, but also by intrinsic motivations. PMID:24744746

Sickle cell disease and HIV: a case highlighting management challenges for children in a resource-limited setting.

PubMed

Odera, Esther Brenda; Kwobah, Charles; Stone, Geren; Some, Faraj; Vreeman, Rachel Christine

2014-01-01

Sickle cell disease (SCD) is a genetic disorder resulting from a mutation in the hemoglobin (Hb) gene. Sickle cell disease results in chronic anemia and a variety of acute and chronic complications that can lead to early mortality. A child with both SCD and HIV presents a management challenge, particularly in a resource-limited setting. In this case report, we describe the case of an 18-month-old Kenyan girl with SCD and HIV who developed a severe hypersensitivity reaction to first-line antiretroviral therapy (ART). Selecting an appropriate drug substitute for a child with SCD and HIV presents a management dilemma when the available options have problematic side effect profiles or are inaccessible or inappropriate according to national guidelines. The challenges in choosing an appropriate ART regimen for a child with SCD and HIV highlight the lack of data and scarcity of treatment options for pediatric patients.

[Novel resources utilization technique for rural domestic refuse].

PubMed

Qiu, Cai-Di; He, Ruo; Chen, Song-Mei; Lou, Bin; Shen, Dong-Sheng

2009-03-15

In order to speed up rural domestic refuse resources utilization, intermittent aeration and continuous aeration were applied to treat rural domestic refuse after anaerobic fermentation. Three kinds of refuse were selected on base of fermentative age, i.e. three months, five months and seven months. Results showed that aeration could remove water and organic materials of the refuse effectively. Points of view on aeration, continuous aeration was better than intermittent aeration, and on the other side, water removal rate increased with ventilation and decreased with fermentative age in the condition of intermittent aeration. On organic materials removal point, it was affected by fermentative age significantly, i. e. increase of fermentative age could resulted in decrease in the removal efficiency. In conclusion, intermittent aeration of 0.06 m3/(min x m3) was considered to be feasible for treatment. The water removal efficiency of three months, five months and seven months fermentative age refuse could be up to 49.1%, 45.3% and 44.0%, and organic compound removal efficiency was 41.9%, 24.8% and 13.1%, respectively, after intermittent aeration for 21 d. Moreover, concentrated effect was presented on major nutrient ingredients, such as total nitrogen, phosphorus, and potassium during the aeration, which realized for resources utilization.

“So far it’s been choosing which side effects I want or I can deal with”: A grounded theory of HIV treatment side effects among people living with HIV

PubMed Central

Holmes, Dave

2016-01-01

Despite the availability of new antiretroviral drugs and the simplification of treatment options, side effects continue to affect people living with HIV. In this paper, we present the findings of a grounded theory study designed to gain a critical understanding of the experience of side effects. Three main categories emerged from the data: the side effects, the experience, and the connections. The first category suggests that we need to change how we think about side effects in order to take into account the context in which they are experienced as well as the types and nature of side effects. The second category puts forward the idea that the experience of side effects is composed of three interrelated processes: becoming with, living with, and dealing with. Finally, the third category points to new connections that are formed with people, things and systems in the presence of side effects. PMID:27867446

Relation between therapeutic response and side effects induced by methylphenidate as observed by parents and teachers of children with ADHD.

PubMed

Lee, James; Grizenko, Natalie; Bhat, Venkataramana; Sengupta, Sarojini; Polotskaia, Anna; Joober, Ridha

2011-04-21

The desired (therapeutic) and undesired (side) effects of methylphenidate might have underlying correlations. The aim of this study was to explore the strength and the possible sources of these correlations. One hundred and fifty-seven children with ADHD (6-12 years) were administered placebo and methylphenidate (0.5 mg/kg in a divided b.i.d. dose), each for a one-week period, in a double-blind, crossover trial. Therapeutic response was assessed using the Conners' Global Index for parents (CGI-Parents) and teachers (CGI-Teachers), while side effects were assessed using the Barkley Side Effects Rating Scale (SERS). The side effect profile as assessed by the SERS was similar to that of previous studies with insomnia, decreased appetite, and headaches showing significant treatment effects (p < 0.005). These "somatic/physical" side effects did not correlate with CGI-Parents or CGI-Teachers. However, the side effects of "irritability", "proneness to crying", and "anxiousness" showed significant relationships with CGI-Parents. These "mood/anxiety" side effects showed no significant correlations with the CGI-Teachers. The greater "mood/anxiety" side effects on methylphenidate and placebo, the less the parents observe improvement of their children while treated with methylphenidate. This suggests that the correlations between "mood/anxiety" side effects and poor response to treatment may be driven by observer effects rather than biological commonalities between therapeutic and side effects of methylphenidate.

Side Effects

Cancer.gov

Side effects are problems that occur when cancer treatment affects healthy tissues or organs. Learn about side effects caused by cancer treatment. Know what signs and symptoms to call your doctor about. Learn about treatments for side effects.

Side Effects of HIV Medicines: HIV and Lactic Acidosis

MedlinePlus

... Drugs Clinical Trials Apps skip to content Side Effects of HIV Medicines Home Understanding HIV/AIDS Fact ... and Immunizations What is a Drug Interaction? Side Effects of HIV Medicines HIV Medicines and Side Effects ...

Real-world health outcomes in adults with moderate-to-severe psoriasis in the United States: a population study using electronic health records to examine patient-perceived treatment effectiveness, medication use, and healthcare resource utilization.

PubMed

Armstrong, April W; Foster, Shonda A; Comer, Brian S; Lin, Chen-Yen; Malatestinic, William; Burge, Russel; Goldblum, Orin

2018-06-28

Little is known regarding real-world health outcomes data among US psoriasis patients, but electronic health records (EHR) that collect structured data at point-of-care may provide opportunities to investigate real-world health outcomes among psoriasis patients. Our objective was to investigate patient-perceived treatment effectiveness, patterns of medication use (duration, switching, and/or discontinuation), healthcare resource utilization, and medication costs using real-world data from psoriasis patients. Data for adults (≥18-years) with a dermatology provider-given diagnosis of psoriasis from 9/2014-9/2015 were obtained from dermatology practices using a widely used US dermatology-specific EHR containing over 500,000 psoriasis patients. Disease severity was captured by static physician's global assessment and body surface area. Patient-perceived treatment effectiveness was assessed by a pre-defined question. Treatment switching and duration were documented. Reasons for discontinuations were assessed using pre-defined selections. Healthcare resource utilization was defined by visit frequency and complexity. From 82,621 patients with psoriasis during the study period, patient-perceived treatment effectiveness was investigated in 2200 patients. The proportion of patients reporting "strongly agree" when asked if their treatment was effective was highest for biologics (73%) and those reporting treatment adherence (55%). In 16,000 patients who received oral systemics and 21,087 patients who received biologics, median treatment duration was longer for those who received biologics (160 vs. 113 days, respectively). Treatment switching was less frequent among patients on systemic monotherapies compared to those on combination therapies. The most common reason for discontinuing biologics was loss of efficacy; the most common reason for discontinuing orals was side effects. In 28,754 patients, higher disease severity was associated with increased healthcare resource utilization (increased visit frequency and complexity). When compared between treatment groups (n = 10,454), healthcare resource utilization was highest for phototherapy. Annual medication costs were higher for biologics ($21,977) than oral systemics ($3413). Real-world research using a widely implemented dermatology EHR provided valuable insights on patient perceived treatment effectiveness, patterns of medication usage, healthcare resource utilization, and medication costs for psoriasis patients in the US. This study and others utilizing EHRs for real-world research may assist clinical and payer decisions regarding the management of psoriasis.

Framing effects on expectations, decisions, and side effects experienced: the case of influenza immunization.

PubMed

O'Connor, A M; Pennie, R A; Dales, R E

1996-11-01

To examine the effects of using positive or negative frames to describe influenza vaccine benefits and side effects on patients' expectations, decisions, decisional conflict, and reported side effects. 292 previously unimmunized patients with chronic respiratory or cardiac disease were randomly assigned to receive benefit/risk information that was framed: (1) positively as the percentage who remain free of influenza and have no vaccine side effects, or (2) negatively as the percentage who acquire influenza and have vaccine side effects. Questionnaires elicited expectations, decisions, and decisional conflict. Vaccines were telephoned 3 days later for a self-report of local and systemic side effects and work absenteeism. Both groups had similar immunization rates and decisional conflict scores. The positive frame group had lower and more realistic expectations of vaccine side effects, fewer systemic side effects, and less work absenteeism (p < 0.05). In contrast to previous studies of health care workers, framing did not influence patients' decisions, possibly due to the patients' awareness of their higher risk of influenza complications and greater desire to follow recommendations. The common practice of using negative frames when describing probabilities of side effects may need to be reexamined, considering its deleterious influence on self-reported side effects and work absenteeism.

Hydrochemical Signatures of Glacier Melt and Groundwater Storage on Volcán Chimborazo, Ecuador

NASA Astrophysics Data System (ADS)

McLaughlin, R.; Ng, G. H. C.; La Frenierre, J.; Wickert, A. D.; Baraer, M.

2016-12-01

With ever-growing water demands for hydroelectricity, agriculture, and domestic use, the accelerated retreat of tropical glaciers is raising concerns about future water supply sustainability. In the tropical Andes, where precipitation is seasonal and spatially heterogeneous, glaciers are particularly important as their storage and slow release of water helps to modulate stream discharge on daily to yearly time scales. Predicting the effect their shrinkage will have on water resources is not straightforward as little is known about the connections in these glaciated volcanic catchments between meltwater, groundwater, precipitation and surficial discharge. Here, stable isotope and major ion analyses inform a hydrochemical mixing model in order to identify water sources and their relative contributions to stream and spring discharge on Volcán Chimborazo, a stratovolcano located in the Ecuadorian Andes. Moisture in this region generally arrives from the Amazon basin to the east, resulting in a steep northeast-southwest precipitation gradient that produces wet and dry sides of the mountain. Dry season water samples were collected on both sides from major streams and springs at varying elevations and distances from the glacier tongues, along with samples of precipitation (when possible) and glacier ice. Data on specific conductivity, pH, and temperature were collected in situ for each sample. The paired catchment study allows us to isolate a primarily glacial melt signature on the dry side and compare it to data on the wet side, where glacial melt and precipitation both contribute to groundwater and surface-water discharge.

Side Effects of Leukotriene Receptor Antagonists in Asthmatic Children.

PubMed

Erdem, Semiha Bahceci; Nacaroglu, Hikmet Tekin; Unsal Karkiner, Canan Sule; Gunay, Ilker; Can, Demet

2015-10-01

Leukotriene receptor antagonists (LTRAs) are drugs which have been widely used more than ten years. As the use of LTRAs increases, our knowledge with respect to their side effects increases as well. The objective of our study was to evaluat the observed side effects of LTRAs used in patients with astma. 1024 patients treated only with LTRAs owing to asthma or early wheezing were included in the study for a five-year period. The observed side effects of LTRAs in these patients were retrospectively investigated. The side effects were divided into two parts as psychiatric and non-psychiatric. Among the 1024 cases included in the study, 67.5% of the patients out of 41 with side effects were male, 32.5% were female and the average age was 6.5 years. The rate of patients with asthma was 63.41% and 36.58% of the patients had early wheezing. It was determined that sex, age and diagnosis (early wheezing or asthma) of the patients were ineffective in the emergence of side effects. The average period for the emergence of side effects was the first month. It was observed that hyperactivity was the most frequently observed psychiatric side effect and that abdominal pain was the non-psychiatric side effect. The side effects of LTRAs were common in children. Therefore, patients must be informed at the beginning of the treatment and they must be evaluated at certain intervals.

Northwest Trajectory Analysis Capability: A Platform for Enhancing Computational Biophysics Analysis

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

Peterson, Elena S.; Stephan, Eric G.; Corrigan, Abigail L.

2008-07-30

As computational resources continue to increase, the ability of computational simulations to effectively complement, and in some cases replace, experimentation in scientific exploration also increases. Today, large-scale simulations are recognized as an effective tool for scientific exploration in many disciplines including chemistry and biology. A natural side effect of this trend has been the need for an increasingly complex analytical environment. In this paper, we describe Northwest Trajectory Analysis Capability (NTRAC), an analytical software suite developed to enhance the efficiency of computational biophysics analyses. Our strategy is to layer higher-level services and introduce improved tools within the user’s familiar environmentmore » without preventing researchers from using traditional tools and methods. Our desire is to share these experiences to serve as an example for effectively analyzing data intensive large scale simulation data.« less

A Comparison of Sexual Side Effects of Antidepressants With and Without Naltrexone.

PubMed

Thapa, Mona; Petrakis, Ismene; Ralevski, Elizabeth

2017-01-01

The aim of the study was to compare the rate of sexual side effects of the selective serotonin reuptake inhibitor paroxetine versus the tricyclic antidepressant desipramine and to examine the effect of co-prescription of naltrexone on sexual side effects among participants in a randomized clinical trial. This was a secondary analysis (N = 88) of veterans who participated in a 12-week trial. All veterans were randomized into one of four treatment groups: (a) desipramine/naltrexone, (b) desipramine/placebo, (c) paroxetine/naltrexone, and (d) paroxetine/placebo. The main outcome measure was the frequency of sexual side effects consisting of "decreased sex drive" and/or "impotence" reported by veterans at each weekly visit. Approximately 61% of the veterans reported sexual side effects at least once during the trial, and 26.4% reported sexual side effects throughout the study. There were no significant differences in the frequency of sexual side effects among the four treatment groups. The results were similar when the comparison was made between the two antidepressant groups. There were no significant differences in the reporting of sexual side effects between those receiving desipramine and paroxetine. Also, the comparison between naltrexone and placebo did not alter the results. This is the first study to compare frequency of sexual side effect reporting between paroxetine and desipramine. We found no statistically significant differences in sexual side effect reporting between the two antidepressants. Also, the addition of naltrexone did not show any beneficial effect on the sexual side effect profile.

How does the side-effect information in patient information leaflets influence peoples' side-effect expectations? A cross-sectional national survey of 18- to 65-year-olds in England.

PubMed

Webster, Rebecca K; Weinman, John; Rubin, G James

2017-12-01

To establish how the terms recommended by the European Commission to describe side-effect risk in patient information leaflets (PILs) influences expectations of side-effects and to identify factors associated with these side-effect expectations. A cross-sectional online survey was carried out by a market research company. Data were collected in England between 18th March and 1st April 2016. A total of 1003 adults aged between 18 and 65. Self-reported expectation that the described side-effects would affect participants if they took the medicine, measured on a likelihood scale from 1 (very unlikely) to 5 (very likely). Participants formed high expectations of side-effects for "very common" and "common" side-effects, with 51.9% and 45.0% of participants rating these as "very likely" or "likely" to happen to them, respectively. This fell to 8.1% for "uncommon," 5.8% for "rare" and 4.1% for "very rare." For each descriptor, higher expectations of side-effects were more associated with women or being from an ethnic minority, or having less education, a household illness, high perceived sensitivity to medicines or negative beliefs about medicines. The current use of verbal descriptors to communicate side-effect risk in PILs leads to high side-effect expectations. These expectations could contribute to nocebo-induced medication side-effects experienced by patients. Additional work is required to identify ways to improve the way risk information is conveyed in PILs. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Palestinian Territories Analysis Brief

EIA Publications

2014-01-01

The Palestinian Territories of the West Bank and Gaza Strip do not have any proved hydrocarbon reserves, but fields on the Israeli side of the boundaries may extend across the West Bank and Gaza borders. The discovery of the Gaza Marine field in the Mediterranean Sea in 2000 indicates the presence of hydrocarbons, although the resources are not yet commercially viable. The Gaza Marine field holds an estimated 1.6 trillion cubic feet in recoverable natural gas resources.

Remote sensing of potential lunar resources. I - Near-side compositional properties

NASA Technical Reports Server (NTRS)

Johnson, Jeffrey R.; Larson, Stephen M.; Singer, Robert B.

1991-01-01

Using telescopic CCD multispectral images of the lunar near side and the results of 330-870 nm spectroscopy of selected regions, the compositional differences relevant to the locations of potential lunar resources (such as ilmenite, FeTiO3, and solar-wind-implanted He-3 and H) are estimated. The 400/560 nm CCD ratio images were converted to weight percent TiO2, and the values were used to construct a new TiO2 abundance map which can be used to estimate the areas potentially rich in ilmenite. A 950/560 nm CCD ratio mosaic of the full moon provides estimates of relative surface maturity. Since high He-3 concentrations correlate with mature ilmenite-rich soils, a combination of relative surface maturity maps and the TiO2 abundance maps can be used to estimate distributions of He-3 (and possibly H) on local scales.

Effects of light touch on postural sway and visual search accuracy: A test of functional integration and resource competition hypotheses.

PubMed

Chen, Fu-Chen; Chen, Hsin-Lin; Tu, Jui-Hung; Tsai, Chia-Liang

2015-09-01

People often multi-task in their daily life. However, the mechanisms for the interaction between simultaneous postural and non-postural tasks have been controversial over the years. The present study investigated the effects of light digital touch on both postural sway and visual search accuracy for the purpose of assessing two hypotheses (functional integration and resource competition), which may explain the interaction between postural sway and the performance of a non-postural task. Participants (n=42, 20 male and 22 female) were asked to inspect a blank sheet of paper or visually search for target letters in a text block while a fingertip was in light contact with a stable surface (light touch, LT), or with both arms hanging at the sides of the body (no touch, NT). The results showed significant main effects of LT on reducing the magnitude of postural sway as well as enhancing visual search accuracy compared with the NT condition. The findings support the hypothesis of function integration, demonstrating that the modulation of postural sway can be modulated to improve the performance of a visual search task. Copyright © 2015 Elsevier B.V. All rights reserved.

Risk Factors for Musculoskeletal Symptoms Among Korean Broadcast Actors.

PubMed

Park, Moon-Hee; Kim, Ham-Gyum; Cho, Jae-Hwan

2015-01-01

Musculoskeletal diseases (MSDs) are functional disabilities in the musculoskeletal area that occur when continuous damage to the muscles or tissues is caused by performing a repetitive task. These diseases are usually found in the waist, shoulder, neck, arm, and wrist. MSD is also referred to as cumulative trauma disorder, repetitive strain injury, occupational overuse syndrome, and visual display terminal, depending on the country. The condition is now commonly referred to as work-related musculoskeletal disorder. The aim of this study was to develop a prevention plan against musculoskeletal disease and to provide better health care to broadcast actors by understanding the association between musculoskeletal symptoms and working conditions. The results of the study can be utilized to maintain effective systematic resources to treat such diseases. A survey was conducted in Seoul between January 1 and May 10, 2014 with broadcast actors working in the South Korean entertainment industry. Tests with respect to musculoskeletal symptoms indicated that the study participants were likely to experience having musculoskeletal symptoms in the shoulders, waist, neck, leg/foot, hand/wrist/finger, and arm/elbow. Most of the participants reported pain on both sides of their shoulders and in their legs/feet or on the right side of the arm/elbow and in hand/wrist/finger. Pain lasted between 1 and 7 days, with an incidence of 33.8% in the neck, 36% in the shoulders, 33.3% in the arm/elbow, 47.4% in the hand/wrist/finger, 34.7% in the waist, and 39.3% in the leg/foot. This study should prove useful in determining systematic and effective resources to prevent broadcast actors from developing MSD in the future. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Usability and acceptance evaluation of ACESO: a Web-based breast cancer survivorship tool.

PubMed

Kapoor, Akshat; Nambisan, Priya

2018-06-01

The specific objective of this research is to design and develop a personalized Web application to support breast cancer survivors after treatment, as they deal with post-treatment challenges, such as comorbidities and side effects of treatment. A mixed-methods approach, utilizing a combination of think-aloud analysis, personal interviews, and surveys, was adopted for user acceptance and usability testing among a group of breast cancer survivors. User feedback was gathered on their perceived value of the application, and any user-interface issues that may hinder the overall usability were identified. The application's portability and capability of organizing their entire breast cancer-related medical history as well as tracking various quality of life indicators were perceived to be valuable features. The application had an overall high usability; however, certain sections of the application were not as intuitive to locate. Visual elements of the website were appreciated; however, overall experience would benefit from incorporating more sociable elements that exhibit positive re-enforcement within the end user and provide a friendlier experience. The results of the study showcase the need for more personalized tools and resources to support survivors in self-management. It also demonstrates the ability to integrate breast cancer survivorship care plans from diverse providers and paves the way to add further value-added features in consumer health applications, such as personal decision support. Using a personal decision support-based tool can serve as a training tool and resource, providing these patients with pertinent information about the various aspects of their long-term health, while educating them about any related side effects and symptoms. It is hoped that making such tools more accessible could help in engaging survivors to play an active role in managing their health and encourage shared decision-making with their providers.

Side Effects to Antidepressant Treatment in Patients With Depression and Comorbid Panic Disorder.

PubMed

Shankman, Stewart A; Gorka, Stephanie M; Katz, Andrea C; Klein, Daniel N; Markowitz, John C; Arnow, Bruce A; Manber, Rachel; Rothbaum, Barbara O; Thase, Michael E; Schatzberg, Alan F; Keller, Martin B; Trivedi, Madhukar H; Kocsis, James H

2017-04-01

Side effects to antidepressant medication can affect the efficacy of treatment, but few predictors foretell who experiences side effects and which side effects they experience. This secondary data analysis examined whether depressed patients with comorbid panic disorder were more likely to experience side effects than those without panic disorder. The study also examined whether greater burden of side effects predicted a poorer treatment course for patients with panic disorder than those without panic disorder. To examine the specificity of these effects, analyses also examined 2 other anxiety disorders-social phobia and generalized anxiety disorder (GAD). Between 2002 and 2006, a large sample (N = 808) of chronically depressed individuals (assessed using the Structured Clinical Interview for DSM-IV-TR Axis I Disorders [SCID-IV]) received antidepressants according to a predetermined algorithm for 12 weeks. Every 2 weeks, depressive symptoms (per the Hamilton Depression Rating Scale) and side effects (specific side effects as well as several indicators of side effect burden) were assessed. Lifetime diagnosis of panic disorder (assessed using the SCID-IV) at baseline was associated with higher likelihood of gastrointestinal (OR = 1.6 [95% CI, 1.0-2.6]), cardiac (OR = 1.8 [95% CI, 1.1-3.1]), neurologic (OR = 2.6 [95% CI, 1.6-4.2]), and genitourinary side effects (OR = 3.0 [95% CI, 1.7-5.3]) during treatment. Increases in side effect frequency, intensity, and impairment over time were more strongly associated with increases in depressive symptoms for patients with panic disorder compared to those without panic disorder. Neither social phobia nor GAD was associated with these effects. Potentially due to heighte​ned interoceptive awareness of changes in their body, chronically depressed individuals with panic disorder may be at greater risk than those without panic disorder for antidepressant side effects and to experience a worsening of depressive symptoms as a result of these side effects over time. ClinicalTrials.gov identifier: NCT00057551​. © Copyright 2017 Physicians Postgraduate Press, Inc.

Medications and Side Effects

MedlinePlus

... to fully work. You might feel some side effects of your medication before your feel the benefits – ... as sleepiness, anxiety or headache) is a side effect or a symptom of your illness. Many side ...

Cancer Treatment for Women: Possible Sexual Side Effects

MedlinePlus

... the clitoris. These play a major part in sexual arousal in women. Removing the vulva and the clitoris ... www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-and-sexual-side-effects/sexuality-for-women-with-cancer.html. ...

"There is a chain of connections": using syndemics theory to understand HIV treatment side effects.

PubMed

Gagnon, Marilou

2018-03-12

Side effects are central to the experience of living longer with HIV but rarely have they been studied alone. Unlike other aspects of that experience, like quality of life, treatment adherence, chronicity, episodic disability, aging, health, and viral load suppression, side effects have not benefited from the same level of empirical and theoretical engagement from qualitative researchers. In this paper, we draw on syndemics theory and 50 qualitative interviews to better understand the experience of HIV treatment side effects. Two main categories were identified in the data: side effects as a product and side effects as a risk factor. The first category suggests that side effects are not just the product of taking antiretroviral drugs. They are also the product of particular conditions and tend to cluster with other health problems. The second category puts forward the idea that side effects can act as a syndemic risk factor by exposing PLWH to a greater risk of developing health problems and creating conditions in which psychosocial issues are more likely to emerge. The paper concludes by calling for more research on the complex nature of side effects and for the development of comprehensive approaches for the assessment and management of side effects.

Patient-provider communication and hormonal therapy side effects in breast cancer survivors.

PubMed

Lin, Jenny J; Chao, Jennifer; Bickell, Nina A; Wisnivesky, Juan P

2017-09-01

Side effects from hormonal therapy (HT) for breast cancer treatment occur frequently and are associated with worse quality of life and HT non-adherence. Whether improved patient-physician communication is associated with patients' reporting of side effects is unknown. We undertook this study to assess factors associated with women's reports of HT side effects. Between December 2012 and April 2013, we conducted a cross-sectional survey of breast cancer patients undergoing HT in an urban medical center. Descriptive statistics, univariate analyses, and multivariate analyses were used to evaluate associations. Of the 100 participants, 67% reported having HT side effects. However, when prompted, an additional 9% reported experiencing specific HT-related symptoms. Despite very high communication scores, one-third of participants reported they had not discussed side effects with providers. Multivariate analysis showed that after controlling for age, education, race, and medication beliefs, women who had difficulty asking providers for more information were more likely to report side effects (odds ratio 8.27, 95% confidence interval 1.01-69.88). Although HT side effects often occur and are bothersome, patient-provider discussions about side effects remain suboptimal. Providers should actively ask patients about medication side effects so that they can be addressed to improve quality of life and potentially, medication adherence.

Side effect burden of antipsychotic drugs in real life - Impact of gender and polypharmacy.

PubMed

Iversen, Trude Seselie Jahr; Steen, Nils Eiel; Dieset, Ingrid; Hope, Sigrun; Mørch, Ragni; Gardsjord, Erlend Strand; Jørgensen, Kjetil Nordbø; Melle, Ingrid; Andreassen, Ole A; Molden, Espen; Jönsson, Erik G

2018-03-02

Antipsychotic-associated side effects are well known and represent a significant treatment challenge. Still, few large studies have investigated the overall side effect burden of antipsychotics in real-life settings. To describe the occurrence of side effects and perceived burden of antipsychotics in a large naturalistic sample, taking polypharmacy and patient characteristics into account. Patients (n=1087) with psychotic disorders were assessed for side effects using the Udvalg for Kliniske Undersøgelser (UKU) side effect rating scale in addition to assessment of clinical and pharmacological data. Statistical analyses were performed controlling for possible confounding factors. Use of antipsychotics showed significant associations to neurologic and sexual symptoms, sedation and weight gain, and >75% of antipsychotics-users reported side effects. More side effects were observed in patients using several antipsychotics (p=0.002), with increasing total dose (p=0.021) and with antipsychotics in combinations with other psychotropic drugs. Patients and investigators evaluated the side effect burden differently, particularly related to severity, gender and antipsychotics dose. Twice as many females described side effect burden as severe (p=0.004). Patients with psychotic disorders have a high occurrence of symptoms associated with use of antipsychotics, and polypharmacy and female gender are seemingly risk factors for reporting a severe side effect burden. Due to the cross-sectional design evaluation of causality is tentative, and these findings should be further investigated in prospective studies. Copyright © 2017 Elsevier Inc. All rights reserved.

The Glasgow antipsychotic side-effects scale for clozapine in inpatients and outpatients with schizophrenia or schizoaffective disorder.

PubMed

Ignjatović Ristić, Dragana; Cohen, Dan; Obradović, Andrea; Nikić-Đuričić, Katarina; Drašković, Marija; Hinić, Darko

2018-02-01

The inconsistency in clinician and patient ratings of clozapine-induced side effects underscore the need to supplement clinician-based estimates of side effects with patient-reported ones. The main aims of the study are validation of the Glasgow antipsychotic side-effects scale for clozapine (GASS-C) in Serbian inpatients/outpatients with schizophrenia or schizo-affective disorder and recommendations for its future use, based on common and rare clozapine-associated side-effects. The GASS-C was administered to 95 outpatients/inpatients diagnosed with schizophrenia, schizoaffective, or chronic psychotic disorder. The scale showed good overall reliability, with an internal consistency coefficient of α = 0.84, an average retest coefficient of rho = 0.76, and a Spearman-Brown coefficient of validity of 0.81. Side effects were absent or mild in 64.2% of the patients, moderate in 31.6%, severe in 4.2%; 14% of the subjects considered their symptoms distressing. The most commonly reported side-effects were drowsiness, thirst, frequent urination, and dry mouth. Women reported more side effects than men, and patients not in a relationship reported significantly fewer side effects than patients in a relationship. Results indicate a weak positive correlation (rho = 0.231; p = .025) between severity of side effects and clozapine dose. The GASS-C showed good psychometric characteristics in clinical population of patients on clozapine. In future studies, clozapine serum concentrations should be measured when using the GASS-C to monitor side effects.

Learning to experience side effects after antidepressant intake - Results from a randomized, controlled, double-blind study.

PubMed

Rheker, Julia; Winkler, Alexander; Doering, Bettina K; Rief, Winfried

2017-02-01

Side effects play a key role in patients' failure to take antidepressants. There is evidence that verbal suggestions and informed consent elicit expectations that can in turn trigger the occurrence of side effects. Prior experience or learning mechanisms are also assumed to contribute to the development of side effects, although their role has not been thoroughly investigated. In this study, we examined whether an antidepressant's side effects can be learned via Pavlovian conditioning. Participants (n = 39) were randomly allocated to one of two groups and were exposed to a classical conditioning procedure. During acquisition, 19 participants received amitriptyline and 20 participants received a placebo pill. Pills were taken for four nights together with a novel-tasting drink. After a washout phase, both groups received a placebo pill together with the novel-tasting drink (evocation). Side effects were assessed via the Generic Assessment of Side Effects Scale prior to acquisition (baseline), after acquisition, and after evocation. A score of antidepressant-specific side effects was calculated. Participants taking amitriptyline reported significantly more antidepressant-specific side effects after acquisition compared to both baseline and the placebo group. After evocation, participants who underwent the conditioning procedure with amitriptyline reported significantly more antidepressant-specific side effects than those who never received amitriptyline, even though both groups received a placebo. Our results indicate that antidepressant side effects can be learned using a conditioning paradigm and evoked via a placebo pill when applied with the same contextual factors as the verum.

Decreasing the Burden of Side Effects Through Positive Message Framing: an Experimental Proof-of-Concept Study.

PubMed

Wilhelm, Marcel; Rief, Winfried; Doering, Bettina K

2018-05-21

Informing patients about treatment side effects increases the occurrence and intensity of side effects. Since the obligatory informed consent procedure in drug treatments requires transparency and nocebo research suggests that the informed consent of a drug leads to an increased occurrence of the mentioned side effects, the aim of this proof of concept study was to determine the effect of two different framings of informed consent on the occurrence, intensity, and perceived threat of side effects. Healthy male participants (n = 80) were randomized to one of two framing groups. The positive framing group was informed that the common side effect dizziness was a sign that the drug had started to work, while the neutral framing group was told that dizziness is an unpleasant but well-known side effect. Side effects were measured after the administration of metoprolol, an antihypertensive agent. Post hoc moderator analyses investigated the effect of pre-existing negative beliefs about the general harm of medication on the framing manipulation. Metoprolol-specific drug-attributed side effects were rated significantly less threatening in the positive framing group. The between-group effect size (Cohen's d) was small (d = 0.38, p = 0.049). Exploratory post hoc moderator analyses suggest that participants who believed that medication is a source of harmful effects benefited from positive framing, compared to neutral framing of drug-attributed side effects. Positive framing was partially effective in decreasing specific side effect measures, particularly among participants with a tendency to believe that medicine is harmful. Informed consent procedures should therefore be personalized, focusing on patients with negative treatment beliefs.

Can authorities appreciably enhance the prescribing of oral generic risperidone to conserve resources? Findings from across Europe and their implications.

PubMed

Godman, Brian; Petzold, Max; Bennett, Kathleen; Bennie, Marion; Bucsics, Anna; Finlayson, Alexander E; Martin, Andrew; Persson, Marie; Piessnegger, Jutta; Raschi, Emanuel; Simoens, Steven; Zara, Corinne; Barbui, Corrado

2014-06-13

Generic atypical antipsychotic drugs offer health authorities opportunities for considerable savings. However, schizophrenia and bipolar disorders are complex diseases that require tailored treatments. Consequently, generally there have been limited demand-side measures by health authorities to encourage the preferential prescribing of generics. This is unlike the situation with hypertension, hypercholaesterolaemia or acid-related stomach disorders.The objectives of this study were to compare the effect of the limited demand-side measures in Western European countries and regions on the subsequent prescribing of risperidone following generics; to utilise the findings to provide future guidance to health authorities; and where possible, to investigate the utilisation of generic versus originator risperidone and the prices for generic risperidone. Principally, this was a segmented regression analysis of retrospective time-series data of the effect of the various initiatives in Belgium, Ireland, Scotland and Sweden following the introduction of generic risperidone. The study included patients prescribed at least one atypical antipsychotic drug up to 20 months before and up to 20 months after generic risperidone. In addition, retrospective observational studies were carried out in Austria and Spain (Catalonia) from 2005 to 2011 as well as one English primary care organisation (Bury Primary Care Trust (PCT)). There was a consistent steady reduction in risperidone as a percentage of total selected atypical antipsychotic utilisation following generics. A similar pattern was seen in Austria and Spain, with stable utilisation in one English PCT. However, there was considerable variation in the utilisation of generic risperidone, ranging from 98% of total risperidone in Scotland to only 14% in Ireland. Similarly, the price of generic risperidone varied considerably. In Scotland, generic risperidone was only 16% of pre-patent loss prices versus 72% in Ireland. Consistent findings of no increased prescribing of risperidone post generics with limited specific demand-side measures suggests no 'spillover' effect from one class to another encouraging the preferential prescribing of generic atypical antipsychotic drugs. This is exacerbated by the complexity of the disease area and differences in the side-effects between treatments. There appeared to be no clinical issues with generic risperidone, and prices inversely reflected measures to enhance their utilisation.

Uncovering the determinants of a highly perturbed tyrosine pKa in the active site of ketosteroid isomerase.

PubMed

Schwans, Jason P; Sunden, Fanny; Gonzalez, Ana; Tsai, Yingssu; Herschlag, Daniel

2013-11-05

Within the idiosyncratic enzyme active-site environment, side chain and ligand pKa values can be profoundly perturbed relative to their values in aqueous solution. Whereas structural inspection of systems has often attributed perturbed pKa values to dominant contributions from placement near charged groups or within hydrophobic pockets, Tyr57 of a Pseudomonas putida ketosteroid isomerase (KSI) mutant, suggested to have a pKa perturbed by nearly 4 units to 6.3, is situated within a solvent-exposed active site devoid of cationic side chains, metal ions, or cofactors. Extensive comparisons among 45 variants with mutations in and around the KSI active site, along with protein semisynthesis, (13)C NMR spectroscopy, absorbance spectroscopy, and X-ray crystallography, was used to unravel the basis for this perturbed Tyr pKa. The results suggest that the origin of large energetic perturbations are more complex than suggested by visual inspection. For example, the introduction of positively charged residues near Tyr57 raises its pKa rather than lowers it; this effect, and part of the increase in the Tyr pKa from the introduction of nearby anionic groups, arises from accompanying active-site structural rearrangements. Other mutations with large effects also cause structural perturbations or appear to displace a structured water molecule that is part of a stabilizing hydrogen-bond network. Our results lead to a model in which three hydrogen bonds are donated to the stabilized ionized Tyr, with these hydrogen-bond donors, two Tyr side chains, and a water molecule positioned by other side chains and by a water-mediated hydrogen-bond network. These results support the notion that large energetic effects are often the consequence of multiple stabilizing interactions rather than a single dominant interaction. Most generally, this work provides a case study for how extensive and comprehensive comparisons via site-directed mutagenesis in a tight feedback loop with structural analysis can greatly facilitate our understanding of enzyme active-site energetics. The extensive data set provided may also be a valuable resource for those wishing to extensively test computational approaches for determining enzymatic pKa values and energetic effects.

Uncovering the Determinants of a Highly Perturbed Tyrosine pKa in the Active Site of Ketosteroid Isomerase†

PubMed Central

Schwans, Jason P.; Sunden, Fanny; Gonzalez, Ana; Tsai, Yingssu; Herschlag, Daniel

2013-01-01

Within the idiosyncratic enzyme active site environment, side chain and ligand pKa values can be profoundly perturbed relative to their values in aqueous solution. Whereas structural inspection of systems has often attributed perturbed pKa values to dominant contributions from placement near to charged groups or within hydrophobic pockets, Tyr57 of a P. putida ketosteroid isomerase (KSI) mutant, suggested to have a pKa perturbed by nearly 4 units to 6.3, is situated within a solvent-exposed active site devoid of cationic side chains, metal ions, or cofactors. Extensive comparisons among 45 variants with mutations in and around the KSI active site, along with protein semi-synthesis, 13C NMR spectroscopy, absorbance spectroscopy, and x-ray crystallography, was used to unravel the basis for this perturbed Tyr pKa. The results suggest that the origin of large energetic perturbations are more complex than suggested by visual inspection. For example, the introduction of positively charged residues near Tyr57 raises its pKa rather than lowers it; this effect, and part of the increase in the Tyr pKa from introduction of nearby anionic groups arise from accompanying active site structural rearrangements. Other mutations with large effects also cause structural perturbations or appear to displace a structured water molecule that is part of a stabilizing hydrogen bond network. Our results lead to a model in which three hydrogen bonds are donated to the stabilized ionized Tyr, with these hydrogen bond donors, two Tyr side chains and a water molecule, positioned by other side chains and by a water-mediated hydrogen bond network. These results support the notion that large energetic effects are often the consequence of multiple stabilizing interactions, rather than a single dominant interaction. Most generally, this work provides a case study for how extensive and comprehensive comparisons via site-directed mutagenesis in a tight feedback loop with structural analysis can greatly facilitate our understanding of enzyme active site energetics. The extensive dataset provided may also be a valuable resource for those wishing to extensively test computational approaches for determining enzymatic pKa values and energetic effects. PMID:24151972

Combined use of alcohol and energy drinks: Dose relationship with self-reported physiological stimulation and sedation side effects.

PubMed

Droste, Nicolas; Peacock, Amy; Bruno, Raimondo; Pennay, Amy; Zinkiewicz, Lucy; Lubman, Dan I; Miller, Peter

2017-08-01

Negative physiological stimulation and sedation side effects are experienced by a significant proportion of consumers who consume alcohol mixed with energy drinks (AmED). Few studies have compared the frequency of side effects between sessions of AmED and sessions of alcohol only within-subject, and none have explored a dose relationship. Explore the occurrence of self-reported physiological stimulant and sedative side effects between sessions of AmED and alcohol only, and at varying ED dosage levels within AmED sessions. A convenience sample of 2953 residents of New South Wales, Australia completed an online survey. N=731 AmED users reported daily caffeine intake, typical alcohol and AmED consumption, and past 12-month experience of physiological stimulation and sedation side effects during AmED and alcohol only sessions. Within-subject analyses compared occurrence of side effects between session types. Hierarchical binary logistic regression analyses explored the association of ED dose during AmED sessions with the experience of physiological side effects. There were greater odds of most stimulant side effects, and lower odds of sedation side effects, during AmED sessions compared to alcohol only sessions. Compared to one ED, consumption of three or more EDs was significantly associated with the majority of both stimulant and alcohol intoxication side effects after controlling for demographics and consumption covariates. AmED is associated with perceived changes in physiological stimulant and sedation side effects of alcohol. Experience of side effects is positively associated with ED dosage. Future research should account for varying ED dosage, and reflect real world consumption levels. Copyright © 2017 Elsevier Ltd. All rights reserved.

Treatment factors affecting longitudinal quality of life in new onset pediatric epilepsy.

PubMed

Modi, Avani C; Ingerski, Lisa M; Rausch, Joseph R; Glauser, Tracy A

2011-05-01

Recognizing the importance of patient-reported outcomes, this longitudinal, prospective study examined: Changes in health-related quality of life (HRQOL) over seven months following antiepileptic drug (AED) initiation and the relationship of seizures, AED side-effects, and AED type to HRQOL. Parents of 124 children with newly diagnosed epilepsy completed measures of HRQOL and side-effects at each clinic visit. Treatment information was also collected. HRQOL remained stable over time; however, seizures and AED side-effects significantly affected multiple HRQOL domains. Higher seizure activity was associated with decreased Physical HRQOL. Side-effects were negatively associated with all HRQOL domains. Children taking carbamazepine who experienced higher side-effects early in therapy demonstrated declining emotional functioning compared to children experiencing no/some side-effects. AED side-effects, AED type, and seizure frequency were associated with longitudinal HRQOL in children with newly-diagnosed epilepsy. Routine assessment of AED side-effects and HRQOL may be useful for clinical decision making.

Screening and characterization of selected drugs having antibacterial potential.

PubMed

Javed, Hina; Tabassum, Sobia; Erum, Shazia; Murtaza, Iram; Muhammad, Aish; Amin, Farhana; Nisar, Muhammad Farrukh

2018-05-01

Due to ever increasing antibiotic resistance offered by pathogenic bacterial strains and side effects of synthetic antibiotics, thereof, there is a need to explore the effective phytochemicals from natural resources. In order to help overcoming the problem of effective natural drug and the side effects posed by the use of the synthetic drugs, five different plants namely Thymus vulgaris, Lavandula angustifolia, Rosmarinus officinalis, Cymbopogon citratus and Achillea millefolium were selected to study their antibacterial potential. Antibacterial activity and minimum inhibitory concentration (MIC) checked against the selected bacterial strains. As compared to other test plants, ethanolic extract of Rosmarinus officinalis leaves showed the most promising inhibitory effect i.e: inhibition zone (18.17± 0.44mm) against Klebsiella pneumoniae and the lowest inhibition (15.5±0.29mm) against Pseudomonas aeruginosa and Escherichia coli (p<0.05). The MIC values were recorded in the range of 1 to 20mg/ml. Screening of the selected extracts for the test plants additionally indicate some unique variations. Results were further confirmed through TLC for alkaloids and terpenoids (15% sulphuric acid and Dragedroff's reagent) in ethanolic extract. Characterization of Rosmarinus officinalis of ethanolic extract was carried out using column chromatography. The appearance of orange crystals may indicate the presence of alkaloidal bioactive compounds which need to be further investigated. The tested plants may have a potential for fighting against some infectious diseases caused by selected human pathogenic bacterial strains. This knowledge may incite a gateway to effective drug search and so on.

Near East/South Asia Report.

DTIC Science & Technology

1987-01-30

nuclear institute of agriculture and Biology , Faisalabad,’ Pakistan Council of Research in Water Resource, "Islamabad. The former organisation...Irrigation, Drainage and Flood Con- trol Research Council, to provide support on researh side to WAPDA and other Federal and provincial

[Treatment side effects and compliance in patients with depression].

PubMed

Petrova, N N; Kucher, E O

2012-01-01

The impact of treatment side-effects on the compliance was studied in 85 depressive patients with different mental disorders - recurrent depressive disorder, postschizophrenic depression and organic affective disorder. The comparison of objective and subjective evaluations of compliance and a comparative analysis of the level of compliance, with its dependence on the treatment specifics, in different diseases were done. A significant role of efficacy and treatment side-effects was identified. The levels of "mental" and "autonomous" side-effects were highest in the treatment of depression: patients with postschizophrenic depression had the highest risk in respect of maintenance treatment; patients with recurrent depressive disorder and organic (affective) disorder were more tolerant to the treatment side-effects and their treatment, including the maintenance therapy, was rather effective. The compliance of all patients with depression was negatively correlated with the severity of side-effects of pharmacotherapy. The greatest side-effects and the lowest level of compliance were observed in the complex treatment with antidepressants and atypical neuroleptics. The effect of side-effects on the compliance was dependent on their severity and subjective tolerability and, to a lesser extent, on the amount of drugs.

Bandwidth and Detection of Packet Length Covert Channels

DTIC Science & Technology

2011-03-01

Shared Resource Matrix ( SRM ): Develop a matrix of all resources on one side and on the other all the processes. Then, determine which process uses which...system calls. This method is similar to that of the SRM . Covert channels have also been created by modulating packet timing, data and headers of net- work...analysis, noninterference analysis, SRM method, and the covert flow tree method [4]. These methods can be used during the design phase of a system. Less

Projections of Demand for Waterborne Transportation, Ohio River Basin, 1980, 1990, 2000, 2020, 2040. Volume 1. Study Summary.

DTIC Science & Technology

1980-12-01

NOTES 3 19. KEY WORDS (Continue on revere side If n.cessary d Identify by block number) Bulk cargo Market demand analysis Commodity resource inventory...The study included a Commodity Resource Inventory, a Modal Split Analysis and a Market Demand Analysis. The work included investigation and analyses...inventory, a modal split analysis and a market demand analysis. The work included investigation and analyses of the production, transportation, and

Sustainable water services and interaction with water resources in Europe and in Brazil

NASA Astrophysics Data System (ADS)

Barraqué, B.; Formiga Johnsson, R. M.; Britto, A. L.

2007-09-01

The increasing interaction between large cities and nature makes "urban water" an issue: water resources and water services - including public water supply, sewage collection and treatment, and in large cities, storm water control -, which had become separate issues thanks to the process of water transport and treatment technologies, are now increasingly interfering with each other. We cannot take nature for granted anymore, and we need to protect water resources, if only to reduce the long term cost of transporting and treating water. In this paper, we compare the historical development of water industry technologies in European and Brazilian metropolitan areas, in their socio-economic and political context, tracing it through three "ages" of water technology and services which developed under civil engineering, sanitary engineering, and environmental engineering perspectives: the "quantity of water" and civil engineering paradigm was developed on the assumption that water should be drawn from natural environments far from the cities; in the "water quality" and chemical/sanitation engineering paradigm, water treatment was invented and allowed cities to take water from rivers closer to them and treat it, but also to reduce sewer discharge impacts; finally, the environmental engineering paradigm proposes to overcome the supply side perspective, by introducing demand side management, water conservation, water allocation flexibilisation, and an integrated approach to water services, water resources management, and land use policies.

Differential Brain Activation to Angry Faces by Elite Warfighters: Neural Processing Evidence for Enhanced Threat Detection

PubMed Central

Paulus, Martin P.; Simmons, Alan N.; Fitzpatrick, Summer N.; Potterat, Eric G.; Van Orden, Karl F.; Bauman, James; Swain, Judith L.

2010-01-01

Background Little is known about the neural basis of elite performers and their optimal performance in extreme environments. The purpose of this study was to examine brain processing differences between elite warfighters and comparison subjects in brain structures that are important for emotion processing and interoception. Methodology/Principal Findings Navy Sea, Air, and Land Forces (SEALs) while off duty (n = 11) were compared with n = 23 healthy male volunteers while performing a simple emotion face-processing task during functional magnetic resonance imaging. Irrespective of the target emotion, elite warfighters relative to comparison subjects showed relatively greater right-sided insula, but attenuated left-sided insula, activation. Navy SEALs showed selectively greater activation to angry target faces relative to fearful or happy target faces bilaterally in the insula. This was not accounted for by contrasting positive versus negative emotions. Finally, these individuals also showed slower response latencies to fearful and happy target faces than did comparison subjects. Conclusions/Significance These findings support the hypothesis that elite warfighters deploy greater processing resources toward potential threat-related facial expressions and reduced processing resources to non-threat-related facial expressions. Moreover, rather than expending more effort in general, elite warfighters show more focused neural and performance tuning. In other words, greater neural processing resources are directed toward threat stimuli and processing resources are conserved when facing a nonthreat stimulus situation. PMID:20418943

Exploring the associations between drug side-effects and therapeutic indications.

PubMed

Wang, Fei; Zhang, Ping; Cao, Nan; Hu, Jianying; Sorrentino, Robert

2014-10-01

Drug therapeutic indications and side-effects are both measurable patient phenotype changes in response to the treatment. Inferring potential drug therapeutic indications and identifying clinically interesting drug side-effects are both important and challenging tasks. Previous studies have utilized either chemical structures or protein targets to predict indications and side-effects. In this study, we compared drug therapeutic indication prediction using various information including chemical structures, protein targets and side-effects. We also compared drug side-effect prediction with various information sources including chemical structures, protein targets and therapeutic indication. Prediction performance based on 10-fold cross-validation demonstrates that drug side-effects and therapeutic indications are the most predictive information source for each other. In addition, we extracted 6706 statistically significant indication-side-effect associations from all known drug-disease and drug-side-effect relationships. We further developed a novel user interface that allows the user to interactively explore these associations in the form of a dynamic bipartitie graph. Many relationship pairs provide explicit repositioning hypotheses (e.g., drugs causing postural hypotension are potential candidates for hypertension) and clear adverse-reaction watch lists (e.g., drugs for heart failure possibly cause impotence). All data sets and highly correlated disease-side-effect relationships are available at http://astro.temple.edu/∼tua87106/druganalysis.html. Copyright © 2014 Elsevier Inc. All rights reserved.

Parental Expectation of Side Effects Following Vaccination Is Self-fulfilling: A Prospective Cohort Study.

PubMed

Smith, Louise E; Weinman, John; Amlôt, Richard; Yiend, Jenny; Rubin, G James

2018-06-02

One of the major factors contributing to parental refusal of vaccinations is the perception that vaccines cause side effects. Although symptoms are commonly reported following vaccinations, their causes are not always straightforward. Although some may be directly attributable to the vaccine itself, others may reflect pre-existing or coincidental symptoms that are misattributed to the vaccine. To investigate psychological factors associated with parental report of side effects following vaccination with the child influenza vaccine, and parental intention to re-vaccinate one's child the following year. A prospective cohort study was run in primary care practices in London in the 2016-2017 influenza season (ClinicalTrials.gov number NCT02909855). Two hundred seventy parents from 14 practices completed a questionnaire before their child's vaccination. Follow-up questionnaires were completed 3 days after vaccination and one month after vaccination. Parental report of side effects and vaccination intention for the subsequent year were measured. Parental report of side effects was strongly associated with pre-vaccination expectation of side effects. Suggestions received from the media, National Health Service (NHS) vaccination leaflet, and health care workers, as well as uncertainty-related beliefs, perceived sensitivity of the child to medicines, pessimism, and anxiety were also associated with reporting side effects. Side effect report was associated with lower vaccination intention for the following influenza season. Side effect perception following vaccination is influenced by psychological factors, in particular expectations. Perceiving side effects reduces future vaccination intention. Future public health communications should aim to decrease unrealistic expectations of side effects to increase vaccine uptake.

Pharmacogenomic and clinical data link non-pharmacokinetic metabolic dysregulation to drug side effect pathogenesis

PubMed Central

Zielinski, Daniel C.; Filipp, Fabian V.; Bordbar, Aarash; Jensen, Kasper; Smith, Jeffrey W.; Herrgard, Markus J.; Mo, Monica L.; Palsson, Bernhard O.

2015-01-01

Drug side effects cause a significant clinical and economic burden. However, mechanisms of drug action underlying side effect pathogenesis remain largely unknown. Here, we integrate pharmacogenomic and clinical data with a human metabolic network and find that non-pharmacokinetic metabolic pathways dysregulated by drugs are linked to the development of side effects. We show such dysregulated metabolic pathways contain genes with sequence variants affecting side effect incidence, play established roles in pathophysiology, have significantly altered activity in corresponding diseases, are susceptible to metabolic inhibitors and are effective targets for therapeutic nutrient supplementation. Our results indicate that metabolic dysregulation represents a common mechanism underlying side effect pathogenesis that is distinct from the role of metabolism in drug clearance. We suggest that elucidating the relationships between the cellular response to drugs, genetic variation of patients and cell metabolism may help managing side effects by personalizing drug prescriptions and nutritional intervention strategies. PMID:26055627

Radiation Therapy Side Effects

Cancer.gov

Radiation therapy has side effects because it not only kills or slows the growth of cancer cells, it can also affect nearby healthy cells. Many people who get radiation therapy experience fatigue. Other side effects depend on the part of the body that is being treated. Learn more about possible side effects.

Influence of opioid-related side effects on disability, mood, and opioid misuse risk among patients with chronic pain in primary care.

PubMed

Jamison, Robert N; Dorado, Kathleen; Mei, Anna; Edwards, Robert R; Martel, Marc O

2017-03-01

There is increasing concern among primary care practitioners about the use of opioids for chronic pain, including their adverse effects, but little attention has been given to how reports of side effects from prescription medication can contribute to outcomes among patients with chronic pain. The aim of this study was to investigate the impact of frequently reported side effects on mood, disability, and opioid misuse in patients with chronic pain prescribed opioids within primary care. Two hundred (N = 200) patients with chronic pain taking opioids for pain were recruited into the study. All patients completed baseline measures and a monthly side effects checklist once a month for 6 months. Patients were divided evenly based on a median split of the number of endorsed side effects over 6 months. The subjects repeated the baseline measures at the end of the study period. Over time, reports of medication side effects tended to decrease, but differences in frequency of reported side effects from baseline to follow-up (6-month time) were not significant, and the order of the frequency of the reported side effects remained similar. Patients who reported significant medication-related adverse effects reported significantly greater activity interference, negative affect, and catastrophizing compared with those with fewer side effects ( P < 0.01). In addition, those patients with pain who reported more side effects showed significantly higher scores on opioid misuse risk ( P < 0.001). This study demonstrates the important role of monitoring medication-related side effects among patients with chronic pain who are prescribed opioid medication for pain within primary care.

Influence of opioid-related side effects on disability, mood, and opioid misuse risk among patients with chronic pain in primary care

PubMed Central

Jamison, Robert N.; Dorado, Kathleen; Mei, Anna; Edwards, Robert R.; Martel, Marc O.

2017-01-01

Abstract Background: There is increasing concern among primary care practitioners about the use of opioids for chronic pain, including their adverse effects, but little attention has been given to how reports of side effects from prescription medication can contribute to outcomes among patients with chronic pain. The aim of this study was to investigate the impact of frequently reported side effects on mood, disability, and opioid misuse in patients with chronic pain prescribed opioids within primary care. Methods: Two hundred (N = 200) patients with chronic pain taking opioids for pain were recruited into the study. All patients completed baseline measures and a monthly side effects checklist once a month for 6 months. Patients were divided evenly based on a median split of the number of endorsed side effects over 6 months. The subjects repeated the baseline measures at the end of the study period. Results: Over time, reports of medication side effects tended to decrease, but differences in frequency of reported side effects from baseline to follow-up (6-month time) were not significant, and the order of the frequency of the reported side effects remained similar. Patients who reported significant medication-related adverse effects reported significantly greater activity interference, negative affect, and catastrophizing compared with those with fewer side effects (P < 0.01). In addition, those patients with pain who reported more side effects showed significantly higher scores on opioid misuse risk (P < 0.001). Discussion: This study demonstrates the important role of monitoring medication-related side effects among patients with chronic pain who are prescribed opioid medication for pain within primary care. PMID:29392205

MX Siting Investigation. Water Resources Program, Technical Summary Report. Volume IIA.

DTIC Science & Technology

1981-11-30

Block 20. it dilfe.ent from Report) L (.TN IS. SUPPLEMENTARY NOTES 19. KEY WORDS (Continue on reserse side It necessary amd Identify by block number...Sv .,zt 2*O:LI-y lo’.L1 _ XI e A.I p .*.",//. / /V_ , 20. ABSTRACT (Conitnuo on reverese side It necessary end idenLiy by b)ock number...51-II A-I WELL AND SPRING NUMBERING SYSTEM-NEVADA The numbering system for wells and springs in this report is based on the rectangular subdivision of

Side effects of low-dose pyridostigmine bromide are not related to cholinesterase inhibition.

PubMed

Cook, M R; Gerkovich, M M; Sastre, A; Graham, C

2001-12-01

Pretreatment with pyridostigmine bromide (PB) has become part of standard military procedures for protection against the effects of possible chemical warfare attack. The purpose of the work reported here was to quantify the type, intensity and frequency of side effects of low-dose PB, and to examine factors that predict the intensity and frequency of side effects. A double-blind, cross-over, placebo (PL)-controlled design was used. Of the 67 subjects, 33 received 30 mg PB every 8 h for 13 doses, and 34 received 60 mg on the same schedule. Order of PB and PL administration was counterbalanced. Overall, side effects were mild, even at the 60-mg dose level. More side effects were reported when volunteers were taking PB than when they were taking placebo. Women reported more symptoms than men. Neither cholinesterase inhibition nor plasma levels of PB predicted side effect scores during the PB week; the best predictor of side effect scores during the PB week was side effect scores during the PL week. PB is well tolerated by healthy young people, even when twice the recommended military dose is administered.

Air Pollution and Control Legislation in India

NASA Astrophysics Data System (ADS)

P Bhave, Prashant; Kulkarni, Nikhil

2015-09-01

Air pollution in urban areas arises from multiple sources, which may vary with location and developmental activities. Anthropogenic activities as rampant industrialization, exploitation and over consumption of natural resources, ever growing population size are major contributors of air pollution. The presented review is an effort to discuss various aspects of air pollution and control legislation in India emphasizing on the history, present scenario, international treaties, gaps and drawbacks. The review also presents legislative controls with judicial response to certain landmark judgments related to air pollution. The down sides related to enforcement mechanism for the effective implementation of environmental laws for air pollution control have been highlighted.

Recycling strategy of the end-of-life rolling stock in China

NASA Astrophysics Data System (ADS)

Guo, L.; Wang, X. W.; Lin, Y.; Shen, X. F.; Liu, Y. Q.

2018-03-01

China's high-speed railway industry is growing fast, the side effect is that plenty of rolling stock come to the end of life each year. However, there are not relevant standards nor regulations for the recycling of rolling stock in China, which causes pollution and a waste of resources. In this paper, the basic meaning and characteristics of the circular economy is reviewed and applied to the rolling stock industry. The recycling steps are elaborated in detail according to the characteristics of rolling stock. The result proves that circular economy has both the theoretical and practical meaning in the rolling stock recycling industry in China.

Exploring the relationship between planning and procurement in Western U.S. electric utilities

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

Carvallo Bodelon, Juan Pablo; Sanstad, Alan H.; Larsen, Peter H.

Integrated resource planning (IRP) is an important regulatory process used in many U.S. states to formulate and evaluate least-cost and risk-assessed portfolios to meet future load requirements for electric utilities. In principle, effective implementation of IRP seeks to assure regulators and the public that utility investment decisions, given uncertainty, are as cost-effective as possible. However, to date, there is no empirical assessment on the effectiveness of IRP implementation. In this analysis, we compare planning, procurement processes and actual decisions for a sample of twelve load serving entities (LSEs) across the Western U. S. from 2003-2014. The 2008/2009 recession provides amore » unique “stress test” to the planning process and offers an excellent opportunity to trace how procurement decisions responded to this largely unforeseen event. In aggregate, there is a general alignment between planned and procured supply-side capacity. However, there are significant differences in the choice of supply-side resources and type of ownership for individual LSEs. We develop case studies for three LSEs and find that subsequent plans differ significantly due to changes in the planning environment and that procurement decisions in some cases are impacted by factors that are not accounted for in the planning process. Our results reveal that a limited amount of information produced during the long-term planning process (e.g., forecasts, methods, and least cost/risk portfolios) are ultimately used during the procurement process, and that the latter process relies extensively on the most recent information available for decision making. These findings suggest that states' IRP rules and regulations mandating long-term planning horizons with the same analytical complexity throughout the planning period may not create useful information for the procurement process. The social value of a long-term planning process that departs from procurement and the balance between transparency and complexity of the planning and procurement processes is an open question.« less

Factors affecting patient's perception of anticancer treatments side-effects: an observational study.

PubMed

Russo, Stefania; Cinausero, Marika; Gerratana, Lorenzo; Bozza, Claudia; Iacono, Donatella; Driol, Pamela; Deroma, Laura; Sottile, Roberta; Fasola, Gianpiero; Puglisi, Fabio

2014-02-01

Analysis of relative importance of side effects of anticancer therapy is extremely useful in the process of clinical decision making. There is evidence that patients' perception of the side effects of anticancer treatments changes over time. Aim of this study was to evaluate the cancer patients' perceptions of physical and non-physical side effects of contemporary anticancer therapy. Four hundred and sixty-four patients entered the study (153 men and 311 women). Participants were asked to rank their side effects in order of distress by using two sets of cards naming physical and non-physical effects, respectively. Influencing factors, including treatment and patient characteristics, were also analysed. Patients ranked the non-physical side effect 'Affects my family or partner' first. 'Constantly tired' and 'Loss of hair' were ranked second and third, respectively. Significant differences from previous studies on this topic emerged. In particular, 'Vomiting', a predominant concern in previous studies, almost disappeared, whereas 'Nausea' and 'Loss of hair' remained important side effects in the patients' perception. Interestingly, marital status was predominant in driving patients' perception, being associated with several side effects ('Constantly tired', 'Loss of appetite', 'Affects my work/Home duties', 'Affects my social activities', 'Infertility'). Other significant factors influencing patient's perception of side effects included age, disease characteristics and ongoing anticancer therapy. This study provided information on current status of patients' perceptions of side effects of anticancer treatment. These results could be used in pre-treatment patient education and counselling.

Perceived risk of tamoxifen side effects: a study of the use of absolute frequencies or frequency bands, with or without verbal descriptors.

PubMed

Knapp, Peter; Gardner, Peter H; Raynor, David K; Woolf, Elizabeth; McMillan, Brian

2010-05-01

To investigate the effectiveness of presenting medicine side effect risk information in different forms, including that proposed by UK guidelines [[1] Medicines and Healthcare products Regulatory Agency. Always read the leaflet-Getting the best information with every medicine. (Report of the Committee on Safety of Medicines Working Group on Patient Information). London: The Stationery Office, 2005.]. 134 Cancer Research UK (CRUK) website users were recruited via a 'pop-up'. Using a 2x2 factorial design, participants were randomly allocated to one of four conditions and asked to: imagine they had to take tamoxifen, estimate the risks of 4 side effects, and indicate a presentation mode preference. Those presented with absolute frequencies demonstrated greater accuracy in estimating 2 of 4 side effects, and of any side effect occurring, than those presented with frequency bands. Those presented with combined descriptors were more accurate at estimating the risk of pulmonary embolism than those presented with numeric descriptors only. Absolute frequencies outperform frequency bands when presenting side effect risk information. However, presenting such exact frequencies for every side effect may be much less digestible than all side effects listed under 5 frequency bands. Combined numerical and verbal descriptors may be better than numeric only descriptors when describing infrequent side effects. Information about side effects should be presented in ways that patients prefer, and which result in most accurate risk estimates. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

Lower East Side Tenement National Historic Site Amendments Act

THOMAS, 113th Congress

Rep. Velazquez, Nydia M. [D-NY-7

2013-05-07

Senate - 12/09/2013 Received in the Senate and Read twice and referred to the Committee on Energy and Natural Resources. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

Medication Side Effects among People with Epilepsy Taking Phenobarbital in Zambia

PubMed Central

Elafros, Melissa A.; Bui, Esther; Birbeck, Gretchen L.

2014-01-01

Phenobarbital remains one of the most widely used antiepileptic drugs worldwide, yet there are limited data regarding side effects associated with its use in routine clinical care settings in low-income countries. Available data suggests that phenobarbital is as effective as other first-line drugs for treating tonic-clonic seizures, but side effect reports differ widely between high and low-income settings. A better understanding of phenobarbital side effect profile and severity in low-income settings is warranted given its role in efforts to decrease the epilepsy treatment gap. We used the Liverpool Adverse Events Profile (LEAP) to assess side effects in consecutive patients with epilepsy on phenobarbital seeking care in rural Zambia. Data regarding age, gender, medication dose, and medication adherence were also collected. T-tests and Spearman’s correlation coefficient were used to assess predictors of LEAP score and medication adherence. Thirty-five patients receiving a mean dose of 2.1 mg/kg/day (SD: 2.78 mg/kg/day) of phenobarbital were assessed. All participants reported at least one side effect in the previous four weeks with a median of 6 symptoms (IQR: 4–8) and a mean side effects score of 28/76 (SD: 5.38). Over half reported sleepiness and dizziness. Memory problems and depression were also common (both 46%). Total LAEP score was not associated with age (p=0.88), gender (p=0.17), or phenobarbital dose (p=0.13). Medication adherence was not associated with side effects total score (p=0.56). Rural Zambian adults taking phenobarbital at doses recommended by the WHO report a significant number of side effects. The most common side effects reported were similar to those reported in high-income countries. The significant burden of phenobarbital-associated side effects in this African cohort is in contrast to data from non-randomized clinical trials in China that reported phenobarbital to be well-tolerated with few side effects. Additional investigations regarding phenobarbital side effects in routine care in low income settings is warranted. PMID:25219354

Medication side effects among people with epilepsy taking phenobarbital in Zambia.

PubMed

Elafros, Melissa A; Bui, Esther; Birbeck, Gretchen L

2014-11-01

Phenobarbital remains one of the most widely used antiepileptic drugs worldwide, yet there are limited data regarding side effects associated with its use in routine clinical care settings in low-income countries. Available data suggests that phenobarbital is as effective as other first-line drugs for treating tonic-clonic seizures, but side effect reports differ widely between high and low-income settings. A better understanding of phenobarbital side effect profile and severity in low-income settings is warranted given its role in efforts to decrease the epilepsy treatment gap. We used the Liverpool adverse events profile (LEAP) to assess side effects in consecutive patients with epilepsy on phenobarbital seeking care in rural Zambia. Data regarding age, gender, medication dose, and medication adherence were also collected. T-tests and Spearman's correlation coefficient were used to assess predictors of LEAP score and medication adherence. Thirty-five patients receiving a mean dose of 2.1mg/kg/day (SD: 2.78 mg/kg/day) of phenobarbital were assessed. All participants reported at least one side effect in the previous four weeks with a median of 6 symptoms (IQR: 4-8) and a mean side effects score of 28/76 (SD: 5.38). Over half reported sleepiness and dizziness. Memory problems and depression were also common (both 46%). Total LAEP score was not associated with age (p=0.88), gender (p=0.17), or phenobarbital dose (p=0.13). Medication adherence was not associated with side effects total score (p=0.56). Rural Zambian adults taking phenobarbital at doses recommended by the World Health Organization report a significant number of side effects. The most common side effects reported were similar to those reported in high-income countries. The significant burden of phenobarbital-associated side effects in this African cohort is in contrast to data from non-randomized clinical trials in China that reported phenobarbital to be well-tolerated with few side effects. Additional investigations regarding phenobarbital side effects during routine care in low income settings is warranted. Copyright © 2014 Elsevier B.V. All rights reserved.

Reducing Aversion to Side Effects in Preventive Medical Treatment Decisions

ERIC Educational Resources Information Center

Waters, Erika A.; Weinstein, Neil D.; Colditz, Graham A.; Emmons, Karen M.

2007-01-01

Laypeople tend to be overly sensitive to side effects of treatments that prevent illness, possibly leading them to refuse beneficial therapies. This Internet-based study attempted to reduce such side effect aversion by adding graphic displays to the numerical risk probabilities. It also explored whether graphics reduce side effect aversion by…

Estimation of marine mineral resources abundance using back-scattering intensity of Deep-tow Side Scan Sonar

NASA Astrophysics Data System (ADS)

Yoo, C. M.; Joo, J.; Hyeong, K.; Chi, S. B.

2016-12-01

Manganese nodule, also known as polymetallic nodule, contains precious elements in high contents and is regarded as one of the most important future mineral resources. It occurs throughout the world oceans, but economically feasible deposits show limited distribution only in several deepsea basins including Clarion-Clipperton Fracture Zone (CCFZ) in northeast equatorial Pacific. Estimation of resources potential is one of the key factors prerequisite for economic feasibility study. Nodule abundance is commonly estimated from direct nodule sampling, however it is difficult to obtain statistically robust data because of highly variable spatial distribution and high cost of direct sampling. Variogram analysis indicates 3.5×3.5km sampling resolution to obtain indicated category of resources data, which requires over 1,000 sampling operations to cover the potential exploitation area with mining life of 20-30 years. High-resolution acoustic survey, bathymetry and back-scattered intensity, can provide high-resolution resources data with the definition of obstacles, such as faults and scarps, for operation of nodule collecting robots. We operated 120 kHz deep-tow side scan sonar (DTSSS) with spatial resolution of 1×1m in a representative area. Sea floor images were also taken continuously by deep-tow camera from selected tracks, converted to nodule abundance using image analysis program and conversion equation, and compared with acoustic data. Back-scattering intensity values could be divided into several group and translated into nodule abundance with high confidence level. Our result indicates that high resolution acoustic survey is appropriate tool for reliable assessment of manganese nodule abundance and definition of minable area.

Systematic identification of proteins that elicit drug side effects

PubMed Central

Kuhn, Michael; Al Banchaabouchi, Mumna; Campillos, Monica; Jensen, Lars Juhl; Gross, Cornelius; Gavin, Anne-Claude; Bork, Peer

2013-01-01

Side effect similarities of drugs have recently been employed to predict new drug targets, and networks of side effects and targets have been used to better understand the mechanism of action of drugs. Here, we report a large-scale analysis to systematically predict and characterize proteins that cause drug side effects. We integrated phenotypic data obtained during clinical trials with known drug–target relations to identify overrepresented protein–side effect combinations. Using independent data, we confirm that most of these overrepresentations point to proteins which, when perturbed, cause side effects. Of 1428 side effects studied, 732 were predicted to be predominantly caused by individual proteins, at least 137 of them backed by existing pharmacological or phenotypic data. We prove this concept in vivo by confirming our prediction that activation of the serotonin 7 receptor (HTR7) is responsible for hyperesthesia in mice, which, in turn, can be prevented by a drug that selectively inhibits HTR7. Taken together, we show that a large fraction of complex drug side effects are mediated by individual proteins and create a reference for such relations. PMID:23632385

Prediction of Central Nervous System Side Effects Through Drug Permeability to Blood-Brain Barrier and Recommendation Algorithm.

PubMed

Fan, Jun; Yang, Jing; Jiang, Zhenran

2018-04-01

Drug side effects are one of the public health concerns. Using powerful machine-learning methods to predict potential side effects before the drugs reach the clinical stages is of great importance to reduce time consumption and protect the security of patients. Recently, researchers have proved that the central nervous system (CNS) side effects of a drug are closely related to its permeability to the blood-brain barrier (BBB). Inspired by this, we proposed an extended neighborhood-based recommendation method to predict CNS side effects using drug permeability to the BBB and other known features of drug. To the best of our knowledge, this is the first attempt to predict CNS side effects considering drug permeability to the BBB. Computational experiments demonstrated that drug permeability to the BBB is an important factor in CNS side effects prediction. Moreover, we built an ensemble recommendation model and obtained higher AUC score (area under the receiver operating characteristic curve) and AUPR score (area under the precision-recall curve) on the data set of CNS side effects by integrating various features of drug.

An Ensemble Approach for Drug Side Effect Prediction

PubMed Central

Jahid, Md Jamiul; Ruan, Jianhua

2014-01-01

In silico prediction of drug side-effects in early stage of drug development is becoming more popular now days, which not only reduces the time for drug design but also reduces the drug development costs. In this article we propose an ensemble approach to predict drug side-effects of drug molecules based on their chemical structure. Our idea originates from the observation that similar drugs have similar side-effects. Based on this observation we design an ensemble approach that combine the results from different classification models where each model is generated by a different set of similar drugs. We applied our approach to 1385 side-effects in the SIDER database for 888 drugs. Results show that our approach outperformed previously published approaches and standard classifiers. Furthermore, we applied our method to a number of uncharacterized drug molecules in DrugBank database and predict their side-effect profiles for future usage. Results from various sources confirm that our method is able to predict the side-effects for uncharacterized drugs and more importantly able to predict rare side-effects which are often ignored by other approaches. The method described in this article can be useful to predict side-effects in drug design in an early stage to reduce experimental cost and time. PMID:25327524

The side-effects to CPAP treatment inventory: the development and initial validation of a new tool for the measurement of side-effects to CPAP treatment.

PubMed

Broström, Anders; Arestedt, Kristofer Franzén; Nilsen, Per; Strömberg, Anna; Ulander, Martin; Svanborg, Eva

2010-12-01

Continuous positive airway pressure (CPAP) is the treatment of choice for obstructive sleep apnoea syndrome (OSAS), but side-effects are common. No validated self-rating scale measuring side-effects to CPAP treatment exists today. The aim was to develop the side-effects to CPAP treatment inventory (SECI), and investigate the validity and reliability of the instrument among patients with OSAS. SECI was developed on the basis of: (1) in-depth interviews with 23 patients; (2) examination of the scientific literature and (3) consensus agreement of a multi-professional expert panel. This yielded 15 different types of side-effects related to CPAP treatment. Each side-effect has three sub-questions (scales): perceived frequency (a) and magnitude (b) of the side-effect, as well as its perceived impact on CPAP use (c). A cross-sectional descriptive design was used. A total of 329 patients with OSAS with an average use of CPAP treatment for 39 months (2 weeks to 182 months) were recruited. Data were collected with SECI, and obtained from medical records (clinical variables and data related to CPAP treatment). Construct validity was confirmed with factor analysis (principal component analysis with orthogonal rotation). A logical two-factor solution, the device subscale and symptom subscale, emerged across all three scales. The symptom subscale describing physical and psychological side-effects and the device subscale described mask and device-related side-effects. Internal consistency reliability of the three scales was good (Cronbach's α = 0.74-0.86) and acceptable for the subscales (Cronbach's α = 0.62-0.86). The satisfactory measurement properties of this new instrument are promising and indicate that SECI can be used to measure side-effects to CPAP treatment. © 2010 European Sleep Research Society.

GILA WILDERNESS, NEW MEXICO.

USGS Publications Warehouse

Ratte, James C.; Stotelmeyer, Ronald B.

1984-01-01

Geologic, geochemical and geophysical indicators delineated during a study of the Gila Wilderness, New Mexico indicate that there are areas of probable and substantiated mineral-resource potential for gold, silver, tellurium, molybdenum, copper, lead, zinc, and fluorite. The areas which have resource potential lie along both sides of the western and southwestern boundaries of the wilderness, and adjacent to the access corridor to the Gila Cliff Dwellings National Monument in the eastern part of the wilderness. Areas marked by geothermal springs along Turkey Creek and Middle Fork of the Gila River have a probable potential for geothermal energy. No other energy-resource potential was identified within the study area.

From "Special K" to "Special M": the evolution of the recreational use of ketamine and methoxetamine.

PubMed

Corazza, Ornella; Assi, Sulaf; Schifano, Fabrizio

2013-06-01

This article reviews the recreational use of ketamine ("Special K"; KET) and explores the recent diffusion of its new derivative methoxetamine ("Special M"; MXE). The literature search on the nonclinical/recreational use of KET and MXE was carried out in a range of medical databases. Considering the limitations of peer-reviewed information, data were integrated with a qualitative assessment of a range of websites, drug fora, and other online resources including e-newsgroups, chat rooms, mailing lists, e-newsletters, and bulletin boards. The recreational use of KET has started since its discovery in 1962. This was due to its rapid onset, short duration of action, and peculiar psychotropic effects ("K-hole"). The latter effect ranges from confusion to dissociation and depersonalization (near-death experience). However, KET abuse is often associated with physical and psychological side effects, of which the worst is urological/bladder toxicity. Recently, MXE has emerged as a legal and "bladder-friendly" KET alternative. MXE presents with the same dissociative effect of KET, but with slower onset and longer duration of action. However, MXE seems to be associated with worse side effects than KET, ranging from mood disturbances/suicidal attempts to acute cerebellar toxicity. After 50 years of its discovery, KET has led to the emergence of MXE. However, this latter derivative does not appear to be a safer alternative to KET itself. © 2013 John Wiley & Sons Ltd.

Saudi medicinal plants for the treatment of scorpion sting envenomation.

PubMed

Al-Asmari, Abdulrahman; Manthiri, Rajamohamed Abbas; Abdo, Nasreddien; Al-Duaiji, Fawzi Abdullah; Khan, Haseeb Ahmad

2017-09-01

Scorpion sting envenoming poses major public health problems. The treatment modalities include antivenoms, chemical antidotes and phytotherapy, with varying degrees of effectiveness and side effects. In this investigation, we reviewed the use of Saudi medicinal plants for the treatment of scorpion sting patients. The relevant literature was collected using the online search engines including Science Direct, Google and PubMed with the help of specific keywords. We also used the printed and online resources at our institutional library to gather the relevant information on the use of medicinal plants for the treatment of scorpion sting patients. A descriptive statistics was used for data compilation and presentation. The results of this survey showed the use of at least 92 medicinal plants with beneficial effects for treating victims of stings of different scorpion species. These commonly used herbs spanned to 37 families whilst different parts of these plants were employed therapeutically for alleviation of envenomation symptoms. The application of leaves (41%) was preferred followed by roots (19%), whole plant (14%) and seeds (9%). The use of latex (4%), stem (3%), flowers (3%) and bark (3%) was also reported. In some cases, tannin (2%), rhizome (1%) and shoot (1%) were also used. In conclusion, herbal medicines are effectively used for the treatment of patients with scorpion envenomation. This type of medication is free from side effects as observed with chemical antidotes or antivenom therapy. It is important to identify the active ingredients of herbal drugs for improving their therapeutic potential in traditional medicine.

Where to Find It. Information Resource Centers, ’A Quick Reference Booklet’,

DTIC Science & Technology

1983-09-01

BROWN SEP 83 UNCLASSIFIED F,’G 5 /2 N EEmhohmoEEoiI I lw lll.f... LEE .. 5 .. 0 .L 1L. IL 1111L5 111111.4 1 6 MICROCOPY RESOLUTION TEST CHART NATIONAL...KEY WORDS (Continue on reverse side it necessay and identiy by block num~ber) Information, Find, Data, and Resource. 5 24L AfNrAC? (Cmhueen erm a t... 5 Central Intelligence Agency (CIA) Publications ............... 6 Data Item Description (DID) .................................. 7 Defense

Getting the Most out of PubChem for Virtual Screening

PubMed Central

Kim, Sunghwan

2016-01-01

Introduction With the emergence of the “big data” era, the biomedical research community has great interest in exploiting publicly available chemical information for drug discovery. PubChem is an example of public databases that provide a large amount of chemical information free of charge. Areas covered This article provides an overview of how PubChem’s data, tools, and services can be used for virtual screening and reviews recent publications that discuss important aspects of exploiting PubChem for drug discovery. Expert opinion PubChem offers comprehensive chemical information useful for drug discovery. It also provides multiple programmatic access routes, which are essential to build automated virtual screening pipelines that exploit PubChem data. In addition, PubChemRDF allows users to download PubChem data and load them into a local computing facility, facilitating data integration between PubChem and other resources. PubChem resources have been used in many studies for developing bioactivity and toxicity prediction models, discovering polypharmacologic (multi-target) ligands, and identifying new macromolecule targets of compounds (for drug-repurposing or off-target side effect prediction). These studies demonstrate the usefulness of PubChem as a key resource for computer-aided drug discovery and related area. PMID:27454129

Multimodel assessment of water scarcity under climate change.

PubMed

Schewe, Jacob; Heinke, Jens; Gerten, Dieter; Haddeland, Ingjerd; Arnell, Nigel W; Clark, Douglas B; Dankers, Rutger; Eisner, Stephanie; Fekete, Balázs M; Colón-González, Felipe J; Gosling, Simon N; Kim, Hyungjun; Liu, Xingcai; Masaki, Yoshimitsu; Portmann, Felix T; Satoh, Yusuke; Stacke, Tobias; Tang, Qiuhong; Wada, Yoshihide; Wisser, Dominik; Albrecht, Torsten; Frieler, Katja; Piontek, Franziska; Warszawski, Lila; Kabat, Pavel

2014-03-04

Water scarcity severely impairs food security and economic prosperity in many countries today. Expected future population changes will, in many countries as well as globally, increase the pressure on available water resources. On the supply side, renewable water resources will be affected by projected changes in precipitation patterns, temperature, and other climate variables. Here we use a large ensemble of global hydrological models (GHMs) forced by five global climate models and the latest greenhouse-gas concentration scenarios (Representative Concentration Pathways) to synthesize the current knowledge about climate change impacts on water resources. We show that climate change is likely to exacerbate regional and global water scarcity considerably. In particular, the ensemble average projects that a global warming of 2 °C above present (approximately 2.7 °C above preindustrial) will confront an additional approximate 15% of the global population with a severe decrease in water resources and will increase the number of people living under absolute water scarcity (<500 m(3) per capita per year) by another 40% (according to some models, more than 100%) compared with the effect of population growth alone. For some indicators of moderate impacts, the steepest increase is seen between the present day and 2 °C, whereas indicators of very severe impacts increase unabated beyond 2 °C. At the same time, the study highlights large uncertainties associated with these estimates, with both global climate models and GHMs contributing to the spread. GHM uncertainty is particularly dominant in many regions affected by declining water resources, suggesting a high potential for improved water resource projections through hydrological model development.

Multimodel assessment of water scarcity under climate change

PubMed Central

Schewe, Jacob; Heinke, Jens; Gerten, Dieter; Haddeland, Ingjerd; Arnell, Nigel W.; Clark, Douglas B.; Dankers, Rutger; Eisner, Stephanie; Fekete, Balázs M.; Colón-González, Felipe J.; Gosling, Simon N.; Kim, Hyungjun; Liu, Xingcai; Masaki, Yoshimitsu; Portmann, Felix T.; Satoh, Yusuke; Stacke, Tobias; Tang, Qiuhong; Wada, Yoshihide; Wisser, Dominik; Albrecht, Torsten; Frieler, Katja; Piontek, Franziska; Warszawski, Lila; Kabat, Pavel

2014-01-01

Water scarcity severely impairs food security and economic prosperity in many countries today. Expected future population changes will, in many countries as well as globally, increase the pressure on available water resources. On the supply side, renewable water resources will be affected by projected changes in precipitation patterns, temperature, and other climate variables. Here we use a large ensemble of global hydrological models (GHMs) forced by five global climate models and the latest greenhouse-gas concentration scenarios (Representative Concentration Pathways) to synthesize the current knowledge about climate change impacts on water resources. We show that climate change is likely to exacerbate regional and global water scarcity considerably. In particular, the ensemble average projects that a global warming of 2 °C above present (approximately 2.7 °C above preindustrial) will confront an additional approximate 15% of the global population with a severe decrease in water resources and will increase the number of people living under absolute water scarcity (<500 m3 per capita per year) by another 40% (according to some models, more than 100%) compared with the effect of population growth alone. For some indicators of moderate impacts, the steepest increase is seen between the present day and 2 °C, whereas indicators of very severe impacts increase unabated beyond 2 °C. At the same time, the study highlights large uncertainties associated with these estimates, with both global climate models and GHMs contributing to the spread. GHM uncertainty is particularly dominant in many regions affected by declining water resources, suggesting a high potential for improved water resource projections through hydrological model development. PMID:24344289

Relating drug–protein interaction network with drug side effects

PubMed Central

Mizutani, Sayaka; Pauwels, Edouard; Stoven, Véronique; Goto, Susumu; Yamanishi, Yoshihiro

2012-01-01

Motivation: Identifying the emergence and underlying mechanisms of drug side effects is a challenging task in the drug development process. This underscores the importance of system–wide approaches for linking different scales of drug actions; namely drug-protein interactions (molecular scale) and side effects (phenotypic scale) toward side effect prediction for uncharacterized drugs. Results: We performed a large-scale analysis to extract correlated sets of targeted proteins and side effects, based on the co-occurrence of drugs in protein-binding profiles and side effect profiles, using sparse canonical correlation analysis. The analysis of 658 drugs with the two profiles for 1368 proteins and 1339 side effects led to the extraction of 80 correlated sets. Enrichment analyses using KEGG and Gene Ontology showed that most of the correlated sets were significantly enriched with proteins that are involved in the same biological pathways, even if their molecular functions are different. This allowed for a biologically relevant interpretation regarding the relationship between drug–targeted proteins and side effects. The extracted side effects can be regarded as possible phenotypic outcomes by drugs targeting the proteins that appear in the same correlated set. The proposed method is expected to be useful for predicting potential side effects of new drug candidate compounds based on their protein-binding profiles. Supplementary information: Datasets and all results are available at http://web.kuicr.kyoto-u.ac.jp/supp/smizutan/target-effect/. Availability: Software is available at the above supplementary website. Contact: yamanishi@bioreg.kyushu-u.ac.jp, or goto@kuicr.kyoto-u.ac.jp PMID:22962476

Variations in judgments of intentional action and moral evaluation across eight cultures.

PubMed

Robbins, Erin; Shepard, Jason; Rochat, Philippe

2017-07-01

Individuals tend to judge bad side effects as more intentional than good side effects (the Knobe or side-effect effect). Here, we assessed how widespread these findings are by testing eleven adult cohorts of eight highly contrasted cultures on their attributions of intentional action as well as ratings of blame and praise. We found limited generalizability of the original side-effect effect, and even a reversal of the effect in two rural, traditional cultures (Samoa and Vanuatu) where participants were more likely to judge the good side effect as intentional. Three follow-up experiments indicate that this reversal of the side-effect effect is not due to semantics and may be linked to the perception of the status of the protagonist. These results highlight the importance of factoring cultural context in our understanding of moral cognition. Copyright © 2017. Published by Elsevier B.V.

Side-effects of topical steroids: A long overdue revisit.

PubMed

Coondoo, Arijit; Phiske, Meghana; Verma, Shyam; Lahiri, Koushik

2014-10-01

The introduction of topical steroids (TS) of varying potency have rendered the therapy of inflammatory cutaneous disorders more effective and less time-consuming. However the usefulness of these has become a double edged sword with constantly rising instances of abuse and misuse leading to serious local, systemic and psychological side effects. These side effects occur more with TS of higher potency and on particular areas of the body like face and genitalia. The article reviews the side effects of TS with special mention about peadiatric age group, also includes the measures for preventing the side effects.

Lower East Side Tenement National Historic Site Improvement Act of 2013

THOMAS, 113th Congress

Sen. Gillibrand, Kirsten E. [D-NY

2013-05-09

Senate - 07/31/2013 Committee on Energy and Natural Resources Subcommittee on National Parks. Hearings held. With printed Hearing: S.Hrg. 113-93. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Synthesis and Characterization of Itaconic Anhydride and Stearyl Methacrylate Copolymers

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

Shang, S.; Huang, S; Weiss, R

The free-radical copolymerization and the properties of comb-like copolymers derived from renewable resources, itaconic anhydride (ITA) and stearyl methacrylate (SM), are described. The ITA-SM copolymers were nearly random with a slight alternating tendency. The copolymers exhibited a nanophase-separated morphology, with the stearate side-chains forming a bilayer, semi-crystalline structure. The melting point (Tm) of the side-chains and the crystallinity decreased with increasing ITA concentration. The crystalline side-chains suppressed molecular motion of the main chain, so that a glass transition temperature (Tg) was not resolved unless the ITA concentration was sufficiently high so that Tg > Tm. The softening point and modulusmore » of the copolymers increased with the increasing ITA concentration, but the thermal stability decreased.« less

Effectiveness and side-effect profile of stimulant therapy as monotherapy and in combination in the central hypersomnias in clinical practice.

PubMed

Thakrar, Chiraag; Patel, Kishankumar; D'ancona, Grainne; Kent, Brian D; Nesbitt, Alexander; Selsick, Hugh; Steier, Joerg; Rosenzweig, Ivana; Williams, Adrian J; Leschziner, Guy D; Drakatos, Panagis

2017-10-19

Effectiveness and side-effect profile data on pharmacotherapy for daytime sleepiness in central hypersomnias are based largely upon randomized controlled trials. Evidence regarding the use of combination therapy is scant. The aim of this study was to examine the effectiveness and occurrence of drug-related side effects of these drugs in routine clinical practice. Adult patients diagnosed with a central hypersomnia during a 54-month period at a tertiary sleep disorders centre were identified retrospectively. Side effects were recorded at every follow-up visit. A total of 126 patients, with 3275 patient-months of drug exposure, were categorized into narcolepsy type 1 (n = 70), narcolepsy type 2 (n = 47) and idiopathic hypersomnia (n = 9). Modafinil was the most common drug used as a first-line treatment (93%) and in combination therapy (70%). Thirty-nine per cent of the patients demonstrated a complete, 25% partial and 36% a poor response to treatment. Combination treatment improved daytime sleepiness in 55% of the patients with residual symptoms despite monotherapy. Sixty per cent of patients reported side effects, and 30% reported treatment-limiting side effects. Drugs had similar side-effect incidence (P = 0.363) and their side-effect profile met those reported in the literature. Twenty-seven per cent of the patients received combination treatment and had fewer side effects compared to monotherapy (29.4% versus 60%, respectively, P = 0.001). Monotherapy appears to achieve satisfactory symptom control in most patients with central hypersomnia, but significant side effects are common. Combination therapy appears to be a useful and safe option in patients with refractory symptoms. © 2017 European Sleep Research Society.

Association of Ocean Energy Exploitation of Resources Promotion Sea of Japan

NASA Astrophysics Data System (ADS)

Aoyama, C.; Aoyama, S.

2014-12-01

Nine prefectures of 1 local government prefecture of the Sea of Japan side established "Association of Ocean Energy Exploitation of Resources Promotion Sea of Japan" (the following, Association of Sea of Japan) in September, 2012. They support methane hydrate exploitation of resources of the government and aim at the local activation and job creation. Niigata and Hyogo that were members of the association of Sea of Japan carried out a prefecture original methane hydrate investigation. They appeal to the government for development promotion of the government by showing the result. On the other hand, Wakayama located on the Pacific side wants to appeal to the government for the reexamination of the development sea area by showing that outer layer type methane hydrate exists to the sea area that is nearer the landside than the sea area that the government develops. The Independent Institute carried out collaborative investigation each with Niigata, Hyogo and Wakayama in 2013. I show the results of research. In the joint investigation with Niigata, plural plumes　were observed in Mogami trough east slope (from depth of the water 200m 600m) . In the joint investigation with Hyogo, I carried out observation of a methane plume and the structure and the seafloor topography under the sea bottom in Oki east sea area. Furthermore, I performed a piston core ring and gathered five samples and confirmed plural traces of the methane hydrate. In the joint investigation with Wakayama, plural plumes were observed in Shionomisaki canyon (from depth of the water 1,700m 2,200m). There is hardly the report of the plume on the Pacific side so far. Therefore I want to continue observing it in future.

Reirradiation on recurrent cervical cancer case: Treatment response and side effects

NASA Astrophysics Data System (ADS)

Siregar, M. F.; Supriana, N.; Nuranna, L.; Prihartono, J.

2017-08-01

Management of recurrent cervical cancer by reirradiation after radiation treatment remains controversial. In Indonesia, there is currently no data about reirradiation tumor response and side effects. This study aims to assess the tumor response to and side effects of reirradiation, the effect of time interval between first radiation treatment and cancer recurrence on the tumor response and side effects, and the effect of tumor size on tumor response. A cohort retrospective study with no comparison was done with the Radiotherapy Department at Cipto Mangunkusumo General Hospital, Jakarta. Participants were recurrent cervical cancer patients undergoing reirradiation. Data was collected from patients’ medical records and follow-up phone calls. Twenty-two patients participated in this study. Nine patients (40.9%) had complete responses, 10 patients (45.5%) had partial responses, 1 patient (4.5%) had a stable response, and 2 patients (9.1%) had tumor progressions. In general, 15 patients (68.2%) had no to light side effects (grade 0-2 RTOG) and 7 patients (31.8%) had severe side effects (grade 3-4 RTOG). Four patients (18.1%) had severe gastrointestinal acute side effects, 6 patients (27.3%) had severe gastrointestinal late side effects, 2 patients (9.1%) had severe urogenital side effects, and there were no patients had severe urogenital late side effects. There was no significant difference in tumor response between patients with time interval between first radiation treatment and recurrence of <12 months vs. ≥12 months. There was no significant difference in tumor response between patients with tumor size ≤4 cm vs. >4 cm. Reirradiation can be considered as a modality in recurrent cervical cancer management since good tumor response was achieved and the majority of patients had no to light side effects (grade 0-2 RTOG). This study found no correlation between tumor response, side effects, and time gap between first radiation treatment and recurrence of <12 months vs. ≥12 months. There was also no correlation between tumor response and tumor size of ≤4 cm vs. > 4 cm.

Incorporating Exercise Into the Cancer Treatment Paradigm.

PubMed

Haas, Barbara K; Hermanns, Melinda; Kimmel, Gary

2016-12-01

The benefits of exercise for patients with cancer are well documented. However, exercise is still not a standard of care for this population. Several factors contribute to the lack of exercise prescriptions for patients with cancer, including challenges posed by treatment-related side effects, lack of knowledge among healthcare providers and the laypeople, and inadequate resources. This article reviews the benefits of exercise in general and specifically to patients with cancer, discusses the specific challenges and considerations required in recommending exercise to this population, and provides specific recommendations for healthcare providers to incorporate exercise into treatment plans. Using a case study exemplar, this article discusses the benefits and challenges to exercise while undergoing treatment for cancer and proposes specific solutions and recommendations. Oncology practitioners can provide the opportunity for patients to safely engage in exercise with the appropriate resources and trained personnel using a successful model of delivering exercise to patients undergoing treatment for cancer. Exercise improves quality of life in all patients, including those with advanced-stage cancers and those actively receiving treatment.

Development of a New Self-Reporting Instrument Measuring Benefits and Side Effects of Corticosteroids in Duchenne Muscular Dystrophy: Report from a Pilot Study.

PubMed

Hendriksen, Ruben G F; Lionarons, Judith M; Hendriksen, Jos G M; Vles, Johan S H; McAdam, Laura C; Biggar, W Douglas

There is no cure for Duchenne Muscular Dystrophy (DMD); treatment is symptomatic and corticosteroids slow the progression. Side effects of corticosteroids - especially the physical effects - have been described, however patients' and caregivers perception on chronic corticosteroid treatment and their side effects is less well known, in particular with regards to cognition, behaviour, and emotional functioning. The primary aim of this pilot study was to (i) construct a self-report questionnaire to assess the perceived benefits and side effects of corticosteroids for patients with DMD and their parents. Furthermore we aimed to (ii) investigate the psychometric qualities of this questionnaire, (iii) whether there was a difference between parents' and patient's perceptions, and finally (iv) to what extent reported side effects may alter over time. A 23-item questionnaire (SIDECORT: side effect of corticosteroids) was constructed to assess the perception of these benefits and side effects in a systematic manner. In total, 86 patients (aged 5 - 28 years) and 125 of their parents completed the questionnaire. Internal consistency was good. Using factor analyses on the side effect items as reported by parents, two underlying factors were found, with the first factor describing cognitive, behavioural and emotional functioning, and the second factor describing physical functioning. The potential benefits of corticosteroids were highly rated among both parents and patients, although parents rated the importance of the benefits higher than their sons (p = 0.002). Similarly, parents rated the severity of the side effects generally higher than their sons (p = 0.011), especially with regards to the physical side effects (p = 0.014). Based on the parent's perception, the neurodevelopmental side effects generally appeared to decline the longer corticosteroids were used. To our knowledge, this is the first explicit study on perceived cognitive-, behavioural-, and emotional side effects and the allocation of benefits to corticosteroids in DMD. On the basis of our research we suggest a short form questionnaire, which proves to be reliable and valid for research- and clinical practice. This questionnaire could provide useful insights for the care of boys and men with DMD.

Central nervous system side effects associated with zolpidem treatment.

PubMed

Toner, L C; Tsambiras, B M; Catalano, G; Catalano, M C; Cooper, D S

2000-01-01

Zolpidem is one of the newer medications developed for the treatment of insomnia. It is an imidazopyridine agent that is an alternative to the typical sedative-hypnotic agents. Zolpidem use is gaining favor because of its efficacy and its side effect profile, which is milder and less problematic than that of the benzodiazepines and barbiturates used to treat insomnia. Still, side effects are not uncommon with zolpidem use. We report a series of cases in which the patients developed delirium, nightmares and hallucinations during treatment with zolpidem. We will review its pharmacology, discuss previous reports of central nervous system side effects, examine the impact of drug interactions with concurrent use of antidepressants, examine gender differences in susceptibility to side effects, and explore the significance of protein binding in producing side effects.

How significant is the slope of the sea-side boundary for modelling seawater intrusion in coastal aquifers?

NASA Astrophysics Data System (ADS)

Walther, Marc; Graf, Thomas; Kolditz, Olaf; Liedl, Rudolf; Post, Vincent

2017-08-01

Application of numerical models is a common method to assess groundwater resources. The versatility of these models allows consideration of different levels of complexity, but the accuracy of the outcomes hinges upon a proper description of the system behaviour. In seawater intrusion assessment, the implementation of the sea-side boundary condition is of particular importance. We evaluate the influence of the slope of the sea-side boundary on the simulation results of seawater intrusion in a freshwater aquifer by employing a series of slope variations together with a sensitivity analysis by varying additional sensitive parameters (freshwater inflow and longitudinal and transverse dispersivities). Model results reveal a multi-dimensional dependence of the investigated variables with an increasing relevance of the sea-side boundary slope for seawater intrusion (decrease of up to 32%), submarine groundwater discharge zone (reduction of up to 55%), and turnover times (increase of up to 730%) with increasing freshwater inflow or dispersivity values.

"Side effects affected my daily activities a lot": a qualitative exploration of the impact of contraceptive side effects in Bangladesh.

PubMed

Jain, Aparna; Reichenbach, Laura; Ehsan, Iqbal; Rob, Ubaidur

2017-01-01

In a country like Bangladesh that has made great progress in contraceptive use with one of the lowest levels of fertility and highest levels of contraceptive use, understanding what factors influence women's decisions to discontinue a contraceptive method and not switch to a new method is critical in designing interventions and programs that will help enable Bangladesh to reach its FP2020 goals. Research on side effects has focused on physical manifestations like headaches, moodiness, abdominal pain, and menstrual irregularities. While physical effects alone may stop women from continuing a contraceptive method, less is known about how side effects influence women's daily activities and lives. The purpose of this study is to understand the ways that side effects affect Bangladeshi women's participation in different social settings. Thirty-five in-depth interviews with married women who recently discontinued or switched to a different contraceptive method were conducted in Sylhet and Khulna Divisions. Interviews explored reasons for discontinuation including experience of side effects and impact of side effects on women's lives. Key themes emerged including that side effects are not only experienced physically but are barriers to women's participation in many aspects of their lives. The spheres of life that most commonly appeared to be influenced by side effects include religion, household, and sexual intimacy irrespective of method used or residence. Family planning providers need to be aware of these additional consequences associated with contraceptive side effects to provide tailored counseling that recognizes these issues and helps women to mitigate them. For Bangladesh to achieve its FP2020 goals, understanding the broader context in which family planning decisions are made vis-à-vis side effects is critical to design programs and interventions that meet all the needs of women beyond just their fertility intentions.

Living on the Edges: Spatial Niche Occupation of Asian Citrus Psyllid, Diaphorina citri Kuwayama (Hemiptera: Liviidae), in Citrus Groves.

PubMed

Sétamou, Mamoudou; Bartels, David W

2015-01-01

The spatial niche occupation of the Asian citrus psyllid, Diaphorina citri Kuwayama, 1908, was evaluated to determine its field colonization and food resource exploitation strategies in citrus groves. Mature grapefruit and sweet orange groves were surveyed as part of an area-wide program in 2009-2010 to determine D. citri population densities and between-tree distribution. In both cultivars, significantly more psyllids were found on perimeter trees throughout the study period suggesting a strong edge effect in D. citri distribution in the groves. D. citri densities and infestation levels gradually declined from the edge to the center of grove. Higher numbers of D. citri were recorded on trees located on the east and south sides of the groves than those on the west and north sides. Citrus groves located at the outer edge of the study with at least one side non-surrounded to other citrus groves harbored significantly more D. citri than groves located within the block cluster and entirely surrounded by other groves. In detailed field studies during 2012, infestation of D. citri started from border trees in the grove where possibly one generation is completed before inner trees become infested. In addition, psyllid densities decreased significantly with increasing distance from the grove edge. Using the selection index, D citri exhibited a strong niche occupation preference for border trees.

Living on the Edges: Spatial Niche Occupation of Asian Citrus Psyllid, Diaphorina citri Kuwayama (Hemiptera: Liviidae), in Citrus Groves

PubMed Central

2015-01-01

The spatial niche occupation of the Asian citrus psyllid, Diaphorina citri Kuwayama, 1908, was evaluated to determine its field colonization and food resource exploitation strategies in citrus groves. Mature grapefruit and sweet orange groves were surveyed as part of an area-wide program in 2009–2010 to determine D. citri population densities and between-tree distribution. In both cultivars, significantly more psyllids were found on perimeter trees throughout the study period suggesting a strong edge effect in D. citri distribution in the groves. D. citri densities and infestation levels gradually declined from the edge to the center of grove. Higher numbers of D. citri were recorded on trees located on the east and south sides of the groves than those on the west and north sides. Citrus groves located at the outer edge of the study with at least one side non-surrounded to other citrus groves harbored significantly more D. citri than groves located within the block cluster and entirely surrounded by other groves. In detailed field studies during 2012, infestation of D. citri started from border trees in the grove where possibly one generation is completed before inner trees become infested. In addition, psyllid densities decreased significantly with increasing distance from the grove edge. Using the selection index, D citri exhibited a strong niche occupation preference for border trees. PMID:26193111

Experimental performance investigation of a shell and tube heat exchanger by exergy based sensitivity analysis

NASA Astrophysics Data System (ADS)

Mert, Suha Orçun; Reis, Alper

2016-06-01

Heat exchangers are used extensively in many industrial branches, primarily so in chemical and energy sectors. They also have important household usage as they are used in central and local heating systems. Any betterment on heat exchangers will serve greatly in preserving our already dwindling and costly energy resources. Strong approach of exergy analysis -which helps find out where the first steps should be taken in determining sources of inefficiencies and how to remedy them- will be used as a means to this end. The maximum useful work that can be harnessed from systems relationships with its environment is defined as exergy. In this study, the inlet and outlet flow rate values of fluids and temperature of hot stream both on shell and tube parts of a shell-tube heat exchange system have been inspected and their effects on the exergy efficiency of this thermal system have been analyzed. It is seen that the combination of high tube side inlet temperature, low shell side flow rate and high tube side flow rate are found to be the optimum for this experimental system with reaching 75, 65, and 32 % efficiencies respectively. Selecting operating conditions suitable to this behavior will help to increase the overall efficiency of shell-tube heat exchange systems and cause an increment in energy conservation.

The dark side of suibsidies: quantifying contaminant exposure to riparian predators via stream insects

EPA Science Inventory

Aquatic insects provide a critical nutrient subsidy to riparian food webs, yet their role as vectors of contaminants to terrestrial ecosystems is poorly understood. We investigated relationships between aquatic (resource utilization) and contaminant exposure for a riparian invert...

Side Effects (Management)

MedlinePlus

... cancer care is relieving side effects, called symptom management, palliative care, or supportive care. It is important ... treat them. To learn about the symptoms and management of the long-term side effects of cancer ...

What side effects are problematic for patients prescribed antipsychotic medication? The Maudsley Side Effects (MSE) measure for antipsychotic medication.

PubMed

Wykes, T; Evans, J; Paton, C; Barnes, T R E; Taylor, D; Bentall, R; Dalton, B; Ruffell, T; Rose, D; Vitoratou, S

2017-10-01

Capturing service users' perspectives can highlight additional and different concerns to those of clinicians, but there are no up to date, self-report psychometrically sound measures of side effects of antipsychotic medications. Aim To develop a psychometrically sound measure to identify antipsychotic side effects important to service users, the Maudsley Side Effects (MSE) measure. An initial item bank was subjected to a Delphi exercise (n = 9) with psychiatrists and pharmacists, followed by service user focus groups and expert panels (n = 15) to determine item relevance and language. Feasibility and comprehensive psychometric properties were established in two samples (N43 and N50). We investigated whether we could predict the three most important side effects for individuals from their frequency, severity and life impact. MSE is a 53-item measure with good reliability and validity. Poorer mental and physical health, but not psychotic symptoms, was related to side-effect burden. Seventy-nine percent of items were chosen as one of the three most important effects. Severity, impact and distress only predicted 'putting on weight' which was more distressing, more severe and had more life impact in those for whom it was most important. MSE is a self-report questionnaire that identifies reliably the side-effect burden as experienced by patients. Identifying key side effects important to patients can act as a starting point for joint decision making on the type and the dose of medication.

Large-scale bioenergy production: how to resolve sustainability trade-offs?

NASA Astrophysics Data System (ADS)

Humpenöder, Florian; Popp, Alexander; Bodirsky, Benjamin Leon; Weindl, Isabelle; Biewald, Anne; Lotze-Campen, Hermann; Dietrich, Jan Philipp; Klein, David; Kreidenweis, Ulrich; Müller, Christoph; Rolinski, Susanne; Stevanovic, Miodrag

2018-02-01

Large-scale 2nd generation bioenergy deployment is a key element of 1.5 °C and 2 °C transformation pathways. However, large-scale bioenergy production might have negative sustainability implications and thus may conflict with the Sustainable Development Goal (SDG) agenda. Here, we carry out a multi-criteria sustainability assessment of large-scale bioenergy crop production throughout the 21st century (300 EJ in 2100) using a global land-use model. Our analysis indicates that large-scale bioenergy production without complementary measures results in negative effects on the following sustainability indicators: deforestation, CO2 emissions from land-use change, nitrogen losses, unsustainable water withdrawals and food prices. One of our main findings is that single-sector environmental protection measures next to large-scale bioenergy production are prone to involve trade-offs among these sustainability indicators—at least in the absence of more efficient land or water resource use. For instance, if bioenergy production is accompanied by forest protection, deforestation and associated emissions (SDGs 13 and 15) decline substantially whereas food prices (SDG 2) increase. However, our study also shows that this trade-off strongly depends on the development of future food demand. In contrast to environmental protection measures, we find that agricultural intensification lowers some side-effects of bioenergy production substantially (SDGs 13 and 15) without generating new trade-offs—at least among the sustainability indicators considered here. Moreover, our results indicate that a combination of forest and water protection schemes, improved fertilization efficiency, and agricultural intensification would reduce the side-effects of bioenergy production most comprehensively. However, although our study includes more sustainability indicators than previous studies on bioenergy side-effects, our study represents only a small subset of all indicators relevant for the SDG agenda. Based on this, we argue that the development of policies for regulating externalities of large-scale bioenergy production should rely on broad sustainability assessments to discover potential trade-offs with the SDG agenda before implementation.

Managing Chemotherapy Side Effects: Constipation

MedlinePlus

... ational C ancer I nstitute Managing Chemotherapy Side Effects Constipation Take these steps: Eat high-fiber foods ... SERVICES National Institutes of Health Managing Chemotherapy Side Effects: Constipation These foods may help if you are ...

HIV Medicines and Side Effects

MedlinePlus

... Apps skip to content Side Effects of HIV Medicines Home Understanding HIV/AIDS Fact Sheets HIV Medicines ... p.m. ET) Send us an email HIV Medicines and Side Effects Last Reviewed: October 9, 2017 ...

The economics of atrial fibrillation: a time for review and prioritization.

PubMed

Cadilhac, Dominique A

2012-08-01

Stroke associated with atrial fibrillation may occur in up to one third of people who experience an ischemic event, and results in greater stroke severity and poorer health outcomes. The ageing population in developed and developing countries will lead to an increase in the prevalence of atrial fibrillation in society. Detecting people who have atrial fibrillation and ensuring optimal prevention management is essential for reducing the burden of stroke worldwide. There is evidence that use of anticoagulants is inadequate in primary and secondary prevention of stroke. New anticoagulants that have fewer side effects and population screening tools are available. However, there is little information available about the cost-effectiveness of these new options for atrial fibrillation detection and stroke prevention management over current practice. Since resources for spending in health are limited, it is essential that formal economic analyses are undertaken to ensure there are informed and evidence-based decisions on where to best invest stroke prevention resources. It is essential that renewed efforts in the area of atrial fibrillation and options for stroke prevention are undertaken within the public health research community. © 2012 The Author. International Journal of Stroke © 2012 World Stroke Organization.

Probiotics: Safety and Side Effects

MedlinePlus

... of this page please turn JavaScript on. Feature: Probiotics Safety and Side Effects Past Issues / Winter 2016 ... Says About the Safety and Side Effects of Probiotics Whether probiotics are likely to be safe for ...

Managing Chemotherapy Side Effects: Pain

MedlinePlus

N ational C ancer I nstitute Managing Chemotherapy Side Effects Pain It’s important to treat pain. If ... help to pay for pain medicine. Managing Chemotherapy Side Effects: Pain Keep track of the pain. Each ...

Managing Chemotherapy Side Effects: Memory Changes

MedlinePlus

... C ancer I nstitute Managing Chemotherapy Side Effects Memory Changes What is causing these changes? Your doctor ... thinking or remembering things Managing Chemotherapy Side Effects: Memory Changes Get help to remember things. Write down ...

The Influence of Social Modeling, Gender, and Empathy on Treatment Side Effects.

PubMed

Faasse, Kate; Parkes, Bryony; Kearney, James; Petrie, Keith J

2018-05-31

Social modeling has the capacity to shape treatment outcomes, including side effects. This study investigated the influence of social modeling of treatment side effects, gender, and participant empathy, on side effects of a placebo treatment. Ninety-six participants (48 females) completed a study purportedly investigating the influence of modafinil (actually placebo) on alertness and fatigue. The participants were randomly seated with a male or female confederate and saw this confederate report experiencing side effects or no side effects. Participant empathy was assessed at baseline. Changes in modeled and general symptoms, and misattribution of symptoms, were assessed during the session and at 24-hr follow-up. During the experimental session, seeing side effect modeling significantly increased modeled symptoms (p = .023, d = 0.56) but not general or misattributed symptoms. Regardless of modeling condition, female participants seated with a female model reported significantly more general symptoms during the session. However, response to social modeling did not differ significantly by model or participant gender. At follow-up, the effect of social modeling of side effects had generalized to other symptoms, resulting in significantly higher rates of modeled symptoms (p = .023, d = 0.48), general symptoms (p = .013, d = 0.49), and misattributed symptoms (p = .022, d = 0.50). The experience of modeled symptoms in response to social modeling was predicted by participants' levels of baseline empathy. Social modeling of symptoms can increase the side effects following treatment, and this effect appears to generalize to a broader range of symptoms and symptom misattribution over time. Higher baseline empathy seems to increase response to social modeling.

"Side effects" of ECT are mainly depressive phenomena and are independent of age.

PubMed

Brodaty, H; Berle, D; Hickie, I; Mason, C

2001-10-01

The aetiology of reported side effects of electroconvulsive therapy (ECT) is unclear. We examined the interaction of depression and age on adverse neuropsychological and putative side effects of ECT. Inpatients (N=81; median age 70 years) with major depression were assessed prospectively pre-ECT, immediately post-ECT and 1-3 years later. Patients were administered the Hamilton Rating Scale for Depression (HRSD), the Global Assessment of Functioning scale (GAF) and neuropsychological tests from the Wechsler Memory Scale. Side effects and total burden scores were rated pre- and post-treatment. HRSD and GAF scores improved with treatment after ECT, but the prevalence and total burden of side effects were unchanged. Side effect burden was related to depression level before and after ECT. Improvement in depression correlated with reduction in side effect burden. There was a significant decline in side effect burden after controlling for change in depression. Patients' scores on neuropsychological measures did not appear to change after ECT or between pre-ECT and follow-up. Re-analysis, allowing for age, chronicity of depression, medication use and development of dementia, did not alter the findings. lack of a control group, lack of information on ECT technique, incomplete data sets and limited neuropsychological testing. ECT, an effective treatment for depression, does not cause significant side effects or neuropsychological impairment, which are more likely to be depressive phenomena. ECT appears to be safe for old (> or =65 years) and very old (> or =75 years) patients, who do not appear to be more susceptible to adverse effects.

A hierarchical anatomical classification schema for prediction of phenotypic side effects

PubMed Central

Kanji, Rakesh

2018-01-01

Prediction of adverse drug reactions is an important problem in drug discovery endeavors which can be addressed with data-driven strategies. SIDER is one of the most reliable and frequently used datasets for identification of key features as well as building machine learning models for side effects prediction. The inherently unbalanced nature of this data presents with a difficult multi-label multi-class problem towards prediction of drug side effects. We highlight the intrinsic issue with SIDER data and methodological flaws in relying on performance measures such as AUC while attempting to predict side effects.We argue for the use of metrics that are robust to class imbalance for evaluation of classifiers. Importantly, we present a ‘hierarchical anatomical classification schema’ which aggregates side effects into organs, sub-systems, and systems. With the help of a weighted performance measure, using 5-fold cross-validation we show that this strategy facilitates biologically meaningful side effects prediction at different levels of anatomical hierarchy. By implementing various machine learning classifiers we show that Random Forest model yields best classification accuracy at each level of coarse-graining. The manually curated, hierarchical schema for side effects can also serve as the basis of future studies towards prediction of adverse reactions and identification of key features linked to specific organ systems. Our study provides a strategy for hierarchical classification of side effects rooted in the anatomy and can pave the way for calibrated expert systems for multi-level prediction of side effects. PMID:29494708

A hierarchical anatomical classification schema for prediction of phenotypic side effects.

PubMed

Wadhwa, Somin; Gupta, Aishwarya; Dokania, Shubham; Kanji, Rakesh; Bagler, Ganesh

2018-01-01

Prediction of adverse drug reactions is an important problem in drug discovery endeavors which can be addressed with data-driven strategies. SIDER is one of the most reliable and frequently used datasets for identification of key features as well as building machine learning models for side effects prediction. The inherently unbalanced nature of this data presents with a difficult multi-label multi-class problem towards prediction of drug side effects. We highlight the intrinsic issue with SIDER data and methodological flaws in relying on performance measures such as AUC while attempting to predict side effects.We argue for the use of metrics that are robust to class imbalance for evaluation of classifiers. Importantly, we present a 'hierarchical anatomical classification schema' which aggregates side effects into organs, sub-systems, and systems. With the help of a weighted performance measure, using 5-fold cross-validation we show that this strategy facilitates biologically meaningful side effects prediction at different levels of anatomical hierarchy. By implementing various machine learning classifiers we show that Random Forest model yields best classification accuracy at each level of coarse-graining. The manually curated, hierarchical schema for side effects can also serve as the basis of future studies towards prediction of adverse reactions and identification of key features linked to specific organ systems. Our study provides a strategy for hierarchical classification of side effects rooted in the anatomy and can pave the way for calibrated expert systems for multi-level prediction of side effects.

Anticancer polysaccharides from natural resources: a review of recent research.

PubMed

Zong, Aizhen; Cao, Hongzhi; Wang, Fengshan

2012-11-06

Taking into account the rising trend of the incidence of cancers of various organs, effective therapies are urgently needed to control human malignancies. However, almost all of the chemotherapy drugs currently on the market cause serious side effects. Fortunately, several previous studies have shown that some non-toxic biological macromolecules, including polysaccharides and polysaccharide-protein complexes, possess anti-cancer activities or can increase the efficacy of conventional chemotherapy drugs. Based on these encouraging observations, a great deal of effort has been focused on discovering anti-cancer polysaccharides and complexes for the development of effective therapeutics for various human cancers. This review focuses on the advancements in the anti-cancer efficacy of various natural polysaccharides and polysaccharide complexes in the past 5 years. Most polysaccharides were tested using model systems, while several involved clinical trials. Copyright © 2012 Elsevier Ltd. All rights reserved.

Reviews Book: The Quantum Story: A History in 40 Moments Resource: Down2Earth Equipment: Irwin Signal Generator/Power Amplifier Book: Laboratory Experiments in Physics for Modern Astronomy Book: Heart of Darkness Book: The Long Road to Stockholm Book: The Address Book: Our Place in the Scheme of Things Equipment: TI-Nspire Datalogger/Calculator Web Watch

NASA Astrophysics Data System (ADS)

2013-07-01

WE RECOMMEND The Quantum Story: A History in 40 Moments Dip into this useful and accessible guide to quantum theory Down2Earth Astronomical-science resource enables students to pursue real, hands-on science, whatever the weather Irwin Signal Generator/Power Amplifier Students enjoy the novelty factor of versatile, affordable kit Laboratory Experiments in Physics for Modern Astronomy Book of experiments would make good supplementary material Heart of Darkness: Unravelling the Mysteries of the Invisible Universe Accessible and distinctive account of cosmology impresses The Long Road to Stockholm: The Story of MRI—An Autobiography Fascinating book tells personal and scientific stories side by side WORTH A LOOK The Address Book: Our Place in the Scheme of Things Entertaining and well-written essays offer insights and anecdotes TI-Nspire Datalogger/Calculator Challenging interface gives this kit a steep learning curve, but once overcome, results are good WEB WATCH Light-beam app game leaves little impression, while astronomy and astrophysics projects provide much-needed resources

A System Architecture for Efficient Transmission of Massive DNA Sequencing Data.

PubMed

Sağiroğlu, Mahmut Şamİl; Külekcİ, M Oğuzhan

2017-11-01

The DNA sequencing data analysis pipelines require significant computational resources. In that sense, cloud computing infrastructures appear as a natural choice for this processing. However, the first practical difficulty in reaching the cloud computing services is the transmission of the massive DNA sequencing data from where they are produced to where they will be processed. The daily practice here begins with compressing the data in FASTQ file format, and then sending these data via fast data transmission protocols. In this study, we address the weaknesses in that daily practice and present a new system architecture that incorporates the computational resources available on the client side while dynamically adapting itself to the available bandwidth. Our proposal considers the real-life scenarios, where the bandwidth of the connection between the parties may fluctuate, and also the computing power on the client side may be of any size ranging from moderate personal computers to powerful workstations. The proposed architecture aims at utilizing both the communication bandwidth and the computing resources for satisfying the ultimate goal of reaching the results as early as possible. We present a prototype implementation of the proposed architecture, and analyze several real-life cases, which provide useful insights for the sequencing centers, especially on deciding when to use a cloud service and in what conditions.

Collation of earth resources data collected by ERIM airborne sensors

NASA Technical Reports Server (NTRS)

Hasell, P. G., Jr.

1975-01-01

Earth resources imagery from nine years of data collection with developmental airborne sensors is cataloged for reference. The imaging sensors include single and multiband line scanners and side-looking radars. The operating wavelengths of the sensors include ultraviolet, visible and infrared band scanners, and X- and L-band radar. Imagery from all bands (radar and scanner) were collected at some sites and many sites had repeated coverage. The multiband scanner data was radiometrically calibrated. Illustrations show how the data can be used in earth resource investigations. References are made to published reports which have made use of the data in completed investigations. Data collection sponsors are identified and a procedure described for gaining access to the data.

Gila Wilderness, New Mexico

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

Ratte, J.C.; Stotelmeyer, R.B.

1984-01-01

Geologic, geochemical, and geophysical indicators delineated during a study of the Gila Wilderness by the USGS and USBM from 1968 to 1971 indicate that there are areas of probable and substantiated mineral-resource potential for gold, silver, tellurium, molybdenum, copper, lead, zinc, and fluorite. The areas which have resource potential lie along both sides of the western and southwestern boundaries of the wilderness, and adjacent to the access corridor to the Gila Cliff Dwellings National Monument in the eastern part of the wilderness. Areas marked by geothermal springs along Turkey Creek and the Middle Fork of the Gila River have amore » probable potential for geothermal energy. No other energy-resource potential was identified within the study area.« less

An integrated hydrogeological study to support sustainable development and management of groundwater resources: a case study from the Precambrian Crystalline Province, India

NASA Astrophysics Data System (ADS)

Madhnure, Pandith; Peddi, Nageshwar Rao; Allani, Damodar Rao

2016-03-01

The rapid expansion of agriculture, industries and urbanization has triggered unplanned groundwater development leading to severe stress on groundwater resources in crystalline rocks of India. With depleting resources from shallow aquifers, end users have developed resources from deeper aquifers, which have proved to be counterproductive economically and ecologically. An integrated hydrogeological study has been undertaken in the semi-arid Madharam watershed (95 km2) in Telangana State, which is underlain by granites. The results reveal two aquifer systems: a weathered zone (maximum 30 m depth) and a fractured zone (30-85 m depth). The weathered zone is unsaturated to its maximum extent, forcing users to tap groundwater from deeper aquifers. Higher orders of transmissivity, specific yield and infiltration rates are observed in the recharge zone, while moderate orders are observed in an intermediate zone, and lower orders in the discharge zone. This is due to the large weathering-zone thickness and a higher sand content in the recharge zone than in the discharge zone, where the weathered residuum contains more clay. The NO3 - concentration is high in shallow irrigation wells, and F- is high in deeper wells. Positive correlation is observed between F- and depth in the recharge zone and its proximity. Nearly 50 % of groundwater samples are unfit for human consumption and the majority of irrigation-well samples are classed as medium to high risk for plant growth. Both supply-side and demand-side measures are recommended for sustainable development and management of this groundwater resource. The findings can be up-scaled to other similar environments.

An Examination of Psychotropic Medication Side Effects: Does Taking a Greater Number of Psychotropic Medications from Different Classes Affect Presentation of Side Effects in adults with ID?

ERIC Educational Resources Information Center

Mahan, Sara; Holloway, Jodie; Bamburg, Jay W.; Hess, Julie A.; Fodstad, Jill C.; Matson, Johnny L.

2010-01-01

This study examined whether the number of psychotropic medications an individual is taking across classes influences side effects among adults with Intellectual Disability (ID). Participants were 80 adults diagnosed with ID. Dependent variables were the composite score and domain scores of the "Matson Evaluation of Drug Side-Effects" ("MEDS"),…

Spring 2006. Industry Study. Environment Study

DTIC Science & Technology

2006-01-01

sustainability. 91 On the positive side, a 2005 survey found that an increasing number of business schools are offering courses in ethics, corporate...Studies Journal. Urbana: 2000.Vol.28, Iss. 3; pg. 576, 21 pgs. 92 World Resource Institute (WRI) (2005, October 19) Business Schools Respond to New

How Significant is the Slope of the Sea-side Boundary for Modelling Seawater Intrusion in Coastal Aquifers?

NASA Astrophysics Data System (ADS)

Walther, Marc; Graf, Thomas; Kolditz, Olaf; Lield, Rudolf; Post, Vincent

2017-04-01

A large number of people live in coastal areas using the available water resources, which in (semi-)arid regions are often taken from groundwater resources as the only sufficient source. Compared to surface water, these usually provide a safe water supply due to the remediation and retention capabilities of the subsurface, their high yield, and potentially longer term stability. With a water withdrawal from a coastal aquifer, coastal water management, however, has to ensure that seawater intrusion is retained in order to keep the water salinity at an acceptable level for all water users (e.g. agriculture, industry, households). Besides monitoring of water levels and saline intrusion, it has become a common practice to use numerical modeling for evaluating the coastal water resources and projecting future scenarios. When applying a model, it is necessary for the simplifications implied during the conceptualization of the setup to include the relevant processes (here variable-density flow and mass transport) and sensitive parameters (for a steady state commonly hydraulic conductivity, density ratio, dispersivity). Additionally, the model's boundary conditions are essential to the simulation results. In order to reduce the number of elements, and thus, the computational burden, one simplification that is made in most regional scale saltwater intrusion applications, is to represent the sea-side boundary with a vertical geometry, contrary to the natural conditions, that usually show a very shallow decent of the interface between the aquifer and the open seawater. We use the scientific open-source modeling toolbox OpenGeoSys [1] to quantify the influence of this simplification on the saline intrusion, submarine groundwater discharge, and groundwater residence times. Using an ensemble of different shelf shapes for a steady state setup, we identified a significant dependency of saline intrusion length on the geometric parameters of the sea-side boundary. Results show that the additional effort to implement a sloped sea-side boundary may have a significant impact for assessing coastal water resources, and its influence may be of a similar magnitude as that of other common uncertainties in numerical modelling. Literature [1] Kolditz, O., Bauer, S., Bilke, L., Böttcher, N., Delfs, J. O., Fischer, T., Görke, U. J., et al. (2012). OpenGeoSys: an open-source initiative for numerical simulation of thermo-hydro-mechanical/chemical (THM/C) processes in porous media. Environmental Earth Sciences, 67(2), 589-599. doi:10.1007/s12665-012-1546-x

Managing Chemotherapy Side Effects: Anemia

MedlinePlus

... ational C ancer I nstitute Managing Chemotherapy Side Effects Anemia “I told my doctor that I was ... exercise a little every day. Managing Chemotherapy Side Effects: Anemia Eat and drink well. ● ● Talk with your ...

Chemotherapy Side Effects: A Cause of Heart Disease?

MedlinePlus

... Can chemotherapy side effects increase the risk of heart disease? Answers from Timothy J. Moynihan, M.D. Chemotherapy side effects may increase the risk of heart disease, including weakening of the heart muscle (cardiomyopathy) and ...

Managing Chemotherapy Side Effects: Skin and Nail Changes

MedlinePlus

... ational C ancer I nstitute Managing Chemotherapy Side Effects Skin and Nail Changes “I was glad to ... services national institutes of health Managing Chemotherapy Side Effects: Skin and Nail Changes Protect your skin from ...

Effects of separation of resources on behaviour, physical condition and production of laying hens in furnished cages.

PubMed

Shimmura, T; Azuma, T; Eguchi, Y; Uetake, K; Tanaka, T

2009-01-01

1. Based on our previous studies, we designed a medium-sized furnished cage with a dust bath and nest box on both sides of the cage (MFS) and evaluated its usefulness. 2. We used 180 White Leghorn layers. At the age of 17 weeks, the birds were distributed at random into one of the 4 cage designs: conventional cages (CC; 6 cages and 5 hens per cage), small (SF; 6 cages and 5 hens per cage) and medium furnished cages (MFL; 6 cages and 10 hens per cage) with a 'localised' dust bath and nest box on one side of the cage, and MFS (6 cages and 10 hens per cage). The total allocation of resources per bird was similar for all furnished cage designs. Behaviour, physical condition and production were measured in each cage. 3. Moving was more frequent in MFS and MFL than in CC and SF. The proportion of hens performing aggressive pecking and severe feather pecking was higher in MFL than CC and SF. These aggressive interactions occurred frequently in the dust bath area in MFL; however, these tendencies were not found in MFS. Egg production and egg mass were lower in MFL than in SF, while the production in MFS was similar to those in CC and SF. MFS hens laid eggs on the cage floor more often than in MFL. 4. In conclusion, these results demonstrate the possible usefulness of MFS. However, some inconsistent results and ways of improving MFS design were also identified.

The magnitude of and health system responses to the mental health treatment gap in adults in India and China.

PubMed

Patel, Vikram; Xiao, Shuiyuan; Chen, Hanhui; Hanna, Fahmy; Jotheeswaran, A T; Luo, Dan; Parikh, Rachana; Sharma, Eesha; Usmani, Shamaila; Yu, Yu; Druss, Benjamin G; Saxena, Shekhar

2016-12-17

This Series paper describes the first systematic effort to review the unmet mental health needs of adults in China and India. The evidence shows that contact coverage for the most common mental and substance use disorders is very low. Effective coverage is even lower, even for severe disorders such as psychotic disorders and epilepsy. There are vast variations across the regions of both countries, with the highest treatment gaps in rural regions because of inequities in the distribution of mental health resources, and variable implementation of mental health policies across states and provinces. Human and financial resources for mental health are grossly inadequate with less than 1% of the national health-care budget allocated to mental health in either country. Although China and India have both shown renewed commitment through national programmes for community-oriented mental health care, progress in achieving coverage is far more substantial in China. Improvement of coverage will need to address both supply-side barriers and demand-side barriers related to stigma and varying explanatory models of mental disorders. Sharing tasks with community-based workers in a collaborative stepped-care framework is an approach that is ripe to be scaled up, in particular through integration within national priority health programmes. India and China need to invest in increasing demand for services through active engagement with the community, to strengthen service user leadership and ensure that the content and delivery of mental health programmes are culturally and contextually appropriate. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Plants supporting the fight against the symptoms of menopause].

PubMed

Gryszczyńska, Agnieszka; Gryszczyńska, Bogna; Opala, Bogna; Łowicki, Zdzisław

2013-01-01

The tradition of the use of plants resources in the fight against many diseases dates back to antiquity. Herbal medicine is used in the fight against less severe, as well as serious diseases. In view of the serious consequences of the use of hormone replacement therapy (HRT) to combat the symptoms of menopause are increasingly used plant medicines. According to the Women's Health Initiative (WHI) reported, their use is becoming more and more popular. An important advantage of this therapy is to prevent such the development of breast cancer, which is often a side effect of HRT. Therefore, this article also presents the most commonly used plants that help counteract the adverse symptoms of menopause.

Reference-frame-independent quantum-key-distribution server with a telecom tether for an on-chip client.

PubMed

Zhang, P; Aungskunsiri, K; Martín-López, E; Wabnig, J; Lobino, M; Nock, R W; Munns, J; Bonneau, D; Jiang, P; Li, H W; Laing, A; Rarity, J G; Niskanen, A O; Thompson, M G; O'Brien, J L

2014-04-04

We demonstrate a client-server quantum key distribution (QKD) scheme. Large resources such as laser and detectors are situated at the server side, which is accessible via telecom fiber to a client requiring only an on-chip polarization rotator, which may be integrated into a handheld device. The detrimental effects of unstable fiber birefringence are overcome by employing the reference-frame-independent QKD protocol for polarization qubits in polarization maintaining fiber, where standard QKD protocols fail, as we show for comparison. This opens the way for quantum enhanced secure communications between companies and members of the general public equipped with handheld mobile devices, via telecom-fiber tethering.

Azathioprine therapy in a case of pediatric multiple sclerosis that was seropositive for MOG-IgG.

PubMed

Zhou, Yifan; Huang, Qiao; Lu, Tingting; Sun, Xiaobo; Fang, Ling; Lu, Zhengqi; Hu, Xueqiang; Kermode, Allan; Qiu, Wei

2017-04-01

There is a lack of evidence for treatment of pediatric multiple sclerosis (PedMS). Treatment using azathioprine for PedMS has not been reported. A 10-year-old boy with multiple sclerosis who was seropositive for antibodies against myelin oligodendrocyte glycoprotein (MOG)-IgG was treated with azathioprine plus oral methylprednisolone. The patient showed clinical and magnetic resonance imaging stability, with MOG-IgG seroconversion. There were no major side effects over a 5-year period. Azathioprine may be a treatment option, particularly in poor medical resource areas, for pediatric patients with multiple sclerosis who are seropositive for MOG-IgG. Copyright © 2017 Elsevier Ltd. All rights reserved.

Cutaneous side effects of doxycycline: a pediatric case series.

PubMed

Bayhan, Gulsum Iclal; Akbayram, Sinan; Ozaydin Yavuz, Goknur; Oner, Ahmet Fayik

2017-06-01

Brucellosis is highly endemic in Turkey and doxycycline is commonly used for its treatment. The present study aimed at documenting the cutaneous side effects of doxycycline in pediatric brucellosis patients in Turkey. Pediatric patients with brucellosis that were treated between February 2014 and January 2016 were analyzed retrospectively, and those that developed doxycycline-related cutaneous side effects were identified. Demographic data, epidemiological history, physical examination findings, laboratory test results, anti-brucellosis treatment regimen, duration of follow up and outcome were recorded. Among the 189 brucellosis patients, 141 treated with doxycycline plus rifampicin. Seven patients (5%) (two female and five male) developed doxycycline-related cutaneous side effects. Mean duration of treatment before the onset of cutaneous side effects was 9.5 weeks. Doxycycline therapy was continued in five of these patients and was changed in two patients. In the patients that continued to receive doxycycline the cutaneous side effects gradually improved. Cutaneous side effects of doxycycline should always be a consideration, especially in regions in which brucellosis is endemic and doxycycline is commonly used to treat it.

Influence of Side Effects on ART Adherence Among PLWH in China: The Moderator Role of ART-Related Knowledge.

PubMed

Zhou, Guangyu; Li, Xiaoming; Qiao, Shan; Shen, Zhiyong; Zhou, Yuejiao

2018-03-01

Despite the medical advancements in HIV treatment, realities of side effects are faced by people living with HIV (PLWH) who receive antiretroviral therapy (ART). Mixed findings have been reported on the association between side effects and ART adherence. However, few studies have explored the combined side effects and behavior-related information on medication adherence. The aim of the current study is to examine moderator role of ART-related knowledge between side effects and ART adherence. A cross-sectional survey was conducted among 2987 PLWH from October 2012 to August 2013 in China. Of the total sample, 2095 patients had received ART and provided ART adherence. Side effects, ART-related knowledge, and ART adherence, as well as potential covariates were assessed. The results revealed that there was a negative relationship of side effects and ART adherence existed among low and medium levels of ART-related knowledge, but not among high level of knowledge. Future interventions to promote HIV medication adherence should focus on providing behavior-related information education among PLWH.

Cancer Treatment Side Effects: A Meta-analysis of the Relationship Between Response Expectancies and Experience.

PubMed

Devlin, Elise J; Denson, Linley A; Whitford, Hayley S

2017-08-01

Although previous research has, overall, suggested a moderate relationship between response expectancies (REs) and cancer treatment-related side effects, empirical results have been mixed. We aimed to further explore these relationships, hypothesizing that REs would predict subsequent toxicities with the inclusion of more recent studies, across a broader range of side effects, while incorporating the impact of potential moderators including patients' experience with treatment and measurement methods. We further investigated the impact of REs across individual toxicities. A systematic search and analysis were conducted across four databases (PsychInfo, PubMed, CINAHL, and Embase) and reference lists, from 1985 to February 2016. This provided 27 eligible studies with 4474 participants, through which the main analysis, moderator analyses, and individual side-effect analyses were explored. REs were moderately related to side effects overall (r = 0.26), and effect sizes were significantly influenced by sample diagnostic homogeneity, whereas differences between type and timing of measurement showed trends. Of the 16 toxicities examined, 15 demonstrated significant relationships between REs and side-effect experience, with hair loss (r = 0.48) the strongest. No clear difference emerged between objective and subjective side effects; however, significant differences across individual toxicities were revealed. Findings support a relationship between REs and a wide range of subsequent side effects, yet differences between individual RE-toxicity associations emerged. These findings provide direction for the measurement of side effects and REs and support REs as potential targets for intervention during the informed consent process. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Anaesthesiological considerations on tocolytic and uterotonic therapy in obstetrics.

PubMed

Vercauteren, M; Palit, S; Soetens, F; Jacquemyn, Y; Alahuhta, S

2009-07-01

Significant side effects of tocolytic and uterotonic substances may be of concern to the anaesthesiologist. Recently, new drugs have been introduced having less side effects for both the mother and the neonate. A literature search was undertaken mainly focusing on meta-analyses, to review the possible side effects that might affect the course of anaesthesia and to suggest which precautions should be considered to prevent the occurrence of significant interactions with anaesthetic manipulations and drugs. Magnesium sulphate has a proven benefit in lowering systolic blood pressure and preventing the occurrence of eclampsia, but not as a tocolytic. beta-adrenergic agonists are being abandoned due to the availability of tocolytic agents causing less side effects. Calcium channel blockers (CCB) are frequently used but can cause major maternal cardiovascular complications. Nitroglycerin seems to be appreciated as an acute tocolytic rather than a routine substance during pre-term labour. Cyclo-oxygenase-2 inhibitors are still under investigation but their tocolytic benefit is questionable mainly due to foetal side effects. Atosiban is considered the first-choice tocolytic. With respect to oxytocic drugs, oxytocine, prostaglandines and methylergometrine may all cause serious side effects especially when combined. The cardiovascular side effects of prostaglandins and methylergometrine can be life-threatening. Both oxytocin and carbetocin have a rather low risk for maternal complications. Atosiban and CCB are at least as effective tocolytic agents as beta-mimetics but have significantly less side effects. Magnesium sulphate can cause neuromuscular blockade, especially when combined with CCB. Concerning oxytocic agents, short-acting oxyctocin and long-acting carbetocin have the least side effects as compared with prostaglandins and methylergometrine.

Effects of cocaine on honey bee dance behaviour

PubMed Central

Barron, Andrew B.; Maleszka, Ryszard; Helliwell, Paul G.; Robinson, Gene E.

2009-01-01

Summary The role of cocaine as an addictive drug of abuse in human society is hard to reconcile with its ecological role as a natural insecticide and plant-protective compound, preventing herbivory of coca plants (Erythroxylum spp.). This paradox is often explained by proposing a fundamental difference in mammalian and invertebrate responses to cocaine, but here we show effects of cocaine on honey bees (Apis mellifera L.) that parallel human responses. Forager honey bees perform symbolic dances to advertise the location and value of floral resources to their nest mates. Treatment with a low dose of cocaine increased the likelihood and rate of bees dancing after foraging but did not otherwise increase locomotor activity. This is consistent with cocaine causing forager bees to overestimate the value of the floral resources they collected. Further, cessation of chronic cocaine treatment caused a withdrawal-like response. These similarities likely occur because in both insects and mammals the biogenic amine neuromodulator systems disrupted by cocaine perform similar roles as modulators of reward and motor systems. Given these analogous responses to cocaine in insects and mammals, we propose an alternative solution to the paradox of cocaine reinforcement. Ecologically, cocaine is an effective plant defence compound via disruption of herbivore motor control but, because the neurochemical systems targeted by cocaine also modulate reward processing, the reinforcing properties of cocaine occur as a `side effect'. PMID:19112134

Geroprotectors.org: a new, structured and curated database of current therapeutic interventions in aging and age-related disease.

PubMed

Moskalev, Alexey; Chernyagina, Elizaveta; de Magalhães, João Pedro; Barardo, Diogo; Thoppil, Harikrishnan; Shaposhnikov, Mikhail; Budovsky, Arie; Fraifeld, Vadim E; Garazha, Andrew; Tsvetkov, Vasily; Bronovitsky, Evgeny; Bogomolov, Vladislav; Scerbacov, Alexei; Kuryan, Oleg; Gurinovich, Roman; Jellen, Leslie C; Kennedy, Brian; Mamoshina, Polina; Dobrovolskaya, Evgeniya; Aliper, Alex; Kaminsky, Dmitry; Zhavoronkov, Alex

2015-09-01

As the level of interest in aging research increases, there is a growing number of geroprotectors, or therapeutic interventions that aim to extend the healthy lifespan and repair or reduce aging-related damage in model organisms and, eventually, in humans. There is a clear need for a manually-curated database of geroprotectors to compile and index their effects on aging and age-related diseases and link these effects to relevant studies and multiple biochemical and drug databases. Here, we introduce the first such resource, Geroprotectors (http://geroprotectors.org). Geroprotectors is a public, rapidly explorable database that catalogs over 250 experiments involving over 200 known or candidate geroprotectors that extend lifespan in model organisms. Each compound has a comprehensive profile complete with biochemistry, mechanisms, and lifespan effects in various model organisms, along with information ranging from chemical structure, side effects, and toxicity to FDA drug status. These are presented in a visually intuitive, efficient framework fit for casual browsing or in-depth research alike. Data are linked to the source studies or databases, providing quick and convenient access to original data. The Geroprotectors database facilitates cross-study, cross-organism, and cross-discipline analysis and saves countless hours of inefficient literature and web searching. Geroprotectors is a one-stop, knowledge-sharing, time-saving resource for researchers seeking healthy aging solutions.

Effects of cocaine on honey bee dance behaviour.

PubMed

Barron, Andrew B; Maleszka, Ryszard; Helliwell, Paul G; Robinson, Gene E

2009-01-01

The role of cocaine as an addictive drug of abuse in human society is hard to reconcile with its ecological role as a natural insecticide and plant-protective compound, preventing herbivory of coca plants (Erythroxylum spp.). This paradox is often explained by proposing a fundamental difference in mammalian and invertebrate responses to cocaine, but here we show effects of cocaine on honey bees (Apis mellifera L.) that parallel human responses. Forager honey bees perform symbolic dances to advertise the location and value of floral resources to their nest mates. Treatment with a low dose of cocaine increased the likelihood and rate of bees dancing after foraging but did not otherwise increase locomotor activity. This is consistent with cocaine causing forager bees to overestimate the value of the floral resources they collected. Further, cessation of chronic cocaine treatment caused a withdrawal-like response. These similarities likely occur because in both insects and mammals the biogenic amine neuromodulator systems disrupted by cocaine perform similar roles as modulators of reward and motor systems. Given these analogous responses to cocaine in insects and mammals, we propose an alternative solution to the paradox of cocaine reinforcement. Ecologically, cocaine is an effective plant defence compound via disruption of herbivore motor control but, because the neurochemical systems targeted by cocaine also modulate reward processing, the reinforcing properties of cocaine occur as a ;side effect'.

Geroprotectors.org: a new, structured and curated database of current therapeutic interventions in aging and age-related disease

PubMed Central

Moskalev, Alexey; Chernyagina, Elizaveta; de Magalhães, João Pedro; Barardo, Diogo; Thoppil, Harikrishnan; Shaposhnikov, Mikhail; Budovsky, Arie; Fraifeld, Vadim E.; Garazha, Andrew; Tsvetkov, Vasily; Bronovitsky, Evgeny; Bogomolov, Vladislav; Scerbacov, Alexei; Kuryan, Oleg; Gurinovich, Roman; Jellen, Leslie C.; Kennedy, Brian; Mamoshina, Polina; Dobrovolskaya, Evgeniya; Aliper, Alex; Kaminsky, Dmitry; Zhavoronkov, Alex

2015-01-01

As the level of interest in aging research increases, there is a growing number of geroprotectors, or therapeutic interventions that aim to extend the healthy lifespan and repair or reduce aging-related damage in model organisms and, eventually, in humans. There is a clear need for a manually-curated database of geroprotectors to compile and index their effects on aging and age-related diseases and link these effects to relevant studies and multiple biochemical and drug databases. Here, we introduce the first such resource, Geroprotectors (http://geroprotectors.org). Geroprotectors is a public, rapidly explorable database that catalogs over 250 experiments involving over 200 known or candidate geroprotectors that extend lifespan in model organisms. Each compound has a comprehensive profile complete with biochemistry, mechanisms, and lifespan effects in various model organisms, along with information ranging from chemical structure, side effects, and toxicity to FDA drug status. These are presented in a visually intuitive, efficient framework fit for casual browsing or in-depth research alike. Data are linked to the source studies or databases, providing quick and convenient access to original data. The Geroprotectors database facilitates cross-study, cross-organism, and cross-discipline analysis and saves countless hours of inefficient literature and web searching. Geroprotectors is a one-stop, knowledge-sharing, time-saving resource for researchers seeking healthy aging solutions. PMID:26342919

Type and frequency of side effects during PC6 acupuncture: observations from therapists and patients participating in clinical efficacy trials of acupuncture.

PubMed

Enblom, Anna; Johnsson, Anna

2017-12-01

Many therapists practise PC6 acupuncture for emesis (nausea and vomiting) during pregnancy, different cancer therapies, palliative care, after surgery, or to induce relaxing effects in general. Knowledge of side effects is central to shared decision-making. To describe the type and frequency of side effects and the level of needle-induced pain during PC6 acupuncture. We included 1298 PC6 acupuncture treatments, delivered to 221 participants (77% women, mean age 52.5, range 18-91 years). The subjects had received genuine PC6 acupuncture, in one of two previous randomised controlled trials, aimed at inducing antiemetic (n=100, with 100 providing data on side effects and 94 on needle-induced pain, respectively) or relaxing (n=121, with 120 providing data) effects. Side effects during and after the acupuncture treatments were registered in structured treatment protocols and study diaries. No serious complications occurred. Side effects during the acupuncture sessions included minor bleeding in 5.0%, tiredness in 4.9%, numbness in 4.5% and dizziness in 1.4% of the 1298 treatments. After treatment, the mean proportions of participants reporting side effects each week were: tiredness 25.8%; feeling cold 17.8%; dizziness 9.7%; sweating 9.3%; haematoma 8.8%; and soreness at the needling sites 4.3%. Participants perceived the needling to be not painful (47.4% of participants), or mildly (39.1%), moderately (11.6%) or very painful (1.4%). Few side effects occurred and those that did were mild. Nearly 90% found PC6 acupuncture to be not painful or only mildly painful. Healthcare professionals may consider the observed levels of side effects when informing patients about side effects of PC6 acupuncture. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Side-gate modulation effects on high-quality BN-Graphene-BN nanoribbon capacitors

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

Wang, Yang; Chen, Xiaolong; Ye, Weiguang

High-quality BN-Graphene-BN nanoribbon capacitors with double side-gates of graphene have been experimentally realized. The double side-gates can effectively modulate the electronic properties of graphene nanoribbon capacitors. By applying anti-symmetric side-gate voltages, we observed significant upward shifting and flattening of the V-shaped capacitance curve near the charge neutrality point. Symmetric side-gate voltages, however, only resulted in tilted upward shifting along the opposite direction of applied gate voltages. These modulation effects followed the behavior of graphene nanoribbons predicted theoretically for metallic side-gate modulation. The negative quantum capacitance phenomenon predicted by numerical simulations for graphene nanoribbons modulated by graphene side-gates was not observed,more » possibly due to the weakened interactions between the graphene nanoribbon and side-gate electrodes caused by the Ga{sup +} beam etching process.« less

A distributed algorithm for demand-side management: Selling back to the grid.

PubMed

Latifi, Milad; Khalili, Azam; Rastegarnia, Amir; Zandi, Sajad; Bazzi, Wael M

2017-11-01

Demand side energy consumption scheduling is a well-known issue in the smart grid research area. However, there is lack of a comprehensive method to manage the demand side and consumer behavior in order to obtain an optimum solution. The method needs to address several aspects, including the scale-free requirement and distributed nature of the problem, consideration of renewable resources, allowing consumers to sell electricity back to the main grid, and adaptivity to a local change in the solution point. In addition, the model should allow compensation to consumers and ensurance of certain satisfaction levels. To tackle these issues, this paper proposes a novel autonomous demand side management technique which minimizes consumer utility costs and maximizes consumer comfort levels in a fully distributed manner. The technique uses a new logarithmic cost function and allows consumers to sell excess electricity (e.g. from renewable resources) back to the grid in order to reduce their electric utility bill. To develop the proposed scheme, we first formulate the problem as a constrained convex minimization problem. Then, it is converted to an unconstrained version using the segmentation-based penalty method. At each consumer location, we deploy an adaptive diffusion approach to obtain the solution in a distributed fashion. The use of adaptive diffusion makes it possible for consumers to find the optimum energy consumption schedule with a small number of information exchanges. Moreover, the proposed method is able to track drifts resulting from changes in the price parameters and consumer preferences. Simulations and numerical results show that our framework can reduce the total load demand peaks, lower the consumer utility bill, and improve the consumer comfort level.

Subjective experience and mental side-effects of antipsychotic treatment.

PubMed

Gerlach, J; Larsen, E B

1999-01-01

Many schizophrenic patients have a negative attitude towards antipsychotic drugs. This attitude is not only due to lack of insight into the disease, lack of recognition of the beneficial effects of the drugs, and to objective side-effects. The negative attitude is to a high degree due to mental side-effects and a sceptical opinion about antipsychotic medication in general. In a study of 53 chronic schizophrenic out-patients receiving maintenance depot antipsychotic treatment, we found that 60% were positive about the treatment, 32% were ambivalent and 8% had a negative attitude. Only 60% complained of side-effects, even though 94% had objective side-effects. Mental side-effects such as subjective akathisia, dysphoria and emotional indifference were most often observed by the patients, while hypokinesia and hyperkinesia were least noticed by them, but most often observed by the physician. No correlation was found between the patients' subjective assessment of their quality of life and the degree of psychosis and side-effects. With the new atypical antipsychotics this situation seems to be changing. These new drugs are primarily characterized by a lower level of motor extrapyramidal side-effects (EPS), and with fewer motor EPS, fewer mental EPS can be expected. In recent studies comparing the new antipsychotics with haloperidol, better effects have been observed with regard to negative symptoms and depression, and this may at least in part be a reflection of a lower level of mental side-effects of the atypical antipsychotics. This improved clinical profile of new antipsychotics is extremely valuable in the context of an integrated treatment in schizophrenia, consisting of early intervention, psychosocial rehabilitation and family/patient psycho-education.

Ayurveda for chemo-radiotherapy induced side effects in cancer patients.

PubMed

Metri, Kashinath; Bhargav, Hemant; Chowdhury, Praerna; Koka, Prasad S

2013-01-01

Chemotherapy drugs and radiotherapy are highly toxic and both damage adjacent healthy cells. Side effects may be acute (occurring within few weeks after therapy), intermediate or late (occurring months or years after the therapy). Some important side effects of chemotherapy are: nausea, vomiting, diarrhea, mucositis, alopecia, constipation etc; whereas radiation therapy though administered locally, can produce systemic side effects such as fatigue, anorexia, nausea, vomiting, alteration in the taste, sleep disturbance, headache, anemia, dry skin, constipation etc. Late complications of these therapies also include pharyngitis, esophagitis, laryngitis, persistent dysphagia, fatigue, hepatotoxicity, infertility and cognitive deficits. These arrays of side effects have a devastating effect on the quality of life of cancer survivors. Due to the inadequacy of most of the radio-protectors and chemo-protectors in controlling the side effects of conventional cancer therapy the complementary and alternative medicines have attracted the view of researchers and medical practitioners more recently. This review aims at providing a comprehensive management protocol of above mentioned chemo-radiotherapy induced side effects based on Ayurveda, which is an ancient system of traditional medicine practiced in Indian peninsula since 5000 BC. When the major side effects of chemo-radiotherapy are looked through an ayurvedic perspective, it appears that they are the manifestations of aggravated pitta dosha, especially under the group of disorders called Raktapitta (haemorrhage) or Raktadushti (vascular inflammation). Based on comprehensive review of ancient vedic literature and modern scientific evidences, ayurveda based interventions are put forth. This manuscript should help clinicians and people suffering from cancer to combat serious chemo-radiotherapy related side effects through simple but effective home-based ayurveda remedies. The remedies described are commonly available and safe. These simple ayurveda based solutions may act as an important adjuvant to chemo-radiotherapy and enhance the quality of life of cancer patients.

Dissatisfaction with opioid maintenance treatment partly explains reported side effects of medications.

PubMed

Muller, Ashley Elizabeth; Bjørnestad, Ronny; Clausen, Thomas

2018-03-29

Drop-out is a core problem in opioid maintenance treatment (OMT), but patients' reactions to and acceptance of the various OMT medications are insufficiently investigated. In Norway, there has been vocal patient resistance to the newest medication, buprenorphine-naloxone (BNX), and complaints have focused on the side effect profile. There has been no comparison of patient satisfaction and side effects of the three most common OMT medications. To compare patient satisfaction with OMT and side effects of BNX, buprenorphine monopreparate (BUP), and methadone (MET) as reported by patients. Data were drawn from a national peer-to-peer survey developed by a patient advocacy group. The survey engaged more than 1000 OMT patients, corresponding to one seventh of OMT patients in Norway. The associations between side effects, treatment satisfaction, and patient characteristics were tested in multinomial logistic regressions. High patient satisfaction with OMT overall was reported despite lower satisfaction with medication itself and widely prevalent side effects. Among each medication group, dissatisfaction with medications or OMT in general along with poor health status increased the relative risk ratio of reporting the heaviest side effect burden. MET users reported the highest side effect burden and BNX users the lightest, but BNX users were more dissatisfied with their medication. Side effects are a concern for nearly all OMT patients, and they do not appear to accumulate with age or length of treatment. BNX users' dissatisfaction with their medication is of particular concern, and expectations and preferences of medication may be influencing their dissatisfaction. Copyright © 2018. Published by Elsevier B.V.

Selective serotonin reuptake inhibitor discontinuation: side effects and other factors that influence medication adherence.

PubMed

Goethe, John W; Woolley, Stephen B; Cardoni, Alex A; Woznicki, Brenda A; Piez, Deborah A

2007-10-01

Patients with major depression discontinue taking their antidepressants for many reasons. Although side effects are often cited as the reason for discontinuation, few prospective studies have addressed this question, and none has specifically examined discontinuation in patients with severe depression. Inpatients and outpatients treated with a selective serotonin reuptake inhibitor for major depressive disorder were identified after admission. Three months later, patients were contacted and interviewed to determine antidepressant usage and the side effects experienced, including when these were experienced and their severity. Between October 2001 and April 2003, 406 English- or Spanish-speaking patients aged 18 to 75 years were followed up. One in 4 patients discontinued the index antidepressant. Among specific side effects noted, only "change in weight" and "anxiety" were significant predictors of discontinuation after controlling for confounders. Experiencing 1 or more "extremely" bothersome side effects was associated with more than a doubling of the risk of discontinuation, but the presence of side effects and side effects less severe than "extremely" bothersome were not significant predictors. There were no differences among selective serotonin reuptake inhibitor antidepressants in either the presence/absence of side effects or in the discontinuation rates. The results suggest that the contribution of side effects to antidepressant discontinuation is more complex than previously suggested. Disparate findings from earlier studies may reflect aspects of study design, such as examining populations whose severity of depression varied widely or not controlling for important confounding factors. Future research should separately examine high-risk groups (or control for severity of depression) and carefully rule out other potential contributors to discontinuation.

Recreation impacts to cliff resources in the Potomac Gorge: Final report, June 2011

USGS Publications Warehouse

Marion, Jeffrey L.; Carr, C.; Davis, C.A.

2011-01-01

Managers of the National Park Service (NPS) are directed by law to accommodate appropriate types and amounts of visitation while ensuring that: any adverse impacts are the minimum necessary, unavoidable, cannot be further mitigated, and do not constitute impairment or derogation of park resources and values. (NPS 2006). The increasing popularity of the national park system presents substantial management challenges. High visitatation may cause unacceptable impacts to fragile natural and cultural resources, and may also cause crowding and other social impacts, which can also degrade the quality of visitor experiences. Responding to these concerns, NPS managers at Chesapeake & Ohio Canal National Historical Park (CHOH) and George Washington Memorial Parkway (GWMP) sponsored this research within the upper Potomac Gorge portions of these parks to investigate visitation-related impacts to the park?s cliff resources. The cliffs and rocky areas within the Great Falls and Mather Gorge areas provide important habitats for numerous sensitive rare plants and plant communities. A recent General Management Planning process for Great Falls Park (GFP), a portion of GWMP, highlighted the potential impacts of cliff-associated recreational activities, including hiking, climbing, and fishing, on sensitive cliff resources. The planning process identified the need for development of a Climbing Management Plan and a Trail Plan to more specifically address site and visitor management actions needed to protect rare and sensitive natural and cultural resources. Good science to assess cliff-associated rare plants and communities and to determine the existing and potential effects of cliff-related recreational activities is required for these new planning efforts. This research is designed to specifically address these informational needs and to assist park managers on both sides of the river with current and future cliff and recreation management decisions.

On being the right size: scaling effects in designing a human-on-a-chip

PubMed Central

Moraes, Christopher; Labuz, Joseph M.; Leung, Brendan M.; Inoue, Mayumi; Chun, Tae-Hwa; Takayama, Shuichi

2013-01-01

Developing a human-on-a-chip by connecting multiple model organ systems would provide an intermediate screen for therapeutic efficacy and toxic side effects of drugs prior to conducting expensive clinical trials. However, correctly designing individual organs and scaling them relative to each other to make a functional microscale human analog is challenging, and a generalized approach has yet to be identified. In this work, we demonstrate the importance of rational design of both the individual organ and its relationship with other organs, using a simple two-compartment system simulating insulin-dependent glucose uptake in adipose tissues. We demonstrate that inter-organ scaling laws depend on both the number of cells, and on the spatial arrangement of those cells within the microfabricated construct. We then propose a simple and novel inter-organ ‘metabolically-supported functional scaling’ approach predicated on maintaining in vivo cellular basal metabolic rates, by limiting resources available to cells on the chip. This approach leverages findings from allometric scaling models in mammals that limited resources in vivo prompts cells to behave differently than in resource-rich in vitro cultures. Although applying scaling laws directly to tissues can result in systems that would be quite challenging to implement, engineering workarounds may be used to circumvent these scaling issues. Specific workarounds discussed include the limited oxygen carrying capacity of cell culture media when used as a blood substitute and the ability to engineer non-physiological structures to augment organ function, to create the transport-accessible, yet resource-limited environment necessary for cells to mimic in vivo functionality. Furthermore, designing the structure of individual tissues in each organ compartment may be a useful strategy to bypass scaling concerns at the inter-organ level. PMID:23925524

Effects of side lying on lung function in older individuals.

PubMed

Manning, F; Dean, E; Ross, J; Abboud, R T

1999-05-01

Body positioning exerts a strong effect on pulmonary function, but its effect on other components of the oxygen transport pathway are less well understood, especially the effects of side-lying positions. This study investigated the interrelationships between side-lying positions and indexes of lung function such as spirometry, alveolar diffusing capacity, and inhomogeneity of ventilation in older individuals. Nineteen nonsmoking subjects (mean age=62.8 years, SD=6.8, range=50-74) with no history of cardiac or pulmonary disease were tested over 2 sessions. The test positions were sitting and left side lying in one session and sitting and right side lying in the other session. In each of the positions, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), single-breath pulmonary diffusing capacity (DLCO/VA), and the slope of phase III (DN2%/L) of the single-breath nitrogen washout test to determine inhomogeneity of ventilation were measured. Compared with measurements obtained in the sitting position, FVC and FEV1 were decreased equally in the side-lying positions, but no change was observed in DLCO/VA or DN2%/L. Side-lying positions resulted in decreases in FVC and FEV1, which is consistent with the well-documented effects of the supine position. These findings further support the need for prescriptive rather than routine body positioning of patients with risks of cardiopulmonary compromise and the need to use upright positions in which lung volumes and capacities are maximized.

Recent advances in discovery and development of natural products as source for anti-Parkinson's disease lead compounds.

PubMed

Zhang, Hongjia; Bai, Lan; He, Jun; Zhong, Lei; Duan, Xingmei; Ouyang, Liang; Zhu, Yuxuan; Wang, Ting; Zhang, Yiwen; Shi, Jianyou

2017-12-01

Parkinson's disease (PD) is a common chronic degenerative disease of the central nervous system. Although the cause remains unknown, several pathological processes and central factors such as oxidative stress, mitochondrial injury, inflammatory reactions, abnormal deposition of α-synuclein, and cell apoptosis have been reported. Currently, anti-PD drugs are classified into two major groups: drugs that affect dopaminergic neurons and anti-cholinergic drugs. Unfortunately, the existing conventional strategies against PD are with numerous side effects, and cannot fundamentally improve the degenerative process of dopaminergic neurons. Therefore, novel therapeutic approaches which have a novel structure, high efficiency, and fewer side effects are needed. For many years, natural products have provided an efficient resource for the discovery of potential therapeutic agents. Among them, many natural products possess anti-PD properties as a result of not only their wellrecognized anti-oxidative and anti-inflammatory activities but also their inhibitory roles regarding protein misfolding and the regulatory effects of PD related pathways. Indeed, with the steady improvement in the technologies for the isolation and purification of natural products and the in-depth studies on the pathogenic mechanisms of PD, many monomer components of natural products that have anti-PD effects have been gradually discovered. In this article, we reviewed the research status of 37 natural products that have been discovered to have significant anti-PD effects as well as their mode of action. Overall, this review may guide the design of novel therapeutic drugs in PD. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Building a Case for Blocks as Kindergarten Mathematics Learning Tools

ERIC Educational Resources Information Center

Kinzer, Cathy; Gerhardt, Kacie; Coca, Nicole

2016-01-01

Kindergarteners need access to blocks as thinking tools to develop, model, test, and articulate their mathematical ideas. In the current educational landscape, resources such as blocks are being pushed to the side and being replaced by procedural worksheets and academic "seat time" in order to address standards. Mathematics research…

Time Is on Your Side

ERIC Educational Resources Information Center

Weinstein, Margery

2010-01-01

Scarce resources mean employees cannot afford to lose a moment of their day to repetitive or useless tasks. This author accompanied learners from a large financial institution in New York City and describes in this article how a productivity workshop can make a difference. The workshop leader, Jason W. Womack, suggested the following "quick…

30 CFR 75.215 - Longwall mining systems.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Longwall mining systems. 75.215 Section 75.215... MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Roof Support § 75.215 Longwall mining systems. For each... a safe travelway out of the section through the tailgate side of the longwall; and (b) The...

30 CFR 75.215 - Longwall mining systems.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Longwall mining systems. 75.215 Section 75.215... MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Roof Support § 75.215 Longwall mining systems. For each... a safe travelway out of the section through the tailgate side of the longwall; and (b) The...

30 CFR 75.215 - Longwall mining systems.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Longwall mining systems. 75.215 Section 75.215... MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Roof Support § 75.215 Longwall mining systems. For each... a safe travelway out of the section through the tailgate side of the longwall; and (b) The...

Poster: "Energy Search."

ERIC Educational Resources Information Center

Social Education, 1982

1982-01-01

Contains a poster dealing with energy uses for use in secondary-level classes. On the reverse side of the poster, there is a discussion of alternative energy resources. Activities in which students calculate the operating costs of solar-powered cars and the size of solar collectors needed to heat water are included. (AM)

Learning to Share

ERIC Educational Resources Information Center

Raths, David

2010-01-01

In the tug-of-war between researchers and IT for supercomputing resources, a centralized approach can help both sides get more bang for their buck. As 2010 began, the University of Washington was preparing to launch its first shared high-performance computing cluster, a 1,500-node system called Hyak, dedicated to research activities. Like other…

7 CFR 1710.115 - Final maturity.

Code of Federal Regulations, 2014 CFR

2014-01-01

... maturities for loans for the implementation of programs for demand side management and energy resource conservation and on and off grid renewable energy sources not owned by the borrower will be determined by RUS... finance working capital required for the initial operation of a new system are a separate class of loans...

Lunar interferometric astronomy: Some basic questions

NASA Technical Reports Server (NTRS)

Woolf, Neville

1992-01-01

The author examines some basic questions as to why there should be astronomical facilities on the far side of the moon. The questions are ones of appropriateness, i.e., is this a proper use for human resources, what the real goals are, and are the present concepts the best match for the goals.

Finite Trigonometry: A Resource for Teachers.

ERIC Educational Resources Information Center

Malcom, Paul Scott

This investigation extends a 25-point geometric system for defining a 25-point trigonometry whose properties are analogous to those of the trigonometry of the Euclidean plane. These properties include definitions of trigonometric functions arising from ratios of sides of right triangles, the relations of elements of a given triangle through the…

Distant and Distributed Learners Are Two Sides of the Same Coin.

ERIC Educational Resources Information Center

Barron, Brette Barclay

2002-01-01

An academic librarian at the University of South Carolina, faced with providing online resources for distant and distributed learners, examines whether there is any difference between distant and distributed learners. Illustrates changes brought on by implementation of information technologies. Discusses seeking a new definition, meeting…

2. SNAKE RIVER VALLEY IRRIGATION DISTRICT DAM, PHOTOGRAPHIC COPY OF ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

2. SNAKE RIVER VALLEY IRRIGATION DISTRICT DAM, PHOTOGRAPHIC COPY OF DRAWING, PLAN, SHEET 5 OF 5, 1924 (on file at the Idaho State Office of Water Resources, Boise, Idaho) - Snake River Valley Irrigation District, East Side of Snake River (River Mile 796), Shelley, Bingham County, ID

30 CFR 282.5 - Disclosure of data and information to the public.

Code of Federal Regulations, 2014 CFR

2014-07-01

... public. 282.5 Section 282.5 Mineral Resources BUREAU OF SAFETY AND ENVIRONMENTAL ENFORCEMENT, DEPARTMENT... (including, but not limited to, bathymetry, side-scan sonar, subbottom profiler, and magnetometer) in compliance with stipulations or orders concerning protection of environmental aspects of the lease may be...

30 CFR 282.5 - Disclosure of data and information to the public.

Code of Federal Regulations, 2012 CFR

2012-07-01

... public. 282.5 Section 282.5 Mineral Resources BUREAU OF SAFETY AND ENVIRONMENTAL ENFORCEMENT, DEPARTMENT... (including, but not limited to, bathymetry, side-scan sonar, subbottom profiler, and magnetometer) in compliance with stipulations or orders concerning protection of environmental aspects of the lease may be...

30 CFR 282.5 - Disclosure of data and information to the public.

Code of Federal Regulations, 2013 CFR

2013-07-01

... public. 282.5 Section 282.5 Mineral Resources BUREAU OF SAFETY AND ENVIRONMENTAL ENFORCEMENT, DEPARTMENT... (including, but not limited to, bathymetry, side-scan sonar, subbottom profiler, and magnetometer) in compliance with stipulations or orders concerning protection of environmental aspects of the lease may be...

Sunny Side Up in Science.

ERIC Educational Resources Information Center

LaHart, David, Ed.

Fossil fuels, upon which we now depend almost exclusively, are finite resources. Because the environmental problems inherent in large scale fossil fuel consumption are increasingly apparent, the reality of developing alternative energy sources must be faced. Solar energy is the obvious solution to the problem. It is a renewable, clean source that…

The Development of Information Manpower Resource.

ERIC Educational Resources Information Center

Farid, Mona

This paper examines the training and education of information manpower in the formal educational institutions of Latin America, Africa, and the Middle East. The nature of the information, social, and economic infrastructures in developing countries is also examined. It is suggested that promotion of the supply side of the information…

Effects and Side Effects of Flemish School Inspection

ERIC Educational Resources Information Center

Penninckx, Maarten; Vanhoof, Jan; De Maeyer, Sven; Van Petegem, Peter

2016-01-01

Despite the increased importance of school inspection in recent years, the current knowledge base does not provide a clear view on the effects and side effects of being inspected. More evidence is needed in more diverse educational contexts. This article responds to this need with a quantitative study on the effects and side effects of school…

Chemotherapy

MedlinePlus

... cells to get better. Because everyone's different, some people will have fewer side effects than others. Common side effects of chemo are ... infections easily. Medicines are available that can help people feel better if they have side effects from chemo. Doctors, nurses, and other members of ...

Alternatives to current HIV/AIDS policies and practices in South African prisons.

PubMed

Goyer, K C; Gow, Jeff

2002-01-01

Prisoners in South Africa face problems of overcrowding, violence and poor nutrition. Added to this burden in recent times is the increased threat from HIV. The HIV epidemic has been relatively late in coming to South Africa but infection rates are now 20% in the adult population. However, there is no data available on the level of HIV infection in the prison population. Overseas studies suggest that the characteristics of prisoners place them at much greater risk of HIV infection. Factors which contribute to increased levels of HIV infection include poor health care facilities, lack of condoms and lack of disinfectants. Current policies and practices on HIV in prison attempt to balance the constraints of limited resources with the need to preserve prisoner human rights. The outcomes include: mass testing not freely available, HIV education is limited, and early release of prisoners with advanced AIDS is not allowed. Constraints on the implementation of effective HIV prevention strategies include: bureaucratic inefficiency, lack of resources, and a reluctance by prison authorities to address the issue of HIV in prison. These problems can possibly be overcome by addressing the issue from both management and prisoner perspectives. On the management side, increased resources, increased training of prison officials, and increased political commitment to address the issue are required. Outside partnerships are probably required for an effective response. Prisoners require better nutrition, better living conditions, better health care, freely available condoms and disinfectants.

On the evolutionary origins of the egalitarian syndrome

PubMed Central

Gavrilets, Sergey

2012-01-01

The evolutionary emergence of the egalitarian syndrome is one of the most intriguing unsolved puzzles related to the origins of modern humans. Standard explanations and models for cooperation and altruism—reciprocity, kin and group selection, and punishment—are not directly applicable to the emergence of egalitarian behavior in hierarchically organized groups that characterized the social life of our ancestors. Here I study an evolutionary model of group-living individuals competing for resources and reproductive success. In the model, the differences in fighting abilities lead to the emergence of hierarchies where stronger individuals take away resources from weaker individuals and, as a result, have higher reproductive success. First, I show that the logic of within-group competition implies under rather general conditions that each individual benefits if the transfer of the resource from a weaker group member to a stronger one is prevented. This effect is especially strong in small groups. Then I demonstrate that this effect can result in the evolution of a particular, genetically controlled psychology causing individuals to interfere in a bully–victim conflict on the side of the victim. A necessary condition is a high efficiency of coalitions in conflicts against the bullies. The egalitarian drive leads to a dramatic reduction in within-group inequality. Simultaneously it creates the conditions for the emergence of inequity aversion, empathy, compassion, and egalitarian moral values via the internalization of behavioral rules imposed by natural selection. It also promotes widespread cooperation via coalition formation. PMID:22891349

Integrating market processes into utility resource planning

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

Kahn, E.P.

1992-11-01

Integrated resource planning has resulted in an abundance of alternatives for meeting existing and new demand for electricity services: (1) utility demand-side management (DSM) programs, (2) DSM bidding, (3) competitive bidding for private power supplies, (4) utility re-powering, and (5) new utility construction. Each alternative relies on a different degree of planning for implementation and, therefore, each alternative relies on markets to a greater or lesser degree. This paper shows how the interaction of planning processes and market forces results in resource allocations among the alternatives. The discussion focuses on three phenomena that are driving forces behind the unanticipated consequences'more » of contemporary integrated resource planning efforts. These forces are: (1) large-scale DSM efforts, (2) customer bypass, and (3) large-scale independent power projects. 22 refs., 3 figs., 2 tabs.« less

An integrated study of earth resources in the state of California based on ERTS-1 and supporting aircraft data

NASA Technical Reports Server (NTRS)

Colwell, R. N.; Thorley, G. A.; Burgy, R. H.; Schubert, G.; Estes, J. E.; Bowden, L. W.; Algazi, V. R.; Wildman, W. E.; Huntington, G. L. (Principal Investigator)

1972-01-01

There are no author-identified significant results in this report. Results of an integrated study of earth resources in the state of California using ERTS-1 and supporting aircraft data are presented. Areas of investigation cover (1) regional agricultural surveys; (2) solving water resource management problems; (3) resource management in Northern California using ERTS-1 data; (4) analysis of river meanders; (5) assessment and monitoring change in west side of the San Joaquin Valley and central coastal zone of state; (6) assessment and monitoring of changes in Southern California environment; (7) digital handling and processing of ERTS-1 data; (8) use of ERTS-1 data in educational and applied research programs of the Agricultural Extension Service; and (9) identification, classification, and mapping of salt affected soils.

Optimal allocation of physical water resources integrated with virtual water trade in water scarce regions: A case study for Beijing, China.

PubMed

Ye, Quanliang; Li, Yi; Zhuo, La; Zhang, Wenlong; Xiong, Wei; Wang, Chao; Wang, Peifang

2018-02-01

This study provides an innovative application of virtual water trade in the traditional allocation of physical water resources in water scarce regions. A multi-objective optimization model was developed to optimize the allocation of physical water and virtual water resources to different water users in Beijing, China, considering the trade-offs between economic benefit and environmental impacts of water consumption. Surface water, groundwater, transferred water and reclaimed water constituted the physical resource of water supply side, while virtual water flow associated with the trade of five major crops (barley, corn, rice, soy and wheat) and three livestock products (beef, pork and poultry) in agricultural sector (calculated by the trade quantities of products and their virtual water contents). Urban (daily activities and public facilities), industry, environment and agriculture (products growing) were considered in water demand side. As for the traditional allocation of physical water resources, the results showed that agriculture and urban were the two predominant water users (accounting 54% and 28%, respectively), while groundwater and surface water satisfied around 70% water demands of different users (accounting 36% and 34%, respectively). When considered the virtual water trade of eight agricultural products in water allocation procedure, the proportion of agricultural consumption decreased to 45% in total water demand, while the groundwater consumption decreased to 24% in total water supply. Virtual water trade overturned the traditional components of water supplied from different sources for agricultural consumption, and became the largest water source in Beijing. Additionally, it was also found that environmental demand took a similar percentage of water consumption in each water source. Reclaimed water was the main water source for industrial and environmental users. The results suggest that physical water resources would mainly satisfy the consumption of urban and environment, and the unbalance between water supply and demand could be filled by virtual water import in water scarce regions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Price elasticity matrix of demand in power system considering demand response programs

NASA Astrophysics Data System (ADS)

Qu, Xinyao; Hui, Hongxun; Yang, Shengchun; Li, Yaping; Ding, Yi

2018-02-01

The increasing renewable energy power generations have brought more intermittency and volatility to the electric power system. Demand-side resources can improve the consumption of renewable energy by demand response (DR), which becomes one of the important means to improve the reliability of power system. In price-based DR, the sensitivity analysis of customer’s power demand to the changing electricity prices is pivotal for setting reasonable prices and forecasting loads of power system. This paper studies the price elasticity matrix of demand (PEMD). An improved PEMD model is proposed based on elasticity effect weight, which can unify the rigid loads and flexible loads. Moreover, the structure of PEMD, which is decided by price policies and load types, and the calculation method of PEMD are also proposed. Several cases are studied to prove the effectiveness of this method.

[Cardiovascular side effects of non-steroidal anti-inflammatory drugs in the light of recent recommendations. Diclofenac is not more dangerous].

PubMed

Horváth, Viktor József; Tabák, Gy Ádám; Szabó, Gergely; Putz, Zsuzsanna; Koós, Csaba Géza; Lakatos, Péter

2015-03-29

Among their beneficial effects, non-steroidal anti-inflammatory drugs may also exert several side effects which depend on the dosage and the type of these medications. The most frequent gastrointestinal side effects usually develop shortly after the beginning of their administration, but others such as cardiovascular interactions (which are present much less frequently than gastrointestinal side effects) can also occur after the beginning of drug administration without a latency period. For a long-term treatment, non-steroidal anti-inflammatory drugs are most frequently used in the elderly population where patients typically have high cardiovascular risk and take other medicines, e.g. low dose acetylsalicylic acid that can interact with non-steroidal anti-inflammatory drugs; in this aspect diclofenac may cause less side effects. In this review, the authors briefly review cardiovascular side effects of non-steroidal anti-inflammatory drugs, the processes which potentially influence them, therapeutic consequences and their interaction with acetylsalicylic acid.

The impact of tamoxifen brand switch on side effects and patient compliance in hormone receptor positive breast cancer patients.

PubMed

Zeidan, B; Anderson, K; Peiris, L; Rainsbury, D; Laws, S

2016-10-01

In 2006 Nolvadex was discontinued and replaced by a variety of alternative generic tamoxifen brands for the adjuvant treatment of breast cancer. Anecdotally, patients are switching brands and taking alternative medications to reduce treatment related symptoms. Nevertheless, more severe side effects may equate to better relapse prevention. This study evaluates generic tamoxifen adherence and its correlation with side effects and brand switch. Consecutive disease free ER positive patients (stage I-III) were invited to respond to a questionnaire. 165 of 327 questionnaires were returned (50% response). Pearson's Chi Square test was used for data analysis. 63 patients (38%) reported a switch between generic tamoxifen. 59% of all patients experienced side effects associated with tamoxifen treatment of which 53% were severe. Patients experiencing differential symptoms dependent on tamoxifen brand reported more severe side effects (p = 0.02). Non-prescribed supplements were taken by 42% of all patients with no significant improvement in climacteric symptoms (p = 0.05). The concomitant use of SSRIs appeared to have no effect on symptoms. A significant number of patients considered discontinuing tamoxifen because of the side effects (p = 0.001), yet this did not translate into discontinuation or non-adherence (p = 0.8 and 0.08 respectively). Severe tamoxifen side effects are commonly experienced by breast cancer patients and can be significantly altered by change in tamoxifen brand. Most patients will continue to take tamoxifen, despite side effects to avoid cancer relapse. Supplementation and antidepressants did not improve tamoxifen related side effects in our cohort. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

The Association of Long-term Treatment-related Side Effects With Cancer-specific and General Quality of Life Among Prostate Cancer Survivors

PubMed Central

Davis, Kimberly M.; Kelly, Scott P.; Luta, George; Tomko, Catherine; Miller, Anthony B.; Taylor, Kathryn L.

2018-01-01

OBJECTIVE To examine the association between treatment-related side effects and cancer-specific and general quality of life (QOL) among long-term prostate cancer survivors. MATERIALS AND METHODS Within the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial, we conducted telephone interviews with prostate cancer survivors (N = 518) who were 5-10 years after diagnosis. We assessed demographic and clinical information, sexual, urinary, and bowel treatment-related side effects (Expanded Prostate Cancer Index Composite), cancer-specific QOL (Functional Assessment of Cancer Therapy—total score), and general QOL (the Medical Outcomes Study Short Form 12’s physical and mental subscales). RESULTS Participants were aged 74.6 years on average, primarily White (88.4%), and married (81.7%). Pearson correlation coefficients between the 3 treatment-related side effect domains (urinary, sexual, and bowel) and QOL ranged between 0.14 and 0.42 (P <.0001). Multivariable linear regression analyses revealed that poorer urinary and sexual functioning and greater bowel side effects were independently associated with poorer cancer-specific QOL (P <.0001). Bowel and urinary functions were also associated with poorer general QOL on the Medical Outcomes Study Short Form 12’s physical component summary and mental component summary (P <.05). Bowel side effects demonstrated the strongest association with all QOL outcomes. CONCLUSION Treatment-related side effects persisted for up to 10 years after diagnosis and continued to be associated with men’s QOL. These results suggest that each of the treatment-related side effects was independently associated with cancer-specific QOL. Compared with the other Expanded Prostate Cancer Index Composite domains, bowel side effects had the strongest association with cancer-specific and general QOL. These associations emphasize the tremendous impact that bowel side effects continue to have for men many years after their initial diagnosis. PMID:24975711

Consumer confusion between prescription drug precautions and side effects.

PubMed

Amoozegar, Jacqueline B; Rupert, Douglas J; Sullivan, Helen W; O'Donoghue, Amie C

2017-06-01

Multiple studies have identified consumers' difficulty correctly interpreting risk information provided about prescription drugs, whether in printed format or online. This study's purpose was to explore whether consumers can distinguish between prescription drug precautions and side effects presented on brand-name drug websites. Participants (n=873) viewed fictitious drug websites that presented both precautions and side effects for one of four drugs, and they completed a survey assessing recall and comprehension. We coded open-ended recall data to identify whether drug precautions were mentioned and, if so, how they were interpreted. Approximately 15% of participants mentioned at least one drug precaution. The majority (59.7%) misinterpreted precautions as potential side effects. Participants who misinterpreted precautions rated the drugs as significantly more likely to cause side effects than participants who accurately interpreted the precautions. Age, education, literacy, and other factors did not appear to predict precaution interpretation. At least some consumers are likely to interpret precautions on drug websites as potential side effects, which might affect consumer preferences, treatment decisions, and medication safety. Healthcare providers should be aware of this potential confusion, assess patients' understanding of precautions and potential side effects, and address any misunderstandings. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Ocular side-effects associated with imatinib mesylate (Gleevec).

PubMed

Fraunfelder, Frederick W; Solomon, Jonathan; Druker, Brian J; Esmaeli, Bita; Kuyl, Jennifer

2003-08-01

This retrospective case series describes ocular side-effects associated with imatinib mesylate (Gleevec) and the clinical characteristics of these adverse reactions. A chart review of 104 patients on imatinib mesylate therapy from Oregon Health & Science University's Cancer Center were studied with regard to ocular side-effects. In addition, spontaneous reports from the Food and Drug Administration, the World Health Organization, and the National Registry of Drug-Induced Ocular Side-Effects databases were reviewed, including a Medline literature search. Seventy-three (70%) of the patients at OHSU developed periorbital edema and 19 patients (18%) developed epiphora after receiving imatinib mesylate. Average dose was 407.5+/-60 mg. Periorbital edema occurred an average of 68+/-48 days after initiation of therapy. WHO classification of side-effects is as follows: certain: periorbital edema; probable: epiphora; possible: extraocular muscle palsy, ptosis, blepharoconjunctivitis; unlikely: glaucoma, papilledema, retinal hemorrhage, photosensitivity, abnormal vision, and increased intraocular pressure. Periorbital edema and epiphora are the two most common ocular side-effects related to imatinib mesylate therapy. Clinical characteristics of imatinib mesylate induced periorbital edema are described. Management of ocular side-effects is conservative except in very rare cases of visually significant periorbital edema.

Fast image decompression for telebrowsing of images

NASA Technical Reports Server (NTRS)

Miaou, Shaou-Gang; Tou, Julius T.

1993-01-01

Progressive image transmission (PIT) is often used to reduce the transmission time of an image telebrowsing system. A side effect of the PIT is the increase of computational complexity at the viewer's site. This effect is more serious in transform domain techniques than in other techniques. Recent attempts to reduce the side effect are futile as they create another side effect, namely, the discontinuous and unpleasant image build-up. Based on a practical assumption that image blocks to be inverse transformed are generally sparse, this paper presents a method to minimize both side effects simultaneously.

A potential role for adjunctive vitamin D therapy in the management of weight gain and metabolic side effects of second-generation antipsychotics

PubMed Central

Nwosu, Benjamin U.; Meltzer, Bruce; Maranda, Louise; Ciccarelli, Carol; Reynolds, Daniel; Curtis, Laura; King, Jean; Frazier, Jean A.; Lee, Mary M.

2014-01-01

Second-generation antipsychotic (SGA) medications introduced about 20 years ago are increasingly used to treat psychiatric illnesses in children and adolescents. There has been a five-fold increase in the use of these medications in U.S. children and adolescents in the past decade. However, there has also been a parallel rise in the incidence of side effects associated with these medications, such as obesity, dyslipidemia, insulin resistance, and diabetes mellitus. Despite the severity of these complications and their financial impact on the national healthcare budget, there is neither a clear understanding of the mechanisms contributing to these side effects nor the best ways to address them. Studies that examined lifestyle modification and pharmaceutical agents have yielded mixed results. Therefore, clinical studies using agents, such as vitamin D, which are inexpensive, readily available, with low side effects profile, and have mechanisms to counteract the metabolic side effects of SGA agents, are warranted. Vitamin D is a prohormone with skeletal and extraskeletal properties that could potentially reduce the severity of these metabolic side effects. Its role as an adjunctive therapy for the management of metabolic side effects of SGA agents has not been adequately studied. Effective strategies to curb these side effects will improve the overall health of youths with psychiatric illnesses who receive SGAs. Herein we present a pilot study on the use of vitamin D in patients on treatment with SGAs. PMID:22145446

Choreatic Side Effects of Deep Brain Stimulation of the Anteromedial Subthalamic Nucleus for Treatment-Resistant Obsessive-Compulsive disorder.

PubMed

Mulders, Anne E P; Leentjens, Albert F G; Schruers, Koen; Duits, Annelien; Ackermans, Linda; Temel, Yasin

2017-08-01

Patients with treatment-resistant obsessive-compulsive disorder (OCD) are potential candidates for deep brain stimulation (DBS). The anteromedial subthalamic nucleus (STN) is among the most commonly used targets for DBS in OCD. We present a patient with a 30-year history of treatment-resistant OCD who underwent anteromedial STN-DBS. Despite a clear mood-enhancing effect, stimulation caused motor side effects, including bilateral hyperkinesia, dyskinesias, and sudden large amplitude choreatic movements of arms and legs when stimulating at voltages greater than approximately 1.5 V. DBS at lower amplitudes and at other contact points failed to result in a significant reduction of obsessions and compulsions without inducing motor side effects. Because of this limitation in programming options, we decided to reoperate and target the ventral capsule/ventral striatum (VC/VS), which resulted in a substantial reduction in key obsessive and compulsive symptoms without serious side effects. Choreatic movements and hemiballismus have previously been linked to STN dysfunction and have been incidentally reported as side effects of DBS of the dorsolateral STN in Parkinson disease (PD). However, in PD, these side effects were usually transient, and they rarely interfered with DBS programming. In our patient, the motor side effects were persistent, and they made optimal DBS programming impossible. To our knowledge, such severe and persistent motor side effects have not been described previously for anteromedial STN-DBS. Copyright © 2017 Elsevier Inc. All rights reserved.

From evidence-based to hope-based medicine? Ethical aspects on conditional market authorization of and early access to new cancer drugs.

PubMed

Sandman, Lars; Liliemark, Jan

2017-08-01

There is a strong patient demand for early access to potentially beneficial cancer drugs. In line with this authorization agencies like the European Medicines Agency are providing drugs with conditional market authorisation based on positive interim analyses. This implies that drugs are used with insecure evidence of efficacy and adverse side-effects. Several authors have pointed to ethical problems with such a system but up to date no indepth ethical analysis of this system is found which is the aim of this article. Drawing of the four generally accepted principles of medical ethics: beneficence, nonmaleficence, respect for autonomy and justice the ethical pros and cons of conditional market authorisation are analysed. From the perspective of beneficence and non-maleficence it is found that the main problem is not risk of adverse side-effects to patients, but rather risk of less beneficial outcomes than what can be expected which could change incentives for patients' choice of treatment. This is also related to the extent to which patients might make an autonomous choice, especially taking into account problematic psychological attitudes and biases in medical decision-making. However, the main problem is related to justice and an equitable distribution of scarce health-care resources given the opportunity cost of drugs treatment. When using resources on cancer treatments which later might be found to be less efficacious than was first expected, other patients (in and outside the cancer field) are deprived of potentially more beneficial treatments even though their needs might be equally or more severe. At the same time, demanding more evidence has an ethical cost to patients in terms of depriving them of potential benefits in terms of reduced mortality and morbidity. In order to handle these ethical conflicts further research and analyses are required and it is suggested that pricing strategies and information requirements are alternatives to be further explored. Copyright © 2017 Elsevier Ltd. All rights reserved.

Measurement of Side Effects of Drugs

PubMed Central

Huskisson, E. C.; Wojtulewski, J. A.

1974-01-01

In a clinical trial of two antirheumatic agents two methods of collection of side effects were used, one with and the other without a check list of possible symptoms. Findings suggested that the use of a check list interfered with the collection of side effects. Known side effects of aspirin—tinnitus, deafness, and gastrointestinal disturbance—were more efficiently shown and symptoms not included in the check list were more likely to be reported when a check list was not used. PMID:4853118

Play-fairway analysis for geothermal resources and exploration risk in the Modoc Plateau region

USGS Publications Warehouse

Siler, Drew; Zhang, Yingqi; Spycher, Nicolas F.; Dobson, Patrick; McClain, James S.; Gasperikova, Erika; Zierenberg, Robert A.; Schiffman, Peter; Ferguson, Colin; Fowler, Andrew; Cantwell, Carolyn

2017-01-01

The region surrounding the Modoc Plateau, encompassing parts of northeastern California, southern Oregon, and northwestern Nevada, lies at an intersection between two tectonic provinces; the Basin and Range province and the Cascade volcanic arc. Both of these provinces have substantial geothermal resource base and resource potential. Geothermal systems with evidence of magmatic heat, associated with Cascade arc magmatism, typify the western side of the region. Systems on the eastern side of the region appear to be fault controlled with heat derived from high crustal heat flow, both of which are typical of the Basin and Range. As it has the potential to host Cascade arc-type geothermal resources, Basin and Range-type geothermal resources, and/or resources with characteristics of both provinces, and because there is relatively little current development, the Modoc Plateau region represents an intriguing potential for undiscovered geothermal resources. It remains unclear however, what specific set(s) of characteristics are diagnostic of Modoc-type geothermal systems and how or if those characteristics are distinct from Basin and Range-type or Cascade arc-type geothermal systems. In order to evaluate the potential for undiscovered geothermal resources in the Modoc area, we integrate a wide variety of existing data in order to evaluate geothermal resource potential and exploration risk utilizing ‘play-fairway’ analysis. We consider that the requisite parameters for hydrothermal circulation are: 1) heat that is sufficient to drive circulation, and 2) permeability that is sufficient to allow for fluid circulation in the subsurface. We synthesize data that indicate the extent and distribution of these parameters throughout the Modoc region. ‘Fuzzy logic’ is used to incorporate expert opinion into the utility of each dataset as an indicator of either heat or permeability, and thus geothermal favorability. The results identify several geothermal prospects, areas that are highly favorable for the occurrence of both heat and permeability. These are also areas where there is sufficient data coverage, quality, and consistency that the exploration risk is relatively low. These unknown, undeveloped, and under-developed prospects are well-suited for continued exploration efforts. The results also indicate to what degree the two ‘play-types,’ i.e. Cascade arc-type or Basin and Range-type, apply to each of the geothermal prospects, a useful guide in exploration efforts.

Design and fabrication of nosecone for WB-57F aircraft fitted with APQ-102A side looking radar

NASA Technical Reports Server (NTRS)

1977-01-01

The design, fabrication, and testing of a nose cone which included a radome for a NASA WB-57F high altitude natural resources mapping aircraft was reviewed. The plane was fitted with a APQ-102A side looking radar operating at 9.6 GHz. The radar is directed normally to the direction of the flight and downward by a changeable angle, and it is assumed that the axis of the plane will not deviate from this direction by more than + or - 6 deg. The radome is required to subtend an angle of 160 deg centered 30 deg below the left horizon.

An Introduction to MAMA (Meta-Analysis of MicroArray data) System.

PubMed

Zhang, Zhe; Fenstermacher, David

2005-01-01

Analyzing microarray data across multiple experiments has been proven advantageous. To support this kind of analysis, we are developing a software system called MAMA (Meta-Analysis of MicroArray data). MAMA utilizes a client-server architecture with a relational database on the server-side for the storage of microarray datasets collected from various resources. The client-side is an application running on the end user's computer that allows the user to manipulate microarray data and analytical results locally. MAMA implementation will integrate several analytical methods, including meta-analysis within an open-source framework offering other developers the flexibility to plug in additional statistical algorithms.

Side-scan sonar assessment of gray whale feeding in the Bering Sea

USGS Publications Warehouse

Johnson, K.R.; Nelson, C.H.

1984-01-01

Side-scan sonar was used to map and measure feeding pits of the California gray whale over 22,000 square kilometers of the northeastern Bering Sea floor. The distribution of pits, feeding whales, ampeliscid amphipods (whale prey), and a fine-sand substrate bearing the amphipods were all closely correlated. The central Chirikov Basin and nearshore areas of Saint Lawrence Island supply at least 6.5 percent of the total gray whale food resource in summer. While feeding, the whales resuspend at least 1.2 x 108 cubic meters of sediment annually; this significantly affects the geology and biology of the region.

Comparison of hair removal efficacy and side effect of neodymium:Yttrium-aluminum-garnet laser and intense pulsed light systems (18-month follow-up).

PubMed

Szima, Georgina Zita; Janka, Eszter Anna; Kovács, Anikó; Bortély, Blanka; Bodnár, Edina; Sawhney, Irina; Szabó, Éva; Remenyik, Éva

2017-06-01

Photothermal destruction of hair shaft melanin with intense pulsed light (IPL) and neodymium:yttrium-aluminum-garnet (Nd:YAG) laser has become an effective treatment of hair removal. Our aim was to compare efficacy, satisfactory levels, safety, and side effects of Nd:YAG and IPL in hair reduction. This was a prospective randomized intrapatient, right-left, assessor-blinded comparison of Nd:YAG vs IPL. There were 38 volunteers recruited. Seven sessions were performed. Hair count, efficacy, and side effects were compared before and after each treatment and 6 months after the last treatment. In respect of 12 volunteers, we have examined the reduction in hair after 18 months. Initially, there was no significant difference between the numbers of hair follicles. There was significant hair reduction after each treatment on the Nd:YAG-treated side. The hair reduction became significant after the third treatment with IPL. Comparison of the efficacy of the two devices on each visits showed no significant difference. There was statistically lower pain score on the IPL-treated side and statistically higher erythema, burning sensation, and edema on the Nd:YAG-treated side. Statistically lower side effect score was observed on the IPL-treated side. Eight months after the last treatment, there was significant hair reduction both on the Nd:YAG and on the IPL-treated side, and there was no difference between the efficacy. The patient satisfaction scores were higher with the IPL. Unwanted hair can be reduced by both systems safely and effectively; however, IPL has less side effects and higher satisfaction scores. © 2017 Wiley Periodicals, Inc.

The importance of employing computational resources for the automation of drug discovery.

PubMed

Rosales-Hernández, Martha Cecilia; Correa-Basurto, José

2015-03-01

The application of computational tools to drug discovery helps researchers to design and evaluate new drugs swiftly with a reduce economic resources. To discover new potential drugs, computational chemistry incorporates automatization for obtaining biological data such as adsorption, distribution, metabolism, excretion and toxicity (ADMET), as well as drug mechanisms of action. This editorial looks at examples of these computational tools, including docking, molecular dynamics simulation, virtual screening, quantum chemistry, quantitative structural activity relationship, principal component analysis and drug screening workflow systems. The authors then provide their perspectives on the importance of these techniques for drug discovery. Computational tools help researchers to design and discover new drugs for the treatment of several human diseases without side effects, thus allowing for the evaluation of millions of compounds with a reduced cost in both time and economic resources. The problem is that operating each program is difficult; one is required to use several programs and understand each of the properties being tested. In the future, it is possible that a single computer and software program will be capable of evaluating the complete properties (mechanisms of action and ADMET properties) of ligands. It is also possible that after submitting one target, this computer-software will be capable of suggesting potential compounds along with ways to synthesize them, and presenting biological models for testing.

Impact of non-medical switching on clinical and economic outcomes, resource utilization and medication-taking behavior: a systematic literature review.

PubMed

Nguyen, Elaine; Weeda, Erin R; Sobieraj, Diana M; Bookhart, Brahim K; Piech, Catherine Tak; Coleman, Craig I

2016-07-01

To evaluate current knowledge of the impact of non-medical switching on clinical and economic outcomes, resource utilization and medication-taking behavior. The literature was searched (Medline and Web of Science, January 2000-November 2015) to identify United States' studies evaluating ≥25 patients and measuring the impact of non-medical switching of drugs (switching to a chemically distinct but similar medication for reasons other than lack of clinical efficacy/response, side effects or poor adherence) on ≥1 clinical, economic, resource utilization or medication-taking behavior outcome. The direction of association between non-medical switching and outcomes was classified as negative or positive if a statistically significant worsening or improvement was reported, or neutral if no significant difference was observed. Twenty-nine studies contributed 96 outcomes (60.4% clinical; 21.9% resource utilization; 13.5% economic; 4.2% medication-taking behavior) within six disease categories (cardio-metabolic, immune-mediated, acid suppression, psychiatric, hormone replacement therapy and pain). The direction of association was more frequently negative (33.3%) or neutral (55.2%) than it was positive (11.5%). Stratified by outcome type, non-medical switching was negatively associated with clinical, economic, healthcare utilization and medication-taking behavior outcomes in 20.7%, 69.2%, 38.1% and 75.0% of cases, respectively; and positively in only 4.8%-17.2% of outcomes subgroups. Of 32 outcomes in patients demonstrating stable/well controlled disease, 68.8% and 31.3% had a negative and neutral direction of association. In patients without demonstrated disease stability, outcomes were negatively, neutrally and positively impacted by non-medical switching in 15.6%, 67.2% and 17.2% of 64 outcomes. Our inability to evaluate specific disease state categories and studies/outcomes received equal weight regardless of sample size or magnitude of effect. Non-medical switching was more often associated with negative or neutral effects than positive effects on an array of important outcomes. Among patients with stable/well controlled disease, non-medical switching was associated with mostly negative effects.

Side effects during subcutaneous immunotherapy in children with allergic diseases.

PubMed

Tophof, Max A; Hermanns, Anne; Adelt, Thomas; Eberle, Peter; Gronke, Christine; Friedrichs, Frank; Knecht, Roland; Mönter, Ernst; Schöpfer, Helmut; Schwerk, Nicolaus; Steinbach, Jörg; Umpfenbach, Hans-Ulrich; Weißhaar, Christian; Wilmsmeyer, Brigitte; Bufe, Albrecht

2018-05-01

Allergen-specific immunotherapy is the only causal form of therapy for IgE-mediated allergic diseases. Subcutaneous immunotherapy (SCIT) is considered safe and well tolerated in adults, yet there is less evidence of safety in the pediatric population. A non-interventional prospective observing longitudinal study was carried out to determine the incidence of local and systemic side effects by SCIT, routinely performed in pediatric patients. A total of 581 pediatric patients were observed in 18 study centers between March 2012 and October 2014, recording 8640 treatments and 10 015 injections. A total of 54.6% of the patients experienced immediate local side effects at least once; delayed local side effects were seen in 56.1%. Immediate systemic adverse reactions occurred in 2.2% of patients; 7.4% experienced delayed systemic side effects. However, severe systemic side effects (grade III in the classification of Ring and Messmer) were seen in 0.03% of all treatments, all appearing within 30 minutes after the injections. No grade IV reactions were observed. In addition, many potential risk factors were investigated, yet only a few were found to be associated with the occurrence of side effects. Subcutaneous immunotherapy is a safe form of therapy in pediatric patients, with similar rates of local side effects compared to adult patients and low rates of severe systemic side effects. However, local and systemic reactions occurring later than 30 minutes after injection were observed more often than expected, which makes it essential to be attentive on behalf of pediatricians, patients, and parents. © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

Women with breast cancer report substantially more disease- and treatment-related side or late effects than registered by clinical oncologists: a cross-sectional study of a standard follow-up program in an oncological department.

PubMed

Ellegaard, Mai-Britt Bjørklund; Grau, Cai; Zachariae, Robert; Jensen, Anders Bonde

2017-08-01

Follow-up after breast cancer treatment is standard due to the risk of development of new primary cancers and recurrent disease. The aim of the present study was to evaluate a standard follow-up program in an oncological department by assessing: (1) Symptoms or signs of new primary cancer or recurrent disease, (2) Disease- and treatment-related physical and psychosocial side or late effects, and (3) relevant actions by oncology staff. In a cross-sectional study, 194 women who came for follow-up visit after treatment for primary surgery were included. The clinical oncologists registered symptoms and signs of recurrent disease or new primary cancer. Side or late effects were both assessed by patient and the clinical oncologists. Loco-regional or distant signs of recurrent disease were suspected in eight (5%) patients. Further examinations revealed no disease recurrence. Most patients (93%) reported some degree of side or late effects. Statistically significant more side or late effects were reported by the women (average: 6.9) than registered by the clinical oncologists (average: 2.4), p < 0.001. The three most often patient-reported side or late effects were hot flushes (35%), fatigue (32%), and sleep disturbance (31%). None of the scheduled or additional visits resulted in detection of recurrent disease. Furthermore, the majority of patients reported side or late effects. Statistically significant more women reported side or late effects than registered by the clinical oncologists. This suggests the need for rethinking of the follow-up programs with more emphasis upon side or late effects of the treatment.

Specific expectancies are associated with symptomatic outcomes and side effect burden in a trial of chamomile extract for Generalized Anxiety Disorder

PubMed Central

Keefe, John R.; Amsterdam, Jay; Li, Qing S; Soeller, Irene; DeRubeis, Robert; Mao, Jun J

2017-01-01

Objective Patient expectancies are hypothesized to contribute to the efficacy and side effects of psychiatric treatments, but little research has investigated this hypothesis in the context of psychopharmacological therapies for anxiety. We prospectively investigated whether expectancies predicted efficacy and adverse events in oral therapy for Generalized Anxiety Disorder (GAD), controlling for confounding patient characteristics correlating with outcomes. Methods Expectancies regarding treatment efficacy and side effects were assessed at baseline of an eight week open-label phase of a trial of chamomile for Generalized Anxiety Disorder (GAD). The primary outcome was patient-reported GAD-7 scores, with clinical response and treatment-emergent side-effects as secondary outcomes. Expectancies were used to predict symptomatic and side-effect outcomes. Results Very few baseline patient characteristics predicted either type of expectancy. Controlling for a patient’s predicted recovery based on their baseline characteristics, higher efficacy expectancies at baseline predicted greater change on the GAD-7 (adjusted β = −0.19, p = 0.011). Efficacy expectancies also predicted a higher likelihood of attaining clinical response (adjusted odds ratio = 1.69, p = 0.002). Patients with higher side effect expectancies reported more side effects (adjusted log expected count = 0.26, p = 0.038). Efficacy expectancies were unrelated to side effect reports (log expected count = −0.05, p = 0.680), and side effect expectancies were unrelated to treatment efficacy (β = 0.08, p = 0.306). Conclusions Patients entering chamomile treatment for GAD with more favorable self-generated expectancies for the treatment experience greater improvement and fewer adverse events. Aligning patient expectancies with treatment selections may optimize outcomes. PMID:27716513

[Extrapyramidal side-effects: avoidance, diagnosis and treatment].

PubMed

Fleischhacker, W Wolfgang; Widschwendter, Christian

2005-04-01

Acute extrapyramidal side-effects (EPS) are a common phenomenon of treatment with antipsychotics. They are associated with a substantial reduction of the patient's quality of life and of compliance with the treatment. This article gives an overview of the different forms of EPS. It outlines strategies to avoid these side-effects and discusses problems in diagnosis and treatment. In comparison to conventional compounds, the clearest advantage of new generation antipsychotics is a reduced risk of the occurrence of extrapyramidal side-effects (EPS). Many studies have found that newer antipsychotics have a lesser propensity to causes EPS. Nevertheless, there are some conflicting results on this topic. This article discusses some of these results and sheds light on methodological problems in the evaluation of side-effects of antipsychotic treatment.

Distributed Coding of Compressively Sensed Sources

NASA Astrophysics Data System (ADS)

Goukhshtein, Maxim

In this work we propose a new method for compressing multiple correlated sources with a very low-complexity encoder in the presence of side information. Our approach uses ideas from compressed sensing and distributed source coding. At the encoder, syndromes of the quantized compressively sensed sources are generated and transmitted. The decoder uses side information to predict the compressed sources. The predictions are then used to recover the quantized measurements via a two-stage decoding process consisting of bitplane prediction and syndrome decoding. Finally, guided by the structure of the sources and the side information, the sources are reconstructed from the recovered measurements. As a motivating example, we consider the compression of multispectral images acquired on board satellites, where resources, such as computational power and memory, are scarce. Our experimental results exhibit a significant improvement in the rate-distortion trade-off when compared against approaches with similar encoder complexity.

CADB: Conformation Angles DataBase of proteins

PubMed Central

Sheik, S. S.; Ananthalakshmi, P.; Bhargavi, G. Ramya; Sekar, K.

2003-01-01

Conformation Angles DataBase (CADB) provides an online resource to access data on conformation angles (both main-chain and side-chain) of protein structures in two data sets corresponding to 25% and 90% sequence identity between any two proteins, available in the Protein Data Bank. In addition, the database contains the necessary crystallographic parameters. The package has several flexible options and display facilities to visualize the main-chain and side-chain conformation angles for a particular amino acid residue. The package can also be used to study the interrelationship between the main-chain and side-chain conformation angles. A web based JAVA graphics interface has been deployed to display the user interested information on the client machine. The database is being updated at regular intervals and can be accessed over the World Wide Web interface at the following URL: http://144.16.71.148/cadb/. PMID:12520049

Effects of patient-reported non-severe hypoglycemia on healthcare resource use, work-time loss, and wellbeing in insulin-treated patients with diabetes in seven European countries.

PubMed

Geelhoed-Duijvestijn, Petronella H; Pedersen-Bjergaard, Ulrik; Weitgasser, Raimund; Lahtela, Jorma; Jensen, Marie Markert; Östenson, Claes-Göran

2013-12-01

Hypoglycemia is a frequent side effect induced by insulin treatment of type 1 (T1DM) and type 2 diabetes (T2DM). Limited data exist on the associated healthcare resource use and patient impact of hypoglycemia, particularly at a country-specific level. This study investigated the effects of self-reported non-severe hypoglycemic events (NSHE) on use of healthcare resources and patient wellbeing. Patients with T1DM or insulin-treated T2DM diabetes from seven European countries were invited to complete four weekly questionnaires. Data were collected on patient demographics, NSHE occurrence in the last 7 days, hypoglycemia-related resource use, and patient impact. NSHE were defined as events with hypoglycemia symptoms, with or without blood glucose measurement, or low blood glucose measurement without symptoms, which the patient could manage without third-party assistance. Three thousand, nine hundred and fifty-nine respondents completed at least one wave of the survey, with 57% completing all four questionnaires; 3827 respondents were used for data analyses. Overall, 2.3% and 8.9% of NSHE in patients with T1DM and T2DM, respectively, resulted in healthcare professional contact. Across countries, there was a mean increase in blood glucose test use of 3.0 tests in the week following a NSHE. Among respondents who were employed (48%), loss of work-time after the last hypoglycemic event was reported for 9.7% of NSHE. Overall, 10.2% (daytime) and 8.0% (nocturnal) NSHE led to work-time loss, with a mean loss of 84.3 (daytime) and 169.6 (nocturnal) minutes among patients reporting work-time loss. Additionally, patients reported feeling tired, irritable, and having negative feelings following hypoglycemia. Direct comparisons between studies must be interpreted with caution because of different definitions of hypoglycemia severity, duration of the studies, and methods of data collection. NSHE were associated with use of extra healthcare resources and work-time loss in all countries studied, suggesting that NSHE have considerable impact on patients/society.

Oral health impacts of medications used to treat mental illness.

PubMed

Cockburn, N; Pradhan, A; Taing, M W; Kisely, S; Ford, P J

2017-12-01

Many psychotropic medications affect oral health. This review identified oral side effects for antidepressant, antipsychotic, anticonvulsant, antianxiety and sedative drugs that are recommended in Australia for the management of common mental illnesses and provides recommendations to manage these side-effects. The Australian Therapeutic Guidelines and the Australian Medicines Handbook were searched for medications used to treat common mental health conditions. For each medication, the generic name, class, and drug company reported side-effects were extracted from the online Monthly Index of Medical Specialties (eMIMs) and UpToDate databases. Meyler's Side Effect of Drugs Encyclopaedia was used to identify additional oral adverse reactions to these medications. Fifty-seven drugs were identified: 23 antidepressants, 22 antipsychotics or mood stabilisers, and 12 anxiolytic or sedative medications. Xerostomia (91%) the most commonly reported side effect among all classes of medications of the 28 identified symptoms. Other commonly reported adverse effects included dysguesia (65%) for antidepressants, and tardive dyskinesia (94%) or increased salivation (78%) for antipsychotic medications. While xerostomia has often been reported as a common adverse effect of psychotropic drugs, this review has identified additional side effects including dysguesia from antidepressants and tardive dyskinesia and increased salivation from antipsychotics. Clinicians should consider oral consequences of psychotropic medication in addition to other side-effects when prescribing. For antidepressants, this would mean choosing duloxetine, agomelatine and any of the serotonin re-uptake inhibitors except sertraline. In the case of antipsychotics and mood stabilisers, atypical agents have less oral side effects than older alternatives. Copyright © 2017 Elsevier B.V. All rights reserved.

Predicting drug side-effect profiles: a chemical fragment-based approach

PubMed Central

2011-01-01

Background Drug side-effects, or adverse drug reactions, have become a major public health concern. It is one of the main causes of failure in the process of drug development, and of drug withdrawal once they have reached the market. Therefore, in silico prediction of potential side-effects early in the drug discovery process, before reaching the clinical stages, is of great interest to improve this long and expensive process and to provide new efficient and safe therapies for patients. Results In the present work, we propose a new method to predict potential side-effects of drug candidate molecules based on their chemical structures, applicable on large molecular databanks. A unique feature of the proposed method is its ability to extract correlated sets of chemical substructures (or chemical fragments) and side-effects. This is made possible using sparse canonical correlation analysis (SCCA). In the results, we show the usefulness of the proposed method by predicting 1385 side-effects in the SIDER database from the chemical structures of 888 approved drugs. These predictions are performed with simultaneous extraction of correlated ensembles formed by a set of chemical substructures shared by drugs that are likely to have a set of side-effects. We also conduct a comprehensive side-effect prediction for many uncharacterized drug molecules stored in DrugBank, and were able to confirm interesting predictions using independent source of information. Conclusions The proposed method is expected to be useful in various stages of the drug development process. PMID:21586169

Impact of present and past antipsychotic side effects on attitude toward typical antipsychotic treatment and adherence.

PubMed

Lambert, M; Conus, P; Eide, P; Mass, R; Karow, A; Moritz, S; Golks, D; Naber, D

2004-11-01

(1) determine which antipsychotic side effects (SE) schizophrenic patients consider the most distressing during treatment with typical antipsychotics, (2) measure the impact of actual and past SE on patients' attitude toward antipsychotics and (3) assess the influence of both on adherence. The 213 schizophrenics, treated with conventional antipsychotics, were recruited in two psychiatric hospitals in Hamburg. Subjects were assessed about type and severity of present and past side effects and their attitude and adherence to antipsychotic treatment. The 82 (39%) patients presented present SE while 131 (61%) did not. Sexual dysfunctions (P < 0.001), extrapyramidal (P < 0.05) and psychic side effects (P < 0.05) were rated as significantly subjectively more distressing than sedation or vegetative side effects. Patients presenting with present SE compared with patients without present SE had a significantly more negative general attitude toward antipsychotics (P < 0.05), were more doubtful about their efficacy (P < 0.01) and were less likely to encourage a relative to take such a medication in case of need (P < 0.001). A regression analysis indicated that nonadherence was mainly influenced by negative general and efficacy attitudes toward antipsychotics and the experience of past or present antipsychotic side effects. All antipsychotic side effects, present or past, can have a durable negative impact on patient's attitude toward antipsychotic treatment and adherence. Non-adherence is mainly determined, among other factors, by these negative attitudes, which are partly influenced by the experience of past or present antipsychotic-induced side effects.

Harsh medicine. [retail wheeling experiment in Michigan and side effects

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

Studness, C.M.

1993-07-15

Retailing wheeling's harmful side-effects may surface in a Michigan experiment. In the final analysis, the debate over retail wheeling is about whether there will be direct price competition in the electric power industry. Retail wheeling would extend to the electric power market the same freedom of choice among customers that is present elsewhere in the economy. It would provide a mechanism through which competition could enforce an efficient allocation of resources. It also undoubtedly would eliminate most of the huge discrepancies that exist between so many neighboring service areas. It is unlikely that permitting retail wheeling would actually result inmore » much wheeling or loss of load. Utilities will no doubt meet the threat of the loss of load by cutting rates to hold their customers. Hence, the primary effect would be on the pricing of electricity, not the wheeling of power. The retail wheeling experiment under consideration in Michigan can become an important step toward making the utility industry more efficient for the nation and more equitable for ratepayers. Unfortunately, it also is potentially unfair to the utilities involved. A retail wheeling experiment in one state is likely to put those utilities at risk for competitive attack, but is unlikely to give those utilities the countervailing power to use retail wheeling elsewhere to market their power. Fairness and economic efficiency require that retail wheeling exist everywhere, and that is is accessible to utilities as well as non-utilities.« less

Blood RNA biomarker panel detects both left- and right-sided colorectal neoplasms: a case-control study.

PubMed

Chao, Samuel; Ying, Jay; Liew, Gailina; Marshall, Wayne; Liew, Choong-Chin; Burakoff, Robert

2013-07-23

Colonoscopy is widely regarded to be the gold standard for colorectal cancer (CRC) detection. Recent studies, however, suggest that the effectiveness of colonoscopy is mostly confined to tumors on the left side of the colon (descending, sigmoid, rectum), and that the technology has poor tumor detection for right-sided (cecum, ascending, transverse) lesions. A minimally invasive test that can detect both left-sided and right-sided lesions could increase the effectiveness of screening colonoscopy by revealing the potential presence of neoplasms in the right-sided "blind spot". We previously reported on a seven-gene, blood-based biomarker panel that effectively stratifies a patient's risk of having CRC. For the current study, we assessed the effectiveness of the seven-gene panel for the detection of left- and right-sided CRC lesions. Results were evaluated for 314 patients with CRC (left-sided: TNM I, 65; TNM II, 57; TNM III, 60; TNM IV, 17; unknown, 9. right-sided: TNM I, 28; TNM II, 29; TNM III, 38; TNM IV, 12; unknown, 1 and including two samples with both left and right lesions) and 328 control samples. Blood samples were obtained prior to clinical staging and therapy. Most CRC subjects had localized disease (stages I and II, 58%); regional (stage III) and systemic (stage IV) disease represented 32% and 9%, respectively, of the study population. The panel detected left-sided (74%, 154/208) and right-sided (85%, 92/108) lesions with an overall sensitivity of 78% (215/316) at a specificity of 66% (215/328). Treatable cancer (stages I to III) was detected with left-sided lesion sensitivity of 76% (138/182) and right-sided sensitivity of 84% (80/95). This seven-gene biomarker panel detected right-sided CRC lesions across all cancer stages with a sensitivity that is at least equal to that for left-sided lesions. This study supports the use of this panel as the basis for a patient-friendly, blood-based test that can be easily incorporated into a routine physical examination in advance of colonoscopy to provide a convenient companion diagnostic and a pre-screening alert, ultimately leading to enhanced CRC screening effectiveness.

30 CFR 57.22219 - Seals and stoppings (II-A mines).

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Seals and stoppings (II-A mines). 57.22219... Standards for Methane in Metal and Nonmetal Mines Ventilation § 57.22219 Seals and stoppings (II-A mines... fire resistance. (b) Seals shall be of substantial construction. Exposed surfaces on the fresh air side...

30 CFR 57.22219 - Seals and stoppings (II-A mines).

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Seals and stoppings (II-A mines). 57.22219... Standards for Methane in Metal and Nonmetal Mines Ventilation § 57.22219 Seals and stoppings (II-A mines... fire resistance. (b) Seals shall be of substantial construction. Exposed surfaces on the fresh air side...

ROBART I: In Retrospect

DTIC Science & Technology

2005-12-01

6-3 6.1.2 Making It Happen ...this approach was that if the beacon happened to be off to the left side versus the right, the events that initiated and terminated the turning...resumed. Making such behavior arbitration happen in a smooth and orderly fashion with extremely limited resources will be the focus of our next section

7 CFR 1710.115 - Final maturity.

Code of Federal Regulations, 2012 CFR

2012-01-01

... implementation of programs for demand side management and energy resource conservation and on and off grid renewable energy sources not owned by the borrower will be determined by RUS. Due to the uncertainty of... operation of a new system are a separate class of loans and usually have a final maturity of less than 10...

7 CFR 1710.115 - Final maturity.

Code of Federal Regulations, 2013 CFR

2013-01-01

... implementation of programs for demand side management and energy resource conservation and on and off grid renewable energy sources not owned by the borrower will be determined by RUS. Due to the uncertainty of... operation of a new system are a separate class of loans and usually have a final maturity of less than 10...

7 CFR 1710.115 - Final maturity.

Code of Federal Regulations, 2011 CFR

2011-01-01

... implementation of programs for demand side management and energy resource conservation and on and off grid renewable energy sources not owned by the borrower will be determined by RUS. Due to the uncertainty of... operation of a new system are a separate class of loans and usually have a final maturity of less than 10...

39. Photo copy of site plan, (original in Forest Service ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

39. Photo copy of site plan, (original in Forest Service Office, Elkins, WV, 'Parsons Nursery Special Use Permit, West Virginia Department of Natural Resources'), 1969. PARSONS NURSERY SITE PLAN. CORROLATES TO PARSONS NURSERY AT TIME OF FLOOD, NOVEMBER, 1985. - Parsons Nursery, South side of U.S. Route 219, Parsons, Tucker County, WV

Educational Resources in the ASCC Library

ERIC Educational Resources Information Center

Lin, Steven

2006-01-01

After two years of construction, American Samoa Community College opened its new library on September 2, 2003. The library is located on the east side of campus and is equipped with ten computer workstations, four online public access catalogs, three copying machines, and an elevator that is in compliance with the Americans with Disabilities Act.…

4. SNAKE RIVER VALLEY IRRIGATION DISTRICT, PHOTOGRAPHIC COPY OF DRAWING, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

4. SNAKE RIVER VALLEY IRRIGATION DISTRICT, PHOTOGRAPHIC COPY OF DRAWING, PROPOSED SECTION OF DIVERSION DAM ACROSS SNAKE RIVER, SHEET 1 OF 5, 1924 (on file at the Idaho State Office of Water Resources, Boise, Idaho) - Snake River Valley Irrigation District, East Side of Snake River (River Mile 796), Shelley, Bingham County, ID

Preparing the Host Country Workforce for Expatriate Managers: The Neglected Other Side of the Coin.

ERIC Educational Resources Information Center

Vance, Charles M.; Ring, Peter Smith

1994-01-01

Using an instructional systems development approach, ways to prepare the host country workforce for the assignment of an expatriate manager are discussed. The model is based on a number of perspectives: exchange theory, participatory management, corporate social responsibility, communication theory, and strategic human resource planning. (SK)

Distance Learning and Jihad: The Dark Side of the Force

ERIC Educational Resources Information Center

Bates, Rodger; Mooney, Mara

2014-01-01

The ability to reach a variety of audiences in diverse environments has made distance learning a major form of education and training in the 21st century. Though traditionally encountered in the educational and business communities, distance learning has proven an important resource for a variety of other constituencies. Terrorist groups have…

Physicians as gatekeepers: illness certification as a rationing device.

PubMed

Stone, D A

1979-01-01

Illness or disability is often used as an eligibility criterion by public programs that distribute money, services, privileges, and exemptions. Physicians then play a central role in the allocation process. But physicians are caught between a large pool of applicants who want some benefit, on the one hand, and an organization with limited resources to distribute, on the other hand. Three conflicts are engendered in this gatekeeping role: the tension between trusting and mistrusting information provided by the patient, the tension between erring on the false positive side and the false negative side in diagnostic decision-making, and the tension between doing everything possible for each patient and allocating limited resources among several needy clients. Several non-medical factors influence the ultimate outcome of this allocation process, which, in theory, rests on clinical decision-making: the specificity and restrictiveness of the formal definitions of illness and disability used by a program; the structure of the determination process; the overall policy of the organization on distribution of benefits; and the ability of the organization to use administrative review, direct incentives, and written standards to control the certifying behavior of physicians.

Psychiatric side effects of antihypertensive drugs other than reserpine.

PubMed

Paykel, E S; Fleminger, R; Watson, J P

1982-02-01

The psychiatric side effects of the major antihypertensive drugs other than reserpine are reviewed, including centrally acting drugs such as methyldopa and clonidine, peripheral adrenergic drugs such as guanethidine, beta-adrenoceptor blockers such as propranolol, and diuretics. Problems with differential diagnosis and with the interpretation of case reports make assessment of psychiatric side effects difficult. Sedation and sleep disturbances are the most common side effects, occurring with methyldopa, clonidine, and propranolol. Only methyldopa is clearly associated with depression. Other reported effects are toxic confusional states and psychotic reactions. These are rare, however, and no clear patterns of development have been recognized.

Commercial equipment loads: End-Use Load and Consumer Assessment Program (ELCAP)

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

Pratt, R.G.; Williamson, M.A.; Richman, E.E.

1990-07-01

The Office of Energy Resources of the Bonneville Power Administration is generally responsible for the agency's power and conservation resource planning. As associated responsibility which supports a variety of office functions is the analysis of historical trends in and determinants of energy consumption. The Office of Energy Resources' End-Use Research Section operates a comprehensive data collection program to provide pertinent information to support demand-side planning, load forecasting, and demand-side program development and delivery. Part of this on-going program is known as the End-Use Load and Consumer Assessment Program (ELCAP), an effort designed to collect electricity usage data through direct monitoringmore » of end-use loads in buildings. This program is conducted for Bonneville by the Pacific Northwest Laboratory. This report provides detailed information on electricity consumption of miscellaneous equipment from the commercial portion of ELCAP. Miscellaneous equipment includes all commercial end-uses except heating, ventilating, air conditioning, and central lighting systems. Some examples of end-uses covered in this report are office equipment, computers, task lighting, refrigeration, and food preparation. Electricity consumption estimates, in kilowatt-hours per square food per year, are provided for each end-use by building type. The following types of buildings are covered: office, retail, restaurant, grocery, warehouse, school, university, and hotel/motel. 6 refs., 35 figs., 12 tabs.« less

The PsyLOG mobile application: development of a tool for the assessment and monitoring of side effects of psychotropic medication.

PubMed

Kuzman, Martina Rojnic; Andlauer, Olivier; Burmeister, Kai; Dvoracek, Boris; Lencer, Rebekka; Koelkebeck, Katja; Nawka, Alexander; Riese, Florian

2017-06-01

Mobile health interventions are regarded as affordable and accessible tools that can enhance standard psychiatric care. As part of the mHealth Psycho-Educational Intervention Versus Antipsychotic-Induced Side Effects (mPIVAS) project (www.psylog.eu), we developed the mobile application "PsyLOG" based on mobile "smartphone" technology to monitor antipsychotic-induced side effects. The aim of this paper is to describe the rationale and development of the PsyLOG and its clinical use. The PsyLOG application runs on smartphones with Android operating system. The application is currently available in seven languages (Croatian, Czech, English, French, German, Japanese and Serbian). It consists of several categories: "My Drug Effects", "My Life Styles", "My Charts", "My Medication", "My Strategies", "My Supporters", "Settings" and "About". The main category "My Drug Effects" includes a list of 30 side effects with the possibility to add three additional side effects. Side effects are each accompanied by an appropriate description and the possibility to rate its severity on a visual analogue scale from 0-100%. The PsyLOG application is intended to enhance the link between patients and mental health professionals, serving as a tool that more objectively monitors side-effects over certain periods of time. To the best of our knowledge, no such applications have so far been developed for patients taking antipsychotic medication or for their therapists.

Enquiry into the Side Effects of School Inspection in a "Low-Stakes" Inspection Context

ERIC Educational Resources Information Center

Penninckx, Maarten; Vanhoof, Jan; De Maeyer, Sven; Van Petegem, Peter

2016-01-01

This article describes a qualitative study into the occurrence of the side effects of school inspection through in-depth interviews in five case schools. The study investigates the extent to which strategic activities, disturbing effects and emotional side effects occur in the case schools. The study also aims to understand features that may…

Inferring protein domains associated with drug side effects based on drug-target interaction network.

PubMed

Iwata, Hiroaki; Mizutani, Sayaka; Tabei, Yasuo; Kotera, Masaaki; Goto, Susumu; Yamanishi, Yoshihiro

2013-01-01

Most phenotypic effects of drugs are involved in the interactions between drugs and their target proteins, however, our knowledge about the molecular mechanism of the drug-target interactions is very limited. One of challenging issues in recent pharmaceutical science is to identify the underlying molecular features which govern drug-target interactions. In this paper, we make a systematic analysis of the correlation between drug side effects and protein domains, which we call "pharmacogenomic features," based on the drug-target interaction network. We detect drug side effects and protein domains that appear jointly in known drug-target interactions, which is made possible by using classifiers with sparse models. It is shown that the inferred pharmacogenomic features can be used for predicting potential drug-target interactions. We also discuss advantages and limitations of the pharmacogenomic features, compared with the chemogenomic features that are the associations between drug chemical substructures and protein domains. The inferred side effect-domain association network is expected to be useful for estimating common drug side effects for different protein families and characteristic drug side effects for specific protein domains.

Vedolizumab is an effective alternative in inflammatory bowel disease patients with anti-TNF-alpha therapy-induced dermatological side effects.

PubMed

Pijls, Philippe A R R; Gilissen, Lennard P L

2016-11-01

The treatment of patients with inflammatory bowel diseases has been revolutionized by the introduction of biological therapy with TNF-alpha blockers. However, TNF-alpha blockers are also associated with a wide variety of dermatological side effects, such as local skin infections, psoriasis and eczema. A new biological therapy, targeting the gut-specific adhesion molecule alpha4beta7 integrin, is the humanized monoclonal IgG1 antibody vedolizumab. Vedolizumab prevents leukocyte migration to the gastrointestinal tract, thereby reducing inflammation. This gut-specific therapy has the potential to reduce systemic side effects, including dermatological ones. We describe 3 inflammatory bowel disease patients who experience anti-TNF-alpha therapy-induced dermatological side effects, consisting of hidradenitis suppurativa, a folliculitis, scalp psoriasis and a dissecting folliculitis. In all patients, anti-TNF-alpha therapy-induced dermatological side effects diminished after switching to vedolizumab. Vedolizumab may be a viable alternative biological therapy in inflammatory bowel disease patients who experience anti-TNF-alpha therapy-induced dermatological side effects. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Experimental Study of Wake / Flap Interaction Noise and the Reduction of Flap Side Edge Noise

NASA Technical Reports Server (NTRS)

Hutcheson, Florence V.; Stead, Daniel J.; Plassman, Gerald E.

2016-01-01

The effects of the interaction of a wake with a half-span flap on radiated noise are examined. The incident wake is generated by bars of various widths and lengths or by a simplified landing gear model. Single microphone and phased array measurements are used to isolate the effects of the wake interaction on the noise radiating from the flap side edge and flap cove regions. The effects on noise of the wake generator's geometry and relative placement with respect to the flap are assessed. Placement of the wake generators upstream of the flap side edge is shown to lead to the reduction of flap side edge noise by introducing a velocity deficit and likely altering the instabilities in the flap side edge vortex system. Significant reduction in flap side edge noise is achieved with a bar positioned directly upstream of the flap side edge. The noise reduction benefit is seen to improve with increased bar width, length and proximity to the flap edge. Positioning of the landing gear model upstream of the flap side edge also leads to decreased flap side edge noise. In addition, flap cove noise levels are significantly lower than when the landing gear is positioned upstream of the flap mid-span. The impact of the local flow velocity on the noise radiating directly from the landing gear is discussed. The effects of the landing gear side-braces on flap side edge, flap cove and landing gear noise are shown.

DSN Resource Scheduling

NASA Technical Reports Server (NTRS)

Wang, Yeou-Fang; Baldwin, John

2007-01-01

TIGRAS is client-side software, which provides tracking-station equipment planning, allocation, and scheduling services to the DSMS (Deep Space Mission System). TIGRAS provides functions for schedulers to coordinate the DSN (Deep Space Network) antenna usage time and to resolve the resource usage conflicts among tracking passes, antenna calibrations, maintenance, and system testing activities. TIGRAS provides a fully integrated multi-pane graphical user interface for all scheduling operations. This is a great improvement over the legacy VAX VMS command line user interface. TIGRAS has the capability to handle all DSN resource scheduling aspects from long-range to real time. TIGRAS assists NASA mission operations for DSN tracking of station equipment resource request processes from long-range load forecasts (ten years or longer), to midrange, short-range, and real-time (less than one week) emergency tracking plan changes. TIGRAS can be operated by NASA mission operations worldwide to make schedule requests for the DSN station equipment.

Mineral resources of the Fort Piute Wilderness Study Area, San Bernardino County, California

USGS Publications Warehouse

Nielson, Jane E.; Frisken, James G.; Jachens, Robert C.; McDonnell, John R.

1987-01-01

The Fort Piute Wilderness Study Area (CDCA-267) is in northeastern San Bernardino County, California, near the boundary between California and Nevada. Mineral surveys were requested for 31,371 acres of the Fort Piute Wilderness Study Area. In this report the area studied is referred to as "the study area". Examination of mines and prospects in the area was accomplished by the U.S. Bureau of Mines in 1981 and 1982. Field investigations of the area were carried out by the U.S. Geological Survey in 1983 and 1985. No mines or prospects, few mining claims, and no identified resources are located within the wilderness study area. Moderate and low potential for gold resources appears limited to outcrops of gneiss and granite exposed along the eastern side of the Piute Range. Available information indicates that there is no potential for energy resources, including oil and gas, uranium, or geothermal, in the study area.

Agriculture and Energy: Implications for Food Security, Water, and Land Use

NASA Astrophysics Data System (ADS)

Tokgoz, S.; Zhang, W.; Msangi, S.; Bhandary, P.

2011-12-01

Sustainable production of agricultural commodities and growth of international trade in these goods are challenged as never before by supply-side constraints (such as climate change, water and land scarcity, and environmental degradation) and by demand-side dynamics (volatility in food and energy markets, the strengthening food-energy linkage, population growth, and income growth). On the one hand, the rapidly expanding demand can potentially create new market opportunities for agriculture. On the other hand, there are many threats to a sufficient response by the supply side to meet this growing and changing demand. Agricultural production systems in many countries are neither resource-efficient, nor producing according to their full potential. The stock of natural resources such as land, water, nutrients, energy, and genetic diversity is shrinking relative to demand, and their use must become increasingly efficient in order to reduce environmental impacts and preserve the planet's productive capacity. World energy prices have increased rapidly in recent years. At the same time, agriculture has become more energy-intensive. Higher energy costs have pushed up the cost of producing, transporting and processing agricultural commodities, driving up commodity prices. Higher energy costs have also affected water use and availability through increased costs of water extraction, conveyance and desalinization, higher demand for hydroelectric power, and increased cost of subsidizing water services. In the meantime, the development of biofuels has diverted increasing amounts of agricultural land and water resources to the production of biomass-based renewable energy. This more "intensified" linkage between agriculture and energy comes at a time when there are other pressures on the world's limited resources. The related high food prices, especially those in the developing countries, have led to setbacks in the poverty alleviation effort among the global community with more population under hunger and poverty. In light of these threats and opportunities facing the global food system, the proposed study takes a long-term perspective and addresses the main medium and long- term drivers of agricultural markets using the International Model for Policy Analysis of Agricultural Commodities and Trade developed by the Environment and Production Technology Division of IFPRI to project future production, consumption, and trade of key agricultural commodities. The main objective of the study is to analyze the link between energy and agricultural markets, focusing on the "new" role of agriculture as a supplier of energy for transportation through biofuels, and the subsequent impact on land use and demand for water from the agricultural sector. In this context, this study incorporates various scenarios of future energy demand and energy price impacts on global agricultural markets (food prices and food security), water use implications (irrigation water consumption by agricultural sector), and land use implications (changes in national and global crop area). The scenarios are designed to understand the impact of energy prices on biofuel production, cost of production for agricultural crops, conversion of rainfed area to irrigated area, and necessary levels of crop productivity growth to counter these effects.

Antipsychotic Drug Side Effects for Persons with Intellectual Disability

ERIC Educational Resources Information Center

Matson, Johnny L.; Mahan, Sara

2010-01-01

Antipsychotic drugs are the most frequently prescribed of the psychotropic drugs among the intellectually disabled (ID) population. Given their widespread use, efforts to systematically assess and report side effects are warranted. Specific scaling methods such as the "Matson Evaluation of Side Effects" ("MEDS"), the "Abnormal Inventory Movement…

Management of Side Effects of Novel Therapies for Multiple Myeloma: Consensus Statements Developed by the International Myeloma Foundation’s Nurse Leadership Board

PubMed Central

Bertolotti, Page; Bilotti, Elizabeth; Colson, Kathleen; Curran, Kathleen; Doss, Deborah; Faiman, Beth; Gavino, Maria; Jenkins, Bonnie; Lilleby, Kathy; Love, Ginger; Mangan, Patricia A.; McCullagh, Emily; Miceli, Teresa; Miller, Kena; Rogers, Kathryn; Rome, Sandra; Sandifer, Stacey; Smith, Lisa C.; Tariman, Joseph D.; Westphal, Jeanne

2014-01-01

Nurses play an essential role in managing the care of patients with multiple myeloma, who require education and support to receive and adhere to optimal therapy. The International Myeloma Foundation created a Nurse Leadership Board comprised of oncology nurses from leading cancer centers and community practices. An assessment survey identified the need for specific recommendations for managing key side effects of novel antimyeloma agents. Myelosuppression, thromboembolic events, peripheral neuropathy, steroid toxicities, and gastrointestinal side effects were selected for the first consensus statements. The board developed recommendations for healthcare providers in any medical setting, including grading of side-effect toxicity and strategies for managing the side effects in general, with specific recommendations pertaining to the novel agents. PMID:18490252

Comprehensive prediction of drug-protein interactions and side effects for the human proteome

PubMed Central

Zhou, Hongyi; Gao, Mu; Skolnick, Jeffrey

2015-01-01

Identifying unexpected drug-protein interactions is crucial for drug repurposing. We develop a comprehensive proteome scale approach that predicts human protein targets and side effects of drugs. For drug-protein interaction prediction, FINDSITEcomb, whose average precision is ~30% and recall ~27%, is employed. For side effect prediction, a new method is developed with a precision of ~57% and a recall of ~24%. Our predictions show that drugs are quite promiscuous, with the average (median) number of human targets per drug of 329 (38), while a given protein interacts with 57 drugs. The result implies that drug side effects are inevitable and existing drugs may be useful for repurposing, with only ~1,000 human proteins likely causing serious side effects. A killing index derived from serious side effects has a strong correlation with FDA approved drugs being withdrawn. Therefore, it provides a pre-filter for new drug development. The methodology is free to the academic community on the DR. PRODIS (DRugome, PROteome, and DISeasome) webserver at http://cssb.biology.gatech.edu/dr.prodis/. DR. PRODIS provides protein targets of drugs, drugs for a given protein target, associated diseases and side effects of drugs, as well as an interface for the virtual target screening of new compounds. PMID:26057345

CHECKPOINT INHIBITOR IMMUNE THERAPY: Systemic Indications and Ophthalmic Side Effects.

PubMed

Dalvin, Lauren A; Shields, Carol L; Orloff, Marlana; Sato, Takami; Shields, Jerry A

2018-06-01

To review immune checkpoint inhibitor indications and ophthalmic side effects. A literature review was performed using a PubMed search for publications between 1990 and 2017. Immune checkpoint inhibitors are designed to treat system malignancies by targeting one of three ligands, leading to T-cell activation for attack against malignant cells. These ligands (and targeted drug) include cytotoxic T-lymphocyte antigen-4 (CTLA-4, ipilimumab), programmed death protein 1 (PD-1, pembrolizumab, nivolumab), and programmed death ligand-1 (PD-L1, atezolizumab, avelumab, durvalumab). These medications upregulate the immune system and cause autoimmune-like side effects. Ophthalmic side effects most frequently manifest as uveitis (1%) and dry eye (1-24%). Other side effects include myasthenia gravis (n = 19 reports), inflammatory orbitopathy (n = 11), keratitis (n = 3), cranial nerve palsy (n = 3), optic neuropathy (n = 2), serous retinal detachment (n = 2), extraocular muscle myopathy (n = 1), atypical chorioretinal lesions (n = 1), immune retinopathy (n = 1), and neuroretinitis (n = 1). Most inflammatory side effects are managed with topical or periocular corticosteroids, but advanced cases require systemic corticosteroids and cessation of checkpoint inhibitor therapy. Checkpoint inhibitors enhance the immune system by releasing inhibition on T cells, with risk of autoimmune-like side effects. Ophthalmologists should include immune-related adverse events in their differential when examining cancer patients with new ocular symptoms.

Body-drug assemblages: theorizing the experience of side effects in the context of HIV treatment.

PubMed

Gagnon, Marilou; Holmes, Dave

2016-10-01

Each of the antiretroviral drugs that are currently used to stop the progression of HIV infection causes its own specific side effects. Despite the expansion, multiplication, and simplification of treatment options over the past decade, side effects continue to affect people living with HIV. Yet, we see a clear disconnect between the way side effects are normalized, routinized, and framed in clinical practice and the way they are experienced by people living with HIV. This paper builds on the premise that new approaches are needed to understand side effects in a manner that is more reflective of the subjective accounts of people living with HIV. Drawing on the work of Deleuze and Guattari, it offers an original application of the theory of 'assemblage'. This theory offers a new way of theorizing side effects, and ultimately the relationship between the body and antiretroviral drugs (as technologies). Combining theory with examples derived from empirical data, we examine the multiple ways in which the body connects not only to the drugs but also to people, things, and systems. Our objective is to illustrate how this theory dares us to think differently about side effects and allows us to originally (re)think the experience of taking antiretroviral drugs. © 2016 The Authors. Nursing Philosophy Published by John Wiley & Sons Ltd.

The Coordinated Noninvasive Studies (CNS) Project. Phase 1

DTIC Science & Technology

1991-12-01

may reveal functional asymmetries that represent the influence of two factors: 1) the "contralateral effect ," based on the side -of-space source of...asymmetries, where processing on that side of the CNS opposite the side of input is favored, and 2) an effect based J.L. Lauter [CNS Project/AFOSR 88-0352...extent that these exist over and above sidedness bias as well as side -of-space asymmetries -- since in these experiments, contralateral effects are

[Impacts of cross-habitat resource subsidies on ecosystems: A review.

PubMed

Zhang, Yi Xin; Xiang, Hong Yong

2017-02-01

The flux of matter, energy and nutrients across ecosystems, i.e., resource subsidy, is a fundamental attribute of ecosystems, as well as one of basic research questions in ecology. Common subsidies include leaf litter and terrestrial insects that fall into waters, the adults of aquatic insects, spawning salmon. The allocthonous input of resource subsidy can influence individual organisms, populations, communities, biodiversity and ecosystem functioning, such as enhancing individual growth, increasing species abundance and diversity, affecting community structure, enhancing secondary productivity, influencing food-chain length and food web. Due to increased human impacts on environments, especially at aspects of land use, climate change and invasive species, the influence of anthropogenic disturbance on cross-ecosystem resource subsidies will be intensified at both spacial and temporary scales, so that ecosystems will face severer threats. Accordingly, future ecological researches in this field should emphasize the following aspects: impacts of single and multiple stressors on subsidies and ecosystems, implementation of dynamic resource subsidies on ecosystem restoration and management, the dark sides of subsidy relating with pollutants, and basic ecological research on cross-ecosystem resource subsidy in tropics and sub-tropics, as well in China.

Briefing notes on emergency medical disembarks by helicopter at sea in North America.

PubMed

Williams, Steve; Dahl, Eilif

2014-01-01

Physicians and nurses from shore based practice who move to work on cruise ships often have concerns about the management of critically ill patients and questions about the resources available to transfer by helicopter to a tertiary care facility. This article seeks to outline some of the clinical, operational and logistical issues associated with using a helicopter to transfer a patient from a ship to a shore-side hospital. While it focuses on resources available in the maritime areas around North America, most of the clinical comments would apply to helicopter evacuations anywhere in the world.

Department of Defense Natural Resources Program: American Woodcock (Scolopax minor). Section 4.1.2. US Army Corps of Engineers Wildlife Resources Management Manual

DTIC Science & Technology

1989-04-01

size of a bob- white. The breast is a light cinnamon color, and the back and sides are washed with black. The head is gray and brown with a series of 3...are a pinkish buff to cinnamon color and are covered with light brown spots or blotches overlaid with darkeL warkings. The shell is smooth and oval...Louisi- ana bottomlands ranged from pastures to fallow fields to agricultural fields planted in corn, cotton, and sugar cane (Glasgow 1958). Two

Gas hydrate inhibition by perturbation of liquid water structure

NASA Astrophysics Data System (ADS)

Sa, Jeong-Hoon; Kwak, Gye-Hoon; Han, Kunwoo; Ahn, Docheon; Lee, Kun-Hong

2015-06-01

Natural gas hydrates are icy crystalline materials that contain hydrocarbons, which are the primary energy source for this civilization. The abundance of naturally occurring gas hydrates leads to a growing interest in exploitation. Despite their potential as energy resources and in industrial applications, there is insufficient understanding of hydrate kinetics, which hinders the utilization of these invaluable resources. Perturbation of liquid water structure by solutes has been proposed to be a key process in hydrate inhibition, but this hypothesis remains unproven. Here, we report the direct observation of the perturbation of the liquid water structure induced by amino acids using polarized Raman spectroscopy, and its influence on gas hydrate nucleation and growth kinetics. Amino acids with hydrophilic and/or electrically charged side chains disrupted the water structure and thus provided effective hydrate inhibition. The strong correlation between the extent of perturbation by amino acids and their inhibition performance constitutes convincing evidence for the perturbation inhibition mechanism. The present findings bring the practical applications of gas hydrates significantly closer, and provide a new perspective on the freezing and melting phenomena of naturally occurring gas hydrates.

Gas hydrate inhibition by perturbation of liquid water structure.

PubMed

Sa, Jeong-Hoon; Kwak, Gye-Hoon; Han, Kunwoo; Ahn, Docheon; Lee, Kun-Hong

2015-06-17

Natural gas hydrates are icy crystalline materials that contain hydrocarbons, which are the primary energy source for this civilization. The abundance of naturally occurring gas hydrates leads to a growing interest in exploitation. Despite their potential as energy resources and in industrial applications, there is insufficient understanding of hydrate kinetics, which hinders the utilization of these invaluable resources. Perturbation of liquid water structure by solutes has been proposed to be a key process in hydrate inhibition, but this hypothesis remains unproven. Here, we report the direct observation of the perturbation of the liquid water structure induced by amino acids using polarized Raman spectroscopy, and its influence on gas hydrate nucleation and growth kinetics. Amino acids with hydrophilic and/or electrically charged side chains disrupted the water structure and thus provided effective hydrate inhibition. The strong correlation between the extent of perturbation by amino acids and their inhibition performance constitutes convincing evidence for the perturbation inhibition mechanism. The present findings bring the practical applications of gas hydrates significantly closer, and provide a new perspective on the freezing and melting phenomena of naturally occurring gas hydrates.

Psychological factors associated with uptake of the childhood influenza vaccine and perception of post-vaccination side-effects: A cross-sectional survey in England.

PubMed

Smith, Louise E; Webster, Rebecca K; Weinman, John; Amlôt, Richard; Yiend, Jenny; Rubin, G James

2017-04-04

To identify predictors of: uptake of the childhood influenza vaccine in the 2015-2016 influenza season, parental perceptions of side-effects from the influenza vaccine and intention to vaccinate one's child for influenza in the 2016-2017 influenza season. Cross-sectional online survey. Data were collected in England shortly after the end of the 2015-2016 immunization campaign. 1001 parents or guardians of children aged between two and seven. Self-reported uptake of the childhood influenza vaccine in the 2015-2016 influenza season, perception of side-effects from the influenza vaccine and intention to vaccinate one's child in the 2016-2017 influenza season. Self-reported uptake of the childhood influenza vaccine was 52.8%. Factors strongly positively associated with uptake included the child having previously been vaccinated against influenza, perceiving the vaccine to be effective and perceiving the child to be susceptible to flu. Factors strongly negatively associated with uptake included perceiving the vaccine to be unsafe, to cause short-term side-effects or long-term health problems and believing that yearly vaccination may overload the immune system. Predictors of intended vaccine uptake in 2016-2017 were similar. Participants who perceived side-effects after the 2015-2016 vaccination reported being less likely to vaccinate their child next year. Side-effects were more likely to be reported in first-born children, by participants who knew another child who had side-effects, those who thought that the vaccine would interact with medication that the child was currently taking, and those who believed the vaccine causes short-term side-effects. Perceptions about the childhood influenza vaccine show strong associations with uptake, intended uptake and perception of side-effects. Attempts to improve uptake rates from their current low levels must address these perceptions. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Persuading drivers to refrain from speeding: Effects of message sidedness and regulatory fit.

PubMed

Pierro, Antonio; Giacomantonio, Mauro; Pica, Gennaro; Giannini, Anna Maria; Kruglanski, Arie W; Higgins, E Tory

2013-01-01

Building on regulatory fit theory (Higgins, 2000, 2005), we tested whether two-sided ads were more effective than one-sided ads in changing intentions toward driving behavior when message recipients were high in assessment orientation rather than locomotion orientation. In one study either a locomotion or an assessment orientation were situationally induced (Study 1) and in another study these different orientations were chronic predispositions (Study 2). As predicted, both studies found that for participants high in assessment, two-sided ads were more effective than one-sided ads, as reflected in stronger engagement with the persuasive message and stronger intentions to reduce driving speed. In contrast, for participants high in locomotion, one-sided ads were more effective than two-sided ads. There was also evidence that the fit effect on intentions to comply was mediated by strength of engagement with the message. Implications for persuasion concerning driving behaviors are discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Side effects of methylphenidate in childhood cancer survivors: a randomized placebo-controlled trial.

PubMed

Conklin, Heather M; Lawford, Joanne; Jasper, Bruce W; Morris, E Brannon; Howard, Scott C; Ogg, Susan W; Wu, Shengjie; Xiong, Xiaoping; Khan, Raja B

2009-07-01

To investigate the frequency and severity of side effects of methylphenidate among childhood survivors of acute lymphoblastic leukemia and brain tumors and identify predictors of higher adverse effect levels. Childhood cancer survivors (N = 103) identified as having attention and learning problems completed a randomized, double-blind, 3-week, home-crossover trial of placebo, low-dose methylphenidate (0.3 mg/kg; 10 mg twice daily maximum) and moderate-dose methylphenidate (0.6 mg/kg; 20 mg twice daily maximum). Caregivers completed the Barkley Side Effects Rating Scale (SERS) at baseline and each week during the medication trial. Siblings of cancer survivors (N = 49) were recruited as a healthy comparison group. There was a significantly higher number and severity of symptoms endorsed on the SERS when patients were taking moderate dose compared with placebo or low dose, but not low dose compared with placebo. The number of side effects endorsed on the SERS was significantly lower during all 3 home-crossover weeks (placebo, low dose, moderate dose) when compared with baseline symptom scores. The severity of side effects was also significantly lower, compared with baseline screening, during placebo and low-dose weeks but not moderate-dose weeks. Both the number and severity of symptoms endorsed at baseline were significantly higher for patients compared with siblings. Female gender and lower IQ were associated with higher adverse effect levels. Methylphenidate is generally well tolerated by childhood cancer survivors. There is a subgroup at increased risk for side effects that may need to be closely monitored or prescribed a lower medication dose. The seemingly paradoxical findings of increased "side effects" at baseline must be considered when monitoring side effects and designing clinical trials.

A method for extending stage-discharge relationships using a hydrodynamic model and quantifying the associated uncertainty

NASA Astrophysics Data System (ADS)

Shao, Quanxi; Dutta, Dushmanta; Karim, Fazlul; Petheram, Cuan

2018-01-01

Streamflow discharge is a fundamental dataset required to effectively manage water and land resources. However, developing robust stage - discharge relationships called rating curves, from which streamflow discharge is derived, is time consuming and costly, particularly in remote areas and especially at high stage levels. As a result stage - discharge relationships are often heavily extrapolated. Hydrodynamic (HD) models are physically based models used to simulate the flow of water along river channels and over adjacent floodplains. In this paper we demonstrate a method by which a HD model can be used to generate a 'synthetic' stage - discharge relationship at high stages. The method uses a both-side Box-Cox transformation to calibrate the synthetic rating curve such that the regression residuals are as close to the normal distribution as possible. By doing this both-side transformation, the statistical uncertainty in the synthetically derived stage - discharge relationship can be calculated. This enables people trying to make decisions to determine whether the uncertainty in the synthetically generated rating curve at high stage levels is acceptable for their decision. The proposed method is demonstrated in two streamflow gauging stations in north Queensland, Australia.

Importance of food-demand management for climate mitigation

NASA Astrophysics Data System (ADS)

Bajželj, Bojana; Richards, Keith S.; Allwood, Julian M.; Smith, Pete; Dennis, John S.; Curmi, Elizabeth; Gilligan, Christopher A.

2014-10-01

Recent studies show that current trends in yield improvement will not be sufficient to meet projected global food demand in 2050, and suggest that a further expansion of agricultural area will be required. However, agriculture is the main driver of losses of biodiversity and a major contributor to climate change and pollution, and so further expansion is undesirable. The usual proposed alternative--intensification with increased resource use--also has negative effects. It is therefore imperative to find ways to achieve global food security without expanding crop or pastureland and without increasing greenhouse gas emissions. Some authors have emphasized a role for sustainable intensification in closing global `yield gaps' between the currently realized and potentially achievable yields. However, in this paper we use a transparent, data-driven model, to show that even if yield gaps are closed, the projected demand will drive further agricultural expansion. There are, however, options for reduction on the demand side that are rarely considered. In the second part of this paper we quantify the potential for demand-side mitigation options, and show that improved diets and decreases in food waste are essential to deliver emissions reductions, and to provide global food security in 2050.

A web-based rapid assessment tool for production publishing solutions

NASA Astrophysics Data System (ADS)

Sun, Tong

2010-02-01

Solution assessment is a critical first-step in understanding and measuring the business process efficiency enabled by an integrated solution package. However, assessing the effectiveness of any solution is usually a very expensive and timeconsuming task which involves lots of domain knowledge, collecting and understanding the specific customer operational context, defining validation scenarios and estimating the expected performance and operational cost. This paper presents an intelligent web-based tool that can rapidly assess any given solution package for production publishing workflows via a simulation engine and create a report for various estimated performance metrics (e.g. throughput, turnaround time, resource utilization) and operational cost. By integrating the digital publishing workflow ontology and an activity based costing model with a Petri-net based workflow simulation engine, this web-based tool allows users to quickly evaluate any potential digital publishing solutions side-by-side within their desired operational contexts, and provides a low-cost and rapid assessment for organizations before committing any purchase. This tool also benefits the solution providers to shorten the sales cycles, establishing a trustworthy customer relationship and supplement the professional assessment services with a proven quantitative simulation and estimation technology.

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

Riggs, J.B.

An experimental test model, which is dynamically similar to an actual UCC (Underground Coal Conversion) system, has been used to determine fluid flow patterns and local heat transfer that occur in the UCC burn cavity. This study was designed to provide insight into the little understood mechanisms (i.e., heat transfer and oxygen transport to the cavity walls) which control maximum cavity width, and therefore resource recovery during UCC. The dynamically similar flow model has been designed by equating the Grashof and Reynolds number of the UCC system and the flow model, which employs water as its fluid. Equating the Grashofmore » number results in a scale factor of 0.13 while equating the Reynolds number yields a volumetric flow rate of water for the model of 30 gallons per minute. Qualitative studies were conducted with the flow model for both a void cavity and a cavity partially filled with simulated rubble. These studies provided insight into the combined effects of forced and free convection in a UCC cavity. In addition, dimensionless correlations were developed for the heat transfer to side walls for the case of a void cavity and these results can be used to predict oxygen transport to the side wall in a UCC cavity.« less

Incremental cost of increasing access to maternal health care services: perspectives from a demand and supply side intervention in Eastern Uganda.

PubMed

Mayora, Chrispus; Ekirapa-Kiracho, Elizabeth; Bishai, David; Peters, David H; Okui, Olico; Baine, Sebastian Olikira

2014-01-01

High maternal and infant mortality continue to be major challenges to the attainment of the Millennium Development Goals for many low and middle-income countries. There is now evidence that voucher initiatives can increase access to maternal health services. However, a dearth of knowledge exists on the cost implications of voucher schemes. This paper estimates the incremental costs of a demand and supply side intervention aimed at increasing access to maternal health care services. This costing study was part of a quasi-experimental voucher study conducted in two districts in Eastern Uganda to explore the impact of demand and supply - side incentives on increasing access to maternal health services. The provider's perspective was used and the ingredients approach to costing was employed. Costs were based on market prices as recorded in program records. Total, unit, and incremental costs were calculated. The estimated total financial cost of the intervention for the one year of implementation was US$525,472 (US$1 = 2200UgShs). The major cost drivers included costs for transport vouchers (35.3%), health system strengthening (29.2%) and vouchers for maternal health services (18.2%). The average cost of transport per woman to and from the health facility was US$4.6. The total incremental costs incurred on deliveries (excluding caesarean section) was US$317,157 and US$107,890 for post natal care (PNC). The incremental costs per additional delivery and PNC attendance were US$23.9 and US$7.6 respectively. Subsidizing maternal health care costs through demand and supply - side initiatives may not require significant amounts of resources contrary to what would be expected. With Uganda's Gross Domestic Product (GDP) per capita of US$55` (2012), the incremental cost per additional delivery (US$23.9) represents about 5% of GDP per capita to save a mother and probably her new born. For many low income countries, this may not be affordable, yet reliance on donor funding is often not sustainable. Alternative ways of raising additional resources for health must be explored. These include; encouraging private investments in critical sectors such as rural transport, health service provision; mobilizing households to save financial resources for preparedness, and financial targeting for the most vulnerable.

Diversity and Genome Analysis of Australian and Global Oilseed Brassica napus L. Germplasm Using Transcriptomics and Whole Genome Re-sequencing.

PubMed

Malmberg, M Michelle; Shi, Fan; Spangenberg, German C; Daetwyler, Hans D; Cogan, Noel O I

2018-01-01

Intensive breeding of Brassica napus has resulted in relatively low diversity, such that B. napus would benefit from germplasm improvement schemes that sustain diversity. As such, samples representative of global germplasm pools need to be assessed for existing population structure, diversity and linkage disequilibrium (LD). Complexity reduction genotyping-by-sequencing (GBS) methods, including GBS-transcriptomics (GBS-t), enable cost-effective screening of a large number of samples, while whole genome re-sequencing (WGR) delivers the ability to generate large numbers of unbiased genomic single nucleotide polymorphisms (SNPs), and identify structural variants (SVs). Furthermore, the development of genomic tools based on whole genomes representative of global oilseed diversity and orientated by the reference genome has substantial industry relevance and will be highly beneficial for canola breeding. As recent studies have focused on European and Chinese varieties, a global diversity panel as well as a substantial number of Australian spring types were included in this study. Focusing on industry relevance, 633 varieties were initially genotyped using GBS-t to examine population structure using 61,037 SNPs. Subsequently, 149 samples representative of global diversity were selected for WGR and both data sets used for a side-by-side evaluation of diversity and LD. The WGR data was further used to develop genomic resources consisting of a list of 4,029,750 high-confidence SNPs annotated using SnpEff, and SVs in the form of 10,976 deletions and 2,556 insertions. These resources form the basis of a reliable and repeatable system allowing greater integration between canola genomics studies, with a strong focus on breeding germplasm and industry applicability.

Switching effect of the side chain on quantum walks on triple graphs

NASA Astrophysics Data System (ADS)

Du, Yi-Mu; Lu, Li-Hua; Li, You-Quan

2015-07-01

We consider a continuous-time quantum walk on a triple graph and investigate the influence of the side chain on propagation in the main chain. Calculating the interchange of the probabilities between the two parts of the main chain, we find that a switching effect appears if there is an odd number of points in the side chain when concrete conditions between the length of the main chain and the position of the side chain are satisfied. However, such an effect does not occur if there is an even number of points in the side chain. We also suggest two proposals for experiments to demonstrate this effect, which may be employed to design a new type of switching device.

A survey of the awareness, knowledge and behavior of hair dye use in a korean population with gray hair.

PubMed

Kim, Jung Eun; Jung, Hee Dam; Kang, Hoon

2012-08-01

Gray hair naturally develops in the process of human aging. Many people with gray hair periodically dye their hair. Hair dyeing products are widely used and they can cause adverse effects. Therefore, the user's knowledge and recognition about hair dyeing and related side effects are important. The goal of this study was to lay the foundation for understanding, preventing and treating side effects caused by hair coloring products. We conducted a questionnaire survey for adult males and females aged over 20 who had gray hair. A total of 500 subjects were included in this study and statistical analysis was performed. Large numbers of the people who had experience with hair dye (233 out of 319 people, 73.0%) did not know about the exact brand name of the hair dye product that they were using. Of 319 hair dye users, 23.8% (76 out of 319) people stated that they experienced side effects. Despite the occurrence of side effects from hair dyeing products, it seems they did not realize the seriousness of the side effects or the need for treatment. It is advisable to introduce a system that enables users to become aware of the ingredients and side effects of hair coloring products and give opportunities for users to become aware of the side effects of hair coloring through education, publicity and publication of an informational booklet.

The Relationship among Side Effects Associated with Anti-Epileptic Medications in Those with Intellectual Disability

ERIC Educational Resources Information Center

Sipes, Megan; Matson, Johnny L.; Belva, Brian; Turygin, Nicole; Kozlowski, Alison M.; Horovitz, Max

2011-01-01

Seizures are fairly common in those with intellectual disabilities. In order to treat these seizures, antiepileptic drugs (AEDs) are often used and in many cases are effective. However, these medications often create a variety of associated side effects. In order to monitor these side effects, measures such as the SEIZES-B have been used. While…

[Side Effects of Occupational Group Therapy].

PubMed

Flöge, B; Fay, D; Jöbges, M; Linden, M; Muschalla, B

2016-12-01

Background: Occupational therapy is an important co-therapy in psychiatric therapy. It is a common belief that no risks are associated with occupational therapy. Negative effects caused by group therapy, especially occupational therapy, have not been in the focus of research yet. In this study we want to illustrate possible types and intensities of group side effects through occupational therapy. Patients and Methods: Patients of an inpatient rehabilitation facility filled out the Adverse Treatment Reaction Group Checklist. The checklist contains 47 items divided in six dimensions: group size, content, group participants, group outcome and global. The self-rating used a 5-point likert scale (0 = not at all; 4 = very much, extremely stressful) and gives information about types and intensities of the side effects. Results: 88.9 % of 45 patients reported negative effects of occupational group therapy. 28.9 % of the patients rated the side effect as at least severe. Discussion: Occupational therapy is associated with side effects as every other group therapy. Possible side effects caused by group therapy should be considered while planning and implementing occupational therapy. © Georg Thieme Verlag KG Stuttgart · New York.

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.

The differences in the assessments of side effects at an oncology outpatient clinic.

PubMed

Bayraktar-Ekincioglu, A; Kucuk, E

2018-04-01

Background There is a growing interest in the use of targeted and immunotherapies in oncology. However, the assessment of side effects can be different due to interpretation of patients' health status by healthcare professionals in oncology outpatient clinics. Objective To demonstrate the differences in the assessments of side effects conducted independently by a clinical pharmacist and nurses in patients who receive targeted therapies at an oncology outpatient clinic. Setting The study was conducted at the University Oncology Hospital in an outpatient clinic from October 2015 to March 2016. Method Patients receiving ipilimumab, nivolumab, pembrolizumab, bevacizumab, panitumumab or cetuximab during study period were included. The assessment of side effects was conducted by a pharmacist and nurse independently using the NCI-CTCAE version-2. Main outcome measure To compare the severity assessments of side effects between a clinical pharmacist and nurses in an outpatient clinic. Results During the study, 204 visits for 43 patients with a total of 5508 side effect assessments were recorded where 1137 (20.64%) assessments were graded differently. Out of 1137 assessments, 473 of them were graded higher by a clinical pharmacist whereas 664 were graded higher by nurses. Statistically significant differences were detected in the assessment of vomiting, taste changes, sense changes, alopecia, fatigue, mood changes, anxiety, hearing impairment, and allergic reactions. Conclusion An assessment of side effects by healthcare providers in patients with cancer may be challenging due to an increased workload in clinics and undistinguishable symptoms of side effects and cancer itself. Therefore, a new care model which increases an interprofessional communication may improve pharmaceutical care in oncology outpatient clinics.

Period Prevalence and Perceived Side Effects of Hormonal Contraceptive Use and the Menstrual Cycle in Elite Athletes.

PubMed

Martin, Daniel; Sale, Craig; Cooper, Simon B; Elliott-Sale, Kirsty J

2017-12-28

To identify the period prevalence of hormonal contraceptive (HC) use and characterise the perceived side effects associated with the menstrual cycle and HC use. 430 elite female athletes completed a questionnaire to assess; the period prevalence of HC use, the reasons for initiation and discontinuation of HCs and the side effects experienced by HC and non-HC users. Descriptive statistics, between-group comparisons and associations between categorical variables were calculated. 49.5% of athletes were currently using HCs and 69.8% had used HCs at some point. Combined oral contraceptives were most commonly used (68.1%), with 30.0% using progestin-only contraceptives (implant = 13.1%; injection = 3.7%; intrauterine system = 2.8%). Perceived negative side effects were more common with progestin-only HC use (39.1%) compared to combined HC use (17.8%; P = 0.001) and were most prevalent in implant users (53.6%; P = 0.004). HC users reported perceived positive side effects relating to the ability to predict and/or manipulate the timing, frequency and amount of menstrual bleeding. Non-HC users had a menstrual cycle length of 29 ± 5 d and 77.4% reported negative side effects during their menstrual cycle, primarily during days 1-2 of menstruation (81.6%). Approximately half of elite athletes used HCs and progestin-only contraceptive users reported greater incidences of negative side effects, especially with the implant. Due to the high inter-individual variability in reported side effects, athletes and practitioners should maintain an open dialogue to pursue the best interests of the athlete.

Effect of Using the HEART Score in Patients With Chest Pain in the Emergency Department: A Stepped-Wedge, Cluster Randomized Trial.

PubMed

Poldervaart, Judith M; Reitsma, Johannes B; Backus, Barbra E; Koffijberg, Hendrik; Veldkamp, Rolf F; Ten Haaf, Monique E; Appelman, Yolande; Mannaerts, Herman F J; van Dantzig, Jan-Melle; van den Heuvel, Madelon; El Farissi, Mohamed; Rensing, Bernard J W M; Ernst, Nicolette M S K J; Dekker, Ineke M C; den Hartog, Frank R; Oosterhof, Thomas; Lagerweij, Ghizelda R; Buijs, Eugene M; van Hessen, Maarten W J; Landman, Marcel A J; van Kimmenade, Roland R J; Cozijnsen, Luc; Bucx, Jeroen J J; van Ofwegen-Hanekamp, Clara E E; Cramer, Maarten-Jan; Six, A Jacob; Doevendans, Pieter A; Hoes, Arno W

2017-05-16

The HEART (History, Electrocardiogram, Age, Risk factors, and initial Troponin) score is an easy-to-apply instrument to stratify patients with chest pain according to their short-term risk for major adverse cardiac events (MACEs), but its effect on daily practice is unknown. To measure the effect of use of the HEART score on patient outcomes and use of health care resources. Stepped-wedge, cluster randomized trial. (ClinicalTrials.gov: NCT01756846). Emergency departments in 9 Dutch hospitals. Unselected patients with chest pain presenting at emergency departments in 2013 and 2014. All hospitals started with usual care. Every 6 weeks, 1 hospital was randomly assigned to switch to "HEART care," during which physicians calculated the HEART score to guide patient management. For safety, a noninferiority margin of a 3.0% absolute increase in MACEs within 6 weeks was set. Other outcomes included use of health care resources, quality of life, and cost-effectiveness. A total of 3648 patients were included (1827 receiving usual care and 1821 receiving HEART care). Six-week incidence of MACEs during HEART care was 1.3% lower than during usual care (upper limit of the 1-sided 95% CI, 2.1% [within the noninferiority margin of 3.0%]). In low-risk patients, incidence of MACEs was 2.0% (95% CI, 1.2% to 3.3%). No statistically significant differences in early discharge, readmissions, recurrent emergency department visits, outpatient visits, or visits to general practitioners were observed. Physicians were hesitant to refrain from admission and diagnostic tests in patients classified as low risk by the HEART score. Using the HEART score during initial assessment of patients with chest pain is safe, but the effect on health care resources is limited, possibly due to nonadherence to management recommendations. Netherlands Organisation for Health Research and Development.

Assessment of gray whale feeding grounds and sea floor interaction in the northeastern Bering Sea

USGS Publications Warehouse

Nelson, C.H.; Johnson, K.R.; Barber, John H.

1983-01-01

A dense ampeliscid amphipod community in Chirikov Basin and around St. Lawrence Island in the northeastern Bering Sea has been outlined by summarizing biological studies, analyzing bioturbation in sediment samples, and examining sea floor photos and videotapes. The amphipod population is associated with a homogeneous, relict fine-grained sand body 0.10-1.5 m thick that is deposited during the marine transgression over the Bering land bridge 8,000-10,000 yr B.P. Modern current and water mass movements and perhaps whale feeding activity prevent modern deposition in this area. The distribution of the transgressive sand sheet, associated amphipod community and feeding gray whales mapped by aerial survey correlate closely with three types of sea-floor pits observed on high (500 kHz) and low (105 kHz) resolution side-scan sonar; they are attributed to gray whale feeding traces and their subsequent current scour modification. The fresh and modified feeding pits are present in 22,000 km2 of the basin and they cover a total of 2 to 18% of the sea floor in different areas of the feeding region. The smallest size class of pits approximates whale mouth gape size and is assumed to represent fresh whale feeding pits. Fresh feeding disturbance of the sea floor is estimated to average about 5.7% for a full feeding season. Combined with information that 34% of the measured benthic biomass is amphipod prey species, and calculating the number of gray whale feeding days in the Alaskan waters plus amount consumed per day, it can be estimated that Chirikov Basin, 2% of the feeding area, supplies a minimum of 5.3 to 7.1% of the gray whale's food resource in the Bering Sea and Arctic Ocean. If a maximum of 50% of the fresh feeding features are assumed to be missed because they parallel side-scan beam paths, then a maximum whale food resource of 14.2% is possible in northeastern Bering Sea. Because of side-scan techniques and possible higher amphipod biomass estimates, a reasonable minimum estimate of the total whale food resource in northeastern Bering Sea is 10%. These data show that side-scan sonar is a powerful new technique for analyzing marine mammal benthic feeding grounds. Sonographs reveal that the gray whales profoundly disturb the substrate and initiate substantial further erosion by bottom currents, all of which enhances productivity of the prey species and results in a 'farming of the sea floor'. In turn, because of the high concentration of whale prey species in a prime feeding ground that is vulnerable to the development of petroleum and mining for sand, great care is required in the exploitation of these resources in the Chirikov Basin.

A Combined Finite-Element/Discrete-Particle Analysis of a Side-Vent-Channel-Based Concept for Improved Blast-Survivability of Light Tactical Vehicles

DTIC Science & Technology

2013-01-01

design of side- vent-channels. The results obtained confirmed the beneficial effects of the side-vent-channels in reducing the blast momentum , although...confirmed the beneficial effects of the side-vent-channels in reducing the blast momentum , although the extent of these effects is relatively small (3...products against the surrounding medium is associated with exchange of linear momentum and various energy components (e.g. potential, thermal

Identity change and informed consent

PubMed Central

Witt, Karsten

2017-01-01

In this paper, I focus on a kind of medical intervention that is at the same time fascinating and disturbing: identity-changing interventions. My guiding question is how such interventions can be ethically justified within the bounds of contemporary bioethical mainstream that places great weight on the patient's informed consent. The answer that is standardly given today is that patients should be informed about the identity effects, thus suggesting that changes in identity can be treated like ‘normal’ side effects. In the paper, I argue that this approach is seriously lacking because it misses important complexities going along with decisions involving identity changes and consequently runs into mistakes. As a remedy I propose a new approach, the ‘perspective-sensitive account’, which avoids these mistakes and thus provides the conceptual resources to systematically reflect on and give a valid consent to identity-changing interventions. PMID:28320773

Evidence-informed frameworks for cost-effective cancer care and prevention in low, middle, and high-income countries.

PubMed

Chalkidou, Kalipso; Marquez, Patricio; Dhillon, Preet K; Teerawattananon, Yot; Anothaisintawee, Thunyarat; Gadelha, Carlos Augusto Grabois; Sullivan, Richard

2014-03-01

Evidence-informed frameworks for cost-effective cancer prevention and management are essential for delivering equitable outcomes and tackling the growing burden of cancer in all resource settings. Evidence can help address the demand side pressures (ie, pressures exerted by people who need care) faced by economies with high, middle, and low incomes, particularly in the context of transitioning towards (or sustaining) universal health-care coverage. Strong systems, as opposed to technology-based solutions, can drive the development and implementation of evidence-informed frameworks for prevention and management of cancer in an equitable and affordable way. For this to succeed, different stakeholders-including national governments, global donors, the commercial sector, and service delivery institutions-must work together to address the growing burden of cancer across economies of low, middle, and high income. Copyright © 2014 Elsevier Ltd. All rights reserved.

Antiepileptic Drug Behavioral Side Effects in Individuals with Mental Retardation and the Use of Behavioral Measurement Techniques.

ERIC Educational Resources Information Center

Kalachnik, John E.; And Others

1995-01-01

Behavioral psychology measurement methods helped assess antiepileptic drug behavioral side effects in five individuals with mental retardation who could not verbally communicate presence of side effects. When the suspected antiepileptic drug was altered, an 81% reduction of maladaptive behaviors occurred. The measurement methods enabled systematic…

Current Status of the Matson Evaluation of Drug Side Effects (MEDS)

ERIC Educational Resources Information Center

Matson, Johnny L.; Cervantes, Paige E.

2013-01-01

The Matson Evaluation of Drug Side Effects (MEDS) is currently the best established and most researched measure of drug side effects in the intellectual disability (ID) literature. Initial research was conducted on its psychometric properties such as reliability and validity. More recent research studies have used the measure to determine the…

Staff Knowledge of the Side Effects of Anti-Psychotic Medication

ERIC Educational Resources Information Center

Fretwell, Christine; Felce, David

2007-01-01

Background: Anti-psychotic medications are widely prescribed to people with intellectual disabilities and have a range of negative side effects. The aim was to identify the level of knowledge of anti-psychotic medications and their side effects among key carers or home managers of adults with intellectual disabilities living in residential group…

Use of a 22-gauge Whitacre needle to reduce the incidence of side effects after lumbar myelography: a prospective randomised study comparing Whitacre and Quincke spinal needles.

PubMed

Pedersen, O N

1996-01-01

In a prospective study lumbar iohexol myelography was performed in 107 consecutive patients, randomised for lumbar puncture with a Quincke or Whitacre spinal needle. All patients answered a questionnaire about possible side effects. Data from 100 patients (58 men, 42 women) were evaluated. In the Quincke group (n = 53), 23 (43%) reported no side effects. In the 30 patients who reported various side effects, post-dural puncture headache (PDPH) occurred in 22 (42%), of whom 9 had mild, 6 moderate and 7 (13%) severe cephalalgia, 18 (34%) reported increased low back pain/sciatica, 5 nausea and 7 dizziness. In the Whitacre group (n = 47), 33 (70%) had no side effects. PDPH was reported by 9 patients (19%), of whom 2 had mild, 6 moderate and only 1 (2%) severe cephalalgia, 4 (9%) reported increased low back pain/sciatica, 5 nausea and 4 dizziness. The conclusion drawn from this study is that lumbar myelography performed with the Whitacre spinal needle reduces postspinal side effects.

The role side effects play in the choice of antiepileptic therapy in brain tumor-related epilepsy: a comparative study on traditional antiepileptic drugs versus oxcarbazepine

PubMed Central

Maschio, Marta; Dinapoli, Loredana; Vidiri, Antonello; Pace, Andrea; Fabi, Alessandra; Pompili, Alfredo; Carapella, Maria Carmine; Jandolo, Bruno

2009-01-01

Background Seizure control doesn't represent the only challenging goal in patients with brain tumor-related epilepsy. Side effects have often taken precedence for patients' quality of life. Methods We performed an observational retrospective study on patients with brain tumor-related epilepsy: 35 who had assumed oxcarbazepine monotherapy and 35 patients who had undergone treatment with traditional antiepileptic drugs. Primary variable of efficacy was the mean seizure frequency per month and safety variables were the drop-out for side effects and total incidence of side effects. We applied the Propensity Score technique to minimize selection bias. Results Our results showed a similar efficacy of oxcarbazepine and traditional antiepileptic drugs over time, but the difference in safety and tolerability between the two groups was significant: traditional AEDs caused more side effects, both serious and non serious. Conclusion This study highlights the importance of taking into consideration not only seizure control but also the appearance of side effects when choosing antiepileptic drugs in this patients population. PMID:19419544

Side effects induced by the acute levodopa challenge in Parkinson's Disease and atypical parkinsonisms.

PubMed

Vasta, Rosario; Nicoletti, Alessandra; Mostile, Giovanni; Dibilio, Valeria; Sciacca, Giorgia; Contrafatto, Donatella; Cicero, Calogero Edoardo; Raciti, Loredana; Luca, Antonina; Zappia, Mario

2017-01-01

Acute levodopa challenge may be performed to predict levodopa chronic responsiveness. The aim of the study was to investigate frequency of side effects during the acute levodopa challenge in PD and atypical parkinsonisms. We enrolled 34 de novo PD patients and 29 patients affected by atypical parkinsonisms (Multiple System Atrophy, MSA, n = 10; Progressive Supranuclear Palsy, PSP, n = 12 and Corticobasal Degeneration, CBD, n = 7) who underwent an acute levodopa challenge. Side effects occurring during test were recorded. Side effects were more frequent among atypical parkinsonisms as unique group when compared to PD patients (64.3% versus 23.5%; p-value 0.002) with an adjusted OR of 4.36 (95%CI 1.40-13.5). Each atypical parkinsonisms showed almost double occurrence of side effects (MSA 90%, PSP 41.7% and CBD 57%). Side effects during acute levodopa challenge may be frequent in atypical parkinsonisms. This information could be useful in order to better prepare the patient for the test. Furthermore, it could represent a useful cue in differential diagnosis with PD.

Cataplexy as a side effect of modafinil in a patient without narcolepsy☆

PubMed Central

Lopes, Eduardo; Pereira, Danielle; da Silva Behrens, Nilce Sanny Costa; de Almeida Fonseca, Hassana; Calvancanti, Paola Oliveira; de Araújo Lima, Taís Figueiredo; Pradella-Hallinan, Marcia; Castro, Juliana; Tufik, Sergio; Coelho, Fernando Morgadinho Santos

2014-01-01

Narcolepsy is a disease in which there is diurnal excessive sleepiness with sleep attacks and a prevalence in the general population of 1/4000 individuals. Classically, it is characterized by cataplexy, sleep paralysis, hypnagogic hallucinations and fragmented sleep. The use of modafinil in the treatment of narcolepsy is the first option of treatment for diurnal excessive sleepiness. Although considered a safe drug for use in patients with narcolepsy, being utilized for more than 20 years, modafinil possesses a series of side effects, some of them still not fully researched or described. Side effects such as headache, nausea, anxiety, insomnia, lumbago, diarrhea, dyspepsia, rhinitis and vertigo are the most frequent. However, the clinical follow-up of patients under treatment with modafinil must be intensive and the side effects ought to be noted and evaluated. The under-response to treatment or the unexpected side effects must always be directed to differential diagnostics. The objective of this article is to describe an unexpected side effect of the use of modafinil in a patient with incorrect diagnosis of narcolepsy. PMID:26483900

Liverpool University Neuroleptic Side-Effect Rating Scale (LUNSERS) as a subjective measure of drug-induced parkinsonism and akathisia.

PubMed

Jung, Hee-Yeon; Kim, Jong-Hoon; Ahn, Yong-Min; Kim, Seong-Chan; Hwang, Samuel S; Kim, Yong-Sik

2005-01-01

The Liverpool University Neuroleptic Side-Effect Rating Scale (LUNSERS) was examined for its usefulness as a subjective measure of drug-induced parkinsonism and akathisia. Eighty-three subjects were assessed using the LUNSERS, the Simpson-Angus Scale (SAS) and the Barnes Akathisia Rating Scale (BARS), before and after a 6-week treatment with olanzapine. Significant correlations were found between the changes in scores of parkinsonism items of LUNSERS and SAS. The changes in scores of akathisia item (restlessness), extrapyramidal side effects (EPS) subscale and psychic side-effects subscale of LUNSERS were significantly correlated with those of the BARS. 'Shakiness', one item of the EPS subscale of LUNSERS, correctly classified between parkinsonism and non-parkinsonism groups with 81.0% accuracy. A combination of four items included in EPS and psychic side-effect subscales of LUNSERS identified akathisia and non-akathisia groups with 76.2% accuracy. These results suggest that the EPS and psychic side-effect subscales of LUNSERS may be useful in screening for drug-induced parkinsonism and akathisia. Copyright (c) 2004 John Wiley & Sons, Ltd.

Seeing is believing: Impact of social modeling on placebo and nocebo responding.

PubMed

Faasse, Kate; Grey, Andrew; Jordan, Rachel; Garland, Stacie; Petrie, Keith J

2015-08-01

This study investigated the impact of the social modeling of side effects following placebo medication ingestion on the nocebo and placebo effect. It also investigated whether medication branding (brand or generic labeling) moderated social modeling effects. Eighty-two university students took part in the study which was purportedly investigating the impact of fast-acting beta-blocker medications (actually placebos) on preexamination anxiety. After taking the medication, participants were randomized to either witness a female confederate report experiencing side effects or no side effects after taking the same medication. Differences in symptom reporting, blood pressure, heart rate, and anxiety were assessed between the social modeling of side effects and no modeling groups. Seeing a female confederate report side effects reduced the placebo effect in systolic (p = .009) and diastolic blood pressure (p = .033). Seeing a female confederate report side effects also increased both total reported symptoms (mean [SE] 7.35 [.54] vs. 5.16 [0.53] p = .005) and symptoms attributed to the medication (5.27 [0.60] vs. 3.04 [0.59] p = .01), although the effect on symptoms was only seen in female participants. Females who saw the confederate report side effects reported approximately twice the number of symptoms as those in the no modeling group. Social modeling did not affect heart rate or anxiety. Medication branding did not influence placebo or nocebo outcomes. The social modeling of symptoms can substantially reduce or eliminate the placebo effect. Viewing a female confederate display symptoms after taking the same medication increases symptom reporting in females. (c) 2015 APA, all rights reserved).

[Gestrinone in pelvic endometriosis. A one-year evaluation].

PubMed

Cervantes Villarreal, E; García Zamarripa, H R; Herrera Prado, E; Barrón Vallejo, J

1995-08-01

The therapeutical effectiveness of gestrinone in endometriosis treatment, as well as its long term side effects, were evaluated. Prospective, clinical trial. At "Dr. Alejandro Castanedo Kimball" Hospital (PEMEX). Salamanca, Guanajuato. México. Thirty women with laparoscopically confirmed endometriosis, were studied. Subjects received 2.5 mg. of gestrinone two times per week for 6 months. Laparoscopy was performed before treatment, and clinical response was determined by second laparoscopy after 6 months. The pregnancy rate, frequency of side effects and recurrence of symptoms were determined. Median total endometriosis scores and symptoms decreased significantly after treatment. Four pregnancies were observed after treatment. The principal side effects were: ponderal increase, changes in the voice and hirsutism. However, the side effects disappeared after one year of clinical survey. The results indicate that gestrinone is effective in the treatment of pelvic endometriosis. In despite of a clear benefic effect on stage of the disease and symptoms; the use of gestrinone should weigh the risk-benefit (cost versus metabolic side effects) of treatment.

Evaluation of patients’ experiences with antidepressants reported by means of a medicine reporting system

PubMed Central

van Geffen, E. C. G.; van der Wal, S. W.; van Hulten, R.; de Groot, M. C. H.; Egberts, A. C. G.

2007-01-01

Objective To assess experiences related to antidepressant use reported to an internet-based medicine reporting system and to compare the nature of the side effects reported by patients with those reported by health care professionals (HCPs). Methods All reports submitted from May 2004 to May 2005 to an internet-based medicine reporting system in The Netherlands related to the use of antidepressants were analysed. Spontaneous reports of adverse drug reactions on antidepressants from HCPs received by The Netherlands Pharmacovigilance Centre Lareb from May 2004 to May 2005 were included for comparison. Results Of the 2232 individuals who submitted a report to the internet-based medicine reporting system, 258 submitted a report on antidepressants. Of these, 92 individuals (36%) reported on effectiveness, 40 (16%) of whom reported on ineffectiveness, and 217 (84%) submitted a report on side effects, with 202 (78%) reporting a total of 630 side effects that were experienced as negative. Fourteen individuals (5%) reported a practical issue and four (2%) reported a reimbursement issue. Of all 630 side effects reported, 48% resulted in the patient discontinuing the antidepressant therapy; of these 29% did not inform their HCP. Of all the side effects reported, 52% were perceived as “very negative”. In comparison to the side effects reported by HCPs, patients more often reported apathy, excessive sweating, ineffectiveness, somnolence, insomnia, sexual problems and weight increase. Conclusion Patients report the ineffectiveness and side effects of antidepressant therapy as negative and leading to discontinuation of the therapy. Patients and HCPs differ in the nature of the reported side effects. Patient experiences should be included in the evaluation of antidepressant treatment in clinical practice. PMID:17874086

Integrative relational machine-learning for understanding drug side-effect profiles

PubMed Central

2013-01-01

Background Drug side effects represent a common reason for stopping drug development during clinical trials. Improving our ability to understand drug side effects is necessary to reduce attrition rates during drug development as well as the risk of discovering novel side effects in available drugs. Today, most investigations deal with isolated side effects and overlook possible redundancy and their frequent co-occurrence. Results In this work, drug annotations are collected from SIDER and DrugBank databases. Terms describing individual side effects reported in SIDER are clustered with a semantic similarity measure into term clusters (TCs). Maximal frequent itemsets are extracted from the resulting drug x TC binary table, leading to the identification of what we call side-effect profiles (SEPs). A SEP is defined as the longest combination of TCs which are shared by a significant number of drugs. Frequent SEPs are explored on the basis of integrated drug and target descriptors using two machine learning methods: decision-trees and inductive-logic programming. Although both methods yield explicit models, inductive-logic programming method performs relational learning and is able to exploit not only drug properties but also background knowledge. Learning efficiency is evaluated by cross-validation and direct testing with new molecules. Comparison of the two machine-learning methods shows that the inductive-logic-programming method displays a greater sensitivity than decision trees and successfully exploit background knowledge such as functional annotations and pathways of drug targets, thereby producing rich and expressive rules. All models and theories are available on a dedicated web site. Conclusions Side effect profiles covering significant number of drugs have been extracted from a drug ×side-effect association table. Integration of background knowledge concerning both chemical and biological spaces has been combined with a relational learning method for discovering rules which explicitly characterize drug-SEP associations. These rules are successfully used for predicting SEPs associated with new drugs. PMID:23802887

Integrative relational machine-learning for understanding drug side-effect profiles.

PubMed

Bresso, Emmanuel; Grisoni, Renaud; Marchetti, Gino; Karaboga, Arnaud Sinan; Souchet, Michel; Devignes, Marie-Dominique; Smaïl-Tabbone, Malika

2013-06-26

Drug side effects represent a common reason for stopping drug development during clinical trials. Improving our ability to understand drug side effects is necessary to reduce attrition rates during drug development as well as the risk of discovering novel side effects in available drugs. Today, most investigations deal with isolated side effects and overlook possible redundancy and their frequent co-occurrence. In this work, drug annotations are collected from SIDER and DrugBank databases. Terms describing individual side effects reported in SIDER are clustered with a semantic similarity measure into term clusters (TCs). Maximal frequent itemsets are extracted from the resulting drug x TC binary table, leading to the identification of what we call side-effect profiles (SEPs). A SEP is defined as the longest combination of TCs which are shared by a significant number of drugs. Frequent SEPs are explored on the basis of integrated drug and target descriptors using two machine learning methods: decision-trees and inductive-logic programming. Although both methods yield explicit models, inductive-logic programming method performs relational learning and is able to exploit not only drug properties but also background knowledge. Learning efficiency is evaluated by cross-validation and direct testing with new molecules. Comparison of the two machine-learning methods shows that the inductive-logic-programming method displays a greater sensitivity than decision trees and successfully exploit background knowledge such as functional annotations and pathways of drug targets, thereby producing rich and expressive rules. All models and theories are available on a dedicated web site. Side effect profiles covering significant number of drugs have been extracted from a drug ×side-effect association table. Integration of background knowledge concerning both chemical and biological spaces has been combined with a relational learning method for discovering rules which explicitly characterize drug-SEP associations. These rules are successfully used for predicting SEPs associated with new drugs.

Patient perceptions of glucocorticoid side effects: a cross-sectional survey of users in an online health community.

PubMed

Costello, Ruth; Patel, Rikesh; Humphreys, Jennifer; McBeth, John; Dixon, William G

2017-04-03

To identify the side effects most important to glucocorticoid (GC) users through a survey of a UK online health community (Healthunlocked.com). Online cross-sectional survey. Participants were recruited through Healthunlocked.com, an online social network for health. Adults who were currently taking GCs, or had taken GCs in the past month. Responders scored the importance of listed side effects from 1 to 10, with 10 being of high importance to them. For each side effect, histograms were plotted, and the median rating and IQR were determined. Side effects were ranked by median ranking (largest to smallest) and then IQR (smallest to largest). The scores were categorised as low (scores 1-3), medium (scores 4-7) and high (scores 8-10) importance. 604 responders completed the survey. Histograms of side effect scores showed a skew towards high importance for weight gain, a U-shaped distribution for cardiovascular disease (CVD), diabetes, eye disease and infections, and a skew towards low importance for acne. When ranked, the side effect of most importance to responders was weight gain (median score=9, IQR 6-10) followed by insomnia and moon face with equal median score (8) and IQR (5-10). Three serious side effects, CVD, diabetes and infections, were ranked of lower importance overall but had wide ranging scores (median score=8, IQR 1-10). The three most highly rated side effects were not clinically serious but remained important to patients, perhaps reflecting their impact on quality of life and high prevalence. This should be taken into consideration when discussing treatment options and planning future GC safety studies. 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/.

Specific expectancies are associated with symptomatic outcomes and side effect burden in a trial of chamomile extract for generalized anxiety disorder.

PubMed

Keefe, John R; Amsterdam, Jay; Li, Qing S; Soeller, Irene; DeRubeis, Robert; Mao, Jun J

2017-01-01

Patient expectancies are hypothesized to contribute to the efficacy and side effects of psychiatric treatments, but little research has investigated this hypothesis in the context of psychopharmacological therapies for anxiety. We prospectively investigated whether expectancies predicted efficacy and adverse events in oral therapy for Generalized Anxiety Disorder (GAD), controlling for confounding patient characteristics correlating with outcomes. Expectancies regarding treatment efficacy and side effects were assessed at baseline of an eight week open-label phase of a trial of chamomile for Generalized Anxiety Disorder (GAD). The primary outcome was patient-reported GAD-7 scores, with clinical response and treatment-emergent side-effects as secondary outcomes. Expectancies were used to predict symptomatic and side-effect outcomes. Very few baseline patient characteristics predicted either type of expectancy. Controlling for a patient's predicted recovery based on their baseline characteristics, higher efficacy expectancies at baseline predicted greater change on the GAD-7 (adjusted β = -0.19, p = 0.011). Efficacy expectancies also predicted a higher likelihood of attaining clinical response (adjusted odds ratio = 1.69, p = 0.002). Patients with higher side effect expectancies reported more side effects (adjusted log expected count = 0.26, p = 0.038). Efficacy expectancies were unrelated to side effect reports (log expected count = -0.05, p = 0.680), and side effect expectancies were unrelated to treatment efficacy (β = 0.08, p = 0.306). Patients entering chamomile treatment for GAD with more favorable self-generated expectancies for the treatment experience greater improvement and fewer adverse events. Aligning patient expectancies with treatment selections may optimize outcomes. Trial Number NCT01072344 at ClinicalTrials.gov. Copyright © 2016 Elsevier Ltd. All rights reserved.

Exploring the role of drug-metabolising enzymes in antidepressant side effects.

PubMed

Hodgson, Karen; Tansey, Katherine E; Uher, Rudolf; Dernovšek, Mojca Zvezdana; Mors, Ole; Hauser, Joanna; Souery, Daniel; Maier, Wolfgang; Henigsberg, Neven; Rietschel, Marcella; Placentino, Anna; Craig, Ian W; Aitchison, Katherine J; Farmer, Anne E; Dobson, Richard J B; McGuffin, Peter

2015-07-01

Cytochrome P450 enzymes are important in the metabolism of antidepressants. The highly polymorphic nature of these enzymes has been linked to variability in antidepressant metabolism rates, leading to hope regarding the use of P450 genotyping to guide treatment. However, evidence that P450 genotypic differences underlie the variation in treatment outcomes is inconclusive. We explored the links between both P450 genotype and serum concentrations of antidepressant with antidepressant side effects, using data from the Genome-Based Therapeutic Drugs for Depression Project (GENDEP), which is a large (n = 868), pharmacogenetic study of depressed individuals treated with escitalopram or nortriptyline. Patients were genotyped for the enzymes CYP2C19 and CYP2D6, and serum concentrations of both antidepressant and primary metabolite were measured after 8 weeks of treatment. Side effects were assessed weekly. We investigated associations between P450 genotypes, serum concentrations of antidepressants and side effects, as well as the relationship between P450 genotype and study discontinuation. P450 genotype did not predict total side effect burden (nortriptyline: n = 251, p = 0.5638, β = -0.133, standard error (SE) = 0.229; escitalopram: n = 340, p = 0.9627, β = -0.004, SE = 0.085), study discontinuation (nortriptyline n = 284, hazard ratio (HR) = 1.300, p = 0.174; escitalopram n = 376, HR = 0.870, p = 0.118) or specific side effects. Serum concentrations of antidepressant were only related to a minority of the specific side effects measured: dry mouth, dizziness and diarrhoea. In this sample where antidepressant dosage is titrated using clinical judgement, P450 genotypes do not explain differences between patients in side effects with antidepressants. Serum drug concentrations appear to only explain variability in the occurrence of a minority of specific side effects.

Antiepileptic drug behavioral side effects and baseline hyperactivity in children and adolescents with new onset epilepsy.

PubMed

Guilfoyle, Shanna M; Follansbee-Junger, Katherine; Smith, Aimee W; Combs, Angela; Ollier, Shannon; Hater, Brooke; Modi, Avani C

2018-01-01

To examine baseline psychological functioning and antiepileptic drug (AED) behavioral side effects in new onset epilepsy and determine, by age, whether baseline psychological functioning predicts AED behavioral side effects 1 month following AED initiation. A retrospective chart review was conducted between July 2011 and December 2014 that included youths with new onset epilepsy. As part of routine interdisciplinary care, caregivers completed the Behavior Assessment System for Children, 2nd Edition: Parent Rating Scale to report on baseline psychological functioning at the diagnostic visit and the Pediatric Epilepsy Side Effects Questionnaire to identify AED behavioral side effects at the 1-month follow-up clinic visit following AED initiation. Children (age = 2-11 years) and adolescents (age = 12-18 years) were examined separately. A total of 380 youths with new onset epilepsy (M age  = 8.9 ± 4.3 years; 83.4% Caucasian; 34.8% focal epilepsy, 41.1% generalized epilepsy, 23.7% unclassified epilepsy) were included. Seventy percent of youths had at-risk or clinically elevated baseline psychological symptoms. Children had significantly greater AED behavioral side effects (M = 25.08 ± 26.36) compared to adolescents (M = 12.36 ± 17.73), regardless of AED. Valproic acid demonstrated significantly greater behavioral side effects compared to all other AEDs, with the exception of levetiracetam. Higher hyperactivity/impulsivity at baseline significantly predicted higher AED behavioral side effects 1 month after AED initiation in both age groups. Younger children seem to be more prone to experience behavioral side effects, and these are likely to be higher if youths with epilepsy have baseline hyperactivity/impulsivity. Baseline psychological screening, specifically hyperactivity, can be used as a precision medicine tool for AED selection. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

Lymphadenitis as a Rare Side Effect of H1N1 Vaccine in a Child

PubMed Central

Gundogdu, Zuhal; Seyhogullari, Mualla

2010-01-01

We present a 5-year-old boy who had the complaint of swelling and pain on the right vaccine shot and right axillary areas. The right axillary area was diagnosed as reactive lymphadenitis, which we believe is a rare local side effect of the swine flu vaccine. The key message to take away from this case is that the patient had lymphadenitis as a local side effect of the swine flu vaccine. Lymphadenitis should be reported as a possible local side effect of the swine flu vaccine. PMID:21209734

A new method of evaluating the side wall interference effect on airfoil angle of attack by suction from the side walls

NASA Technical Reports Server (NTRS)

Sawada, H.; Sakakibara, S.; Sato, M.; Kanda, H.; Karasawa, T.

1984-01-01

A quantitative evaluation method of the suction effect from a suction plate on side walls is explained. It is found from wind tunnel tests that the wall interference is basically described by the summation form of wall interferences in the case of two dimensional flow and the interference of side walls.

Side to Side Supercharging Allograft

DTIC Science & Technology

Side-to-side grafting between the PNA and regional in situ nerve trunks may be able to increase the effective critical length of the PNA. Nerve tissue...and provides an effective scaffolding system but depends on in situ Schwann cell migration to support axon regeneration. Though this process appears...loss and retraction can result in segmental gaps requiring some form of grafting. Autologous nerve grafting is associated with potential donor

Design and implementation of online automatic judging system

NASA Astrophysics Data System (ADS)

Liang, Haohui; Chen, Chaojie; Zhong, Xiuyu; Chen, Yuefeng

2017-06-01

For lower efficiency and poorer reliability in programming training and competition by currently artificial judgment, design an Online Automatic Judging (referred to as OAJ) System. The OAJ system including the sandbox judging side and Web side, realizes functions of automatically compiling and running the tested codes, and generating evaluation scores and corresponding reports. To prevent malicious codes from damaging system, the OAJ system utilizes sandbox, ensuring the safety of the system. The OAJ system uses thread pools to achieve parallel test, and adopt database optimization mechanism, such as horizontal split table, to improve the system performance and resources utilization rate. The test results show that the system has high performance, high reliability, high stability and excellent extensibility.

Earth and water resources and hazards in Central America

USGS Publications Warehouse

Cunningham, Charles G.; Fary, R.W.; Guffanti, Marianne; Laura, Della; Lee, M.P.; Masters, C.D.; Miller, R.L.; Quinones-Marques, Ferdinand; Peebles, R.W.; Reinemund, J.A.; Russ, D.P.

1984-01-01

Long-range economic development in Central America will depend in large part on production of indigenous mineral, energy, and water resources and on mitigation of the disastrous effects of geologic and hydrologic hazards such as landslides, earthquakes, volcanic eruptions, and floods. The region has six world-class metal mines at present as well as additional evidence of widespread mineralization. Systematic investigations using modern mineral exploration techniques should reveal more mineral deposits suitable for development. Widespread evidence of lignite and geothermal resources suggests that intensive studies could identify producible energy sources in most Central American countries. Water supply and water quality vary greatly from country to country. Local problems of ground- and surface-water availability and of contamination create a need for systematic programs to provide better hydrologic data, capital improvements, and management. Disastrous earthquakes have destroyed or severely damaged many cities in Central America. Volcanic eruptions, landslides, mudflows, and floods have devastated most of the Pacific side of Central America at one time or another. A regional approach to earthquake, volcano, and flood-risk analysis and monitoring, using modern technology and concepts, would provide the facilities and means for acquiring knowledge necessary to reduce future losses. All Central American countries need to strengthen institutions and programs dealing with earth and water resources and natural hazards. Some of these needs may be satisfied through existing or pending projects and technical and economic assistance from U.S. or other sources. The need for a comprehensive study of the natural resources of Central America and the requirements for their development is evident. The U.S. Caribbean Basin Initiative offers both an excellent opportunity for a regional approach to these pervasive problems and an opportunity for international cooperation.

A second international cooperative investigation into thioacetazone side effects

PubMed Central

Miller, A. B.; Nunn, A. J.; Robinson, D. K.; Fox, Wallace; Somasundaram, P. R.; Tall, Ruth

1972-01-01

As part of a large-scale international cooperative investigation into the side effects of thioacetazone-containing regimens in the treatment of tuberculosis, an evaluation has been made of the variation in the frequency of side effects between different countries and between different centres in the same country and of the likely reasons for this variation. In 3 countries patients of different racial origin were under observation in the same hospital. Over a 12-week period of treatment there was considerable variation between the countries and centres in the overall frequency of side effects and of those leading to a major departure from prescribed treatment, the variation being similar for the two thioacetazone-containing regimens and for the streptomycin plus isoniazid control regimen, though at a lower level for the latter. In Malaysia, Singapore, and Trinidad, where different racial groups were under treatment, there was no clear indication that race was an important factor in explaining the differences between countries, except for cutaneous side effects in Trinidad and possibly in Malaysia. It is concluded that the differences in the frequency of side effects to thioacetazone-containing regimens probably result from variation in the closeness of supervision of patients, in the recording and interpretation of side effects, and in environmental factors including the previous use of other medicaments or exposure to sensitizing substances. PMID:4118761

Factors associated with current and severe physical side-effects after prostate cancer treatment: What men report.

PubMed

Steentjes, L; Siesling, S; Drummond, F J; van Manen, J G; Sharp, L; Gavin, A

2018-01-01

We identified patient and disease characteristics associated with (1) "current" physical side-effects of any severity; and (2) "severe" physical side-effects "ever" experienced by 3,348 (54%) prostate cancer (PCa) survivors in Ireland diagnosed 2-18 years previously. Postal questionnaires collected symptoms at diagnosis, post-biopsy complications, comorbidities, primary treatments and physical side-effects post-treatment (urinary incontinence, erectile dysfunction, libido loss, bowel problems, breast changes, hot flushes, and fatigue, "ever" and "current" at time of questionnaire completion). Men were grouped by "early" (localised) and "late" (locally advanced/advanced) disease at diagnosis. Multivariable logistic regression analysis identified patient and disease-related factors associated with post-treatment side-effects. Complications post-biopsy were associated with higher risk of "current" libido loss and impotence. Radical prostatectomy was associated with higher risk of "current" and "severe" incontinence, libido loss and impotence in both early and late disease. In early disease, brachytherapy was associated with lower risk of "current" fatigue and "severe" impotence. Comorbidities were associated with higher risk of "current" experience of four side-effects (incontinence, libido loss, bowel problems, fatigue). Men on active surveillance/watchful-waiting reported lower risk of sexual dysfunction. These findings could inform development of tailored information on side-effects, which, in turn, could inform treatment decision-making and post-treatment monitoring. © 2016 John Wiley & Sons Ltd.

Spontaneous mental associations with the words "side effect": Implications for informed and shared decision making.

PubMed

Izadi, Sonya; Pachur, Thorsten; Wheeler, Courtney; McGuire, Jaclyn; Waters, Erika A

2017-10-01

To gain insight into patients' medical decisions by exploring the content of laypeople's spontaneous mental associations with the term "side effect." An online cross-sectional survey asked 144 women aged 40-74, "What are the first three things you think of when you hear the words 'side effect?"' Data were analyzed using content analysis, chi-square, and Fisher's exact tests. 17 codes emerged and were grouped into 4 themes and a Miscellaneous category: Health Problems (70.8% of participants), Decision-Relevant Evaluations (52.8%), Negative Affect (30.6%), Practical Considerations (18.1%) and Miscellaneous (9.7%). The 4 most frequently identified codes were: Risk (36.1%), Health Problems-Specific Symptoms (35.4%), Health Problems-General Terms (32.6%), and Negative Affect-Strong (19.4%). Code and theme frequencies were generally similar across demographic groups (ps>0.05). The term "side effect" spontaneously elicited comments related to identifying health problems and expressing negative emotions. This might explain why the mere possibility of side effects triggers negative affect for people making medical decisions. Some respondents also mentioned decision-relevant evaluations and practical considerations in response to side effects. Addressing commonly-held associations and acknowledging negative affects provoked by side effects are first steps healthcare providers can take towards improving informed and shared patient decision making. Copyright © 2017 Elsevier B.V. All rights reserved.

Mobile Phone Based System Opportunities to Home-based Managing of Chemotherapy Side Effects.

PubMed

Davoodi, Somayeh; Mohammadzadeh, Zeinab; Safdari, Reza

2016-06-01

Applying mobile base systems in cancer care especially in chemotherapy management have remarkable growing in recent decades. Because chemotherapy side effects have significant influences on patient's lives, therefore it is necessary to take ways to control them. This research has studied some experiences of using mobile phone based systems to home-based monitor of chemotherapy side effects in cancer. In this literature review study, search was conducted with keywords like cancer, chemotherapy, mobile phone, information technology, side effects and self managing, in Science Direct, Google Scholar and Pub Med databases since 2005. Today, because of the growing trend of the cancer, we need methods and innovations such as information technology to manage and control it. Mobile phone based systems are the solutions that help to provide quick access to monitor chemotherapy side effects for cancer patients at home. Investigated studies demonstrate that using of mobile phones in chemotherapy management have positive results and led to patients and clinicians satisfactions. This study shows that the mobile phone system for home-based monitoring chemotherapy side effects works well. In result, knowledge of cancer self-management and the rate of patient's effective participation in care process improved.

Inferring protein domains associated with drug side effects based on drug-target interaction network

PubMed Central

2013-01-01

Background Most phenotypic effects of drugs are involved in the interactions between drugs and their target proteins, however, our knowledge about the molecular mechanism of the drug-target interactions is very limited. One of challenging issues in recent pharmaceutical science is to identify the underlying molecular features which govern drug-target interactions. Results In this paper, we make a systematic analysis of the correlation between drug side effects and protein domains, which we call "pharmacogenomic features," based on the drug-target interaction network. We detect drug side effects and protein domains that appear jointly in known drug-target interactions, which is made possible by using classifiers with sparse models. It is shown that the inferred pharmacogenomic features can be used for predicting potential drug-target interactions. We also discuss advantages and limitations of the pharmacogenomic features, compared with the chemogenomic features that are the associations between drug chemical substructures and protein domains. Conclusion The inferred side effect-domain association network is expected to be useful for estimating common drug side effects for different protein families and characteristic drug side effects for specific protein domains. PMID:24565527

Anxiety Sensitivity and Nicotine Replacement Therapy Side Effects: Examining the Role of Emotion Dysregulation Among Treatment-Seeking Smokers.

PubMed

Zvolensky, Michael J; Paulus, Daniel J; Garey, Lorra; Raines, Amanda M; Businelle, Michael; Shankman, Stewart A; Manning, Kara; Goodwin, Renee D; Schmidt, Norman B

2017-11-01

Nicotine replacement therapy (NRT) significantly increases the likelihood of quit success at least over the short term, yet some smokers prematurely discontinue use. NRT side effects are often cited as the primary reason for medication discontinuation. The current study examined a theoretical pathway by which two smoking-related emotional vulnerabilities (anxiety sensitivity and emotion dysregulation) were related to the number of NRT (nicotine patch) side effects reported 1 week following a scheduled quit attempt. It was hypothesized that anxiety sensitivity would have an indirect effect on NRT side effects through emotion dysregulation. A total of 179 treatment-seeking, adult daily smokers with elevated anxiety sensitivity (47.5% male; M age = 39.73 years, SD = 13.87) were enrolled in a smoking cessation trial. Covariate-adjusted analyses provided support for the hypothesized pathway, such that emotion dysregulation explained the association between anxiety sensitivity and NRT side effects (b = 0.02, SE = 0.01, 95% CI [0.002, 0.03]; completely standardized estimate = .15). The findings underscore the importance of developing cessation treatments that incorporate techniques to enhance emotion regulation, particularly among smokers higher in anxiety sensitivity, to decrease the risk of NRT side effects.

Contribution of ventral tegmental GABA receptors to cocaine self-administration in rats.

PubMed

Backes, E N; Hemby, S E

2008-03-01

Recent evidence has suggested that compounds affecting GABAergic transmission may provide useful pharmacological tools for the treatment of cocaine addiction. Using a rat model of self-administration, the present study examined the effects of GABA agonists and antagonists injected directly into the ventral tegmental area (VTA) on cocaine intake in rats trained to self-administer cocaine (0, 125, 250 and 500 microg/infusion) under an FR5 schedule of reinforcement. Separate groups of rats received bilateral intra-VTA injections of the GABA-A antagonist picrotoxin (34 ng/side, n = 7; 68 ng/side, n = 8), GABA-A agonist muscimol (14 ng/side, n = 8), GABA-B agonist baclofen (56 ng/side, n = 7; 100 ng/side, n = 6), picrotoxin (68 ng/side) co-injected with the GABA-B antagonist 2-hydroxysaclofen (100 ng/side, n = 7; 2 microg/side, n = 8) or artificial cerebrospinal fluid (aCSF, n = 6) to assess the effects of the various compounds on the cocaine self-administration dose-response curve. Both picrotoxin and baclofen reduced responding maintained by cocaine, whereas muscimol had no effect on responding. In contrast, neither picrotoxin (n = 6) nor baclofen (n = 8) affected responding maintained by food. Interestingly, 2-hydroxysaclofen effectively blocked the suppression of responding produced by picrotoxin, suggesting that both picrotoxin and baclofen exert their effects via activation of GABA-B receptors. Additionally, these effects appear to be specific to cocaine reinforcement, supporting current investigation of baclofen as a treatment for cocaine addiction.

Contribution of ventral tegmental GABA receptors to cocaine self-administration in rats

PubMed Central

Backes, E.N.; Hemby, S.E.

2008-01-01

Recent evidence has suggested that compounds affecting GABAergic transmission may provide useful pharmacological tools for the treatment of cocaine addiction. Using a rat model of self-administration, the present study examined the effects of GABA agonists and antagonists injected directly into the ventral tegmental area (VTA) on cocaine intake in rats trained to self-administer cocaine (0, 125, 250 and 500 µg/infusion) under an FR5 schedule of reinforcement. Separate groups of rats received bilateral intra-VTA injections of the GABA-A antagonist picrotoxin (34 ng/side, n=7; 68 ng/side, n=8), GABA-A agonist muscimol (14 ng/side, n=8), GABA-B agonist baclofen (56 ng/side, n=7; 100 ng/side, n=6), picrotoxin (68 ng/side) co-injected with the GABA-B antagonist 2-hydroxysaclofen (100 ng/side, n=7; 2 µg/side, n=8) or artificial cerebrospinal fluid (aCSF, n=6) to assess the effects of the various compounds on the cocaine self-administration dose-response curve. Both picrotoxin and baclofen reduced responding maintained by cocaine, whereas muscimol had no effect on responding. In contrast, neither picrotoxin (n=6) nor baclofen (n=8) affected responding maintained by food. Interestingly, 2-hydroxysaclofen effectively blocked the suppression of responding produced by picrotoxin, suggesting that both picrotoxin and baclofen exert their effects via activation of GABA-B receptors. Additionally, these effects appear to be specific to cocaine reinforcement, supporting current investigation of baclofen as a treatment for cocaine addiction. PMID:17943439

Effects of granulocyte-colony-stimulating factor on potential normal granulocyte donors.

PubMed

McCullough, J; Clay, M; Herr, G; Smith, J; Stroncek, D

1999-10-01

The use of granulocyte-colony-stimulating factor (G-CSF) to increase the granulocyte count and the yield from leukapheresis in normal donors is leading to renewed interest in granulocyte transfusion. Therefore, it is important to understand the side effects of G-CSF. We studied the effect of G-CSF on peripheral blood counts and recorded the side effects experienced 24 hours after an injection of G-CSF in normal subjects donating peripheral blood progenitor cells for research. Following administration of G-CSF to 261 donors, the neutrophil count increased to 20.6 to 24.5 x 10(9) per microL depending on the dose of G-CSF. This represented a 6.2 to 7.4-fold increase over the neutrophil count before G-CSF administration. Of all donors, 69 percent experienced one or more side effects. The most common effects were: muscle and bone pain, headache, fatigue, and nausea. There was a relationship between the dose of G-CSF and the likelihood of experiencing a side effect. Most side effects were mild, but about 75 percent of donors took analgesics because of them. In a granulocyte donation program involving G-CSF stimulation, about two-thirds of donors would experience one or more side effects, but these would usually be mild and well tolerated.

Initial estimates of hurricane Katrina impacts of Mississippi gulf coast forest resources

Treesearch

Patrick A. Glass; Sonja N. Oswalt

2007-01-01

Hurricane Katrina pummeled the Gulf Coast of Mississippi on August 29, 2005. The eye wall of the storm passed directly over Hancock and Pearl River Counties. Harrison, Jackson, Stone, and George Counties on the windward side of the hurricane's path sustained severe damage before the storm's strength dissipated as it moved farther inland (fig. 1).

An Empirical Analysis of Borrowing Behaviour of Higher Education Students in the Netherlands

ERIC Educational Resources Information Center

Oosterbeek, Hessel; van den Broek, Anja

2009-01-01

Many higher education students combine their study with a job on the side instead of taking up a loan. This paper examines the factors underlying this apparently myopic behaviour. We find that standard economic factors explain observed borrowing decisions to some extent. Students with easier access to financial resources borrow less often.…

78 FR 79661 - Gallatin County Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-31

... visiting the Act's Web site at www.fs.usda.gov/gallatin and clicking on the right-hand highlight that... the Large Conference Room located in the foyer on the North side of the building. Written comments may.... Individuals wishing to make an oral statement should submit a request in writing by February 10, 2014 to be...

American business ethics and health care costs.

PubMed

Garrett, T M; Klonoski, R J; Baillie, H W

1993-01-01

The health care industry operates in the margin between market competition and social welfare programs. Violations of business ethics on the market side add considerably to costs. When the inefficient use of resources and market distortions due to power and ignorance as well as legal and subsidized monopolies are added, increased costs can approach $100 billion. Modest remedies are suggested.

30 CFR 75.403 - Maintenance of incombustible content of rock dust.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Maintenance of incombustible content of rock... Materials and Rock Dusting § 75.403 Maintenance of incombustible content of rock dust. [Statutory Provision] Where rock dust is required to be applied, it shall be distributed upon the top, floor, and sides of all...

Privacy-Preserving RFID Authentication Using Public Exponent Three RSA Algorithm

NASA Astrophysics Data System (ADS)

Kim, Yoonjeong; Ohm, Seongyong; Yi, Kang

In this letter, we propose a privacy-preserving authentication protocol with RSA cryptosystem in an RFID environment. For both overcoming the resource restriction and strengthening security, our protocol uses only modular exponentiation with exponent three at RFID tag side, with the padded random message whose length is greater than one-sixth of the whole message length.

Landscape models: helping land managers think big

Treesearch

Rachel White; Rhonda Mazza

2011-01-01

In a sun-baked, grassy clearing on the east side of the Cascade Range in central Washington, Pacific Northwest (PNW) Research Station landscape ecologist Miles Hemstrom and a group of ecologists and land managers from the Washington Department of Natural Resources (DNR) gather in the shade of a ponderosa pine. Hundreds of years old, this ancient pine has withstood...

Two Sides of the Same Coin: Senior Faculty: Staying on or Opting Out?

ERIC Educational Resources Information Center

Schuett, Faye

1999-01-01

Discusses an initiative to revitalize senior faculty through an interview with Dr. Bernice Braid, Dean of Academic and Instructional Resources at Long Island University (New York). Also presents the inducements for early retirement in the second half of this article via an interview with Dr. Leonard T. Kreisman, Senior Professor of Economics,…

Self-Perceptions and Roles: How Eastern Mediterranean University Students and Teachers View Online Program and Courses

ERIC Educational Resources Information Center

Isman, Aytekin; Altinay, Zehra

2006-01-01

Distance Education--new trend in the world--has developed from the result of competition, developments on marketing, globalization and technology. Online education as a practical side, saves time, eliminates distance among communicators by giving equal opportunities, resources to everyone. Online courses and program are the new application and the…

Literature Search and Records Inventory for Cultural Resources Along the East Side of the Missouri River, Miles 498.03-732.31,

DTIC Science & Technology

1978-05-01

Chicago: National Pub- lishing Company, 1890. History of Pottawattamie County, Iowa. Chicago: O.L. Baskin & Co., Historical Publishers, 1883. History of...Historical Society- of Iowa, 1941. Pratt, LeRoy G. Discovering Historic Iowa. Des Moines, Iowa Department of Public instrucU-n, 1975. Robbins , Willard

3. SNAKE RIVER VALLEY IRRIGATION DISTRICT, PHOTOGRAPHIC COPY OF DRAWING, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

3. SNAKE RIVER VALLEY IRRIGATION DISTRICT, PHOTOGRAPHIC COPY OF DRAWING, PROFILE AND ALIGNMENT OF DAM ACROSS WEST CHANNEL OF SNAKE RIVER, SHEET 3 OF 5, 1924 (on file at the Idaho State Office of Water Resources, Boise, Idaho) - Snake River Valley Irrigation District, East Side of Snake River (River Mile 796), Shelley, Bingham County, ID

Phenology and trend indicators derived from spatially dynamic bi-weekly satellite imagery to support ecosystem monitoring

Treesearch

Barron J. Orr; Grant M. Casady; Daniel G. Tuttle; Willem J. D. van Leeuwen; Laura E. Baker; Colleen I. McDonald; Stuart E. Marsh

2005-01-01

Ground-based ecosystem monitoring presents some practical challenges to natural resource managers and ecologists tasked with assessing vegetation dynamics across large areas through time. RangeView (http://rangeview.arizona.edu) provides online access to spatially and temporally explicit biweekly vegetation indices derived from satellite data. It also permits side-by-...

End User Information Searching on the Internet: How Do Users Search and What Do They Search For? (SIG USE)

ERIC Educational Resources Information Center

Saracevic, Tefko

2000-01-01

Summarizes a presentation that discussed findings and implications of research projects using an Internet search service and Internet-accessible vendor databases, representing the two sides of public database searching: query formulation and resource utilization. Presenters included: Tefko Saracevic, Amanda Spink, Dietmar Wolfram and Hong Xie.…

Pride on the Other Side: The Emergence of LGBT Web Sites for Prospective Students

ERIC Educational Resources Information Center

Mathis, Daniel; Tremblay, Christopher

2010-01-01

For several decades, colleges have maintained an LGBT Web presence for currently enrolled students. These Web sites inform students about resources, services, events, and staff . They serve as a way to communicate a school's inclusivity and commitment to the LGBT population. Only recently have Web sites specifically targeted for the prospective…

National Drug Formulary review of statin therapeutic group using the multiattribute scoring tool

PubMed Central

Ramli, Azuana; Aljunid, Syed Mohamed; Sulong, Saperi; Md Yusof, Faridah Aryani

2013-01-01

Purpose HMG-CoA reductase inhibitors (statins) are extensively used in treating hypercholesterolemia. The statins available in Malaysia include atorvastatin, lovastatin, pravastatin, rosuvastatin, simvastatin, and fluvastatin. Over the years, they have accumulated in the National Drug Formulary; hence, the need for review. Effective selection of the best drugs to remain in the formulary can become complex due to the multiple drug attributes involved, and is made worse by the limited time and resources available. The multiattribute scoring tool (MAST) systematizes the evaluation of the drug attributes to facilitate the drug selection process. In this study, a MAST framework was developed to rank the statins based on their utilities or benefits. Methods Published literature on multicriteria decision analysis (MCDA) were studied and five sessions of expert group discussions were conducted to build the MAST framework and to review the evidence. The attributes identified and selected for analysis were efficacy (clinical efficacy, clinical endpoints), safety (drug interactions, serious side effects and documentation), drug applicability (drug strength/formulation, indications, dose frequency, side effects, food–drug interactions, and dose adjustments), and cost. The average weights assigned by the members for efficacy, safety, drug applicability and cost were 32.6%, 26.2%, 24.1%, and 17.1%, respectively. The utility values of the attributes were scored based on the published evidence or/and agreements during the group discussions. The attribute scores were added up to provide the total utility score. Results Using the MAST, the six statins under review were successfully scored and ranked. Atorvastatin scored the highest total utility score (TUS) of 84.48, followed by simvastatin (83.11). Atorvastatin and simvastatin scored consistently high, even before drug costs were included. The low scores on the side effects for atorvastatin were compensated for by the higher scores on the clinical endpoints resulting in a higher TUS for atorvastatin. Fluvastatin recorded the lowest TUS. Conclusion The multiattribute scoring tool was successfully applied to organize decision variables in reviewing statins for the formulary. Based on the TUS, atorvastatin is recommended to remain in the formulary and be considered as first-line in the treatment of hypercholesterolemia. PMID:24353428

The dark side of social capital: A systematic review of the negative health effects of social capital.

PubMed

Villalonga-Olives, E; Kawachi, I

2017-12-01

There is a growing literature demonstrating the health benefits of social capital (defined as the resources accessed through social connections). However, social capital is also acknowledged to be a "double-edged" phenomenon, whose effects on health are not always positive. We sought to systematically review studies that have found a negative (i.e. harmful) association between social capital and health outcomes. Our objective was to classify the different types of negative effects, following a framework originally proposed by Portes (1998). We conducted a literature search in Pubmed, Embase and PsychInfo. We identified 3530 manuscripts. After detailed review, we included 44 articles in our systematic review. There are at least two negative consequences of social capital besides the classification proposed by Portes: behavioral contagion and cross-level interactions between social cohesion and individual characteristics. When leveraging the concept of social capital for health promotion interventions, researchers need to take account of these potential "downsides" for health outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Collecting Psycholinguistic Response Time Data Using Amazon Mechanical Turk

PubMed Central

Enochson, Kelly; Culbertson, Jennifer

2015-01-01

Researchers in linguistics and related fields have recently begun exploiting online crowd-sourcing tools, like Amazon Mechanical Turk (AMT), to gather behavioral data. While this method has been successfully validated for various offline measures—grammaticality judgment or other forced-choice tasks—its use for mainstream psycholinguistic research remains limited. This is because psycholinguistic effects are often dependent on relatively small differences in response times, and there remains some doubt as to whether precise timing measurements can be gathered over the web. Here we show that three classic psycholinguistic effects can in fact be replicated using AMT in combination with open-source software for gathering response times client-side. Specifically, we find reliable effects of subject definiteness, filler-gap dependency processing, and agreement attraction in self-paced reading tasks using approximately the same numbers of participants and/or trials as similar laboratory studies. Our results suggest that psycholinguists can and should be taking advantage of AMT and similar online crowd-sourcing marketplaces as a fast, low-resource alternative to traditional laboratory research. PMID:25822348

The effect of health payment reforms on cost containment in Taiwan hospitals: the agency theory perspective.

PubMed

Chang, Li

2011-01-01

This study aims to determine whether the Taiwanese government's implementation of new health care payment reforms (the National Health Insurance with fee-for-service (NHI-FFS) and global budget (NHI-GB)) has resulted in better cost containment. Also, the question arises under the agency theory whether the monitoring system is effective in reducing the risk of information asymmetry. This study uses panel data analysis with fixed effects model to investigate changes in cost containment at Taipei municipal hospitals before and after adopting reforms from 1989 to 2004. The results show that the monitoring system does not reduce information asymmetry to improve cost containment under the NHI-FFS. In addition, after adopting the NHI-GB system, health care costs are controlled based on an improved monitoring system in the policymaker's point of view. This may suggest that the NHI's fee-for-services system actually causes health care resource waste. The GB may solve the problems of controlling health care costs only on the macro side.

Comparison of side effects of pentagastrin test and calcium stimulation test in patients with increased basal calcitonin concentration: the gender-specific differences.

PubMed

Ubl, Philipp; Gincu, Tatiana; Keilani, Mohammad; Ponhold, Lothar; Crevenna, Richard; Niederle, Bruno; Hacker, Marcus; Li, Shuren

2014-08-01

The aim of this study was to compare the side effects of the pentagastrin test and the calcium stimulation test in patients with increased basal calcitonin concentration, especially the gender-specific differences of side effects. A total of 256 patients (123 females and 133 males, mean age of 56 ± 27 years, range 21-83 years) had both pentagastrin and calcium stimulation tests. All patients filled in a questionnaire regarding the side effects within 30 min after completion of the stimulation tests. The differences of side effects between female and male patients as well as between the pentagastrin stimulation test and the calcium stimulation test were evaluated. Warmth feeling was the most frequent occurring side effect in all patients who had both pentagastrin and calcium stimulation tests, followed by nausea, altered gustatory sensation, and dizziness. The incidences of urgency to micturate (p < 0.05) and dizziness (p < 0.05) were significantly increased in the female patients as compared to male patients by calcium stimulation test. Significant higher incidences of urgency to micturate (p < 0.05) and warmth feeling (p < 0.05) were found by calcium stimulation test as compared with those by pentagastrin test in female patients. The incidences of nausea (p < 0.05) and abdominal cramping (p < 0.05) in male patients were significantly higher by pentagastrin stimulation test than by calcium stimulation test. There is a significant gender-specific difference in side effects induced by calcium stimulation test. Female patients have fewer side effects by pentagastrin test than by calcium stimulation test. Male patients may tolerate the calcium stimulation test better than the pentagastrin test.

Quantitative prediction of drug side effects based on drug-related features.

PubMed

Niu, Yanqing; Zhang, Wen

2017-09-01

Unexpected side effects of drugs are great concern in the drug development, and the identification of side effects is an important task. Recently, machine learning methods are proposed to predict the presence or absence of interested side effects for drugs, but it is difficult to make the accurate prediction for all of them. In this paper, we transform side effect profiles of drugs as their quantitative scores, by summing up their side effects with weights. The quantitative scores may measure the dangers of drugs, and thus help to compare the risk of different drugs. Here, we attempt to predict quantitative scores of drugs, namely the quantitative prediction. Specifically, we explore a variety of drug-related features and evaluate their discriminative powers for the quantitative prediction. Then, we consider several feature combination strategies (direct combination, average scoring ensemble combination) to integrate three informative features: chemical substructures, targets, and treatment indications. Finally, the average scoring ensemble model which produces the better performances is used as the final quantitative prediction model. Since weights for side effects are empirical values, we randomly generate different weights in the simulation experiments. The experimental results show that the quantitative method is robust to different weights, and produces satisfying results. Although other state-of-the-art methods cannot make the quantitative prediction directly, the prediction results can be transformed as the quantitative scores. By indirect comparison, the proposed method produces much better results than benchmark methods in the quantitative prediction. In conclusion, the proposed method is promising for the quantitative prediction of side effects, which may work cooperatively with existing state-of-the-art methods to reveal dangers of drugs.

Systemic bias in the medical literature on androgen deprivation therapy and its implication to clinical practice.

PubMed

Phillips, J L; Wassersug, R J; McLeod, D L

2012-12-01

LHRH agonists are used for androgen deprivation therapy (ADT) to treat prostate cancer, but have many side effects that reduce of the quality of life of prostate cancer patients and their partners. Patients are poorly informed about the side effects of these drugs and how to manage them. To test the hypothesis that there is bias in the peer-reviewed literature on ADT that correlates with an association between authors and the luteinising hormone-releasing hormone (LHRH) agonists pharmaceutical industry. We assessed 155 articles on ADT published in English-language peer-reviewed journals in terms of how comprehensive they were in acknowledging LHRH agonists' side effects. Although the literature regarding ADT is substantial, the vast majority of articles failed to acknowledge many of the more stressful side effects of ADT for patients and their partners. Articles most likely to acknowledge the psychosocial impact of ADT were significantly less likely to have had industrial support than those articles that did not mention those side effects. Alternative treatments to the LHRH agonists were rarely mentioned. Authors who indicated some association with a pharmaceutical company tended to minimise the side effects of LHRH agonists and not acknowledge alternatives to the LHRH agonists for ADT. Industrial support is associated with a proliferation of articles published in the peer-reviewed literature directed at practising physicians. Such flooding of the literature may, in part, limit physicians' knowledge of the side effects of these drugs and, in turn, account for the poor knowledge that patients on LHRH agonists have about the drugs they are taking and ways to manage their side effects. © 2012 Blackwell Publishing Ltd.

Radiogenic Side Effects After Hypofractionated Stereotactic Photon Radiotherapy of Choroidal Melanoma in 212 Patients Treated Between 1997 and 2007

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

Dunavoelgyi, Roman; Dieckmann, Karin; Gleiss, Andreas

2012-05-01

Purpose: To evaluate side effects of hypofractionated stereotactic photon radiotherapy for patients with choroidal melanoma. Patients and Methods: Two hundred and twelve patients with choroidal melanoma unsuitable for ruthenium-106 brachytherapy or local resection were treated stereotactically at the Medical University of Vienna between 1997 and 2007 with a Linac with 6-MV photon beams in five fractions with 10, 12, or 14 Gy per fraction. Examinations for radiogenic side effects were performed at baseline and every 3 months in the first 2 years, then every 6 months until 5 years and then once a year thereafter until 10 years after radiotherapy.more » Adverse side effects were assessed using slit-lamp examination, funduscopy, gonioscopy, tonometry, and, if necessary, fundus photography and fluorescein angiography. Evaluations of incidence of side effects are based on an actuarial analysis. Results: One hundred and eighty-nine (89.2%) and 168 (79.2%) of the tumors were within 3 mm of the macula and the optic disc, respectively. The five most common radiotherapy side effects were retinopathy and optic neuropathy (114 cases and 107 cases, respectively), cataract development (87 cases), neovascular glaucoma (46 cases), and corneal epithelium defects (41 cases). In total, 33.6%, 38.5%, 51.2%, 75.5%, and 77.6% of the patients were free of any radiation retinopathy, optic neuropathy, cataract, neovascular glaucoma, or corneal epithelium defects 5 years after radiotherapy, respectively. Conclusion: In centrally located choroidal melanoma hypofractionated stereotactic photon radiotherapy shows a low to moderate rate of adverse long-term side effects comparable with those after proton beam radiotherapy. Future fractionation schemes should seek to further reduce adverse side effects rate while maintaining excellent local tumor control.« less

Nurses' discourse in contraceptive prescribing: an analysis using Foucault's 'procedures of exclusion'.

PubMed

Hayter, Mark

2007-05-01

This paper is a report of an analysis of the discourse about contraceptive efficacy and side effects used by nurses when prescribing contraception. All women seeking contraception should be informed of the efficacy and potential adverse effects of the particular method they are considering. This information facilitates an informed choice. Women also require this information in order to monitor for any side effects. Paradoxically, side effects are also a key factor in reducing adherence with contraceptive regimens. However, there is no literature that explores specifically how this issue is addressed in clinical consultations, or places these practices in a theoretical context. Forty-nine consultations between nurses and women in sexual health clinics were audio-recorded during 2002. Data were subject to a discourse analysis using Foucault's 'procedures of exclusion' to explore the discursive construction of contraceptive efficacy and side effects The nurses employed specific discursive strategies when discussing contraception. When addressing efficacy, discourse centred on medico-statistical facts, but side effects were described in lay terms that minimized their severity. Nurses contextualized contraceptive side effects within potential problems that women might experience in pregnancy, and also attempted to 'normalize' contraceptive-related problems. Discourse and its deployment play a key role in practitioner-client relationships that sexual health nurses need to become more aware of how they discuss clinical issues about contraception with women. Clinical data on contraceptive side-effects are present in the literature, and it is important that sexual health nurses use this to help women make truly informed decisions.

Exanthema medicamentosum as a side effect of promazine.

PubMed

Lasić, Davor; Cvitanović, Marija Zuljan; Uglešić, Boran; Višić, Vitomir; Hlevnjak, Ivana

2011-06-01

Dermatological side effects of psychopharmacological drugs are fortunately not so often. They are mostly presented in the group of mood stabilizers and antiepileptic drugs, particularly the carbamazepine and lamotrigine, and can be manifested through the Stevens Johnson syndrome, Toxic Epidermal Necrolysis (TEN)/Lyell's syndrome with about 30% lethality. According to the literature the group of phenothiazines is the category of drugs with rare appearances of skin reactions. Promazine, aliphatic phenothiazines antipsychotic, including less frequent side effects in the leaflet states increased skin sensitivity to sun, skin rash-associated with contact dermatitis, allergic reactions, cholestatic icterus. The only reported dermatological side effect of promazine is its metabolites deposition in the cornea. Analyzing the e-data basis we have not found references connecting the Exanthema medicamentosum as a side effect of promazine. A forty-two years old female patient was admitted to the Dermatological Clinic because of suspected exanthema, undoubtedly caused by promazine as a medication for Sy. Borderline.

Numerical analysis of urine flow through the side holes of a double J stent in a ureteral stenosis.

PubMed

Kim, Hyoung-Ho; Choi, Young Ho; Lee, Seung Bae; Baba, Yasutaka; Kim, Kyung-Wuk; Suh, Sang-Ho

2017-07-20

Ureteral stenosis presents with a narrowing in the ureter, due to an intrinsic or extrinsic ureteral disease, such as ureter cancer or retroperitoneal fibrosis. The placement of a double J stent in the upper urinary system is one of the most common treatments of ureteral stenosis, along with the insertion of a percutaneous nephrostomy tube into the renal pelvis. The effect that the side holes in a double J stent have on urine flow has been evaluated in a few studies using straight ureter models. In this study, urine flow through a double J stent's side holes was analyzed in curved ureter models, which were based on human anatomy. In ureteral stenosis, especially in severe ureteral stenosis, a stent with side holes had a positive effect on the luminal and total flow rates, compared with the rates for a stent without side holes. The more side holes a stent has, the greater the luminal and total flow rates. However, the angular positions of the side holes did not affect flow rate. In conclusion, the side holes in a double J stent had a positive effect on ureteral stenosis, and the effect became greater as the ureteral stenosis became more severe.

Not in My Navy. A Legal Guide to Drug Abuse.

DTIC Science & Technology

1984-06-01

opiates produces drowsiness, sleep, and a reduction in physical activity. Side effects can include nausea and vomiting, constipation, itching, flushing...diarrhea, pallor, and dilation of the pupils. Such effects are generally seen only with high doses or as occasional side effects with therapeutic doses...that will produce low-level side effects . or, a person might be drowsy from ingesting a nonprescription product - such as an antihistamine. A clue to

Leader’s Guide to Crew Endurance

DTIC Science & Technology

1997-08-01

unusual side effects . The flight surgeon personally issues each aviator�s supply immediately before the mission and collects all unused medication after...operational flexibility. n Temazepam has fewer side effects than triazolam and has few residual effects following an 8-hour sleep period. A new...nonbenzodiazepine agent, zolpidem (Ambien�) has a short half-life and low incidence of side effects . Zolpidem has recently been approved for use by aviators after

Ocular side effects of biological agents in oncology: what should the clinician be aware of?

PubMed Central

Hager, Tobias; Seitz, B

2014-01-01

During the last 20 years, biologicals have become increasingly relevant in oncologic therapy. Depending on the medication used, there are different profiles of ocular side effects. Although these can be present in up to 70% of patients, they are generally underreported in the literature. Therefore, the pathophysiological details of their development are often poorly understood. Herein we attempt to identify groups of biologicals to which a specific side effect profile can be assigned. We also tried to capture all relevant side effects and therefore conducted several database investigation including Medline, Cochrane library, and the drugs section of the US Food and Drug Administration (FDA), using the following search strings: “name of biological agent (both generic and commercial names)” AND “eye” OR “ocular”. If we found a side effect that has been associated with a drug, we researched Medline using the following search string: “name of biological agent” (both generic and commercial names) AND “term for the specific side effect”. Due to the wealth of material we report only the drugs that are approved by the FDA. PMID:24391443

[Psychoanalysis and Side Effect].

PubMed

Shirahase, Joichiro

2015-01-01

A study of psychoanalysis from the perspective of side effects reveals that its history was a succession of measures to deal with its own side effects. This, however, does not merely suggest that, as a treatment method, psychoanalysis is incomplete and weak: rather, its history is a record of the growth and development of psychoanalysis that discovered therapeutic significance from phenomena that were initially regarded as side effects, made use of these discoveries, and elaborated them as a treatment method. The approach of research seen during the course of these developments is linked to the basic therapeutic approach of psychoanalysis. A therapist therefore does not draw conclusions about a patient's words and behaviors from a single aspect, but continues to make efforts to actively discover a variety of meanings and values from them, and to make the patient's life richer and more productive. This therapeutic approach is undoubtedly one of the unique aspects of psychoanalysis. I discuss the issue of psychoanalysis and side effects with the aim of clarifying this unique characteristic of psychoanalysis. The phenomenon called resistance inevitably emerges during the process of psychoanalytic treatment. Resistance can not only obstruct the progress of therapy; it also carries the risk of causing a variety of disadvantages to the patient. It can therefore be seen as an adverse effect. However, if we re-examine this phenomenon from the perspective of transference, we find that resistance is in fact a crucial tool in psychoanalysis, and included in its main effect, rather than a side effect. From the perspective of minimizing the character of resistance as a side effect and maximizing its character as a main effect, I have reviewed logical organization, dynamic evaluation, the structuring of treatment, the therapist's attitudes, and the training of therapists. I conclude by stating that psychoanalysis has aspects that do not match the perspective known as a side effect.

Managing the oral side-effects of medications used to treat multiple sclerosis.

PubMed

Cockburn, N; Pateman, K; Taing, M W; Pradhan, A; Ford, P J

2017-09-01

Many medications used to manage multiple sclerosis (MS) affect oral health. This review aimed to identify the oral side-effects of the current drugs recommended in Australia to treat MS and make dental practitioners aware of the range of symptoms. The Australian Therapeutic Guidelines and the Australian Medicines Handbook were searched for medications used to treat MS. For each medication, the generic name, class, route of administration, dosage and drug company reported side-effects were extracted from the online Monthly Index of Medical Specialties (MIMs) database. Meyler's Side-effect of Drugs Encyclopaedia was used to identify any additional oral adverse reactions to medications used to treat MS. Fourteen drugs were identified for the treatment of MS progression and 13 drugs for the treatment of MS symptoms. For these medications, 18 oral side-effects were documented: xerostomia was the most common, followed by dysgeusia, dysphagia, mouth ulceration and sinusitis. Anticholinergic drugs caused xerostomia while immunosuppressants resulted in more infection-related side-effects. Dental practitioners should be aware of the range of symptoms likely to be reported by this population. Clinicians are encouraged to continue providing dental care for their patients who develop MS and refer complex cases to specialists. © 2017 Australian Dental Association.

Exploiting variability for energy optimization of parallel programs

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

Lavrijsen, Wim; Iancu, Costin; de Jong, Wibe

2016-04-18

Here in this paper we present optimizations that use DVFS mechanisms to reduce the total energy usage in scientific applications. Our main insight is that noise is intrinsic to large scale parallel executions and it appears whenever shared resources are contended. The presence of noise allows us to identify and manipulate any program regions amenable to DVFS. When compared to previous energy optimizations that make per core decisions using predictions of the running time, our scheme uses a qualitative approach to recognize the signature of executions amenable to DVFS. By recognizing the "shape of variability" we can optimize codes withmore » highly dynamic behavior, which pose challenges to all existing DVFS techniques. We validate our approach using offline and online analyses for one-sided and two-sided communication paradigms. We have applied our methods to NWChem, and we show best case improvements in energy use of 12% at no loss in performance when using online optimizations running on 720 Haswell cores with one-sided communication. With NWChem on MPI two-sided and offline analysis, capturing the initialization, we find energy savings of up to 20%, with less than 1% performance cost.« less

The role of nuclear energy in mitigating greenhouse warming

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

Krakowski, R.A.

1997-12-31

A behavioral, top-down, forced-equilibrium market model of long-term ({approximately} 2,100) global energy-economics interactions has been modified with a bottom-up nuclear energy model and used to construct consistent scenarios describing future impacts of civil nuclear materials flows in an expanding, multi-regional (13) world economy. The relative measures and tradeoffs between economic (GNP, tax impacts, productivity, etc.), environmental (greenhouse gas accumulations, waste accumulation, proliferation risk), and energy (resources, energy mixes, supply-side versus demand-side attributes) interactions that emerge from these analyses are focused herein on advancing understanding of the role that nuclear energy (and other non-carbon energy sources) might play in mitigating greenhousemore » warming. Two ostensibly opposing scenario drivers are investigated: (a) demand-side improvements in (non-price-induced) autonomous energy efficiency improvements; and (b) supply-side carbon-tax inducements to shift energy mixes towards reduced- or non-carbon forms. In terms of stemming greenhouse warming for minimal cost of greenhouse-gas abatement, and with the limitations of the simplified taxing schedule used, a symbiotic combination of these two approaches may offer advantages not found if each is applied separately.« less

Dynamic postural control and associated attentional demands in contemporary dancers versus non-dancers

PubMed Central

Sirois-Leclerc, Geneviève; Remaud, Anthony

2017-01-01

Postural control is not a fully automatic process, but requires a certain level of attention, particularly as the difficulty of the postural task increases. This study aimed at testing whether experienced contemporary dancers, because of their specialized training involving the control of posture/balance, would present with a dual-task performance suggesting lesser attentional demands associated with dynamic postural control compared with non-dancers. Twenty dancers and 16 non-dancers performed a dynamic postural tracking task in both antero-posterior and side-to-side directions, while standing on a force platform. The postural task was performed, in turn, 1) as a stand-alone task, and concurrently with both 2) a simple reaction time task and 3) a choice reaction time task. Postural control performance was estimated through variables calculated from centre of pressure movements. Although no overall group difference was found in reaction time values, we found a better ability to control the side to side movements of the centre of pressure during the tracking task in dancers compared with non-dancers, which was dependent on the secondary task. This suggests that such increased ability is influenced by available attentional resources. PMID:28323843

Dynamic postural control and associated attentional demands in contemporary dancers versus non-dancers.

PubMed

Sirois-Leclerc, Geneviève; Remaud, Anthony; Bilodeau, Martin

2017-01-01

Postural control is not a fully automatic process, but requires a certain level of attention, particularly as the difficulty of the postural task increases. This study aimed at testing whether experienced contemporary dancers, because of their specialized training involving the control of posture/balance, would present with a dual-task performance suggesting lesser attentional demands associated with dynamic postural control compared with non-dancers. Twenty dancers and 16 non-dancers performed a dynamic postural tracking task in both antero-posterior and side-to-side directions, while standing on a force platform. The postural task was performed, in turn, 1) as a stand-alone task, and concurrently with both 2) a simple reaction time task and 3) a choice reaction time task. Postural control performance was estimated through variables calculated from centre of pressure movements. Although no overall group difference was found in reaction time values, we found a better ability to control the side to side movements of the centre of pressure during the tracking task in dancers compared with non-dancers, which was dependent on the secondary task. This suggests that such increased ability is influenced by available attentional resources.

Older People's Preferences for Side Effects Associated with Antimuscarinic Treatments of Overactive Bladder: A Discrete-Choice Experiment.

PubMed

Decalf, Veerle H; Huion, Anja M J; Benoit, Dries F; Denys, Marie-Astrid; Petrovic, Mirko; Everaert, Karel C M M

2017-08-01

Understanding the importance older people attribute to the different side effects associated with oral antimuscarinic treatments for overactive bladder (OAB) could help inform prescribers, healthcare policy makers and the drug industry. Our objective was to quantify the importance of the most prevalent cognitive and side effects of oral antimuscarinic treatments for OAB in older people. We conducted a discrete-choice experiment (DCE) with the assistance of an interviewer with community-dwelling and hospitalized older people aged >65 years. The DCE involved two hypothetical drugs for imaginary OAB, with three levels of four side effects for each drug, and the International Consultation on Incontinence Questionnaire-Overactive Bladder and EuroQol 5-Dimensions (EQ-5D) questionnaire were also administered. Data were analysed using a conditional logit model. In total, 276 older people participated in the study. The median age was 75 years (interquartile range [IQR] 69-80), 63% were women and 21% had OAB syndrome. The most unwanted side effect in the choice of antimuscarinics for OAB was severe cognitive effects, followed by severe constipation, severe blurred vision, severe dry mouth, moderate cognitive effects and moderate constipation. Severe cognitive effects were at least 1.7 times as important as severe constipation. Exploratory subgroup analysis showed that none of the attributes was found to be significant in people who scored as anxious or depressed on the EQ-5D, and preferences about cognitive effects, constipation and blurred vision were equal in people with and without OAB. Older people attribute more importance to loss of cognitive function as a possible side effect of antimuscarinic treatment than to the three most prevalent possible side effects of this treatment.

Geohydrology, water quality, and estimation of ground-water recharge in San Francisco, California, 1987-92

USGS Publications Warehouse

Phillips, S.P.; Hamlin, S.N.; Yates, E.B.

1993-01-01

The city of San Francisco is considering further development of local groundwater resources as a supplemental source of water for potable or nonpotable use. By the year 2010, further water demand is projected to exceed the delivery capacity of the existing supply system, which is fed by surface-water sources; thus supplies are susceptible to drought conditions and damage to conveyance lines by earthquakes. The primary purpose of this study is to describe local geohydrology and water quality and to estimate groundwater recharge in the area of the city of San Francisco. Seven groundwater basins were identified in San Francisco on the basis of geologic and geophysical data. Basins on the east side of the city are relatively thin and contain a greater percentage of fine-grained sediments than those on the west side. The relatively small capacity of the basins and greater potential for contamination from sewer sources may limit the potential for groundwater development on the east side. Basins on the west side of the city have a relatively large capacity and low density sewer network. Water-level data indicate that the southern part of the largest basin on the west side of the city (Westside basin) probably cannot accommodate additional groundwater development without adversely affecting water levels and water quality in Lake Merced; however, the remainder of the basin, which is largely undeveloped, could be developed further. A hydrologic routing model was developed for estimating groundwater recharge throughout San Francisco. The model takes into account climatic factors, land and water use, irrigation, leakage from underground pipes, rainfall runoff, evapotranspiration, and other factors associated with an urban environment. Results indicate that area recharge rates for water years 1987-88 for the 7 groundwater basins ranged from 0.32 to 0.78 feet per year. Recharge for the Westside basin was estimated at 0.51 feet per year. Average annual groundwater recharge represents the maximum annual long-term yield of the basin. Attainable yield may be less than the volume of groundwater recharge because interception of all discharge from the basin may not be feasible without inducing seawater intrusion or causing other undesirable effects.

Effects of user fee exemptions on the provision and use of maternal health services: a review of literature.

PubMed

Hatt, Laurel E; Makinen, Marty; Madhavan, Supriya; Conlon, Claudia M

2013-12-01

User fee removal has been put forward as an approach to increasing priority health service utilization, reducing impoverishment, and ultimately reducing maternal and neonatal mortality. However, user fees are a source of facility revenue in many low-income countries, often used for purchasing drugs and supplies and paying incentives to health workers. This paper reviews evidence on the effects of user fee exemptions on maternal health service utilization, service provision, and outcomes, including both supply-side and demand-side effects. We reviewed 19 peer-reviewed research articles addressing user fee exemptions and maternal health services or outcomes published since 1990. Studies were identified through a USAID-commissioned call for evidence, key word search, and screening process. Teams of reviewers assigned criteria-based quality scores to each paper and prepared structured narrative reviews. The grade of the evidence was found to be relatively weak, mainly from short-term, non-controlled studies. The introduction of user fee exemptions appears to have resulted in increased rates of facility-based deliveries and caesarean sections in some contexts. Impacts on maternal and neonatal mortality have not been conclusively demonstrated; exemptions for delivery care may contribute to modest reductions in institutional maternal mortality but the evidence is very weak. User fee exemptions were found to have negative, neutral, or inconclusive effects on availability of inputs, provider motivation, and quality of services. The extent to which user fee revenue lost by facilities is replaced can directly affect service provision and may have unintended consequences for provider motivation. Few studies have looked at the equity effects of fee removal, despite clear evidence that fees disproportionately burden the poor. This review highlights potential and documented benefits (increased use of maternity services) as well as risks (decreased provider motivation and quality) of user fee exemption policies for maternal health services. Governments should link user fee exemption policies with the replacement of lost revenue for facilities as well as broader health system improvements, including facility upgrades, ensured supply of needed inputs, and improved human resources for health. Removing user fees may increase uptake but will not reduce mortality proportionally if the quality of facility-based care is poor. More rigorous evaluations of both demand- and supply-side effects of mature fee exemption programmes are needed.

Econophysics of a ranked demand and supply resource allocation problem

NASA Astrophysics Data System (ADS)

Priel, Avner; Tamir, Boaz

2018-01-01

We present a two sided resource allocation problem, between demands and supplies, where both parties are ranked. For example, in Big Data problems where a set of different computational tasks is divided between a set of computers each with its own resources, or between employees and employers where both parties are ranked, the employees by their fitness and the employers by their package benefits. The allocation process can be viewed as a repeated game where in each iteration the strategy is decided by a meta-rule, based on the ranks of both parties and the results of the previous games. We show the existence of a phase transition between an absorbing state, where all demands are satisfied, and an active one where part of the demands are always left unsatisfied. The phase transition is governed by the ratio between supplies and demand. In a job allocation problem we find positive correlation between the rank of the workers and the rank of the factories; higher rank workers are usually allocated to higher ranked factories. These all suggest global emergent properties stemming from local variables. To demonstrate the global versus local relations, we introduce a local inertial force that increases the rank of employees in proportion to their persistence time in the same factory. We show that such a local force induces non trivial global effects, mostly to benefit the lower ranked employees.

The Clinical Effectiveness and Cost-Effectiveness of Lamotrigine in Borderline Personality Disorder: A Randomized Placebo-Controlled Trial.

PubMed

Crawford, Mike J; Sanatinia, Rahil; Barrett, Barbara; Cunningham, Gillian; Dale, Oliver; Ganguli, Poushali; Lawrence-Smith, Geoff; Leeson, Verity; Lemonsky, Fenella; Lykomitrou, Georgia; Montgomery, Alan A; Morriss, Richard; Munjiza, Jasna; Paton, Carol; Skorodzien, Iwona; Singh, Vineet; Tan, Wei; Tyrer, Peter; Reilly, Joseph G

2018-04-06

The authors examined whether lamotrigine is a clinically effective and cost-effective treatment for people with borderline personality disorder. This was a multicenter, double-blind, placebo-controlled randomized trial. Between July 2013 and November 2016, the authors recruited 276 people age 18 or over who met diagnostic criteria for borderline personality disorder. Individuals with coexisting bipolar affective disorder or psychosis, those already taking a mood stabilizer, and women at risk of pregnancy were excluded. A web-based randomization service was used to allocate participants randomly in a 1:1 ratio to receive either an inert placebo or up to 400 mg/day of lamotrigine. The primary outcome measure was score on the Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD) at 52 weeks. Secondary outcome measures included depressive symptoms, deliberate self-harm, social functioning, health-related quality of life, resource use and costs, side effects of treatment, and adverse events. A total of 195 (70.6%) participants were followed up at 52 weeks, at which point 49 (36%) of those in the lamotrigine group and 58 (42%) of those in the placebo group were taking study medication. The mean ZAN-BPD score was 11.3 (SD=6.6) among those in the lamotrigine group and 11.5 (SD=7.7) among those in the placebo group (adjusted difference in means=0.1, 95% CI=-1.8, 2.0). There was no evidence of any differences in secondary outcomes. Costs of direct care were similar in the two groups. The results suggest that treating people with borderline personality disorder with lamotrigine is not a clinically effective or cost-effective use of resources.

Does contraceptive treatment in wildlife result in side effects? A review of quantitative and anecdotal evidence.

PubMed

Gray, Meeghan E; Cameron, Elissa Z

2010-01-01

The efficacy of contraceptive treatments has been extensively tested, and several formulations are effective at reducing fertility in a range of species. However, these formulations should minimally impact the behavior of individuals and populations before a contraceptive is used for population manipulation, but these effects have received less attention. Potential side effects have been identified theoretically and we reviewed published studies that have investigated side effects on behavior and physiology of individuals or population-level effects, which provided mixed results. Physiological side effects were most prevalent. Most studies reported a lack of secondary effects, but were usually based on qualitative data or anecdotes. A meta-analysis on quantitative studies of side effects showed that secondary effects consistently occur across all categories and all contraceptive types. This contrasts with the qualitative studies, suggesting that anecdotal reports are insufficient to investigate secondary impacts of contraceptive treatment. We conclude that more research is needed to address fundamental questions about secondary effects of contraceptive treatment and experiments are fundamental to conclusions. In addition, researchers are missing a vital opportunity to use contraceptives as an experimental tool to test the influence of reproduction, sex and fertility on the behavior of wildlife species.

Complaints associated with the use of antiepileptic drugs: results from a community-based study.

PubMed

Carpay, J A; Aldenkamp, A P; van Donselaar, C A

2005-04-01

Few data exist with respect to the occurrence of chronic side effects due to antiepileptic drugs (AED) in routine clinical practice. To evaluate the prevalence of subjective complaints which patients with epilepsy regard as side effects of their AED treatment in a community-based population. Cross-sectional study. Subjects were identified through the database of AED-use in the pharmacies in a suburban area in The Netherlands. Respondents completed a brief questionnaire about their epilepsy, including a checklist with 30 complaints, which are common in AED users. We present data of 346 responding adults with treated epilepsy from a population of 107,000 adult inhabitants. Eighty percent was using monotherapy, with few patients taking new AEDs. Almost 60% of the patients reported complaints probably due to side effects in at least three domains. General CNS-related side effects were reported most often; memory problems (21.4% of the patients) and fatigue (20.3%) were dominant. Polytherapy was associated with more side effects than monotherapy. We identified differences in profiles of complaints between valproate, carbamazepine and phenytoin monotherapy. Complaints were not substantially associated with ongoing seizures or other treatment factors. The majority of patients taking AEDs for epilepsy think they have side effects form their drugs, even when seizures were in remission and when monotherapy was used. Our findings suggest a need to improve monitoring of complaints of side effects of AEDs and to explore the feasibility of interventions aimed at reduction of such complaints in everyday clinical practice.

Innovative solutions for intractable water problems in the face of climate change in southern and East African sub regions

NASA Astrophysics Data System (ADS)

Mapani, Benjamin; Makurira, Hodson; Magole, Lapologang; Meck, Maideyi; Mkandawire, Theresa; Mul, Marloes; Ngongondo, Cosmo

2018-06-01

This issue has a total of thirty-two (32) papers; and covers the IWRM sub themes of Hydrology, Land and People, Water Resources Management, Water and Environment and Wastewater and Sanitation. Water issues have become more and more complex as the supply side is affected by issues of quantity, availability and vulnerability due to natural factors such as climate change and urbanization. These challenges call for new management strategies and governance styles. Access to clean freshwater is a basic requirement for enhanced quality of life and development by all. However, this access has three main components that must be met adequately as this issue illustrates. These components are firstly, the quantity of water available; secondly, the quality and thirdly supply and appropriate delivery of this precious resource to domestic, commercial and industrial users. The demand side has also become more challenging, especially in urban areas as more and more people move from the rural areas to the cities. It has become a daily challenge in many African cities to supply water to these new urban dwellers and more so in unplanned settlements. These issues require a way and manner of delivering solutions and new innovative ideas. The topics in this issue vary from climate variability and how we are to improve our management strategies to mitigation, through to vulnerability of water resources and how to strengthen governance issues that plague some institutions in our region.