Sample records for superior effects compared

  1. Aging and the Picture Superiority Effect in Recall.

    ERIC Educational Resources Information Center

    Winograd, Eugene; And Others

    1982-01-01

    Compared verbal and visual encoding using the picture superiority effect. One experiment found an interaction between age and type of material. In other experiments, the picture superiority effect was found in both age groups with no interaction. Performing a semantic-orienting task had no effect on recall. (Author/RC)

  2. Enhanced anger superiority effect in generalized anxiety disorder and panic disorder

    PubMed Central

    Ashwin, Chris; Holas, Pawel; Broadhurst, Shanna; Kokoszka, Andrzej; Georgiou, George A.; Fox, Elaine

    2012-01-01

    People are typically faster and more accurate to detect angry compared to happy faces, which is known as the anger superiority effect. Many cognitive models of anxiety suggest anxiety disorders involve attentional biases towards threat, although the nature of these biases remains unclear. The present study used a Face-in-the-Crowd task to investigate the anger superiority effect in a control group and patients diagnosed with either generalized anxiety disorder (GAD) or panic disorder (PD). The main finding was that both anxiety groups showed an enhanced anger superiority effect compared to controls, which is consistent with key theories of anxiety. Furthermore, both anxiety groups showed a differential pattern of enhanced bias towards threat depending on the crowd in the displays. The different attentional bias patterns between the GAD and PD groups may be related to the diverse symptoms in these disorders. These findings have implications for the diagnosis and treatment of anxiety. PMID:22196167

  3. Biomechanical Effects of Acromioplasty on Superior Capsule Reconstruction for Irreparable Supraspinatus Tendon Tears.

    PubMed

    Mihata, Teruhisa; McGarry, Michelle H; Kahn, Timothy; Goldberg, Iliya; Neo, Masashi; Lee, Thay Q

    2016-01-01

    Acromioplasty is increasingly being performed for both reparable and irreparable rotator cuff tears. However, acromioplasty may destroy the coracoacromial arch, including the coracoacromial ligament, consequently causing a deterioration in superior stability even after superior capsule reconstruction. The purpose of this study was to investigate the effects of acromioplasty on shoulder biomechanics after superior capsule reconstruction for irreparable supraspinatus tendon tears. The hypothesis was that acromioplasty with superior capsule reconstruction would decrease the area of subacromial impingement without increasing superior translation and subacromial contact pressure. Controlled laboratory study. Seven fresh-frozen cadaveric shoulders were evaluated using a custom shoulder testing system. Glenohumeral superior translation, the location of the humeral head relative to the glenoid, and subacromial contact pressure and area were compared among 4 conditions: (1) intact shoulder, (2) irreparable supraspinatus tendon tear, (3) superior capsule reconstruction without acromioplasty, and (4) superior capsule reconstruction with acromioplasty. Superior capsule reconstruction was performed using the fascia lata. Compared with the intact shoulder, the creation of an irreparable supraspinatus tear significantly shifted the humeral head superiorly in the balanced muscle loading condition (without superior force applied) (0° of abduction: 2.8-mm superior shift [P = .0005]; 30° of abduction: 1.9-mm superior shift [P = .003]) and increased both superior translation (0° of abduction: 239% of intact [P = .04]; 30° of abduction: 199% of intact [P = .02]) and subacromial peak contact pressure (0° of abduction: 308% of intact [P = .0002]; 30° of abduction: 252% of intact [P = .001]) by applying superior force. Superior capsule reconstruction without acromioplasty significantly decreased superior translation (0° of abduction: 86% of intact [P = .02]; 30° of abduction: 75% of intact [P = .002]) and subacromial peak contact pressure (0° of abduction: 47% of intact [P = .0002]; 30° of abduction: 83% of intact [P = .0005]; 60° of abduction: 38% of intact [P = .04]) compared with after the creation of a supraspinatus tear. Adding acromioplasty significantly decreased the subacromial contact area compared with superior capsule reconstruction without acromioplasty (0° of abduction: 26% decrease [P = .01]; 30° of abduction: 21% decrease [P = .009]; 60° of abduction: 61% decrease [P = .003]) and did not alter humeral head position, superior translation, or subacromial peak contact pressure. Superior capsule reconstruction repositioned the superiorly migrated humeral head and restored superior stability in the shoulder joint. Adding acromioplasty decreased the subacromial contact area without increasing the subacromial contact pressure. When superior capsule reconstruction is performed for irreparable rotator cuff tears, acromioplasty may help to decrease the postoperative risk of abrasion and tearing of the graft beneath the acromion. © 2015 The Author(s).

  4. A regulator's view of comparative effectiveness research.

    PubMed

    Temple, Robert

    2012-02-01

    'Comparative effectiveness' is the current enthusiasm, and for good reason. After knowing a treatment works, the most critical question is how it compares with alternatives. Comparative studies are not commonly conducted by drug companies and they represent a significant methodological challenge. Comparative data could include evidence of overall superiority to an alternative or advantages in identifiable subsets, for example, people who do not respond to or tolerate alternatives, or members of a genetic subset and could also include convincing evidence that there is little difference between two treatments. To describe regulations, guidance, and Food and Drug Administration experience related to studies of comparative effectiveness, including approaches to showing superiority and problems encountered in showing similarity. Review of Food and Drug Administration regulations and guidance and experience with showing superiority and similarity, particularly related to randomized trials and epidemiologic studies. Methods exist, and they have been successful for showing overall superiority of one drug over another, advantages in specific population subsets. Efforts to show true equivalence face problems of definition and very large sample sizes needed to rule out small differences. There is need for further discussion of what is meant by similarity or equivalence of two treatments. Comparative studies are challenging because differences between effective therapies are likely to be small and can be detected reliably only in randomized trials, often large ones. Despite the difficulties, comparative trials have been successful and we clearly would like to see more of them.

  5. The picture superiority effect in patients with Alzheimer's disease and mild cognitive impairment.

    PubMed

    Ally, Brandon A; Gold, Carl A; Budson, Andrew E

    2009-01-01

    The fact that pictures are better remembered than words has been reported in the literature for over 30 years. While this picture superiority effect has been consistently found in healthy young and older adults, no study has directly evaluated the presence of the effect in patients with Alzheimer's disease (AD) or mild cognitive impairment (MCI). Clinical observations have indicated that pictures enhance memory in these patients, suggesting that the picture superiority effect may be intact. However, several studies have reported visual processing impairments in AD and MCI patients which might diminish the picture superiority effect. Using a recognition memory paradigm, we tested memory for pictures versus words in these patients. The results showed that the picture superiority effect is intact, and that these patients showed a similar benefit to healthy controls from studying pictures compared to words. The findings are discussed in terms of visual processing and possible clinical importance.

  6. The picture superiority effect in patients with Alzheimer’s disease and mild cognitive impairment

    PubMed Central

    Ally, Brandon A.; Gold, Carl A.; Budson, Andrew E.

    2009-01-01

    The fact that pictures are better remembered than words has been reported in the literature for over 30 years. While this picture superiority effect has been consistently found in healthy young and older adults, no study has directly evaluated the presence of the effect in patients with Alzheimer’s disease (AD) or mild cognitive impairment (MCI). Clinical observations have indicated that pictures enhance memory in these patients, suggesting that the picture superiority effect may be intact. However, several studies have reported visual processing impairments in AD and MCI patients which might diminish the picture superiority effect. Using a recognition memory paradigm, we tested memory for pictures versus words in these patients. The results showed that the picture superiority effect is intact, and that these patients showed a similar benefit to healthy controls from studying pictures compared to words. The findings are discussed in terms of visual processing and possible clinical importance. PMID:18992266

  7. THE WESTERN LAKE SUPERIOR COMPARATIVE WATERSHED FRAMEWORK: A FIELD TEST OF GEOGRAPHICALLY-DEPENDENT VS. THRESHOLD-BASED GEOGRAPHICALLY-INDEPENDENT CLASSIFICATION SCHEMES

    EPA Science Inventory

    Main and interactive effects of watershed storage and forest fragmentation on watershed exports, habitat quality, community composition and food-web relationships were compared within and acoss two hydrogeomorphic regions (HGM, North Shore Highlands and Lake Superior clay plains/...

  8. Subjective qualities of memories associated with the picture superiority effect in schizophrenia.

    PubMed

    Huron, Caroline; Danion, Jean-Marie; Rizzo, Lydia; Killofer, Valérie; Damiens, Annabelle

    2003-02-01

    Patients with schizophrenia (n = 24) matched with 24 normal subjects were presented with both words and pictures. On a recognition memory task, they were asked to give remember, know, or guess responses to items that were recognized on the basis of conscious recollection, familiarity, or guessing, respectively. Compared with normal subjects, patients exhibited a lower picture superiority effect selectively related to remember responses. Unlike normal subjects, they did not exhibit any word superiority effect in relation to guess responses; this explains why the overall picture superiority effect appeared to be intact. These results emphasize the need to take into account the subjective states of awareness when analyzing memory impairments in schizophrenia.

  9. Aging and the picture superiority effect in recall.

    PubMed

    Winograd, E; Smith, A D; Simon, E W

    1982-01-01

    One recurrent theme in the literature on aging and memory is that the decline of memory for nonverbal information is steeper than for verbal information. This research compares verbal and visual encoding using the picture superiority effect, the finding that pictures are remembered better than words. In the first experiment, an interaction was found between age and type of material; younger subjects recalled more pictures than words while older subjects did not. However, the overall effect was small and two further experiments were conducted. In both of these experiments, the picture superiority effect was found in both age groups with no interaction. In addition, performing a semantic orienting task had no effect on recall. The finding of a picture superiority effect in older subjects indicates that nonverbal codes can be effectively used by subjects in all age groups to facilitate memory performance.

  10. A mechano-acoustic model of the effect of superior canal dehiscence on hearing in chinchilla

    PubMed Central

    Songer, Jocelyn E.; Rosowski, John J.

    2008-01-01

    Superior canal dehiscence (SCD) is a pathological condition of the ear that can cause a conductive hearing loss. The effect of SCD (a hole in the bony wall of the superior semicircular canal) on chinchilla middle- and inner-ear mechanics is analyzed with a circuit model of the dehiscence. The model is used to predict the effect of dehiscence on auditory sensitivity and mechanics. These predictions are compared to previously published measurements of dehiscence related changes in chinchilla cochlear potential, middle-ear input admittance and stapes velocity. The comparisons show that the model predictions are both qualitatively and quantitatively similar to the physiological results for frequencies where physiologic data are available. The similarity supports the third-window hypothesis of the effect of superior canal dehiscence on auditory sensitivity and mechanics and provides the groundwork for the development of a model that predicts the effect of superior canal dehiscence syndrome on auditory sensitivity and mechanics in humans. PMID:17672643

  11. Memory for Pictorial Information and the Picture Superiority Effect.

    ERIC Educational Resources Information Center

    Maisto, Albert A.; Queen, Debbie Elaine

    1992-01-01

    The performance of 53 younger adults (mean age 20.7) and 52 older adults (mean age 68.3) was compared in a memory task involving pictures, words, and pictures-plus-words. Results showed (1) significantly higher recall scores for younger adults; (2) equivalent picture superiority effect for both groups; and (3) decline in older adults' performance…

  12. Post-transplant diabetes mellitus (PTDM) in heart recipients.

    PubMed

    Garlicki, Mirosław

    2005-01-01

    In conclusion, comparative clinical studies with tacrolimus in heart recipients tend to show a similar or increased diabetogenic potential compared with cyclosporine-ME-based therapy. However, these changes are often accompanied by a reduced effect on lipid metabolism and hypertension suggesting a superior cardiovascular risk profile. The superior control of acute rejection also positions tacrolimus as an attractive alternative to cyclosporine for heart recipients.

  13. Inferior or double joint spaces injection versus superior joint space injection for temporomandibular disorders: a systematic review and meta-analysis.

    PubMed

    Li, Chunjie; Zhang, Yifan; Lv, Jun; Shi, Zongdao

    2012-01-01

    To compare the effect and safety of inferior or double temporomandibular joint spaces drug injection versus superior temporomandibular joint space injection in the treatment of temporomandibular disorders. MEDLINE (via Ovid, 1948 to March 2011), CENTRAL (Issue 1, 2011), Embase (1984 to March 2011), CBM (1978 to March 2011), and World Health Organization International Clinical Trials Registry Platform were searched electronically; relevant journals as well as references of included studies were hand-searched for randomized controlled trials comparing effect or safety of inferior or double joint spaces drug injection technique with those of superior space injection technique. Risk of bias assessment with the tool recommended by Cochrane Collaboration, reporting quality assessment with CONSORT and data extraction, were carried out independently by 2 reviewers. Meta-analysis was delivered with RevMan 5.0.23. Four trials with 349 participants were included. All the included studies had moderate risk of bias. Meta-analysis showed that inferior or double spaces injection technique could significantly increase 2.88 mm more maximal mouth opening (P = .0001) and alleviate pain intensity in the temporomandibular area on average by 9.01 mm visual analog scale scores (P = .0001) compared with superior space injection technique, but could not markedly change synthesized clinical index (P = .05) in the short term; nevertheless, they showed more beneficial maximal mouth opening (P = .002), pain relief (P < .0001), and synthesized clinical variable (P < .0001) in the long term than superior space injection. No serious adverse events were reported. Inferior or double temporomandibular joint spaces drug injection technique shows better effect than superior space injection technique, and their safety is affirmative. However, more high-quality studies are still needed to test and verify the evidence. Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.

  14. Bayesian adaptive trials offer advantages in comparative effectiveness trials: an example in status epilepticus.

    PubMed

    Connor, Jason T; Elm, Jordan J; Broglio, Kristine R

    2013-08-01

    We present a novel Bayesian adaptive comparative effectiveness trial comparing three treatments for status epilepticus that uses adaptive randomization with potential early stopping. The trial will enroll 720 unique patients in emergency departments and uses a Bayesian adaptive design. The trial design is compared to a trial without adaptive randomization and produces an efficient trial in which a higher proportion of patients are likely to be randomized to the most effective treatment arm while generally using fewer total patients and offers higher power than an analogous trial with fixed randomization when identifying a superior treatment. When one treatment is superior to the other two, the trial design provides better patient care, higher power, and a lower expected sample size. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Facilitating Effects of Emotion on the Perception of Biological Motion: Evidence for a Happiness Superiority Effect.

    PubMed

    Lee, Hannah; Kim, Jejoong

    2017-06-01

    It has been reported that visual perception can be influenced not only by the physical features of a stimulus but also by the emotional valence of the stimulus, even without explicit emotion recognition. Some previous studies reported an anger superiority effect while others found a happiness superiority effect during visual perception. It thus remains unclear as to which emotion is more influential. In the present study, we conducted two experiments using biological motion (BM) stimuli to examine whether emotional valence of the stimuli would affect BM perception; and if so, whether a specific type of emotion is associated with a superiority effect. Point-light walkers with three emotion types (anger, happiness, and neutral) were used, and the threshold to detect BM within noise was measured in Experiment 1. Participants showed higher performance in detecting happy walkers compared with the angry and neutral walkers. Follow-up motion velocity analysis revealed that physical difference among the stimuli was not the main factor causing the effect. The results of the emotion recognition task in Experiment 2 also showed a happiness superiority effect, as in Experiment 1. These results show that emotional valence (happiness) of the stimuli can facilitate the processing of BM.

  16. Comparative effectiveness of immunosuppressants and biologics for inducing and maintaining remission in Crohn's disease: a network meta-analysis.

    PubMed

    Hazlewood, Glen S; Rezaie, Ali; Borman, Meredith; Panaccione, Remo; Ghosh, Subrata; Seow, Cynthia H; Kuenzig, Ellen; Tomlinson, George; Siegel, Corey A; Melmed, Gil Y; Kaplan, Gilaad G

    2015-02-01

    There is controversy regarding the best treatment for patients with Crohn's disease because of the lack of direct comparative trials. We compared therapies for induction and maintenance of remission in patients with Crohn's disease, based on direct and indirect evidence. We performed systematic reviews of MEDLINE, EMBASE, and Cochrane Central databases, through June 2014. We identified randomized controlled trials (N = 39) comparing methotrexate, azathioprine/6-mercaptopurine, infliximab, adalimumab, certolizumab, vedolizumab, or combined therapies with placebo or an active agent for induction and maintenance of remission in adult patients with Crohn's disease. Pairwise treatment effects were estimated through a Bayesian random-effects network meta-analysis and reported as odds ratios (OR) with a 95% credible interval (CrI). Infliximab, the combination of infliximab and azathioprine (infliximab + azathioprine), adalimumab, and vedolizumab were superior to placebo for induction of remission. In pair-wise comparisons of anti-tumor necrosis factor agents, infliximab + azathioprine (OR, 3.1; 95% CrI, 1.4-7.7) and adalimumab (OR, 2.1; 95% CrI, 1.0-4.6) were superior to certolizumab for induction of remission. All treatments were superior to placebo for maintaining remission, except for the combination of infliximab and methotrexate. Adalimumab, infliximab, and infliximab + azathioprine were superior to azathioprine/6-mercaptopurine: adalimumab (OR, 2.9; 95% CrI, 1.6-5.1), infliximab (OR, 1.6; 95% CrI, 1.0-2.5), infliximab + azathioprine (OR, 3.0; 95% CrI, 1.7-5.5) for maintenance of remission. Adalimumab and infliximab + azathioprine were superior to certolizumab: adalimumab (OR, 2.5; 95% CrI, 1.4-4.6) and infliximab + azathioprine (OR, 2.6; 95% CrI, 1.3-6.0). Adalimumab was superior to vedolizumab (OR, 2.4; 95% CrI, 1.2-4.6). Based on a network meta-analysis, adalimumab and infliximab + azathioprine are the most effective therapies for induction and maintenance of remission of Crohn's disease. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

  17. Gist-based conceptual processing of pictures remains intact in patients with amnestic mild cognitive impairment.

    PubMed

    Deason, Rebecca G; Hussey, Erin P; Budson, Andrew E; Ally, Brandon A

    2012-03-01

    The picture superiority effect, better memory for pictures compared to words, has been found in young adults, healthy older adults, and, most recently, in patients with Alzheimer's disease and mild cognitive impairment. Although the picture superiority effect is widely found, there is still debate over what drives this effect. One main question is whether it is enhanced perceptual or conceptual information that leads to the advantage for pictures over words. In this experiment, we examined the picture superiority effect in healthy older adults and patients with amnestic mild cognitive impairment (MCI) to better understand the role of gist-based conceptual processing. We had participants study three exemplars of categories as either words or pictures. In the test phase, participants were again shown pictures or words and were asked to determine whether the item was in the same category as something they had studied earlier or whether it was from a new category. We found that all participants demonstrated a robust picture superiority effect, better performance for pictures than for words. These results suggest that the gist-based conceptual processing of pictures is preserved in patients with MCI. While in healthy older adults preserved recollection for pictures could lead to the picture superiority effect, in patients with MCI it is most likely that the picture superiority effect is a result of spared conceptually based familiarity for pictures, perhaps combined with their intact ability to extract and use gist information.

  18. Gist-based conceptual processing of pictures remains intact in patients with amnestic mild cognitive impairment

    PubMed Central

    Deason, Rebecca G.; Hussey, Erin P.; Budson, Andrew E.; Ally, Brandon A.

    2012-01-01

    Objective The picture superiority effect, better memory for pictures compared to words, has been found in young adults, healthy older adults, and, most recently, in patients with Alzheimer’s disease and mild cognitive impairment. Although the picture superiority effect is widely found, there is still debate over what drives this effect. One main question is whether it is enhanced perceptual or conceptual information that leads to the advantage for pictures over words. In this experiment, we examined the picture superiority effect in healthy older adults and patients with amnestic mild cognitive impairment (MCI) to better understand the role of gist-based conceptual processing. Method We had participants study three exemplars of categories as either words or pictures. In the test phase, participants were again shown pictures or words and were asked to determine whether the item was in the same category as something they had studied earlier or whether it was from a new category. Results We found that all participants demonstrated a robust picture superiority effect, better performance for pictures than for words. Conclusions These results suggest that the gist-based conceptual processing of pictures is preserved in patients with MCI. While in healthy older adults preserved recollection for pictures could lead to the picture superiority effect, in patients with MCI it is most likely that the picture superiority effect is a result of spared conceptually-based familiarity for pictures, perhaps combined with their intact ability to extract and use gist information. PMID:22229341

  19. The effect of superior auditory skills on vocal accuracy

    NASA Astrophysics Data System (ADS)

    Amir, Ofer; Amir, Noam; Kishon-Rabin, Liat

    2003-02-01

    The relationship between auditory perception and vocal production has been typically investigated by evaluating the effect of either altered or degraded auditory feedback on speech production in either normal hearing or hearing-impaired individuals. Our goal in the present study was to examine this relationship in individuals with superior auditory abilities. Thirteen professional musicians and thirteen nonmusicians, with no vocal or singing training, participated in this study. For vocal production accuracy, subjects were presented with three tones. They were asked to reproduce the pitch using the vowel /a/. This procedure was repeated three times. The fundamental frequency of each production was measured using an autocorrelation pitch detection algorithm designed for this study. The musicians' superior auditory abilities (compared to the nonmusicians) were established in a frequency discrimination task reported elsewhere. Results indicate that (a) musicians had better vocal production accuracy than nonmusicians (production errors of 1/2 a semitone compared to 1.3 semitones, respectively); (b) frequency discrimination thresholds explain 43% of the variance of the production data, and (c) all subjects with superior frequency discrimination thresholds showed accurate vocal production; the reverse relationship, however, does not hold true. In this study we provide empirical evidence to the importance of auditory feedback on vocal production in listeners with superior auditory skills.

  20. Neither fixed nor random: weighted least squares meta-analysis.

    PubMed

    Stanley, T D; Doucouliagos, Hristos

    2015-06-15

    This study challenges two core conventional meta-analysis methods: fixed effect and random effects. We show how and explain why an unrestricted weighted least squares estimator is superior to conventional random-effects meta-analysis when there is publication (or small-sample) bias and better than a fixed-effect weighted average if there is heterogeneity. Statistical theory and simulations of effect sizes, log odds ratios and regression coefficients demonstrate that this unrestricted weighted least squares estimator provides satisfactory estimates and confidence intervals that are comparable to random effects when there is no publication (or small-sample) bias and identical to fixed-effect meta-analysis when there is no heterogeneity. When there is publication selection bias, the unrestricted weighted least squares approach dominates random effects; when there is excess heterogeneity, it is clearly superior to fixed-effect meta-analysis. In practical applications, an unrestricted weighted least squares weighted average will often provide superior estimates to both conventional fixed and random effects. Copyright © 2015 John Wiley & Sons, Ltd.

  1. An fMRI comparison of neural activity associated with recognition of familiar melodies in younger and older adults

    PubMed Central

    Sikka, Ritu; Cuddy, Lola L.; Johnsrude, Ingrid S.; Vanstone, Ashley D.

    2015-01-01

    Several studies of semantic memory in non-musical domains involving recognition of items from long-term memory have shown an age-related shift from the medial temporal lobe structures to the frontal lobe. However, the effects of aging on musical semantic memory remain unexamined. We compared activation associated with recognition of familiar melodies in younger and older adults. Recognition follows successful retrieval from the musical lexicon that comprises a lifetime of learned musical phrases. We used the sparse-sampling technique in fMRI to determine the neural correlates of melody recognition by comparing activation when listening to familiar vs. unfamiliar melodies, and to identify age differences. Recognition-related cortical activation was detected in the right superior temporal, bilateral inferior and superior frontal, left middle orbitofrontal, bilateral precentral, and left supramarginal gyri. Region-of-interest analysis showed greater activation for younger adults in the left superior temporal gyrus and for older adults in the left superior frontal, left angular, and bilateral superior parietal regions. Our study provides powerful evidence for these musical memory networks due to a large sample (N = 40) that includes older adults. This study is the first to investigate the neural basis of melody recognition in older adults and to compare the findings to younger adults. PMID:26500480

  2. Effectiveness of conservative interventions including exercise, manual therapy and medical management in adults with shoulder impingement: a systematic review and meta-analysis of RCTs.

    PubMed

    Steuri, Ruedi; Sattelmayer, Martin; Elsig, Simone; Kolly, Chloé; Tal, Amir; Taeymans, Jan; Hilfiker, Roger

    2017-09-01

    To investigate the effectiveness of conservative interventions for pain, function and range of motion in adults with shoulder impingement. Systematic review and meta-analysis of randomised trials. Medline, CENTRAL, CINAHL, Embase and PEDro were searched from inception to January 2017. Randomised controlled trials including participants with shoulder impingement and evaluating at least one conservative intervention against sham or other treatments. For pain, exercise was superior to non-exercise control interventions (standardised mean difference (SMD) -0.94, 95% CI -1.69 to -0.19). Specific exercises were superior to generic exercises (SMD -0.65, 95% CI -0.99 to -0.32). Corticosteroid injections were superior to no treatment (SMD -0.65, 95% CI -1.04 to -0.26), and ultrasound guided injections were superior to non-guided injections (SMD -0.51, 95% CI -0.89 to -0.13). Nonsteroidal anti-inflammatory drugs (NSAIDS) had a small to moderate SMD of -0.29 (95% CI -0.53 to -0.05) compared with placebo. Manual therapy was superior to placebo (SMD -0.35, 95% CI -0.69 to -0.01). When combined with exercise, manual therapy was superior to exercise alone, but only at the shortest follow-up (SMD -0.32, 95% CI -0.62 to -0.01). Laser was superior to sham laser (SMD -0.88, 95% CI -1.48 to -0.27). Extracorporeal shockwave therapy (ECSWT) was superior to sham (-0.39, 95% CI -0.78 to -0.01) and tape was superior to sham (-0.64, 95% CI -1.16 to -0.12), with small to moderate SMDs. Although there was only very low quality evidence, exercise should be considered for patients with shoulder impingement symptoms and tape, ECSWT, laser or manual therapy might be added. NSAIDS and corticosteroids are superior to placebo, but it is unclear how these treatments compare to exercise. © 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.

  3. Midshaft Fractures of the Clavicle: A Meta-analysis Comparing Surgical Fixation Using Anteroinferior Plating Versus Superior Plating.

    PubMed

    Nourian, Alex; Dhaliwal, Satvinder; Vangala, Sitaram; Vezeridis, Peter S

    2017-09-01

    To compare the outcomes of clavicle fracture fixation using anteroinferior versus superior plate placement. We performed a meta-analysis of studies that have reported on outcomes after superior or anteroinferior plate fixation for acute midshaft clavicle fractures (Orthopaedic Trauma Association 15-B). A computerized literature search in the Pubmed, Scopus, and Cochrane Library databases was used to identify relevant articles. Only full text articles without language restrictions were evaluated. The inclusion criteria consisted of: (1) fracture of the midshaft clavicle; (2) surgery for acute fractures (within 1 month of the fracture); (3) adult patients (16 years of age and older); and (4) open reduction and internal fixation with plate application in either the anteroinferior or superior position. Studies were excluded if they did not specify plate location, evaluated multitrauma patients, investigated minimally invasive procedures, or studied operations for revision, nonunion, malunion, or infection. The primary measured outcomes were symptomatic hardware (implant prominence or irritation) and surgery for implant removal. The secondary outcomes were time to union, fracture union, nonunion, malunion, Disabilies of the Arm, Shoulder and Hand score, Constant score, and implant failure. Frequencies and proportions of cases were recorded for binary outcomes, whereas mean and standard deviations were recorded for continuous outcomes. Other summary statistics provided were used to impute mean and standard deviations under the assumption of normality when these were not reported. Continuous outcomes were compared between groups using linear mixed effects models, whereas binary outcomes were compared using mixed effects logistic regression models, including fixed group effects and random study effects. P-values less than 0.05 were considered statistically significant. All analyses were performed using SAS v. 9.4 (SAS Institute Inc, Cary, NC). A total of 1428 articles were identified among the 3 databases, of which 897 remained after removing duplicates. From that pool, 57 relevant studies were evaluated. Articles were excluded because of an inability to specify plate location (6), a subject pool not exclusively consisting of acute fractures (4) or midshaft fractures (2), a minimally invasive surgical approach (6), use of nonstandard plates (1), poor reporting of functional outcomes (2), and a duplicate group of patients (2). This left 34 articles to be used in the meta-analysis. Of these, 8 studies reported on patients with anteroinferior plating (N = 390) and 27 studies reported on patients with superior plating (N = 1104). No significant differences were found with respect to the functional shoulder scores (Disabilies of the Arm, Shoulder and Hand and Constant) between the 2 groups. There was no significant difference between each group for the probability of having a union (P = 0.41), malunion (P = 0.28), nonunion (0.29), or implant failure (P = 0.39). Patients in the superior plating group had a significantly higher probability of suffering from symptomatic hardware (0.17) as compared to patients in the anteroinferior plating group (0.08), (P = 0.005). In addition, the superior plating group had a significantly higher rate of surgery for implant removal (0.11 vs. 0.05), (P = 0.008). The findings of this investigation demonstrate that plating along the superior and anteroinferior aspects of the clavicle lead to similar operative outcomes with respect to union, nonunion, malunion, and implant failure, as well as similar functional outcomes scores. Plates applied to the superior aspect of the clavicle are associated with higher rates of symptomatic hardware and more frequent implant removal. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

  4. Early development of polyphonic sound encoding and the high voice superiority effect.

    PubMed

    Marie, Céline; Trainor, Laurel J

    2014-05-01

    Previous research suggests that when two streams of pitched tones are presented simultaneously, adults process each stream in a separate memory trace, as reflected by mismatch negativity (MMN), a component of the event-related potential (ERP). Furthermore, a superior encoding of the higher tone or voice in polyphonic sounds has been found for 7-month-old infants and both musician and non-musician adults in terms of a larger amplitude MMN in response to pitch deviant stimuli in the higher than the lower voice. These results, in conjunction with modeling work, suggest that the high voice superiority effect might originate in characteristics of the peripheral auditory system. If this is the case, the high voice superiority effect should be present in infants younger than 7 months. In the present study we tested 3-month-old infants as there is no evidence at this age of perceptual narrowing or specialization of musical processing according to the pitch or rhythmic structure of music experienced in the infant׳s environment. We presented two simultaneous streams of tones (high and low) with 50% of trials modified by 1 semitone (up or down), either on the higher or the lower tone, leaving 50% standard trials. Results indicate that like the 7-month-olds, 3-month-old infants process each tone in a separate memory trace and show greater saliency for the higher tone. Although MMN was smaller and later in both voices for the group of sixteen 3-month-olds compared to the group of sixteen 7-month-olds, the size of the difference in MMN for the high compared to low voice was similar across ages. These results support the hypothesis of an innate peripheral origin of the high voice superiority effect. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Anterior inferior plating versus superior plating for clavicle fracture: a meta-analysis.

    PubMed

    Ai, Jie; Kan, Shun-Li; Li, Hai-Liang; Xu, Hong; Liu, Yang; Ning, Guang-Zhi; Feng, Shi-Qing

    2017-04-18

    The position of plate fixation for clavicle fracture remains controversial. Our objective was to perform a comprehensive review of the literature and quantify the surgical parameters and clinical indexes between the anterior inferior plating and superior plating for clavicle fracture. PubMed, EMBASE, and the Cochrane Library were searched for randomized and non-randomized studies that compared the anterior inferior plating with the superior plating for clavicle fracture. The relative risk or standardized mean difference with 95% confidence interval was calculated using either a fixed- or random-effects model. Four randomized controlled trials and eight observational studies were identified to compare the surgical parameters and clinical indexes. For the surgical parameters, the anterior inferior plating group was better than the superior plating group in operation time and blood loss (P < 0.05). Furthermore, in terms of clinical indexes, the anterior inferior plating was superior to the superior plating in reducing the union time, and the two kinds of plate fixation methods were comparable in constant score, and the rate of infection, nonunion, and complications (P > 0.05). Based on the current evidence, the anterior inferior plating may reduce the blood loss, the operation and union time, but no differences were observed in constant score, and the rate of infection, nonunion, and complications between the two groups. Given that some of the studies have low quality, more randomized controlled trails with high quality should be conduct to further verify the findings.

  6. Word and pseudoword superiority effects reflected in the ERP waveform

    PubMed Central

    Coch, Donna; Mitra, Priya

    2010-01-01

    A variant of the Reicher-Wheeler task was used to determine when in the event-related potential (ERP) waveform indices of word and pseudoword superiority effects might be present, and whether ERP measures of superiority effects correlated with standardized behavioral measures of orthographic fluency and single word reading. ERPs were recorded to briefly presented, masked letter strings that included real words (DARK/PARK), pseudowords (DARL/PARL), nonwords (RDKA/RPKA), and letter-in-xs (DXXX, PXXX) stimuli. Participants decided which of two letters occurred at a given position in the string (here, forced-choice alternatives D and P). Behaviorally, both word (more accurate choices for letters in words than in baseline nonwords or letter-in-xs) and pseudoword (more accurate choices for letters in pseudowords than in baseline conditions) superiority effects were observed. Electrophysiologically, effects of orthographic regularity and familiarity were apparent as early as the P150 time window (100–160 ms), an effect of lexicality was observed as early as the N200 time window (160–200 ms), and peak amplitude of the N300 and N400 also differentiated word and pseudoword as compared to baseline stimuli. Further, the size of the P150 and N400 ERP word superiority effects was related to standardized behavioral measures of fluency and reading. Results suggest that orthographic fluency is reflected in both lower-level, sublexical, perceptual processing and higher-level, lexical processing in fluently reading adults. PMID:20211607

  7. Effects of the angiotensin receptor blocker azilsartan medoxomil versus olmesartan and valsartan on ambulatory and clinic blood pressure in patients with stages 1 and 2 hypertension.

    PubMed

    White, William B; Weber, Michael A; Sica, Domenic; Bakris, George L; Perez, Alfonso; Cao, Charlie; Kupfer, Stuart

    2011-03-01

    Azilsartan medoxomil is an angiotensin receptor blocker (ARB) being developed for hypertension treatment. To compare this ARB with others in the class, we studied the effects of 2 doses of azilsartan medoxomil, with valsartan 320 mg and olmesartan medoxomil (olmesartan) 40 mg, in a randomized, double-blind, placebo-controlled trial using ambulatory blood pressure (BP) monitoring and clinic BP measurements. The primary efficacy end point was the change from baseline in 24-hour mean systolic BP. Hierarchical analysis testing for superiority over placebo was followed by noninferiority analysis and then superiority testing of azilsartan medoxomil (80 mg and then 40 mg) versus the comparator ARBs. For 1291 randomized patients, mean age was 56 years, 54% were men, and baseline 24-hour mean systolic BP was 145 mm Hg. Azilsartan medoxomil at 80 mg had superior efficacy to both valsartan at 320 mg and olmesartan at 40 mg: placebo-adjusted 24-hour systolic BP was lowered (-14.3 mm Hg) more than 320 mg of valsartan (-10.0 mm Hg; P<0.001) and 40 mg of olmesartan (-11.7 mm Hg; P=0.009). Azilsartan medoxomil at 40 mg was noninferior to 40 mg of olmesartan (difference: -1.4 mm Hg [95% CI: -3.3 to 0.5]). For clinic systolic BP, both doses of azilsartan medoxomil were superior to the comparator ARBs. Safety and tolerability were similar among the placebo and 4 active treatments. These data demonstrate that azilsartan medoxomil at its maximal dose has superior efficacy to both olmesartan and valsartan at their maximal, approved doses without increasing adverse events. Azilsartan medoxomil could provide higher rates of hypertension control within the ARB class.

  8. Comparing efficacy of reduced-toxicity allogeneic hematopoietic cell transplantation with conventional chemo-(immuno) therapy in patients with relapsed or refractory CLL: a Markov decision analysis.

    PubMed

    Kharfan-Dabaja, M A; Pidala, J; Kumar, A; Terasawa, T; Djulbegovic, B

    2012-09-01

    Despite therapeutic advances, relapsed/refractory CLL, particularly after fludarabine-based regimens, remains a major challenge for which optimal therapy is undefined. No randomized comparative data exist to suggest the superiority of reduced-toxicity allogeneic hematopoietic cell transplantation (RT-allo-HCT) over conventional chemo-(immuno) therapy (CCIT). By using estimates from a systematic review and by meta-analysis of available published evidence, we constructed a Markov decision model to examine these competing modalities. Cohort analysis demonstrated superior outcome for RT-allo-HCT, with a 10-month overall life expectancy (and 6-month quality-adjusted life expectancy (QALE)) advantage over CCIT. Although the model was sensitive to changes in base-case assumptions and transition probabilities, RT-allo-HCT provided superior overall life expectancy through a range of values supported by the meta-analysis. QALE was superior for RT-allo-HCT compared with CCIT. This conclusion was sensitive to change in the anticipated state utility associated with the post-allogeneic HCT state; however, RT-allo-HCT remained the optimal strategy for values supported by existing literature. This analysis provides a quantitative comparison of outcomes between RT-allo-HCT and CCIT for relapsed/refractory CLL in the absence of randomized comparative trials. Confirmation of these findings requires a prospective randomized trial, which compares the most effective RT-allo-HCT and CCIT regimens for relapsed/refractory CLL.

  9. Age-related changes in brain activation associated with dimensional shifts of attention: an fMRI study.

    PubMed

    Morton, J Bruce; Bosma, Rachael; Ansari, Daniel

    2009-05-15

    Brain activation associated with dimensional shifts of attention was measured in 14 children and 13 adults using 4 T fMRI. Across all participants, dimensional shifting was associated with activity in a distributed frontoparietal network, including superior parietal cortex, dorsolateral prefrontal cortex, inferior frontal junction, and the pre-supplementary motor region. There were also age-related differences in brain activity, with children but not adults showing an effect of dimension shifting in the right superior frontal sulcus, and adults but not children showing an effect of dimension shifting in the left superior parietal cortex and the right thalamus. These differences were likely not attributable to behavioral differences as children and adults performed comparably. Implications for neurodevelopmental accounts of shifting are discussed.

  10. The effectiveness of extracorporeal shockwave therapy in common lower limb conditions: a systematic review including quantification of patient-rated pain reduction.

    PubMed

    Korakakis, Vasileios; Whiteley, Rodney; Tzavara, Alexander; Malliaropoulos, Nikolaos

    2018-03-01

    To evaluate extracorporeal shockwave therapy (ESWT) in treating Achilles tendinopathy (AT), greater trochanteric pain syndrome (GTPS), medial tibial stress syndrome (MTSS), patellar tendinopathy (PT) and proximal hamstring tendinopathy (PHT). Systematic review. Randomised and non-randomised studies assessing ESWT in patients with AT, GTPS, MTSS, PT and PHT were included. Risk of bias and quality of studies were evaluated. Moderate-level evidence suggests (1) no difference between focused ESWT and placebo ESWT at short and mid-term in PT and (2) radial ESWT is superior to conservative treatment at short, mid and long term in PHT. Low-level evidence suggests that ESWT (1) is comparable to eccentric training, but superior to wait-and-see policy at 4 months in mid-portion AT; (2) is superior to eccentric training at 4 months in insertional AT; (3) less effective than corticosteroid injection at short term, but ESWT produced superior results at mid and long term in GTPS; (4) produced comparable results to control treatment at long term in GTPS; and (5) is superior to control conservative treatment at long term in PT. Regarding the rest of the results, there was only very low or no level of evidence. 13 studies showed high risk of bias largely due to methodology, blinding and reporting. Low level of evidence suggests that ESWT may be effective for some lower limb conditions in all phases of the rehabilitation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. A comparison of conscious and automatic memory processes for picture and word stimuli: a process dissociation analysis.

    PubMed

    McBride, Dawn M; Anne Dosher, Barbara

    2002-09-01

    Four experiments were conducted to evaluate explanations of picture superiority effects previously found for several tasks. In a process dissociation procedure (Jacoby, 1991) with word stem completion, picture fragment completion, and category production tasks, conscious and automatic memory processes were compared for studied pictures and words with an independent retrieval model and a generate-source model. The predictions of a transfer appropriate processing account of picture superiority were tested and validated in "process pure" latent measures of conscious and unconscious, or automatic and source, memory processes. Results from both model fits verified that pictures had a conceptual (conscious/source) processing advantage over words for all tasks. The effects of perceptual (automatic/word generation) compatibility depended on task type, with pictorial tasks favoring pictures and linguistic tasks favoring words. Results show support for an explanation of the picture superiority effect that involves an interaction of encoding and retrieval processes.

  12. Study protocol for a randomised pragmatic trial comparing the clinical and cost effectiveness of lithium and quetiapine augmentation in treatment resistant depression (the LQD study).

    PubMed

    Marwood, L; Taylor, R; Goldsmith, K; Romeo, R; Holland, R; Pickles, A; Hutchinson, J; Dietch, D; Cipriani, A; Nair, R; Attenburrow, M-J; Young, A H; Geddes, J; McAllister-Williams, R H; Cleare, A J

    2017-06-26

    Approximately 30-50% of patients with major depressive disorder can be classed as treatment resistant, widely defined as a failure to respond to two or more adequate trials of antidepressants in the current episode. Treatment resistant depression is associated with a poorer prognosis and higher mortality rates. One treatment option is to augment an existing antidepressant with a second agent. Lithium and the atypical antipsychotic quetiapine are two such add-on therapies and are currently recommended as first line options for treatment resistant depression. However, whilst neither treatment has been established as superior to the other in short-term studies, they have yet to be compared head-to-head in longer term studies, or with a superiority design in this patient group. The Lithium versus Quetiapine in Depression (LQD) study is a parallel group, multi-centre, pragmatic, open-label, patient randomised clinical trial designed to address this gap in knowledge. The study will compare the clinical and cost effectiveness of the decision to prescribe lithium or quetiapine add-on therapy to antidepressant medication for patients with treatment resistant depression. Patients will be randomised 1:1 and followed up over 12 months, with the hypothesis being that quetiapine will be superior to lithium. The primary outcomes will be: (1) time to all-cause treatment discontinuation over one year, and (2) self-rated depression symptoms rated weekly for one year via the Quick Inventory of Depressive Symptomatology. Other outcomes will include between group differences in response and remission rates, quality of life, social functioning, cost-effectiveness and the frequency of serious adverse events and side effects. The trial aims to help shape the treatment pathway for patients with treatment resistant depression, by determining whether the decision to prescribe quetiapine is superior to lithium. Strengths of the study include its pragmatic superiority design, broad inclusion criteria (external validity) and longer follow up than previous studies. ISRCTN registry: ISRCTN16387615 , registered 28 February 2016. ClinicalTrials.gov: NCT03004521 , registered 17 November 2016.

  13. Intrathecal Drug Delivery Systems for Noncancer Pain: A Health Technology Assessment.

    PubMed

    2016-01-01

    Intrathecal drug delivery systems can be used to manage refractory or persistent chronic nonmalignant (noncancer) pain. We investigated the benefits, harms, cost-effectiveness, and budget impact of these systems compared with current standards of care for adult patients with chronic pain owing to nonmalignant conditions. We searched Ovid MEDLINE, Ovid Embase, the Cochrane Library, and the National Health Service's Economic Evaluation Database and Tufts Cost-Effectiveness Analysis Registry from January 1994 to April 2014 for evidence of effectiveness, harms, and cost-effectiveness. We used existing systematic reviews that had employed reliable search and screen methods and also searched for studies published after the search date reported in the latest systematic review to identify studies. Two reviewers screened records and assessed study validity. We found comparative evidence of effectiveness and harms in one cohort study at high risk of bias (≥ 3-year follow-up, N = 130). Four economic evaluations of low to very low quality were also included. Compared with oral opioid analgesia alone or a program of analgesia plus rehabilitation, intrathecal drug delivery systems significantly reduced pain (27% additional improvement) and morphine consumption. Despite these reductions, intrathecal drug delivery systems were not superior in patient-reported well-being or quality of life. There is no evidence of superiority of intrathecal drug delivery systems over oral opioids in global pain improvement and global treatment satisfaction. Comparative evidence of harms was not found. Cost-effectiveness evidence is of insufficient quality to assess the appropriateness of funding intrathecal drug delivery systems. Evidence comparing intrathecal drug delivery systems with standard care was of very low quality. Current evidence does not establish (or rule out) superiority or cost-effectiveness of intrathecal drug delivery systems for managing chronic refractory nonmalignant pain. The budget impact of funding intrathecal drug delivery systems would be between $1.5 and $5.0 million per year.

  14. The Effectiveness of Two Grammar Treatment Procedures for Children with SLI: A Randomized Clinical Trial

    ERIC Educational Resources Information Center

    Smith-Lock, Karen M.; Leitão, Suze; Prior, Polly; Nickels, Lyndsey

    2015-01-01

    Purpose: This study compared the effectiveness of two grammar treatment procedures for children with specific language impairment. Method: A double-blind superiority trial with cluster randomization was used to compare a cueing procedure, designed to elicit a correct production following an initial error, to a recasting procedure, which required…

  15. Comparative effectiveness.

    PubMed

    Brown, Gary C; Brown, Melissa M

    2009-05-01

    To familiarize the clinician with the concept of comparative effectiveness. Recent data support the concept that utility analysis is the quality-of-life instrument best able to perform comparative effectiveness analyses. The use of time tradeoff utilities for comparative effectiveness analyses in interventions across diverse specialties of medicine can be undertaken with both excellent reliability and superior construct validity. Physicians should familiarize themselves with quality-of-life instruments that can be used to assess the comparative effectiveness of healthcare interventions. Rather than delegating comparative effectiveness to others, physicians must become involved in creating and implementing comparative effectiveness standards. Physician involvement is crucial for the best interests of patients, as physicians most intimately understand the complexities and nuances associated with healthcare interventions.

  16. Effects of Elastic Resistance Exercise on Muscle Strength and Functional Performance in Healthy Adults: A Systematic Review and Meta-Analysis.

    PubMed

    de Oliveira, Poliana Alves; Blasczyk, Juscelino Castro; Souza Junior, Gerson; Lagoa, Karina Ferreira; Soares, Milene; de Oliveira, Ricardo Jacó; Filho, Paulo José Barbosa Gutierres; Carregaro, Rodrigo Luiz; Martins, Wagner Rodrigues

    2017-04-01

    Elastic Resistance Exercise (ERE) has already demonstrated its effectiveness in older adults and, when combined with the resistance generated by fixed loads, in adults. This review summarizes the effectiveness of ERE performed as isolated method on muscle strength and functional performance in healthy adults. A database search was performed (MEDLine, Cochrane Library, PEDro and Web of Knowledge) to identify controlled clinical trials in English language. The mean difference (MD) with 95% confidence intervals (CIs) and overall effect size were calculated for all comparisons. The PEDro scale was used assess the methodological quality. From the 93 articles identified by the search strategy, 5 met the inclusion criteria, in which 3 presented high quality (PEDro > 6). Meta-analyses demonstrated that the effects of ERE were superior when compared with passive control on functional performance and muscle strength. When compared with active controls, the effect of ERE was inferior on function performance and with similar effect on muscle strength. ERE are effective to improve functional performance and muscle strength when compared with no intervention, in healthy adults. ERE are not superior to other methods of resistance training to improve functional performance and muscle strength in health adults.

  17. The Spacing Effect and Metacognitive Control

    ERIC Educational Resources Information Center

    Mulligan, Neil W.; Peterson, Daniel J.

    2014-01-01

    Research suggests that spaced learning, compared with massed learning, results in superior long-term retention (the spacing effect). Son (2010) identified a potentially important moderator of the spacing effect: metacognitive control. Specifically, when participants chose massed restudy but were instead forced to space the restudy, the spacing…

  18. Tricyclic and Tetracyclic Antidepressants for the Prevention of Frequent Episodic or Chronic Tension-Type Headache in Adults: A Systematic Review and Meta-Analysis.

    PubMed

    Jackson, Jeffrey L; Mancuso, Josephine M; Nickoloff, Sarah; Bernstein, Rebecca; Kay, Cynthia

    2017-12-01

    Tension-type headaches are a common source of pain and suffering. Our purpose was to assess the efficacy of tricyclic (TCA) and tetracyclic antidepressants in the prophylactic treatment of tension-type headache. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, the ISI Web of Science, and clinical trial registries through 11 March 2017 for randomized controlled studies of TCA or tetracyclic antidepressants in the prevention of tension-type headache in adults. Data were pooled using a random effects approach. Among 22 randomized controlled trials, eight included a placebo comparison and 19 compared at least two active treatments. Eight studies compared TCAs to placebo, four compared TCAs to selective serotonin reuptake inhibitors (SSRIs), and two trials compared TCAs to behavioral therapies. Two trials compared tetracyclics to placebo. Single trials compared TCAs to tetracyclics, buspirone, spinal manipulation, transcutaneous electrical stimulation, massage, and intra-oral orthotics. High-quality evidence suggests that TCAs were superior to placebo in reducing headache frequency (weighted mean differences (WMD): -4.8 headaches/month, 95% CI: -6.63 to -2.95) and number of analgesic medications consumed (WMD: -21.0 doses/month, 95% CI: -38.2 to -3.8). TCAs were more effective than SSRIs. Low-quality studies suggest that TCAs are superior to buspirone, but equivalent to behavioral therapy, spinal manipulation, intra-oral orthotics, and massage. Tetracyclics were no better than placebo for chronic tension-type headache. Tricyclic antidepressants are modestly effective in reducing chronic tension-type headache and are superior to buspirone. In limited studies, tetracyclics appear to be ineffective in the prophylactic treatment of chronic tension-type headache.

  19. The Superior-Edge-of-the-Knee Incision Method in Lymphaticovenular Anastomosis for Lower Extremity Lymphedema.

    PubMed

    Seki, Yukio; Yamamoto, Takumi; Yoshimatsu, Hidehiko; Hayashi, Akitatsu; Kurazono, Arito; Mori, Masanori; Kato, Yoichi; Koshima, Isao

    2015-11-01

    Lymphatic vessel diameter and lymph flow are important for accurate anastomosis and effective lymph-to-venous flow in lymphaticovenular anastomosis. The authors developed a reliable method, the superioredge-of-the-knee incision method, for detecting and making the best use of high-flow lymphatic vessels in the distal medial thigh between the deep and superficial fascia, where movement of the knee, combined with compression between these fascial layers, theoretically results in upward propulsion of lymphatic fluid. Intraoperative detection of large lymphatic vessels and of venous reflux and postoperative lymphedematous volume reduction were compared between 15 patients in whom lymphaticovenular anastomoses with the superior-edge-of-the-knee incision method were undergone and 15 in whom conventional lymphaticovenular anastomoses were undergone. Lymphaticovenular anastomosis at the thigh yielded 30 anastomoses in the superior-edge-of-the-knee incision group and 32 anastomoses in the non-superior-edge-of-the-knee incision group. Large lymphatic vessels were more frequently found in the superior-edge-of-the-knee incision group than in the non-superior-edge-of-the-knee incision group (60.0 percent versus 18.8 percent; p = 0.002). Venous reflux occurred less frequently in the superior-edge-of-the-knee incision group than in the non-superior-edge-of-the-knee incision group (10.0 percent versus 65.6 percent; p < 0.001). Reduction of the lower extremity lymphedema index was significantly greater in the superior-edge-of-the-knee incision group than in the non-superior-edge-of-the-knee incision group (24.427 ± 12.400 versus 0.032 ± 20.535; p < 0.001). The superior-edge-of-the-knee incision method facilitates detection and use of large, high-flow lymphatic vessels in the distal medial thigh, both of which are important for optimum therapeutic effects in patients with lower extremity lymphedema. Therapeutic, III.

  20. Inferior retinal light exposure is more effective than superior retinal exposure in suppressing melatonin in humans

    NASA Technical Reports Server (NTRS)

    Glickman, Gena; Hanifin, John P.; Rollag, Mark D.; Wang, Jenny; Cooper, Howard; Brainard, George C.

    2003-01-01

    Illumination of different areas of the human retina elicits differences in acute light-induced suppression of melatonin. The aim of this study was to compare changes in plasma melatonin levels when light exposures of equal illuminance and equal photon dose were administered to superior, inferior, and full retinal fields. Nine healthy subjects participated in the study. Plexiglass eye shields were modified to permit selective exposure of the superior and inferior halves of the retinas of each subject. The Humphrey Visual Field Analyzer was used both to confirm intact full visual fields and to quantify exposure of upper and lower visual fields. On study nights, eyes were dilated, and subjects were exposed to patternless white light for 90 min between 0200 and 0330 under five conditions: (1) full retinal exposure at 200 lux, (2) full retinal exposure at 100 lux, (3) inferior retinal exposure at 200 lux, (4) superior retinal exposure at 200 lux, and (5) a dark-exposed control. Plasma melatonin levels were determined by radioimmunoassay. ANOVA demonstrated a significant effect of exposure condition (F = 5.91, p < 0.005). Post hoc Fisher PLSD tests showed significant (p < 0.05) melatonin suppression of both full retinal exposures as well as the inferior retinal exposure; however, superior retinal exposure was significantly less effective in suppressing melatonin. Furthermore, suppression with superior retinal exposure was not significantly different from that of the dark control condition. The results indicate that the inferior retina contributes more to the light-induced suppression of melatonin than the superior retina at the photon dosages tested in this study. Findings suggest a greater sensitivity or denser distribution of photoreceptors in the inferior retina are involved in light detection for the retinohypothalamic tract of humans.

  1. Aging memory for pictures: using high-density event-related potentials to understand the effect of aging on the picture superiority effect.

    PubMed

    Ally, Brandon A; Waring, Jill D; Beth, Ellen H; McKeever, Joshua D; Milberg, William P; Budson, Andrew E

    2008-01-31

    High-density event-related potentials (ERPs) were used to understand the effect of aging on the neural correlates of the picture superiority effect. Pictures and words were systematically varied at study and test while ERPs were recorded at retrieval. Here, the results of the word-word and picture-picture study-test conditions are presented. Behavioral results showed that older adults demonstrated the picture superiority effect to a greater extent than younger adults. The ERP data helped to explain these findings. The early frontal effect, parietal effect, and late frontal effect were all indistinguishable between older and younger adults for pictures. In contrast, for words, the early frontal and parietal effects were significantly diminished for the older adults compared to the younger adults. These two old/new effects have been linked to familiarity and recollection, respectively, and the authors speculate that these processes are impaired for word-based memory in the course of healthy aging. The findings of this study suggest that pictures allow older adults to compensate for their impaired memorial processes, and may allow these memorial components to function more effectively in older adults.

  2. Aging memory for pictures: Using high-density event-related potentials to understand the effect of aging on the picture superiority effect

    PubMed Central

    Ally, Brandon A.; Waring, Jill D.; Beth, Ellen H.; McKeever, Joshua D.; Milberg, William P.; Budson, Andrew E.

    2008-01-01

    High-density event-related potentials (ERPs) were used to understand the effect of aging on the neural correlates of the picture superiority effect. Pictures and words were systematically varied at study and test while ERPs were recorded at retrieval. Here, the results of the word-word and picture-picture study-test conditions are presented. Behavioral results showed that older adults demonstrated the picture superiority effect to a greater extent than younger adults. The ERP data helped to explain these findings. The early frontal effect, parietal effect, and late frontal effect, were all indistinguishable between older and younger adults for pictures. In contrast, for words, the early frontal and parietal effects were significantly diminished for the older adults compared to the younger adults. These two old/new effects have been linked to familiarity and recollection, respectively, and the authors speculate that these processes are impaired for word-based memory in the course of healthy aging. The findings of this study suggest that pictures allow older adults to compensate for their impaired memorial processes, and may allow these memorial components to function more effectively in older adults. PMID:17981307

  3. Azilsartan medoxomil in the management of hypertension: an evidence-based review of its place in therapy

    PubMed Central

    Angeloni, Emiliano

    2016-01-01

    Background Azilsartan (AZI) is a relatively new angiotensin receptor blocker available for the treatment of any stage of hypertension, which was eventually given in combination with chlorthalidone (CLT). Objective To review pharmacology and clinical role of AZI monotherapy and AZI/CLT or AZI/amlodipine combination therapies for hypertension management. Methods PubMed, Embase, and Cochrane Library were searched using search terms “ azilsartan”, “chlorthalidone,” “pharmacology,” “pharmacokinetics,” “pharmacodynamics,” “pharmacoeconomics,” and “cost-effectiveness.” To obtain other relevant information, US Food and Drug Association as well as manufacturer prescribing information were also reviewed. Results Randomized controlled trials demonstrated AZI to be superior to other sartans, such as valsartan, olmesartan, and candesartan, in terms of 24-hour ambulatory blood pressure monitoring (ABPM) reduction with respect. That beneficial effect of azilsartan was also associated with similar safety profiles. When compared to other antihypertensive drugs, azilsartan was found to be superior to any angiotensin-converting enzyme inhibitor, including ramipril, in terms of ABPM results, and noninferior to amlodipine in terms of sleep-BP control. The association of AZI and CLT was then found to be superior to other sartans + thiazide combination therapies in terms of both BP lowering and goal achievement. The combination of AZI and amlodipine has also been tested in clinical trials, but compared only with placebo, demonstrating its superiority in terms of efficacy and similarity in terms of safety. Conclusion Azilsartan is a safe and effective treatment option for every stage of hypertension, both alone or in fixed-dose combination tablets with chlorthalidone or amlodipine. Beneficial effects of AZI were also noted in patients with any degree of renal impairment. In addition, safety profiles of AZI were similar to that of the placebo. PMID:27103882

  4. Azilsartan medoxomil in the management of hypertension: an evidence-based review of its place in therapy.

    PubMed

    Angeloni, Emiliano

    2016-01-01

    Azilsartan (AZI) is a relatively new angiotensin receptor blocker available for the treatment of any stage of hypertension, which was eventually given in combination with chlorthalidone (CLT). To review pharmacology and clinical role of AZI monotherapy and AZI/CLT or AZI/amlodipine combination therapies for hypertension management. PubMed, Embase, and Cochrane Library were searched using search terms " azilsartan", "chlorthalidone," "pharmacology," "pharmacokinetics," "pharmacodynamics," "pharmacoeconomics," and "cost-effectiveness." To obtain other relevant information, US Food and Drug Association as well as manufacturer prescribing information were also reviewed. Randomized controlled trials demonstrated AZI to be superior to other sartans, such as valsartan, olmesartan, and candesartan, in terms of 24-hour ambulatory blood pressure monitoring (ABPM) reduction with respect. That beneficial effect of azilsartan was also associated with similar safety profiles. When compared to other antihypertensive drugs, azilsartan was found to be superior to any angiotensin-converting enzyme inhibitor, including ramipril, in terms of ABPM results, and noninferior to amlodipine in terms of sleep-BP control. The association of AZI and CLT was then found to be superior to other sartans + thiazide combination therapies in terms of both BP lowering and goal achievement. The combination of AZI and amlodipine has also been tested in clinical trials, but compared only with placebo, demonstrating its superiority in terms of efficacy and similarity in terms of safety. Azilsartan is a safe and effective treatment option for every stage of hypertension, both alone or in fixed-dose combination tablets with chlorthalidone or amlodipine. Beneficial effects of AZI were also noted in patients with any degree of renal impairment. In addition, safety profiles of AZI were similar to that of the placebo.

  5. Virtual reality exposure versus cognitive restructuring for treatment of public speaking anxiety: a pilot study.

    PubMed

    Wallach, Helene S; Safir, Marilyn P; Bar-Zvi, Margalit

    2011-01-01

    To determine the utility of Virtual Reality Exposure Therapy (VRE) in comparison with Cognitive Therapy (CT ) and with Cognitive-Behavior Therapy (CBT). Subjects suffering from public speaking anxiety (PSA) were randomly allocated to VRE and CT , and received 12 therapy sessions, employing standardized treatment manuals. Outcome (questionnaires, observer and self ratings of a behavioral task) was compared to results of subjects in a previous study CBT and Wait List Controls who were not significantly different on demographic data. CT was not superior to VRE on cognitive measures, but was superior to VRE on one behavioral measure (LSAS fear). VRE was superior to CT on one behavioral measure (fear reduction on a behavioral task). No differences were found between either CT , or VRE, and CBT and all were superior to WL. Subject group was small and homogeneous. It appeared advisable to increase number of therapy sessions. VRE and CT proved to be equally effective to CBT in reducing PSA relative to a control group, with minimal differential effects between them. Therefore, employing either one may be satisfactory and sufficient.

  6. Unique properties of halide perovskites as possible origins of the superior solar cell performance.

    PubMed

    Yin, Wan-Jian; Shi, Tingting; Yan, Yanfa

    2014-07-16

    Halide perovskites solar cells have the potential to exhibit higher energy conversion efficiencies with ultrathin films than conventional thin-film solar cells based on CdTe, CuInSe2 , and Cu2 ZnSnSe4 . The superior solar-cell performance of halide perovskites may originate from its high optical absorption, comparable electron and hole effective mass, and electrically clean defect properties, including point defects and grain boundaries. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  7. Neural correlates of the eye dominance effect in human face perception: the left-visual-field superiority for faces revisited.

    PubMed

    Jung, Wookyoung; Kang, Joong-Gu; Jeon, Hyeonjin; Shim, Miseon; Sun Kim, Ji; Leem, Hyun-Sung; Lee, Seung-Hwan

    2017-08-01

    Faces are processed best when they are presented in the left visual field (LVF), a phenomenon known as LVF superiority. Although one eye contributes more when perceiving faces, it is unclear how the dominant eye (DE), the eye we unconsciously use when performing a monocular task, affects face processing. Here, we examined the influence of the DE on the LVF superiority for faces using event-related potentials. Twenty left-eye-dominant (LDE group) and 23 right-eye-dominant (RDE group) participants performed the experiments. Face stimuli were randomly presented in the LVF or right visual field (RVF). The RDE group exhibited significantly larger N170 amplitudes compared with the LDE group. Faces presented in the LVF elicited N170 amplitudes that were significantly more negative in the RDE group than they were in the LDE group, whereas the amplitudes elicited by stimuli presented in the RVF were equivalent between the groups. The LVF superiority was maintained in the RDE group but not in the LDE group. Our results provide the first neural evidence of the DE's effects on the LVF superiority for faces. We propose that the RDE may be more biologically specialized for face processing. © The Author (2017). Published by Oxford University Press.

  8. Neural correlates of the eye dominance effect in human face perception: the left-visual-field superiority for faces revisited

    PubMed Central

    Jung, Wookyoung; Kang, Joong-Gu; Jeon, Hyeonjin; Shim, Miseon; Sun Kim, Ji; Leem, Hyun-Sung

    2017-01-01

    Abstract Faces are processed best when they are presented in the left visual field (LVF), a phenomenon known as LVF superiority. Although one eye contributes more when perceiving faces, it is unclear how the dominant eye (DE), the eye we unconsciously use when performing a monocular task, affects face processing. Here, we examined the influence of the DE on the LVF superiority for faces using event-related potentials. Twenty left-eye-dominant (LDE group) and 23 right-eye-dominant (RDE group) participants performed the experiments. Face stimuli were randomly presented in the LVF or right visual field (RVF). The RDE group exhibited significantly larger N170 amplitudes compared with the LDE group. Faces presented in the LVF elicited N170 amplitudes that were significantly more negative in the RDE group than they were in the LDE group, whereas the amplitudes elicited by stimuli presented in the RVF were equivalent between the groups. The LVF superiority was maintained in the RDE group but not in the LDE group. Our results provide the first neural evidence of the DE’s effects on the LVF superiority for faces. We propose that the RDE may be more biologically specialized for face processing. PMID:28379584

  9. Efficacy of terbinafine compared to lanoconazole and luliconazole in the topical treatment of dermatophytosis in a guinea pig model.

    PubMed

    Ghannoum, M A; Long, L; Kim, H G; Cirino, A J; Miller, A R; Mallefet, P

    2010-05-01

    The in vivo efficacy of terbinafine was compared to lanoconazole and luliconazole in the topical treatment of dermatophytosis caused by Trichophyton mentagrophytes using a guinea pig model. Topical antifungal treatment commenced three days post-infection, and each agent was applied once daily for seven consecutive days. Upon completion of the treatment period, evaluations of clinical and mycological efficacies were performed, as was scanning electron microscopy (SEM) analyses. Data showed that while all tested antifungals demonstrated significant mycological efficacy in terms of eradicating the fungi over untreated control, terbinafine and luliconazole showed superior clinical efficacy compared to lanoconazole (P-values < 0.001 & 0.003, respectively). Terbinafine demonstrated the highest clinical percent efficacy. SEM analysis revealed hairs from terbinafine and lanoconazole-treated animals had near complete clearance of fungi, while samples from luliconazole-treated animals were covered with debris and few conidia. This study demonstrates that, in general, terbinafine possessed similar efficacy to lanoconazole and luliconazole in the treatment of dermatophytosis. Terbinafine tended to have superior clinical efficacy compared to the azoles tested, although this difference was not statistically significant against luliconazole. This apparent superiority may be due to the fungicidal activity of terbinafine compared to the fungistatic effect of the other two drugs.

  10. Higher Anti-Liver Fibrosis Effect of Cordyceps militaris-Fermented Product Cultured with Deep Ocean Water via Inhibiting Proinflammatory Factors and Fibrosis-Related Factors Expressions.

    PubMed

    Hung, Yu-Ping; Lee, Chun-Lin

    2017-06-08

    Deep ocean water (DOW) has been shown to enhance the functional components of fungi, resulting in increased health benefits. Therefore, using DOW for culturing fungi can enhance the cordycepin and adenosine of Cordyceps militaris (CM) and its protective effects on the liver. In this study, the antiliver fibrosis effects and mechanisms of ultrapure water-cultured CM (UCM), DOW-cultured CM (DCM), synthetic water-cultured CM, DOW, cordycepin, and adenosine were compared in the liver fibrosis mice induced by intraperitoneal injections of thioacetamide (TAA). The results indicated that DCM exhibited superior performance in reducing liver collagen accumulation, mitigating liver injuries, inhibiting proinflammatory factors and fibrosis-related factor (TGF-β1, Smad2/3, α-SMA, COL1A1) expression compared with UCM. DOW, cordycepin, and adenosine also performed antiliver fibrosis effect. Therefore, because DCM is rich in DOW and functional components, it can achieve anti-liver fibrosis effects through multiple pathways. These ameliorative effects are considerably superior to those of UCM.

  11. Short-term effects of escitalopram on regional brain function in first-episode drug-naive patients with major depressive disorder assessed by resting-state functional magnetic resonance imaging.

    PubMed

    Wang, L; Li, K; Zhang, Q; Zeng, Y; Dai, W; Su, Y; Wang, G; Tan, Y; Jin, Z; Yu, X; Si, T

    2014-05-01

    Most knowledge regarding the effects of antidepressant drugs is at the receptor level, distal from the nervous system effects that mediate their clinical efficacy. Using functional magnetic resonance imaging (fMRI), this study investigated the effects of escitalopram, a selective serotonin reuptake inhibitor (SSRI), on resting-state brain function in patients with major depressive disorder (MDD). Fourteen first-episode drug-naive MDD patients completed two fMRI scans before and after 8 weeks of escitalopram therapy. Scans were also acquired in 14 matched healthy subjects. Data were analyzed using the regional homogeneity (ReHo) approach. Compared to controls, MDD patients before treatment demonstrated decreased ReHo in the frontal (right superior frontal gyrus), temporal (left middle and right inferior temporal gyri), parietal (right precuneus) and occipital (left superior occipital gyrus and right cuneus) cortices, and increased ReHo in the left dorsal medial prefrontal gyrus and left anterior lobe of the cerebellum. Compared to the unmedicated state, ReHo in the patients after treatment was decreased in the left dorsal medial prefrontal gyrus, the right insula and the bilateral thalamus, and increased in the right superior frontal gyrus. Compared to controls, patients after treatment displayed a ReHo decrease in the right precuneus and a ReHo increase in the left anterior lobe of the cerebellum. Successful treatment with escitalopram may be associated with modulation of resting-state brain activity in regions within the fronto-limbic circuit. This study provides new insight into the effects of antidepressants on functional brain systems in MDD.

  12. Comparative efficacy of two daily use mouthrinses: randomized clinical trial using an experimental gingivitis model.

    PubMed

    Charles, Christine Ann; McGuire, James Anthony; Sharma, Naresh Chandra; Qaqish, James

    2011-01-01

    Two antimicrobial agents, a fixed combination of essential oils (EOs) and 0.07% cetylpyridinium chloride (CPC) are found in commercially available mouthrinses, Listerine® Antiseptic and Crest® Pro HealthTM, respectively. Both mouthrinses have been shown to control dental plaque and gingivitis in short and longer term studies. The aim of this study was to determine the comparative effectiveness of these two mouthrinses using a 2-week experimental gingivitis model. Qualified subjects were randomly assigned to one of three mouthrinse groups: a fixed combination of EOs, 0.07% CPC, or negative control (C) rinse. Following baseline clinical assessments and a dental prophylaxis, subjects began a two-week period in which they rinsed twice daily with their assigned rinse and abstained from any mechanical oral hygiene procedures or other oral care products. Subjects were reassessed at the end of the two-week period. One hundred and forty-seven subjects were randomized and 142 completed this study. After two weeks use, the EOs rinse was superior (p < 0.011) to the CPC rinse in inhibiting the development of gingivitis, plaque, and bleeding, with 9.4% and 6.6% reductions compared to CPC for gingivitis and plaque, respectively. Both rinses were superior to the negative control rinse (p < 0.001). This study demonstrates that the essential oil-containing mouthrinse has superior antiplaque/antigingivitis effectiveness compared to the 0.07% CPC-containing mouthrinse without mechanical oral hygiene influence.

  13. Emotional expressions in voice and music: same code, same effect?

    PubMed

    Escoffier, Nicolas; Zhong, Jidan; Schirmer, Annett; Qiu, Anqi

    2013-08-01

    Scholars have documented similarities in the way voice and music convey emotions. By using functional magnetic resonance imaging (fMRI) we explored whether these similarities imply overlapping processing substrates. We asked participants to trace changes in either the emotion or pitch of vocalizations and music using a joystick. Compared to music, vocalizations more strongly activated superior and middle temporal cortex, cuneus, and precuneus. However, despite these differences, overlapping rather than differing regions emerged when comparing emotion with pitch tracing for music and vocalizations, respectively. Relative to pitch tracing, emotion tracing activated medial superior frontal and anterior cingulate cortex regardless of stimulus type. Additionally, we observed emotion specific effects in primary and secondary auditory cortex as well as in medial frontal cortex that were comparable for voice and music. Together these results indicate that similar mechanisms support emotional inferences from vocalizations and music and that these mechanisms tap on a general system involved in social cognition. Copyright © 2011 Wiley Periodicals, Inc.

  14. Memory as embodiment: The case of modality and serial short-term memory.

    PubMed

    Macken, Bill; Taylor, John C; Kozlov, Michail D; Hughes, Robert W; Jones, Dylan M

    2016-10-01

    Classical explanations for the modality effect-superior short-term serial recall of auditory compared to visual sequences-typically recur to privileged processing of information derived from auditory sources. Here we critically appraise such accounts, and re-evaluate the nature of the canonical empirical phenomena that have motivated them. Three experiments show that the standard account of modality in memory is untenable, since auditory superiority in recency is often accompanied by visual superiority in mid-list serial positions. We explain this simultaneous auditory and visual superiority by reference to the way in which perceptual objects are formed in the two modalities and how those objects are mapped to speech motor forms to support sequence maintenance and reproduction. Specifically, stronger obligatory object formation operating in the standard auditory form of sequence presentation compared to that for visual sequences leads both to enhanced addressability of information at the object boundaries and reduced addressability for that in the interior. Because standard visual presentation does not lead to such object formation, such sequences do not show the boundary advantage observed for auditory presentation, but neither do they suffer loss of addressability associated with object information, thereby affording more ready mapping of that information into a rehearsal cohort to support recall. We show that a range of factors that impede this perceptual-motor mapping eliminate visual superiority while leaving auditory superiority unaffected. We make a general case for viewing short-term memory as an embodied, perceptual-motor process. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  15. Time-Dependent Traveling Wave Tube Model for Intersymbol Interference Investigations

    DTIC Science & Technology

    2001-06-01

    band is 5.7 degrees. C. Differences between broadband and single-tone excitations The TWT characteristics are compared when excited by single-tones...direct description of the effects of the TWT on modulated digital signals. The TWT model comprehensively takes into account the effects of frequency...of the high power amplifier and the operational digital signal. This method promises superior predictive fidelity compared to methods using TWT

  16. Distributed Retrieval Practice Promotes Superior Recall of Anatomy Information

    ERIC Educational Resources Information Center

    Dobson, John L.; Perez, Jose; Linderholm, Tracy

    2017-01-01

    Effortful retrieval produces greater long-term recall of information when compared to studying (i.e., reading), as do learning sessions that are distributed (i.e., spaced apart) when compared to those that are massed together. Although the retrieval and distributed practice effects are well-established in the cognitive science literature, no…

  17. Cognitive-Behavioral and Pharmacological Interventions for Hyperactive Boys: Comparative and Combined Effects.

    ERIC Educational Resources Information Center

    Hinshaw, Stephen P.; And Others

    1984-01-01

    Assessed the effects of two interventions on hyperactive children's (N=24) social behavior. Results indicated that both methylphenidate (Ritalin) and reinforced self-evaluation were superior to the contrast treatments. Medication plus cognitive-behavioral self-evaluation proved optimal, and placebo plus reinforcement alone was significantly worse…

  18. Research on the Treatment of Couple Distress

    ERIC Educational Resources Information Center

    Lebow, Jay L.; Chambers, Anthony L.; Christensen, Andrew; Johnson, Susan M.

    2012-01-01

    This article reviews the research on couple therapy over the last decade. The research shows that couple therapy positively impacts 70% of couples receiving treatment. The effectiveness rates of couple therapy are comparable to the effectiveness rates of individual therapies and vastly superior to control groups not receiving treatment. The…

  19. Residual symptoms after surgery for unilateral congenital superior oblique palsy.

    PubMed

    Caca, Ihsan; Sahin, Alparslan; Cingu, Abdullah; Ari, Seyhmus; Akbas, Umut

    2012-01-01

    To establish the surgical results and residual symptoms in 48 cases with unilateral congenital superior oblique muscle palsy that had surgical intervention to the vertical muscles alone. Myectomy and concomitant disinsertion of the inferior oblique (IO) muscle was performed in 38 cases and myectomy and concomitant IO disinsertion and recession of the superior rectus muscle in the ipsilateral eye was performed in 10 cases. The preoperative and postoperative vertical deviation values and surgical results were compared. Of the patients who had myectomy and concomitant IO disinsertion, 74% achieved an "excellent" result, 21% a "good" result, and 5% a "poor" result postoperatively. The difference in deviation between preoperative and postoperative values was statistically significant (P < .001). Of the patients who had myectomy and concomitant inferior oblique disinsertion and ipsilateral superior rectus recession, 50% achieved an "excellent" result, 20% a "good" result, and 30% a "poor" result postoperatively. The difference in deviation between preoperative and postoperative values was statistically significant (P < .001). Both procedures are effective and successful in patients with superior oblique muscle palsy, but a secondary surgery may be required. Copyright 2012, SLACK Incorporated.

  20. Effects of Pilates-based exercises on pain and disability in individuals with persistent nonspecific low back pain: a systematic review with meta-analysis.

    PubMed

    Lim, Edwin Choon Wyn; Poh, Ruby Li Choo; Low, Ai Ying; Wong, Wai Pong

    2011-02-01

    A systematic review with meta-analysis. To compare pain and disability in individuals with persistent nonspecific low back pain who were treated with Pilates exercises compared to minimal or other interventions. Searches of Medline, CINAHL, Embase, Cochrane library, PEDro, and ProQuest Dissertations and Thesis databases were conducted. Randomized controlled trials (RCTs) were selected and reviewed if they compared pain and disability in individuals with persistent nonspecific low back pain who were treated with Pilates exercises compared to other treatment approaches. Quality of the trials was evaluated. Data for pain and disability scores were extracted. Narrative synthesis plus meta-analyses were performed, with either a fixed-effects or random-effects model, standardized mean differences (SMDs), and tests for heterogeneity. Seven RCTs were identified and included in the meta-analyses. Data pooling was performed using RevMan 5. When compared to minimal intervention, Pilates-based exercise provided superior pain relief (pooled SMD, -2.72; 95% CI: -5.33, -0.11; P = .04) but the pooled disability scores were not significantly different (pooled SMD, -0.74; 95% CI: -1.81, 0.33;P = .17). No significant differences were found when comparing Pilates-based exercise to other forms of exercise for pain (pooled SMD, 0.03; 95% CI: -0.52, 0.58; P = .92) or disability scores (pooled SMD, -0.41; 95% CI: -0.96, 0.14; P = .14). Pilates-based exercises are superior to minimal intervention for pain relief. Existing evidence does not establish superiority of Pilates-based exercise to other forms of exercise to reduce pain and disability for patients with persistent nonspecific low back pain. However, the relatively low quality of existing studies and the heterogeneity of pooled studies in this systematic review combine to suggest that these results should be interpreted with caution. Therapy, level 1a.

  1. Supervised Disulfiram's Superior Effectiveness in Alcoholism Treatment: Ethical, Methodological, and Psychological Aspects.

    PubMed

    Brewer, Colin; Streel, Emmanuel; Skinner, Marilyn

    2017-03-09

    Disulfiram (DSF) causes the ALDH-mediated deterrence of alcohol consumption. We review recent meta-analyses showing the superior effectiveness of supervised disulfiram (SD) in alcoholism treatment compared with oral naltrexone or acamprosate (ACP). The success of SD is also consistent with the almost complete absence of alcoholism in Japanese homozygotes for 'inefficient' ALDH. However, SD is an underused treatment and some clinicians have ethical objections to DSF. We examine these objections and argue that they are based on a misunderstanding of how DSF works. In particular, we argue that SD is not as is often claimed a variety of aversion therapy but aids cognitive, behavioural, educational and psychosocial interventions. It has some unique features that need to be better understood if it is to be properly compared with other treatments and effectively employed to help alcoholic patients, especially those who have not responded to other evidence-based interventions. © The Author 2017. Medical Council on Alcohol and Oxford University Press. All rights reserved.

  2. Effect of acupuncture on clinical symptoms and laboratory indicators for chronic prostatitis/chronic pelvic pain syndrome: a systematic review and meta-analysis.

    PubMed

    Liu, Bu-Ping; Wang, Yun-Ting; Chen, Si-da

    2016-12-01

    To systematically review the efficacy and safety of acupuncture for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). PubMed, Cochrane library Central, Web of Science, Wang-fang Database, and CNKI were searched from their inception to June 30, 2016. Data of acupuncture for CP/CPPS following randomized controlled trials (RCTs) was included. The data were analyzed using the Cochrane Collaboration Review Manager. The primary data were the National Institute of Health-Chronic Prostatitis Index (NIH-CPSI) score at the end of follow-up. Ten RCTs were enrolled. Acupuncture was superior to the control in NIH-CPSI (MD -3.98, [95 % CI -5.78 to -2.19]; P < 0.0001) and response rate (RR 4.12, [95 % CI 1.67-10.18]; P = 0.002). Acupuncture was superior to sham acupuncture on NIH-CPSI, response rate, pain, urinary, and quality of life (QOL). Standard medication was inferior to acupuncture in terms of NIH-CPSI (MD -3.08, [95 % CI -5.57 to -0.60]; P = 0.02) and response rate (RR 2.03, [95 % CI 1.04-3.97]; P = 0.04), but standard medication was superior to acupuncture on improving urinary symptoms. There was no significant difference in the adverse events. Acupuncture/acupuncture plus standard medication significantly down-regulated IL-1β compared with standard medication in prostatic fluid. Acupuncture treating CP/CPPS is effective and safe. The effects of acupuncture on NIH-CPSI, response rate, pain symptoms, and QOF were superior to the control, but standard medication significantly improved urinary symptoms compared with acupuncture. Acupuncture can decrease the IL-1β in prostatic fluid for CP/CPPS.

  3. Omeprazole. A review of its use in Helicobacter pylori infection, gastro-oesophageal reflux disease and peptic ulcers induced by nonsteroidal anti-inflammatory drugs.

    PubMed

    Langtry, H D; Wilde, M I

    1998-09-01

    Omeprazole is a well studied proton pump inhibitor that reduces gastric acid secretion. This review examines its use in Helicobacter pylori infection, gastro-oesophageal reflux disease (GORD) with or without oesophagitis and gastrointestinal damage caused by nonsteroidal anti-inflammatory drugs (NSAIDs). Optimal omeprazole regimens for anti-H. pylori therapy are those that administer the drug at a dosage of 40 mg/day (in 1 or 2 divided doses) for 7, 10 or 14 days in combination with 2 antibacterial agents. As a component of 3-drug regimens in direct comparative studies, omeprazole was at least as effective as lansoprazole, pantoprazole, bismuth compounds and ranitidine. However, a meta-analysis suggests that triple therapies with omeprazole are more effective than comparable regimens containing ranitidine, lansoprazole or bismuth. Omeprazole also appears to be successful in triple therapy regimens used in children with H. pylori infection. In patients with acute GORD with oesophagitis, omeprazole is at least as effective as lansoprazole or pantoprazole in promoting healing, and superior to ranitidine, cimetidine or cisapride in oesophagitis healing and symptom relief. Omeprazole was similar to lansoprazole and superior to ranitidine in preventing oesophagitis relapse in patients with all grades of oesophagitis, but may be superior to lansoprazole or pantoprazole in patients with more severe disease. More patients with symptomatic GORD without oesophagitis experienced symptom relief after short term treatment with omeprazole than with ranitidine, cisapride or placebo, and symptoms were more readily prevented by omeprazole than by cimetidine or placebo. Omeprazole was effective in healing and relieving symptoms of reflux oesophagitis in children with oesophagitis refractory to histamine H2 receptor antagonists. Omeprazole is superior to placebo in preventing NSAID-induced gastrointestinal damage in patients who must continue to take NSAIDs. It is also similar to misoprostol and superior to ranitidine in its ability to heal NSAID-induced peptic ulcers and erosions, and superior to misoprostol, ranitidine or placebo in its ability to prevent relapse. In long and short term studies, omeprazole was well tolerated, with diarrhoea, headache, dizziness, flatulence, abdominal pain and constipation being the most commonly reported adverse events. Usual omeprazole dosages, alone or combined with other agents, are 10 to 40 mg/day for adults and 10 to 20 mg/day for children. Omeprazole is a well studied and well tolerated agent effective in adults or children as a component in regimens aimed at eradicating H. pylori infections or as monotherapy in the treatment and prophylaxis of GORD with or without oesophagitis or NSAID-induced gastrointestinal damage.

  4. Superior versus inferior Ahmed glaucoma valve implantation.

    PubMed

    Pakravan, Mohammad; Yazdani, Shahin; Shahabi, Camelia; Yaseri, Mehdi

    2009-02-01

    To compare the efficacy and safety of Ahmed glaucoma valve (AGV) (New World Medical Inc., Rancho Cucamonga, CA) implantation in the superior versus inferior quadrants. Prospective parallel cohort study. A total of 106 eyes of 106 patients with refractory glaucoma. Consecutive patients with refractory glaucoma underwent AGV implantation in the superior or inferior quadrants. Main outcome measures included intraocular pressure (IOP) and rate of complications. Other outcome measures included best corrected visual acuity (BCVA), number of glaucoma medications, and success rate (defined as at least 30% IOP reduction and 50.122). After 1 year, statistically significant but comparable IOP reduction from baseline (P<0.001) was achieved in both groups (47.0%+/-27.2% and 43.0%+/-24.5% reduction for superior and inferior groups, respectively, P = 0.725). The mean number of glaucoma medications was comparable after 1 year (1.3+/-1.2 vs. 1.9+/-0.8 for superior and inferior implants, respectively, P = 0.256). Success rates were also similar at 1 year: 27 eyes (81.8%) versus 20 eyes (95.2%) for superior and inferior implants, respectively (P = 0.227). However, the overall rate of complications, such as implant exposure necessitating removal, cosmetically unappealing appearance, and endophthalmitis, was higher in the inferior group: 12 eyes (25%) versus 3 eyes (5.2%) for superior and inferior groups, respectively, (P = 0.004). Superior and inferior AGV implants have similar intermediate efficacy in terms of IOP reduction, decrease in number of glaucoma medications, and preservation of vision. However, the inferior quadrants entail significantly more complications. It may be prudent to avoid AGV implantation in the inferior quadrants if the superior quadrants have no contraindications to surgery. Proprietary or commercial disclosure may be found after the references.

  5. First evaluation of automated specimen inoculation for wound swab samples by use of the Previ Isola system compared to manual inoculation in a routine laboratory: finding a cost-effective and accurate approach.

    PubMed

    Mischnik, Alexander; Mieth, Markus; Busch, Cornelius J; Hofer, Stefan; Zimmermann, Stefan

    2012-08-01

    Automation of plate streaking is ongoing in clinical microbiological laboratories, but evaluation for routine use is mostly open. In the present study, the recovery of microorganisms from the Previ Isola system plated polyurethane (PU) swab samples is compared to manually plated control viscose swab samples from wounds according to the CLSI procedure M40-A (quality control of microbiological transport systems). One hundred twelve paired samples (224 swabs) were analyzed. In 80/112 samples (71%), concordant culture results were obtained with the two methods. In 32/112 samples (29%), CFU recovery of microorganisms from the two methods was discordant. In 24 (75%) of the 32 paired samples with a discordant result, Previ Isola plated PU swabs were superior. In 8 (25%) of the 32 paired samples with a discordant result, control viscose swabs were superior. The quality of colony growth on culture media for further investigations was superior with Previ Isola inoculated plates compared to manual plating techniques. Gram stain results were concordant between the two methods in 62/112 samples (55%). In 50/112 samples (45%), the results of Gram staining were discordant between the two methods. In 34 (68%) of the 50 paired samples with discordant results, Gram staining of PU swabs was superior to that of control viscose swabs. In 16 (32%) of the 50 paired samples, Gram staining of control viscose swabs was superior to that of PU swabs. We report the first clinical evaluation of Previ Isola automated specimen inoculation for wound swab samples. This study suggests that use of an automated specimen inoculation system has good results with regard to CFU recovery, quality of Gram staining, and accuracy of diagnosis.

  6. First Evaluation of Automated Specimen Inoculation for Wound Swab Samples by Use of the Previ Isola System Compared to Manual Inoculation in a Routine Laboratory: Finding a Cost-Effective and Accurate Approach

    PubMed Central

    Mieth, Markus; Busch, Cornelius J.; Hofer, Stefan; Zimmermann, Stefan

    2012-01-01

    Automation of plate streaking is ongoing in clinical microbiological laboratories, but evaluation for routine use is mostly open. In the present study, the recovery of microorganisms from the Previ Isola system plated polyurethane (PU) swab samples is compared to manually plated control viscose swab samples from wounds according to the CLSI procedure M40-A (quality control of microbiological transport systems). One hundred twelve paired samples (224 swabs) were analyzed. In 80/112 samples (71%), concordant culture results were obtained with the two methods. In 32/112 samples (29%), CFU recovery of microorganisms from the two methods was discordant. In 24 (75%) of the 32 paired samples with a discordant result, Previ Isola plated PU swabs were superior. In 8 (25%) of the 32 paired samples with a discordant result, control viscose swabs were superior. The quality of colony growth on culture media for further investigations was superior with Previ Isola inoculated plates compared to manual plating techniques. Gram stain results were concordant between the two methods in 62/112 samples (55%). In 50/112 samples (45%), the results of Gram staining were discordant between the two methods. In 34 (68%) of the 50 paired samples with discordant results, Gram staining of PU swabs was superior to that of control viscose swabs. In 16 (32%) of the 50 paired samples, Gram staining of control viscose swabs was superior to that of PU swabs. We report the first clinical evaluation of Previ Isola automated specimen inoculation for wound swab samples. This study suggests that use of an automated specimen inoculation system has good results with regard to CFU recovery, quality of Gram staining, and accuracy of diagnosis. PMID:22692745

  7. High intensity training in obesity: a Meta‐analysis

    PubMed Central

    Theel, W.; Kasteleyn, M. J.; Franssen, F. M. E.; Hiemstra, P. S.; Rudolphus, A.; Taube, C.; Braunstahl, G. J.

    2017-01-01

    Summary Introduction High Intensity training (HIT) is a time‐effective alternative to traditional exercise programs in adults with obesity, but the superiority in terms of improving cardiopulmonary fitness and weight loss has not been demonstrated. Objective to determine the effectiveness of HIT on cardiopulmonary fitness and body composition in adults with obesity compared to traditional (high volume continuous) exercise. Methods A systematic search of the main health science databases was conducted for randomized controlled trials comparing HIT with traditional forms of exercise in people with obesity. Eighteen studies were included in the meta‐analysis. The (unstandardized) mean difference of each outcome parameters was calculated and pooled with the random effects model. Results HIT resulted in greater improvement of cardiopulmonary fitness (VO2max) (MD 1.83, 95% CI 0.70, 2.96, p<0.005; I2=31%) and a greater reduction of %body fat (MD ‐1.69, 95% CI ‐3.10, ‐0.27, p=0.02, I2=30%) compared to traditional exercise. Overall effect for BMI was not different between HIT and traditional exercise. Conclusion Training at high intensity is superior to improve cardiopulmonary fitness and to reduce %body fat in adults with obesity compared to traditional exercise. Future studies are needed to design specific HIT programs for the obese with regard to optimal effect and long‐term adherence. PMID:29071102

  8. The efficacy of atomoxetine in treating adult attention deficit hyperactivity disorder (ADHD): A meta-analysis of controlled trials.

    PubMed

    Ravishankar, Vinutha; Chowdappa, Suresh Vedaveni; Benegal, Vivek; Muralidharan, Kesavan

    2016-12-01

    Atomoxetine, a non-stimulant, is FDA approved drug used in the management of adult ADHD. Since the presentation of adult ADHD is different from the childhood onset condition, there is an urgent need to study the efficacy of atomoxetine on the different symptom domains of adult ADHD. To study the efficacy of atomoxetine in treating adult ADHD compared to placebo, we performed a Medline search for English language publications of Randomized Controlled Trials (RCTs) comparing atomoxetine to placebo for adult ADHD using the keywords "adult ADHD", "atomoxetine" and "placebo". A total of 41 RCTs were returned of which we included 13 relevant RCTs reporting data on 1824 patients with adult ADHD in the analysis. Standardized mean difference between atomoxetine and placebo for the mean baseline-to-endpoint change in total ADHD scores, impulsivity/hyperactivity and inattention scores was calculated, with a 95% confidence limit. Atomoxetine had superior efficacy than placebo on overall adult ADHD scores [-0.45; 95% CI -0.54, -0.35; overall effect p<0.00001]. Atomoxetine was superior to placebo on the domains of both inattention [-0.42; 95% CI -0.49, -0.35; overall effect p<0.00001] and impulsivity/hyperactivity [-0.36; 95% CI -0.44, -0.29; overall effect p<0.00001]. Atomoxetine was significantly more efficacious (p<0.00001) in treating inattention than hyperactivity/impulsivity. Atomoxetine is efficacious in treating adult ADHD compared to placebo, though the efficacy is significantly superior for inattention than hyperactivity/impulsivity. Copyright © 2016. Published by Elsevier B.V.

  9. Superior-inferior position of patellar component affects patellofemoral kinematics and contact forces in computer simulation.

    PubMed

    Nakamura, Shinichiro; Tanaka, Yoshihisa; Kuriyama, Shinichi; Nishitani, Kohei; Ito, Hiromu; Furu, Moritoshi; Matsuda, Shuichi

    2017-06-01

    Anterior knee pain has been reported as a major postoperative complication after total knee arthroplasty, which may lead to patient dissatisfaction. Rotational alignment and the medial-lateral position correlate with patellar maltracking, which can cause knee pain postoperatively. However, the superior-inferior position of the patellar component has not been investigated. The purpose of the current study was to investigate the effects of the patellar superior-inferior position on patellofemoral kinematics and kinetics. Superior, central, and inferior models with a dome patellar component were constructed. In the superior and inferior models, the position of the patellar component translated superiorly and inferiorly, respectively, by 3mm, relative to the center model. Kinematics of the patellar component, quadriceps force, and patellofemoral contact force were calculated using a computer simulation during a squatting activity in a weight-bearing deep knee bend. In the inferior model, the flexion angle, relative to the tibial component, was the greatest among all models. The inferior model showed an 18.0%, 36.5%, and 22.7% increase in the maximum quadriceps force, the maximum medial patellofemoral force, and the maximum lateral patellofemoral force, respectively, compared with the superior model. Superior-inferior positions affected patellofemoral kinematic and kinetics. Surgeons should avoid the inferior position of the patellar component, because the inferior positioned model showed greater quadriceps and patellofemoral force, resulting in a potential risk for anterior knee pain and component loosening. Copyright © 2017. Published by Elsevier Ltd.

  10. Effects of generation mode in fMRI adaptations of semantic fluency: Paced production and overt speech

    PubMed Central

    Basho, Surina; Palmer, Erica D.; Rubio, Miguel A.; Wulfeck, Beverly; Müller, Ralph-Axel

    2007-01-01

    Verbal fluency is a widely used neuropsychological paradigm. In fMRI implementations, conventional unpaced (self-paced) versions are suboptimal due to uncontrolled timing of responses, and overt responses carry the risk of motion artifact. We investigated the behavioral and neurofunctional effects of response pacing and overt speech in semantic category-driven word generation. Twelve right-handed adults (8 female) ages 21–37 were scanned in four conditions each: Paced-Overt, Paced-Covert, Unpaced-Overt, and Unpaced-Covert. There was no significant difference in the number of exemplars generated between overt versions of the paced and unpaced conditions. Imaging results for category-driven word generation overall showed left-hemispheric activation in inferior frontal cortex, premotor cortex, cingulate gyrus, thalamus, and basal ganglia. Direct comparison of generation modes revealed significantly greater activation for the paced compared to unpaced conditions in right superior temporal, bilateral middle frontal, and bilateral anterior cingulate cortex, including regions associated with sustained attention, motor planning, and response inhibition. Covert (compared to overt) conditions showed significantly greater effects in right parietal and anterior cingulate, as well as left middle temporal and superior frontal regions. We conclude that paced overt paradigms are useful adaptations of conventional semantic fluency in fMRI, given their superiority with regard to control over and monitoring of behavioral responses. However, response pacing is associated with additional non-linguistic effects related to response inhibition, motor preparation, and sustained attention. PMID:17292926

  11. Writing superiority in cued recall

    PubMed Central

    Fueller, Carina; Loescher, Jens; Indefrey, Peter

    2013-01-01

    In list learning paradigms with free recall, written recall has been found to be less susceptible to intrusions of related concepts than spoken recall when the list items had been visually presented. This effect has been ascribed to the use of stored orthographic representations from the study phase during written recall (Kellogg, 2001). In other memory retrieval paradigms, by contrast, either better recall for modality-congruent items or an input-independent writing superiority effect have been found (Grabowski, 2005). In a series of four experiments using a paired associate learning paradigm we tested (a) whether output modality effects on verbal recall can be replicated in a paradigm that does not involve the rejection of semantically related intrusion words, (b) whether a possible superior performance for written recall was due to a slower response onset for writing as compared to speaking in immediate recall, and (c) whether the performance in paired associate word recall was correlated with performance in an additional episodic memory recall task. We observed better written recall in the first half of the recall phase, irrespective of the modality in which the material was presented upon encoding. An explanation for this effect based on longer response latencies for writing and hence more time for memory retrieval could be ruled out by showing that the effect persisted in delayed response versions of the task. Although there was some evidence that stored additional episodic information may contribute to the successful retrieval of associate words, this evidence was only found in the immediate response experiments and hence is most likely independent from the observed output modality effect. In sum, our results from a paired associate learning paradigm suggest that superior performance for written vs. spoken recall cannot be (solely) explained in terms of additional access to stored orthographic representations from the encoding phase. Our findings rather suggest a general writing-superiority effect at the time of memory retrieval. PMID:24151483

  12. Studying the Immunomodulatory Effects of Small Molecule Ras Inhibitors in Animal Models of Rheumatoid Arthritis

    DTIC Science & Technology

    2017-10-01

    methotrexate (MTX) provides a superior protective effect compared to monotherapy. (iii) In the AIA model the FTS derivative, F-FTS, showed higher...therapeutic efficacy compared to FTS. (iv) The functional genomics studies showed that FTS therapy inhibits the in vivo TH17 immune response. (v) FTS semi... Description shall include pertinent data and graphs in sufficient detail to explain any significant results achieved. A succinct description of the

  13. Treatment strategy for sacroiliac joint-related pain at or around the posterior superior iliac spine.

    PubMed

    Murakami, Eiichi; Kurosawa, Daisuke; Aizawa, Toshimi

    2018-02-01

    Pain at or around the posterior superior iliac spine (PSIS) is characteristic of sacroiliac joint (SIJ) -related pain. This pain can be treated by either a peri- or intra-articular injection into the joint, with the former being much easier to perform. We investigated whether peri- or intra-articular injections were more frequently effective in patients with SIJ-related pain, and aimed to create an efficient treatment strategy for SIJ-related pain at or around the PSIS. Prospective case-control study. We evaluated 85 patients with pain at or around the posterior superior iliac spine as indicated by the one finger test. First, we performed a peri-articular sacroiliac joint injection. If it was ineffective, an intra-articular injection was later given. Groin pain, sitting pain, sacroiliac joint shear test results, and posterior superior iliac spine and sacro-tuberous ligament tenderness were also compared between patients for whom a peri- or intra-articular injection was effective. Seventy-two (85%) of 85 patients had an effective injection. Out of these 72 patients, 58 (81%) had a positive peri-articular injection and 14 (19%) had a positive intra-articular injection. Four items, excluding tenderness of the sacro-tuberous ligament had no significant difference between these two injection types. To treat sacroiliac joint-related pain at or around the posterior superior iliac spine, a peri-articular injection should be performed first, and only if it is not effective should an intra-articular injection be administered. Using this strategy, we expect that most patients with sacroiliac joint-related pain will be efficiently diagnosed and treated. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Memory for pictures, words, and spatial location in older adults: evidence for pictorial superiority.

    PubMed

    Park, D C; Puglisi, J T; Sovacool, M

    1983-09-01

    In the present study the spatial location of picture and word stimuli was varied across four quadrants of photographic slides. Young and old people received either pictures or words to study and were told to remember either just the item or the item and its location. Recognition memory for items and memory for spatial location were tested. A pictorial superiority effect occurred for both old and young people's item recognition. Additionally, instructions to study position decreased item memory and facilitated position memory in both age groups. Spatial memory was markedly superior for pictures compared with matched words for old and young adults. The results are interpreted within the Hasher and Zacks framework of automatic processing. The implications of the data for designing mnemonic aids for elderly persons are considered.

  15. The Effects of Elaboration and Rehearsal on Long-Term Retention of Shape Names by Kindergarteners

    ERIC Educational Resources Information Center

    Gallimore, Ronald; And Others

    1977-01-01

    Elaboration and overt rehearsal are compared as instructional paradigms for memory retention. Superior long-term retention was produced in the elaboration condition when the initial acquisition effects were statistically removed. Short-term data suggest acquisition was complexly affected by experimental condition, I.Q., and task. Elaboration…

  16. Breviscapine Injection Improves the Therapeutic Effect of Western Medicine on Angina Pectoris Patients.

    PubMed

    Wang, Chuan; Li, Yafeng; Gao, Shoucui; Cheng, Daxin; Zhao, Sihai; Liu, Enqi

    2015-01-01

    To evaluate the beneficial and adverse effects of breviscapine injection in combination with Western medicine on the treatment of patients with angina pectoris. The Cochrane Central Register of Controlled Trials, Medline, Science Citation Index, EMBASE, the China National Knowledge Infrastructure, the Wanfang Database, the Chongqing VIP Information Database and the China Biomedical Database were searched to identify randomized clinical trials (RCTs) that evaluated the effects of Western medicine compared to breviscapine injection plus Western medicine on angina pectoris patients. The included studies were analyzed using RevMan 5.1.0 software. The literature search yielded 460 studies, wherein 16 studies matched the selection criteria. The results showed that combined therapy using Breviscapine plus Western medicine was superior to Western medicine alone for improving angina pectoris symptoms (OR=3.77, 95% Cl: 2.76~5.15) and also resulted in increased electrocardiogram (ECG) improvement (OR=2.77, 95% Cl: 2.16~3.53). The current evidence suggests that Breviscapine plus Western medicine achieved a superior therapeutic effect compared to Western medicine alone.

  17. Breviscapine Injection Improves the Therapeutic Effect of Western Medicine on Angina Pectoris Patients

    PubMed Central

    Wang, Chuan; Li, Yafeng; Gao, Shoucui; Cheng, Daxin; Zhao, Sihai; Liu, Enqi

    2015-01-01

    To evaluate the beneficial and adverse effects of breviscapine injection in combination with Western medicine on the treatment of patients with angina pectoris. The Cochrane Central Register of Controlled Trials, Medline, Science Citation Index, EMBASE, the China National Knowledge Infrastructure, the Wanfang Database, the Chongqing VIP Information Database and the China Biomedical Database were searched to identify randomized clinical trials (RCTs) that evaluated the effects of Western medicine compared to breviscapine injection plus Western medicine on angina pectoris patients. The included studies were analyzed using RevMan 5.1.0 software. The literature search yielded 460 studies, wherein 16 studies matched the selection criteria. The results showed that combined therapy using Breviscapine plus Western medicine was superior to Western medicine alone for improving angina pectoris symptoms (OR =3.77, 95% Cl: 2.76~5.15) and also resulted in increased electrocardiogram (ECG) improvement (OR=2.77, 95% Cl: 2.16~3.53). The current evidence suggests that Breviscapine plus Western medicine achieved a superior therapeutic effect compared to Western medicine alone. PMID:26052709

  18. Interplay of the production and picture superiority effects: a signal detection analysis.

    PubMed

    Fawcett, Jonathan M; Quinlan, Chelsea K; Taylor, Tracy L

    2012-01-01

    Three experiments explored the interaction between the production effect (greater memory for produced compared to non-produced study items) and the picture superiority effect (greater memory for pictures compared to words). Pictures and words were presented in a blocked (E1) or mixed (E2, E3) design, each accompanied by an instruction to silently name (non-produced condition) or quietly mouth (produced condition) the corresponding referent. Memory was then tested for all study items as well as an equal number of foil items using a speeded (E1, E2) or self-paced (E3) yes-no recognition task. Experiments 1, 2, and 3 all revealed a small but reliable production × stimulus interaction. Production was also found to result in a liberal shift in response bias that could result in the overestimation of the production effect when measured using hits instead of sensitivity. Together our findings suggest that the application of multiple distinctive processes at study produces an especially discriminative memory trace at test, more so than the summation of each process individually.

  19. Comparison of superior septal approach with left atriotomy in mitral valve surgery

    PubMed Central

    Aydin, Ebuzer; Arslan, Akin; Ozkokeli, Mehmet

    2014-01-01

    Objective In this study, we aimed to compare clinical outcomes of superior transseptal approach with the conventional left atriotomy in patients undergoing mitral valve surgery. Methods Between January 2010 and November 2012, a total of 91 consecutive adult patients (39 males, 52 females; mean age: 54.0±15.4 years; range, 16 to 82 years) who underwent mitral valve surgery in the Division of Cardiovascular Surgery at Koşuyolu Training Hospital were included. The patients were randomized to either superior transseptal approach (n=47) or conventional left atriotomy (n=44). Demographic characteristics of the patients, comorbidities, additional interventions, intraoperational data, pre- and postoperative electrophysiological study findings, and postoperative complications were recorded. Results Of all patients, 86.7% (n=79) were in New York Heart Association Class III, while 12 were in New York Heart Association Class IV. All patients underwent annuloplasty (42.9%) or valve replacement surgery (57.1%). There was no significant difference in pre- and postoperative electrocardiogram findings between the groups. Change from baseline in the cardiac rhythm was statistically significant in superior transseptal approach group alone (P<0.001). There was no statistically significant difference in mortality rate between the groups. Permanent pacemaker implantation was performed in 10.6% of the patients in superior transseptal approach group and 4.5% in the conventional left atriotomy group. No statistically significant difference in bleeding, total length of hospital and intensive care unit stay, the presence of low cardiac output syndrome was observed between the groups. Conclusion Our study results suggest that superior transseptal approach does not lead to serious or fatal adverse effects on sinus node function or atrial vulnerability, compared to conventional approach. PMID:25372911

  20. Magnetic guidance versus manual control: comparison of radiofrequency lesion dimensions and evaluation of the effect of heart wall motion in a myocardial phantom.

    PubMed

    Bhaskaran, Abhishek; Barry, M A Tony; Al Raisi, Sara I; Chik, William; Nguyen, Doan Trang; Pouliopoulos, Jim; Nalliah, Chrishan; Hendricks, Roger; Thomas, Stuart; McEwan, Alistair L; Kovoor, Pramesh; Thiagalingam, Aravinda

    2015-10-01

    Magnetic navigation system (MNS) ablation was suspected to be less effective and unstable in highly mobile cardiac regions compared to radiofrequency (RF) ablations with manual control (MC). The aim of the study was to compare the (1) lesion size and (2) stability of MNS versus MC during irrigated RF ablation with and without simulated mechanical heart wall motion. In a previously validated myocardial phantom, the performance of Navistar RMT Thermocool catheter (Biosense Webster, CA, USA) guided with MNS was compared to manually controlled Navistar irrigated Thermocool catheter (Biosense Webster, CA, USA). The lesion dimensions were compared with the catheter in inferior and superior orientation, with and without 6-mm simulated wall motion. All ablations were performed with 40 W power and 30 ml/ min irrigation for 60 s. A total of 60 ablations were performed. The mean lesion volumes with MNS and MC were 57.5 ± 7.1 and 58.1 ± 7.1 mm(3), respectively, in the inferior catheter orientation (n = 23, p = 0.6), 62.8 ± 9.9 and 64.6 ± 7.6 mm(3), respectively, in the superior catheter orientation (n = 16, p = 0.9). With 6-mm simulated wall motion, the mean lesion volumes with MNS and MC were 60.2 ± 2.7 and 42.8 ± 8.4 mm(3), respectively, in the inferior catheter orientation (n = 11, p = <0.01*), 74.1 ± 5.8 and 54.2 ± 3.7 mm(3), respectively, in the superior catheter orientation (n = 10, p = <0.01*). During 6-mm simulated wall motion, the MC catheter and MNS catheter moved 5.2 ± 0.1 and 0 mm, respectively, in inferior orientation and 5.5 ± 0.1 and 0 mm, respectively, in the superior orientation on the ablation surface. The lesion dimensions were larger with MNS compared to MC in the presence of simulated wall motion, consistent with greater catheter stability. However, similar lesion dimensions were observed in the stationary model.

  1. Gray matter increases in fronto-parietal regions of depression patients with aripiprazole monotherapy

    PubMed Central

    Lai, Chien-Han; Wu, Yu-Te; Chen, Cheng-Yu; Hou, Yi-Cheng

    2016-01-01

    Abstract We investigated the treatment effects of aripiprazole monotherapy in first-episode medication-naïve patients with major depressive disorder (MDD). The accompanying changes in the gray matter volume (GMV) were also explored. Fifteen patients completed the trial and received structural scans by 3-Tesla magnetic resonance imaging at baseline and partially responding state (sixth week). To account for the test–retest bias, 27 healthy controls were scanned twice within 6 weeks. We utilized optimized voxel-based morphometry with different comparisons between groups. The partially responding patients with MDD had greater GMV in left middle frontal gyrus and left superior parietal gyrus when compared with baseline. However, they had decreases in the GMV of right orbitofrontal gyrus and right inferior temporal gyrus after response. The partially responding patients with MDD still had residual GMV deficits in right superior frontal gyrus when compared with controls. However, the lack of second patient group without aripiprazole intervention would be a significant limitation to interpret the aripiprazole-specific effects on GMV. The changes in the GMV of fronto-parieto-temporal regions and residual GMV deficits in the superior frontal gyrus might represent “state-dependent brain changes” and “residual-deficit brain regions,” respectively, for aripiprzole monotherapy in MDD. PMID:27559967

  2. Visual processing in adolescents with autism spectrum disorder: evidence from embedded figures and configural superiority tests.

    PubMed

    Dillen, Claudia; Steyaert, Jean; Op de Beeck, Hans P; Boets, Bart

    2015-05-01

    The embedded figures test has often been used to reveal weak central coherence in individuals with autism spectrum disorder (ASD). Here, we administered a more standardized automated version of the embedded figures test in combination with the configural superiority task, to investigate the effect of contextual modulation on local feature detection in 23 adolescents with ASD and 26 matched typically developing controls. On both tasks both groups performed largely similarly in terms of accuracy and reaction time, and both displayed the contextual modulation effect. This indicates that individuals with ASD are equally sensitive compared to typically developing individuals to the contextual effects of the task and that there is no evidence for a local processing bias in adolescents with ASD.

  3. The Superior Anti-caries Efficacy of Fluoride Toothpaste Containing 1.5% Arginine.

    PubMed

    Cummins, D

    2016-06-01

    Innovation in the dental caries area and the development of new superior efficacy treatments to prevent dental caries are as important today as they have ever been, because caries remains a highly prevalent disease globally. Appropriately designed and well-conducted, randomized clinical trials (RCTs) are best-in-class evidence of the effectiveness of a new intervention in medicine and dentistry, and traditional two- to threeyear caries clinical trials are currently the gold standard for proof of superior caries prevention efficacy. Based upon a detailed understanding of plaque metabolism and the importance of pH rise factors in the prevention of caries, a novel toothpaste containing 1.5% arginine, an insoluble calcium compound, and fluoride has been developed, and its superior efficacy compared to toothpaste with fluoride alone has been validated in an unprecedented series of ten RCTs. The results of these RCTs are summarized, and some of the details of the procedures used in the studies are clarified in order to provide an opportunity for objective assessment of their quality. In addition, the results of studies which explored the mechanism of action of this toothpaste are summarized. The arginine-containing fluoride toothpaste offers its users the opportunity to supplement mechanical plaque control with a new technology that helps maintain the natural oral flora in a state that is compatible with health, so as to retain the beneficial effects of the natural flora while significantly reducing the risk of dental caries compared to conventional fluoride toothpaste. Copyright© by the YES Group, Inc.

  4. The influence of working memory on the anger superiority effect.

    PubMed

    Moriya, Jun; Koster, Ernst H W; De Raedt, Rudi

    2014-01-01

    The anger superiority effect shows that an angry face is detected more efficiently than a happy face. However, it is still controversial whether attentional allocation to angry faces is a bottom-up process or not. We investigated whether the anger superiority effect is influenced by top-down control, especially working memory (WM). Participants remembered a colour and then searched for differently coloured facial expressions. Just holding the colour information in WM did not modulate the anger superiority effect. However, when increasing the probabilities of trials in which the colour of a target face matched the colour held in WM, participants were inclined to direct attention to the target face regardless of the facial expression. Moreover, the knowledge of high probability of valid trials eliminated the anger superiority effect. These results suggest that the anger superiority effect is modulated by top-down effects of WM, the probability of events and expectancy about these probabilities.

  5. Advanced Propulsion Power Distribution System for Next Generation Electric/Hybrid Vehicle. Phase 1; Preliminary System Studies

    NASA Technical Reports Server (NTRS)

    Bose, Bimal K.; Kim, Min-Huei

    1995-01-01

    The report essentially summarizes the work performed in order to satisfy the above project objective. In the beginning, different energy storage devices, such as battery, flywheel and ultra capacitor are reviewed and compared, establishing the superiority of the battery. Then, the possible power sources, such as IC engine, diesel engine, gas turbine and fuel cell are reviewed and compared, and the superiority of IC engine has been established. Different types of machines for drive motor/engine generator, such as induction machine, PM synchronous machine and switched reluctance machine are compared, and the induction machine is established as the superior candidate. Similar discussion was made for power converters and devices. The Insulated Gate Bipolar Transistor (IGBT) appears to be the most superior device although Mercury Cadmium Telluride (MCT) shows future promise. Different types of candidate distribution systems with the possible combinations of power and energy sources have been discussed and the most viable system consisting of battery, IC engine and induction machine has been identified. Then, HFAC system has been compared with the DC system establishing the superiority of the former. The detailed component sizing calculations of HFAC and DC systems reinforce the superiority of the former. A preliminary control strategy has been developed for the candidate HFAC system. Finally, modeling and simulation study have been made to validate the system performance. The study in the report demonstrates the superiority of HFAC distribution system for next generation electric/hybrid vehicle.

  6. Antileishmanial activity of essential oil from Chenopodium ambrosioides and its main components against experimental cutaneous leishmaniasis in BALB/c mice.

    PubMed

    Monzote, L; Pastor, J; Scull, R; Gille, L

    2014-01-01

    Chenopodium ambrosioides have been used during centuries by native people to treat parasitic diseases. To compare the in vivo anti-leishmanial activity of the essential oil (EO) from C. ambrosioides and its major components (ascaridole, carvacrol and caryophyllene oxide). Anti-leishmanial effect was evaluated in BALB/c mice infected with Leishmania amazonensis and treated with the EO, main compounds and artificial mix of pure components by intralesional route at 30 mg/kg every 4 days during 14 days. Diseases progression and parasite burden in infected tissues were determined. EO prevented lesion development compared (p<0.05) with untreated animals and treated with vehicle. In addition, the efficacy of EO was also statistically superior (p<0.05) compared with the glucantime-treated animals. No potential effects were observed with pure components treatment. Mix of pure compounds cause death of animals after 3 days of treatment. Our results demonstrate the superiority of EO against experimental cutaneous leishmaniasis caused by L. amazonensis. Copyright © 2014 Elsevier GmbH. All rights reserved.

  7. More on the Effects of Early Manual Communication on the Cognitive Development of Deaf Children.

    ERIC Educational Resources Information Center

    Zwiebel, Abraham

    1987-01-01

    A study compared intelligence scores of three groups of Israeli deaf children--23 with deaf parents/deaf siblings and manual communication (DpDs), 76 with hearing parents/deaf siblings, and 144 with hearing parents and siblings. The DpDs children were superior to other deaf children and comparable to hearing children on most intelligence measures.…

  8. [Comparative study between film mammography and xeromammography; including specimen radiography].

    PubMed

    Maeda, M; Hayakawa, K; Okuno, Y; Torizuka, T; Mitsumori, M; Soga, T; Misaki, T; Dokou, S; Ito, K

    1990-10-01

    We retrospectively evaluated preoperative film- and xeromammography of 23 cases with breast cancers, and compared with postoperative specimen radiography to assess tumor delineation and microcalcification detectability. In tumor detection and margin delineation, film mammography was superior to xeromammography, and in microcalcification, film mammography was equal to xeromammography. These results had a effect on the diagnosis of breast cancers.

  9. A randomized controlled trial of brief interventions for body dissatisfaction.

    PubMed

    Wade, Tracey; George, Wing Man; Atkinson, Melissa

    2009-10-01

    The authors examined the relative effectiveness of 3 different approaches to the experience of body dissatisfaction compared to a control and ruminative attention control condition, with respect to increasing weight and appearance satisfaction. One hundred female undergraduates (mean age = 24.38, SD = 9.39) underwent a body dissatisfaction induction procedure, which significantly decreased levels of weight and appearance satisfaction. Participants were then randomized, 20 to each of 5 groups: control, ruminative attention control, acceptance, distraction, and cognitive dissonance. With the exception of the control group, participants were briefly trained in their assigned technique and were asked to practice this over the next 5 min while repeated measures of weight and appearance satisfaction were recorded. Acceptance, cognitive dissonance, and distraction were superior to both control conditions in increasing weight satisfaction and were superior to a control condition in improving appearance satisfaction. Only acceptance was superior in improving appearance satisfaction compared to a ruminative attention control. The evidence suggests that acceptance is a promising approach to investigate further with respect to its efficacy for reducing body dissatisfaction. (c) 2009 APA, all rights reserved.

  10. A biomechanical cadaveric study comparing superior capsule reconstruction using fascia lata allograft with human dermal allograft for irreparable rotator cuff tear.

    PubMed

    Mihata, Teruhisa; Bui, Christopher N H; Akeda, Masaki; Cavagnaro, Matthew A; Kuenzler, Michael; Peterson, Alexander B; McGarry, Michelle H; Itami, Yasuo; Limpisvasti, Orr; Neo, Masashi; Lee, Thay Q

    2017-12-01

    Biomechanical and clinical success of the superior capsule reconstruction (SCR) using fascia lata (FL) grafts has been reported. In the United States, human dermal (HD) allograft has been used successfully for SCRs; however, the biomechanical characteristics have not been reported. Eight cadaveric shoulders were tested in 5 conditions: (1) intact; (2) irreparable supraspinatus tear; (3) SCR using FL allograft with anterior and posterior suturing; (4) SCR using HD allograft with anterior and posterior suturing; and (5) SCR using HD allograft with posterior suturing. Rotational range of motion, superior translation, glenohumeral joint force, and subacromial contact were measured at 0°, 30°, and 60° of glenohumeral abduction in the scapular plane. Graft dimensions before and after testing were also recorded. Biomechanical parameters were compared using a repeated-measures analysis of variance with Tukey post hoc test, and graft dimensions were compared using a Student t-test (P < .05). Irreparable supraspinatus tear significantly increased superior translation, superior glenohumeral joint force, and subacromial contact pressure, which were completely restored with the SCR FL allografts. Both SCR HD allograft repairs partially restored superior translation and completely restored subacromial contact and superior glenohumeral joint force. The HD allografts significantly elongated by 15% during testing, whereas the FL allograft lengths were unchanged. Single-layered HD SCR allografts partially restored superior glenohumeral stability, whereas FL allograft SCR completely restored the superior glenohumeral stability. This may be due to the greater flexibility of the HD allograft, and the SCR procedure used was developed on the basis of FL grafts. Published by Elsevier Inc.

  11. Design of clinical trials of antidepressants: should a placebo control arm be included?

    PubMed

    Fritze, J; Möller, H J

    2001-01-01

    There is no doubt that available antidepressants are efficacious and effective. Nevertheless, more effective drugs with improved tolerability are needed. With this need in mind, some protagonists claim that future antidepressants should be proved superior to, or at least as effective as, established antidepressants, making placebo control methodologically dispensable in clinical trials. Moreover, the use of placebo control is criticised as unethical because it might result in effective treatment being withheld. There are, however, a number of methodological reasons why placebo control is indispensable for the proof of efficacy of antidepressants. Comparing investigational antidepressants only with standard antidepressants and not placebo yields ambiguous results that are difficult to interpret, be it in superiority or equivalence testing, and this method of assessment requires larger sample sizes than those required with the use of placebo control. Experimental methodology not adhering to the optimal study design is ethically questionable. Restricting the testing of investigational antidepressants only to superiority over standard antidepressants is an obstacle to therapeutic progress in terms of tolerability and the detection of innovative mechanisms of action from which certain subgroups of future patients might benefit. The use of a methodology that requires larger samples for testing of superiority or equivalence is also ethically questionable. In view of the high placebo response rates in trials of antidepressants, placebo treatment does not mean withholding effective treatment. Accepting the necessity of the clinical evaluation of new, potentially ineffective antidepressants implicitly means accepting placebo control as ethically justified. Three- or multi-arm comparisons including placebo and an active reference represent the optimal study design.

  12. Physical activity limits the effects of age and Alzheimer's disease on postural control.

    PubMed

    Debove, Lola; Bru, Noelle; Couderc, Martine; Noé, Frederic; Paillard, Thierry

    2017-09-01

    The aim was to study the possible influence of physical activity on the postural performance of subjects with Alzheimer's disease (AD). The postural performance (i.e. surface area of the center of foot pressure displacement) of 3 groups was compared: Alzheimer active group (AA), Alzheimer non-active group (ANA) and healthy non-active group (HNA). The AA group's postural performance was superior to that of the ANA and HNA groups. AD disturbed postural performance but participation in regular physical activity made it possible to limit the disturbing effects of AD to a surprising extent, since the postural performance of active AD subjects was also superior to that of healthy subjects. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  13. Differential change in integrative psychotherapy: a re-analysis of a change-factor based RCT in a naturalistic setting.

    PubMed

    Holtforth, Martin Grosse; Wilm, Katharina; Beyermann, Stefanie; Rhode, Annemarie; Trost, Stephanie; Steyer, Rolf

    2011-11-01

    General Psychotherapy (GPT; Grawe, 1997) is a research-informed psychotherapy that combines cognitive-behavioral and process-experiential techniques and that assumes motivational clarification and problem mastery as central mechanisms of change. To isolate the effect of motivational clarification, GPT was compared to a treatment that proscribed motivational clarification (General Psychotherapy Minus Clarification, GPT-C) in a randomized-controlled trial with 67 diagnostically heterogeneous outpatients. Previous analyses demonstrated equal outcomes and some superiority for highly avoidant patients in GPT. Re-analyses using causal-analytic methods confirmed equal changes, but also showed superior effects for GPT in highly symptomatic patients. Results are discussed regarding theory, methodological limitations, and implications for research and practice.

  14. A comparison of visual and kinesthetic-tactual displays for compensatory tracking

    NASA Technical Reports Server (NTRS)

    Jagacinski, R. J.; Flach, J. M.; Gilson, R. D.

    1983-01-01

    Recent research on manual tracking with a kinesthetic-tactual (KT) display suggests that under certain conditions it can be an effective alternative or supplement to visual displays. In order to understand better how KT tracking compares with visual tracking, both a critical tracking and stationary single-axis tracking tasks were conducted with and without velocity quickening. In the critical tracking task, the visual displays were superior, however, the quickened KT display was approximately equal to the unquickened visual display. In stationary tracking tasks, subjects adopted lag equalization with the quickened KT and visual displays, and mean-squared error scores were approximately equal. With the unquickened displays, subjects adopted lag-lead equalization, and the visual displays were superior. This superiority was partly due to the servomotor lag in the implementation of the KT display and partly due to modality differences.

  15. Evolution of Endovascular Therapy in Acute Stroke: Implications of Device Development

    PubMed Central

    Balasubramaian, Adithya; Mitchell, Peter; Dowling, Richard

    2015-01-01

    Intravenous thrombolysis is an effective treatment for acute ischaemic stroke. However, vascular recanalization rates remain poor especially in the setting of large artery occlusion. On the other hand, endovascular intra-arterial therapy addresses this issue with superior recanalization rates compared with intravenous thrombolysis. Although previous randomized controlled studies of intra-arterial therapy failed to demonstrate superiority, the failings may be attributed to a combination of inferior intra-arterial devices and suboptimal selection criteria. The recent results of several randomized controlled trials have demonstrated significantly improved outcomes, underpinning the advantage of newer intra-arterial devices and superior recanalization rates, leading to renewed interest in establishing intra-arterial therapy as the gold standard for acute ischaemic stroke. The aim of this review is to outline the history and development of different intra-arterial devices and future directions in research. PMID:26060800

  16. Radiofrequency and Microwave Ablation Compared to Systemic Chemotherapy and to Partial Hepatectomy in the Treatment of Colorectal Liver Metastases: A Systematic Review and Meta-Analysis.

    PubMed

    Meijerink, Martijn R; Puijk, Robbert S; van Tilborg, Aukje A J M; Henningsen, Kirsten Holdt; Fernandez, Llenalia Garcia; Neyt, Mattias; Heymans, Juanita; Frankema, Jacqueline S; de Jong, Koert P; Richel, Dick J; Prevoo, Warner; Vlayen, Joan

    2018-04-17

    To assess safety and outcome of radiofrequency ablation (RFA) and microwave ablation (MWA) as compared to systemic chemotherapy and partial hepatectomy (PH) in the treatment of colorectal liver metastases (CRLM). MEDLINE, Embase and the Cochrane Library were searched. Randomized trials and comparative observational studies with multivariate analysis and/or matching were included. Guidelines from National Guideline Clearinghouse and Guidelines International Network were assessed using the AGREE II instrument. The search revealed 3530 records; 328 were selected for full-text review; 48 were included: 8 systematic reviews, 2 randomized studies, 26 comparative observational studies, 2 guideline-articles and 10 case series; in addition 13 guidelines were evaluated. Literature to assess the effectiveness of ablation was limited. RFA + systemic chemotherapy was superior to chemotherapy alone. PH was superior to RFA alone but not to RFA + PH or to MWA. Compared to PH, RFA showed fewer complications, MWA did not. Outcomes were subject to residual confounding since ablation was only employed for unresectable disease. The results from the EORTC-CLOCC trial, the comparable survival for ablation + PH versus PH alone, the potential to induce long-term disease control and the low complication rate argue in favour of ablation over chemotherapy alone. Further randomized comparisons of ablation to current-day chemotherapy alone should therefore be considered unethical. Hence, the highest achievable level of evidence for unresectable CRLM seems reached. The apparent selection bias from previous studies and the superior safety profile mandate the setup of randomized controlled trials comparing ablation to surgery.

  17. Pictorial Superiority Effect

    ERIC Educational Resources Information Center

    Nelson, Douglas L.; And Others

    1976-01-01

    Pictures generally show superior recognition relative to their verbal labels. This experiment was designed to link this pictorial superiority effect to sensory or meaning codes associated with the two types of symbols. (Editor)

  18. Optimized survey design for electrical resistivity tomography: combined optimization of measurement configuration and electrode placement

    NASA Astrophysics Data System (ADS)

    Uhlemann, Sebastian; Wilkinson, Paul B.; Maurer, Hansruedi; Wagner, Florian M.; Johnson, Timothy C.; Chambers, Jonathan E.

    2018-07-01

    Within geoelectrical imaging, the choice of measurement configurations and electrode locations is known to control the image resolution. Previous work has shown that optimized survey designs can provide a model resolution that is superior to standard survey designs. This paper demonstrates a methodology to optimize resolution within a target area, while limiting the number of required electrodes, thereby selecting optimal electrode locations. This is achieved by extending previous work on the `Compare-R' algorithm, which by calculating updates to the resolution matrix optimizes the model resolution in a target area. Here, an additional weighting factor is introduced that allows to preferentially adding measurement configurations that can be acquired on a given set of electrodes. The performance of the optimization is tested on two synthetic examples and verified with a laboratory study. The effect of the weighting factor is investigated using an acquisition layout comprising a single line of electrodes. The results show that an increasing weight decreases the area of improved resolution, but leads to a smaller number of electrode positions. Imaging results superior to a standard survey design were achieved using 56 per cent fewer electrodes. The performance was also tested on a 3-D acquisition grid, where superior resolution within a target at the base of an embankment was achieved using 22 per cent fewer electrodes than a comparable standard survey. The effect of the underlying resistivity distribution on the performance of the optimization was investigated and it was shown that even strong resistivity contrasts only have minor impact. The synthetic results were verified in a laboratory tank experiment, where notable image improvements were achieved. This work shows that optimized surveys can be designed that have a resolution superior to standard survey designs, while requiring significantly fewer electrodes. This methodology thereby provides a means for improving the efficiency of geoelectrical imaging.

  19. Optimized survey design for Electrical Resistivity Tomography: combined optimization of measurement configuration and electrode placement

    NASA Astrophysics Data System (ADS)

    Uhlemann, Sebastian; Wilkinson, Paul B.; Maurer, Hansruedi; Wagner, Florian M.; Johnson, Timothy C.; Chambers, Jonathan E.

    2018-03-01

    Within geoelectrical imaging, the choice of measurement configurations and electrode locations is known to control the image resolution. Previous work has shown that optimized survey designs can provide a model resolution that is superior to standard survey designs. This paper demonstrates a methodology to optimize resolution within a target area, while limiting the number of required electrodes, thereby selecting optimal electrode locations. This is achieved by extending previous work on the `Compare-R' algorithm, which by calculating updates to the resolution matrix optimizes the model resolution in a target area. Here, an additional weighting factor is introduced that allows to preferentially adding measurement configurations that can be acquired on a given set of electrodes. The performance of the optimization is tested on two synthetic examples and verified with a laboratory study. The effect of the weighting factor is investigated using an acquisition layout comprising a single line of electrodes. The results show that an increasing weight decreases the area of improved resolution, but leads to a smaller number of electrode positions. Imaging results superior to a standard survey design were achieved using 56 per cent fewer electrodes. The performance was also tested on a 3D acquisition grid, where superior resolution within a target at the base of an embankment was achieved using 22 per cent fewer electrodes than a comparable standard survey. The effect of the underlying resistivity distribution on the performance of the optimization was investigated and it was shown that even strong resistivity contrasts only have minor impact. The synthetic results were verified in a laboratory tank experiment, where notable image improvements were achieved. This work shows that optimized surveys can be designed that have a resolution superior to standard survey designs, while requiring significantly fewer electrodes. This methodology thereby provides a means for improving the efficiency of geoelectrical imaging.

  20. The Sport Expert's Attention Superiority on Skill-related Scene Dynamic by the Activation of left Medial Frontal Gyrus: An ERP and LORETA Study.

    PubMed

    He, Mengyang; Qi, Changzhu; Lu, Yang; Song, Amanda; Hayat, Saba Z; Xu, Xia

    2018-05-21

    Extensive studies have shown that a sports expert is superior to a sports novice in visually perceptual-cognitive processes of sports scene information, however the attentional and neural basis of it has not been thoroughly explored. The present study examined whether a sport expert has the attentional superiority on scene information relevant to his/her sport skill, and explored what factor drives this superiority. To address this problem, EEGs were recorded as participants passively viewed sport scenes (tennis vs. non-tennis) and negative emotional faces in the context of a visual attention task, where the pictures of sport scenes or of negative emotional faces randomly followed the pictures with overlapping sport scenes and negative emotional faces. ERP results showed that for experts, the evoked potential of attentional competition elicited by the overlap of tennis scene was significantly larger than that evoked by the overlap of non-tennis scene, while this effect was absent for novices. The LORETA showed that the experts' left medial frontal gyrus (MFG) cortex was significantly more active as compared to the right MFG when processing the overlap of tennis scene, but the lateralization effect was not significant in novices. Those results indicate that experts have attentional superiority on skill-related scene information, despite intruding the scene through negative emotional faces that are prone to cause negativity bias toward their visual field as a strong distractor. This superiority is actuated by the activation of left MFG cortex and probably due to self-reference. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Peripheral Defocus and Myopia Progression in Myopic Children Randomly Assigned to Wear Single Vision and Progressive Addition Lenses

    PubMed Central

    Berntsen, David A.; Barr, Christopher D.; Mutti, Donald O.; Zadnik, Karla

    2013-01-01

    Purpose. To determine the effect of progressive addition lenses (PALs) and single vision lenses (SVLs) on peripheral defocus in myopic children, and to compare the effect of myopic versus hyperopic peripheral defocus on foveal myopia progression. Methods. Eighty-four myopic children aged 6 to 11 years with spherical equivalent (SE) cycloplegic autorefraction between −0.75 diopters (D) and −4.50 D were randomly assigned to wear SVLs or PALs. Aberrometry measurements of the eye and spectacles were made centrally, 30° nasally, temporally, and superiorly, and 20° inferiorly on the retina using a Complete Ophthalmic Analysis System for Vision Research (COAS-VR). The association between peripheral defocus and the 1-year change in central myopia was investigated. Results. SVLs caused a hyperopic shift in peripheral defocus at all locations (all P ≤ 0.0003). PALs caused a myopic shift in peripheral defocus in three of four locations measured (all P ≤ 0.01) with the greatest shift superiorly due to the PAL addition (−1.04 ± 0.30 D). Superior retinal defocus when wearing either SVLs or PALs was associated with the 1-year change in central myopia. The adjusted 1-year change in central SE myopia was −0.38 D for children with absolute superior myopic defocus (n = 67) and −0.65 D for children with absolute superior hyperopic defocus (n = 17; difference = 0.27 D; P = 0.002). Conclusions. PALs caused a myopic shift in peripheral defocus. Superior myopic defocus was associated with less central myopia progression. These data support the continued investigation of optical designs that result in peripheral myopic defocus as a potential way to slow myopia progression. (ClinicalTrials.gov number, NCT00335049.) PMID:23838771

  2. Semantic Encoding Enhances the Pictorial Superiority Effect in the Oldest-Old

    PubMed Central

    Cherry, Katie E.; Brown, Jennifer Silva; Walker, Erin Jackson; Smitherman, Emily A.; Boudreaux, Emily O.; Volaufova, Julia; Jazwinski, S. Michal

    2011-01-01

    We examined the effect of a semantic orienting task during encoding on free recall and recognition of simple line drawings and matching words in middle-aged (44 to 59 years), older (60 to 89 years), and oldest-old (90 + years) adults. Participants studied line drawings and matching words presented in blocked order. Half of the participants were given a semantic orienting task and the other half received standard intentional learning instructions. Results confirmed that the pictorial superiority effect was greater in magnitude following semantic encoding compared to the control condition. Analyses of clustering in free recall revealed that oldest-old adults’ encoding and retrieval strategies were generally similar to the two younger groups. Self-reported strategy use was less frequent among the oldest-old adults. These data strongly suggest that semantic elaboration is an effective compensatory mechanism underlying preserved episodic memory performance that persists well into the ninth decade of life. PMID:22053814

  3. Rating leniency and halo in multisource feedback ratings: testing cultural assumptions of power distance and individualism-collectivism.

    PubMed

    Ng, Kok-Yee; Koh, Christine; Ang, Soon; Kennedy, Jeffrey C; Chan, Kim-Yin

    2011-09-01

    This study extends multisource feedback research by assessing the effects of rater source and raters' cultural value orientations on rating bias (leniency and halo). Using a motivational perspective of performance appraisal, the authors posit that subordinate raters followed by peers will exhibit more rating bias than superiors. More important, given that multisource feedback systems were premised on low power distance and individualistic cultural assumptions, the authors expect raters' power distance and individualism-collectivism orientations to moderate the effects of rater source on rating bias. Hierarchical linear modeling on data collected from 1,447 superiors, peers, and subordinates who provided developmental feedback to 172 military officers show that (a) subordinates exhibit the most rating leniency, followed by peers and superiors; (b) subordinates demonstrate more halo than superiors and peers, whereas superiors and peers do not differ; (c) the effects of power distance on leniency and halo are strongest for subordinates than for peers and superiors; (d) the effects of collectivism on leniency were stronger for subordinates and peers than for superiors; effects on halo were stronger for subordinates than superiors, but these effects did not differ for subordinates and peers. The present findings highlight the role of raters' cultural values in multisource feedback ratings. PsycINFO Database Record (c) 2011 APA, all rights reserved

  4. Experimental Comparison of Inquiry and Direct Instruction in Science

    ERIC Educational Resources Information Center

    Cobern, William; Schuster, David; Adams, Betty

    2010-01-01

    It is evident that "experientially-based" instruction and "active student engagement" are advantageous for effective science learning. However, "hands-on" and "minds-on" aspects can occur in both inquiry and direct science instruction, and convincing comparative evidence for the superiority of either mode…

  5. Interruption as a test of the user-computer interface

    NASA Technical Reports Server (NTRS)

    Kreifeldt, J. G.; Mccarthy, M. E.

    1981-01-01

    In order to study the effects different logic systems might have on interrupted operation, an algebraic calculator and a reverse polish notation calculator were compared when trained users were interrupted during problem entry. The RPN calculator showed markedly superior resistance to interruption effects compared to the AN calculator although no significant differences were found when the users were not interrupted. Causes and possible remedies for interruption effects are speculated. It is proposed that because interruption is such a common occurrence, it be incorporated into comparative evaluation tests of different logic system and control/display system and that interruption resistance be adopted as a specific design criteria for such design.

  6. Picture superiority in free recall: the effects of normal aging and primary degenerative dementia.

    PubMed

    Rissenberg, M; Glanzer, M

    1986-01-01

    A key factor in the decline of memory with age may be a breakdown of communication in the information network involved in memory and cognitive processing. A special case of this communication is assumed to underlie the picture superiority effect in recall. From this hypothesis it follows that the picture superiority effect should lessen with age. In Experiment 1, three groups of adults (young, old normal, and old memory-impaired) were tested in free recall of pictures and word lists. As predicted, the picture superiority effect declined with age. Experiment 2 replicated these findings and showed, moreover, that the picture superiority effect can be reestablished in normal old adults by instructing them to verbalize overtly during item presentation.

  7. Biochemical changes in grape rootstocks resulted from humic acid treatments in relation to nematode infection.

    PubMed

    Kesba, Hosny H; El-Beltagi, Hossam S

    2012-04-01

    To investigate the effect of humic acid on nematode infected, resistant and susceptible grapes in relation to lipid peroxidation and antioxidant mechanisms on selected biochemical parameters known as proactive substances. The grape rootstocks, superior, superior/freedom and freedom were reacted differently to Meloidogyne incognita and Rotylenchulus reniformis according to rootstock progenitor. Two weeks after inoculation, two commercial products of humic acid were applied at the rate of (2, 4 mL or grams/plant) as soil drench. After 4 months, nematode soil populations were extracted and counted. A subsample of roots from each plant was stained and gall numbers, embedded stages per root were calculated, final population, nematode build up (Pf/Pi), average of eggs/eggmass were estimated. Subsamples of fresh root of each treatment were chemically analyzed. Freedom reduced significantly the nematode criteria and build up. Humic acid granules appeared to be more suppressive to nematode build up on superior and the higher dose on superior/freedom than liquid treatments. On freedom, all treatments reduced significantly the nematode build up regardless to the material nature. The higher dose was more effective than the lower one. As a result of humic acid applications, the malondialdehyde (MDA) and H2O2 contents were significantly reduced after humic acid treatments while the antioxidant compounds glutathione (GSH), ascorbic acid (ASA) and total phenol contents were significantly increased when compared with check. Antioxidant defense enzymes ascorbate peroxidase (APX), superoxide dismutase (SOD), catalase (CAT) and polyphenol oxidase (PPO)showed significant increase in their specific activities in treated plants compared with nematode treated check. Humic acid treatments improve the yield of grape by increasing the contents of antioxidant compounds and the specific activities of antioxidant enzymes.

  8. Biochemical changes in grape rootstocks resulted from humic acid treatments in relation to nematode infection

    PubMed Central

    Kesba, Hosny H; El-Beltagi, Hossam S

    2012-01-01

    Objective To investigate the effect of humic acid on nematode infected, resistant and susceptible grapes in relation to lipid peroxidation and antioxidant mechanisms on selected biochemical parameters known as proactive substances. Methods The grape rootstocks, superior, superior/freedom and freedom were reacted differently to Meloidogyne incognita and Rotylenchulus reniformis according to rootstock progenitor. Two weeks after inoculation, two commercial products of humic acid were applied at the rate of (2, 4 mL or grams/plant) as soil drench. After 4 months, nematode soil populations were extracted and counted. A subsample of roots from each plant was stained and gall numbers, embedded stages per root were calculated, final population, nematode build up (Pf/Pi), average of eggs/eggmass were estimated. Subsamples of fresh root of each treatment were chemically analyzed. Results Freedom reduced significantly the nematode criteria and build up. Humic acid granules appeared to be more suppressive to nematode build up on superior and the higher dose on superior/freedom than liquid treatments. On freedom, all treatments reduced significantly the nematode build up regardless to the material nature. The higher dose was more effective than the lower one. As a result of humic acid applications, the malondialdehyde (MDA) and H2O2 contents were significantly reduced after humic acid treatments while the antioxidant compounds glutathione (GSH), ascorbic acid (ASA) and total phenol contents were significantly increased when compared with check. Antioxidant defense enzymes ascorbate peroxidase (APX), superoxide dismutase (SOD), catalase (CAT) and polyphenol oxidase (PPO)showed significant increase in their specific activities in treated plants compared with nematode treated check. Conclusions Humic acid treatments improve the yield of grape by increasing the contents of antioxidant compounds and the specific activities of antioxidant enzymes. PMID:23569915

  9. Visual search for emotional expressions: Effect of stimulus set on anger and happiness superiority.

    PubMed

    Savage, Ruth A; Becker, Stefanie I; Lipp, Ottmar V

    2016-01-01

    Prior reports of preferential detection of emotional expressions in visual search have yielded inconsistent results, even for face stimuli that avoid obvious expression-related perceptual confounds. The current study investigated inconsistent reports of anger and happiness superiority effects using face stimuli drawn from the same database. Experiment 1 excluded procedural differences as a potential factor, replicating a happiness superiority effect in a procedure that previously yielded an anger superiority effect. Experiments 2a and 2b confirmed that image colour or poser gender did not account for prior inconsistent findings. Experiments 3a and 3b identified stimulus set as the critical variable, revealing happiness or anger superiority effects for two partially overlapping sets of face stimuli. The current results highlight the critical role of stimulus selection for the observation of happiness or anger superiority effects in visual search even for face stimuli that avoid obvious expression related perceptual confounds and are drawn from a single database.

  10. Anti-inflammatory and pro-angiogenic effects of beta blockers in a canine model of chronic ischemic cardiomyopathy: comparison between carvedilol and metoprolol

    PubMed Central

    Le, D. Elizabeth; Pascotto, Marco; Leong-Poi, Howard; Sari, Ibrahim; Micari, Antonio; Kaul, Sanjiv

    2013-01-01

    There is controversy regarding the superiority of carvedilol (C) over metoprolol (M) in congestive heart failure. We hypothesized that C is superior to M in chronic ischemic cardiomyopathy because of its better anti-inflammatory and pro-angiogenic effects. In order to test our hypothesis we used a chronic canine model of multivessel ischemic cardiomyopathy where myocardial microcatheters were placed from which interstitial fluid was collected over time to measure leukocyte count and cytokine levels. After development of left ventricular dysfunction, the animals were randomized into four groups: sham (n = 7), placebo (n = 8), M (n = 11), and C (n = 10), and followed for 3 months after treatment initiation. Tissue was examined for immunohistochemistry, oxidative stress, and capillary density. At 3 months both rest and stress wall thickening were better in C compared to the other groups. At the end of 3 months of treatment endsystolic wall stress also decreased the most in C. Similarly resting myocardial blood flow (MBF) improved the most in C as did the stress endocardial/epicardial MBF. Myocardial interstitial fluid showed greater attenuation of leukocytosis with C compared to M, which was associated with less fibrosis and oxidative stress. C also had higher IL-10 level and capillary density. In conclusion, in a chronic canine model of multivessel ischemic cardiomyopathy we found 3 months of C treatment resulted in better resting global and regional function as well as better regional function at stress compared to M. These changes were associated with higher myocardial levels of the anti-inflammatory cytokine IL-10 and less myocardial oxidative stress, leukocytosis, and fibrosis. Capillary density and MBF were almost normalized. Thus in the doses used in this study, C appears to be superior to M in a chronic canine model of ischemic cardiomyopathy from beneficial effects on inflammation and angiogenesis. Further studies are required for comparing additional doses of these drugs. PMID:24072434

  11. Comparative Effectiveness of Hierarchical, Flowchart and Spider Concept Mapping Strategies on Students' Performance in Chemistry

    ERIC Educational Resources Information Center

    Bamidele, E. F.; Oloyede, E. O.

    2013-01-01

    This study investigated the relative effectiveness of three types of concept maps (hierarchy, flowchart and spider) on the performance of students in Chemistry. This is with a view to find out which of the concept mapping types is more superior in enhancing students' performance in the numerical aspect of Chemistry. The pre-test, post-test…

  12. Transjugular intrahepatic portosystemic shunt creation for cirrhotic portal hypertension is well tolerated among patients with portal vein thrombosis.

    PubMed

    Merola, Jonathan; Fortune, Brett E; Deng, Yanhong; Ciarleglio, Maria; Amirbekian, Smbat; Chaudhary, Noami; Shanbhogue, Alampady; Ayyagari, Rajasekhara; Rodriguez-Davalos, Manuel I; Teperman, Lewis; Charles, Hearns W; Sigal, Samuel H

    2018-06-01

    Portal vein thrombosis (PVT) develops in cirrhotic patients because of stagnation of blood flow. Transjugular intrahepatic portosystemic shunt (TIPS) creates a low-resistance conduit that restores portal venous patency and blood flow. The effect of PVT on transplant-free survival in cirrhotic patients undergoing TIPS creation was evaluated. A multicenter, retrospective cohort study of patients who underwent TIPS creation for cirrhotic portal hypertension was carried out. A Cox model with propensity score adjustment was developed to evaluate the effect of PVT on 90-day and 3-year transplant-free survival. A subgroup analysis examining mortality of those with superior and inferior PVT was also carried out. A total of 252 consecutive TIPS creations were assessed, including 65 in patients with PVT. Survival of patients with high Model for End-stage Liver Disease scores (≥18) and PVT was not statistically different compared with patients with low Model for End-stage Liver Disease scores (<18) and no PVT at 90 days (P=0.46) and 3 years (P=0.42). Those with superior PVT had improved 90-day and 3-year survival both compared with patients with a inferior PVT and those without a PVT (P<0.01, all cases). The presence of PVT does not impair the prognosis of patients following TIPS creation, particularly in patients with superior portal occlusion.

  13. An Evaluation of Computer-Aided Instruction in an Introductory Biostatistics Course.

    ERIC Educational Resources Information Center

    Forsythe, Alan B.; Freed, James R.

    1979-01-01

    Evaluates the effectiveness of computer assisted instruction for teaching biostatistics to first year students at the UCLA School of Dentistry. Results do not demonstrate the superiority of CAI but do suggest that CAI compares favorably to conventional lecture and programed instruction methods. (RAO)

  14. Development of Alendronate-conjugated Poly (lactic-co-glycolic acid)-Dextran Nanoparticles for Active Targeting of Cisplatin in Osteosarcoma

    PubMed Central

    Liu, Ping; Sun, Liang; Zhou, Dong-sheng; Zhang, Peng; Wang, Yong-hui; Li, Dong; Li, Qing-hu; Feng, Rong-jie

    2015-01-01

    In this study, we developed a novel poly (lactic-co-glycolic acid)-dextran (PLD)-based nanodelivery system to enhance the anticancer potential of cisplatin (CDDP) in osteosarcoma cells. A nanosized CDDP-loaded PLGA-DX nanoparticle (PLD/CDDP) controlled the release rate of CDDP up to 48 h. In vitro cytotoxicity assay showed a superior anticancer effect for PLD/CDDP and with an appreciable cellular uptake via endocytosis-mediated pathways. PLD/CDDP exhibited significant apoptosis of MG63 cancer cells compared to that of free CDDP. Approximately ~25% of cells were in early apoptosis phase after PLD/CDDP treatment comparing to ~15% for free CDDP after 48h incubation. Similarly, PLD/CDDP exhibited ~30% of late apoptosis cells comparing to only ~8% for free drug treatment. PLD/CDDP exhibited significantly higher G2/M phase arrest in MG63 cells than compared to free CDDP with a nearly 2-fold higher arrest in case of PLD/CDDP treated group (~60%). Importantly, PLD/CDDP exhibited a most significant anti-tumor activity with maximum tumor growth inhibition. The superior inhibitory effect was further confirmed by a marked reduction in the number of CD31 stained tumor blood vessels and decrease in the Ki67 staining intensity for PLD/CDDP treated animal group. Overall, CDDP formulations could provide a promising and most effective platform in the treatment of osteosarcoma. PMID:26619950

  15. Relational demography in the workplace and health: an analysis of gender and the subordinate-superordinate role-set.

    PubMed

    Schieman, Scott; McMullen, Taralyn

    2008-09-01

    Using data from a 2005 national survey of working adults in the United States, we examine the effects of the gender composition of the superordinate-subordinate role-set on mental and physical health measures. Subordinates' and superordinates' genders are important determinants. Men who work in gender-mixed superordinate contexts (i.e., with one male and one female superior) report lower levels of distress and physical symptoms than men who work with one male superior. Women who work with one male superior report less distress and fewer physical symptoms compared to women who work with one female superior or in gender-mixed superordinate contexts. With a few exceptions, these observations generally hold net of occupation, job sector, and an array of work-related conditions. We discuss the implications of these findings in light of predictions derived from the similarity-attraction and role congruity theories. We also outline ways that theoretical development in relational demography can be refined by a more specific focus on the demographic characteristics--especially gender--of the superordinate-subordinate role-set.

  16. Oscillatory EEG dynamics underlying automatic chunking during sentence processing.

    PubMed

    Bonhage, Corinna E; Meyer, Lars; Gruber, Thomas; Friederici, Angela D; Mueller, Jutta L

    2017-05-15

    Sentences are easier to remember than random word sequences, likely because linguistic regularities facilitate chunking of words into meaningful groups. The present electroencephalography study investigated the neural oscillations modulated by this so-called sentence superiority effect during the encoding and maintenance of sentence fragments versus word lists. We hypothesized a chunking-related modulation of neural processing during the encoding and retention of sentences (i.e., sentence fragments) as compared to word lists. Time-frequency analysis revealed a two-fold oscillatory pattern for the memorization of sentences: Sentence encoding was accompanied by higher delta amplitude (4Hz), originating both from regions processing syntax as well as semantics (bilateral superior/middle temporal regions and fusiform gyrus). Subsequent sentence retention was reflected in decreased theta (6Hz) and beta/gamma (27-32Hz) amplitude instead. Notably, whether participants simply read or properly memorized the sentences did not impact chunking-related activity during encoding. Therefore, we argue that the sentence superiority effect is grounded in highly automatized language processing mechanisms, which generate meaningful memory chunks irrespective of task demands. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Psychotherapy Versus Pharmacotherapy of Depression: What's the Evidence?

    PubMed

    Leichsenring, Falk; Steinert, Christiane; Hoyer, Jürgen

    Depression may be treated by psychotherapy or pharmacotherapy or their combination. There is an ongoing debate whether one of these approaches is possibly superior. A recent meta-analysis reported results in favour of pharmacotherapy. Individual studies and meta-analyses on the comparative efficacy of psychotherapy vs. pharmacotherapy were reviewed. Evidence suggests that psychotherapy and pharmacotherapy are equally efficacious in the short-term, but psychotherapy is superior in the long-term. For the recently stated hypothesis that pharmacotherapy is superior to psychotherapy in studies without a pill placebo condition, which implies equally including a positive expectancy effect for both pharmacotherapy and psychotherapy no evidence was found. Depression may be treated by psychotherapy or pharmacotherapy with equivalent results in the short-term and advantages for psychotherapy in the long-term. As the rates of response and remission are still limited in both treatments, further improvement of treatments is required.

  18. [Efficacy comparison between needle-knife therapy and acupuncture-cupping for cervical spondylosis of cervical type].

    PubMed

    Cao, Li; Wang, Fan

    2014-05-01

    To compare the efficacy differences between needle-knife therapy and acupuncture-cupping for treatment of cervical spondylosis (CS) of cervical type. Sixty cases of CS were randomly divided into a needle-knife group (30 cases) and an acupuncture-cupping group (30 cases). The needle-knife therapy was applied at points among superior nuchal line of occipital bone, bilateral neck muscle, neck centerline, trapezius and medial border scapula for only once. In the acupuncture-cupping group, acupuncture was applied at Fengchi (GB 20), Fengfu (GV 16), Tianzhu (BL 10), Dazhui (GV 14), Jianjing (GB 21), Jiaji (Ex-B2, from C4 to C6), Houxi (SI 3) and Ashi point, followed by cupping on local skin, once every other day for totally six times. The score of neck stiffness and visual analogue scale (VAS) were observed before and after treatment, in follow-up of 1, 3 and 6 months after treatment in the two groups, and the efficacy was compared. In the needle-knife group, 9 cases were cured, 12 cases were markedly effective, 8 cases were effective and 1 case was failed; the total effective rate was 96.7% (29/30) and the cured and markedly effective rate was 70.0% (21/30). In the acupuncture-cupping group, 8 cases were cured, 9 cases were markedly effective, 11 cases were effective and 2 cases were failed; the total effective rate was 93.3% (28/30) and the cured and markedly effective rate was 56.7% (17/30). The difference of total effective rate in the two groups was not statistically significant (P > 0.05), but the cured and markedly effective rate of needle-knife group was significantly superior to that of acupuncture-cupping group (P < 0.05). The needle-knife therapy was significantly superior to acupuncture-cupping on improvement of neck stiffness in the follow-up of 1, 3, 6 months after treatment (P < 0.05, P < 0.001); both treatments were effective on relief of neck pain, but the needle-knife group had better effects in the follow-up of 3 and 6 months after treatment compared with acupuncture-cupping group (both P < 0.01). The needle-knife therapy has better effects on neck stiffness and pain relief than acupuncture-cupping, and it is more treatment time saving.

  19. Cellulosic Biomass-Reinforced Polyvinylidene Fluoride Separators with Enhanced Dielectric Properties and Thermal Tolerance.

    PubMed

    Li, Lei; Yu, Miao; Jia, Chao; Liu, Jianxin; Lv, Yanyan; Liu, Yanhua; Zhou, Yi; Liu, Chuanting; Shao, Ziqiang

    2017-06-21

    Safety issues are critical barriers to large-scale energy storage applications of lithium-ion batteries (LIBs). Using an ameliorated, thermally stable, shutdown separator is an effective method to overcome the safety issues. Herein, we demonstrate a novel, cellulosic biomass-material-blended polyvinylidene fluoride separator that was prepared using a simple nonsolvent-induced phase separation technique. This process formed a microporous composite separator with reduced crystallinity, uniform pore size distribution, superior thermal tolerance, and enhanced electrolyte wettability and dielectric and mechanical properties. In addition, the separator has a superior capacity retention and a better rate capability compared to the commercialized microporous polypropylene membrane. This fascinating membrane was fabricated via a relatively eco-friendly and cost-effective method and is an alternative, promising separator for high-power LIBs.

  20. Effect and safety of deep needling and shallow needling for functional constipation: a multicenter, randomized controlled trial.

    PubMed

    Wu, Jiani; Liu, Baoyan; Li, Ning; Sun, Jianhua; Wang, Lingling; Wang, Liping; Cai, Yuying; Ye, Yongming; Liu, Jun; Wang, Yang; Liu, Zhishun

    2014-12-01

    Aupuncture is widely used for functional constipation. Effect of acupuncture might be related to the depth of needling; however, the evidence is limited. This trial aimed to evaluate the effect and safety of deep needling and shallow needling for functional constipation, and to assess if the deep needling and shallow needling are superior to lactulose. We conducted a prospective, superiority-design, 5-center, 3-arm randomized controlled trial. A total of 475 patients with functional constipation were randomized to the deep needling group (237), shallow needling group (119), and lactulose-controlled group (119) in a ratio of 2:1:1. Sessions lasted 30 minutes each time and took place 5 times a week for 4 weeks in 2 acupuncture groups. Participants in the lactulose group took lactulose orally for 16 continuous weeks. The primary outcome was the change from baseline of mean weekly spontaneous bowel movements (SBMs) during week 1 to 4 (changes from the baselines of the weekly SBMs at week 8 and week 16 in follow-up period were also assessed simultaneously). Secondary outcomes were the weekly SBMs of each assessing week, the mean score change from the baseline of constipation-related symptoms over week 1 to 4, and the time to the first SBM. Emergency drug usage and adverse effects were monitored throughout the study.SBMs and constipation-related symptoms were all improved in the 3 groups compared with baseline at each time frame (P<0.01, all). The changes in the mean weekly SBMs over week 1 to 4 were 2 (1.75) in the deep needling group, 2 (1.75) in the shallow needling group, and 2 (2) in the lactulose group (P>0.05, both compared with the lactulose group). The changes of mean weekly SBMs at week 8 and week 16 in the follow-up period were 2 (2), 2 (2.5) in the deep needling group, 2 (3), 1.5 (2.5) in the shallow needling group, and 1 (2), 1 (2) in the lactulose group (P<0.05, all compared with the lactulose group). No significant difference was observed among the 3 groups regarding the score changes of straining, incomplete evacuation, abdominal distention during spontaneous defecating, or Cleveland Clinic Scores over week 1 to 4. However, the lactulose group got better effect than other 2 acupuncture groups in improving stool consistency (P<0.01, both) and shortening the time to the first SBM (P<0.05, both). The percentage of emergency drugs used in the 2 acupuncture groups were both lower than in the lactulose group at each time frame (P<0.01, all). No obvious adverse event was observed in the deep or shallow needling group. Deep and shallow needling at Tianshu (ST25) can improve intestinal function remarkably and safely. Therapeutic effects of deep and shallow needling are not superior to that of lactulose; however, the sustained effects of deep and shallow needling after stopping the acupuncture treatments are superior to the therapeutic effect of lactulose, which might qualify the superiority of deep and shallow needling.

  1. Effect and Safety of Deep Needling and Shallow Needling for Functional Constipation

    PubMed Central

    Wu, Jiani; Liu, Baoyan; Li, Ning; Sun, Jianhua; Wang, Lingling; Wang, Liping; Cai, Yuying; Ye, Yongming; Liu, Jun; Wang, Yang; Liu, Zhishun

    2014-01-01

    Abstract Aupuncture is widely used for functional constipation. Effect of acupuncture might be related to the depth of needling; however, the evidence is limited. This trial aimed to evaluate the effect and safety of deep needling and shallow needling for functional constipation, and to assess if the deep needling and shallow needling are superior to lactulose. We conducted a prospective, superiority-design, 5-center, 3-arm randomized controlled trial. A total of 475 patients with functional constipation were randomized to the deep needling group (237), shallow needling group (119), and lactulose-controlled group (119) in a ratio of 2:1:1. Sessions lasted 30 minutes each time and took place 5 times a week for 4 weeks in 2 acupuncture groups. Participants in the lactulose group took lactulose orally for 16 continuous weeks. The primary outcome was the change from baseline of mean weekly spontaneous bowel movements (SBMs) during week 1 to 4 (changes from the baselines of the weekly SBMs at week 8 and week 16 in follow-up period were also assessed simultaneously). Secondary outcomes were the weekly SBMs of each assessing week, the mean score change from the baseline of constipation-related symptoms over week 1 to 4, and the time to the first SBM. Emergency drug usage and adverse effects were monitored throughout the study. SBMs and constipation-related symptoms were all improved in the 3 groups compared with baseline at each time frame (P < 0.01, all). The changes in the mean weekly SBMs over week 1 to 4 were 2 (1.75) in the deep needling group, 2 (1.75) in the shallow needling group, and 2 (2) in the lactulose group (P > 0.05, both compared with the lactulose group). The changes of mean weekly SBMs at week 8 and week 16 in the follow-up period were 2 (2), 2 (2.5) in the deep needling group, 2 (3), 1.5 (2.5) in the shallow needling group, and 1 (2), 1 (2) in the lactulose group (P < 0.05, all compared with the lactulose group). No significant difference was observed among the 3 groups regarding the score changes of straining, incomplete evacuation, abdominal distention during spontaneous defecating, or Cleveland Clinic Scores over week 1 to 4. However, the lactulose group got better effect than other 2 acupuncture groups in improving stool consistency (P < 0.01, both) and shortening the time to the first SBM (P < 0.05, both). The percentage of emergency drugs used in the 2 acupuncture groups were both lower than in the lactulose group at each time frame (P < 0.01, all). No obvious adverse event was observed in the deep or shallow needling group. Deep and shallow needling at Tianshu (ST25) can improve intestinal function remarkably and safely. Therapeutic effects of deep and shallow needling are not superior to that of lactulose; however, the sustained effects of deep and shallow needling after stopping the acupuncture treatments are superior to the therapeutic effect of lactulose, which might qualify the superiority of deep and shallow needling. PMID:25526462

  2. Treatment of Phobic Disorders Using Cognitive and Exposure Methods: A Self-Efficacy Analysis.

    ERIC Educational Resources Information Center

    Biran, Mia; Wilson, G. Terence

    1981-01-01

    Examined predictions derived from self-efficacy theory in comparing the effects of exposure and cognitive interventions with simple phobics. Guided exposure (GE) was significantly superior to cognitive restructuring (CR) in enhancing approach behavior, increasing level and strength of self-efficacy, reducing subjective fear, and decreasing…

  3. A randomized single blind crossover trial comparing leather and commercial wrist splints for treating chronic wrist pain in adults

    PubMed Central

    Thiele, Jill; Nimmo, Rachel; Rowell, Wendy; Quinn, Stephen; Jones, Graeme

    2009-01-01

    Background To compare the effectiveness of a custom-made leather wrist splint (LS) with a commercially available fabric splint (FS) in adults with chronic wrist pain. Methods Participants (N = 25, mean age = 54) were randomly assigned to treatment order in a 2-phase crossover trial. Splints were worn for 2 weeks, separated by a one-week washout period. Outcomes were assessed at baseline and after each splint phase using the Australian/Canadian Osteoarthritis Hand Index (AUSCAN), the Canadian Occupational Performance Measure (COPM) and Jamar dynamometer by an observer blinded to treatment allocation. Results Both styles of wrist splint significantly reduced pain (effect size LS 0.79, FS 0.43), improved hand function and increased grip strength compared to baseline (all p < 0.05) with no increase in wrist stiffness. There was a consistent trend for the LS to be superior to the FS but this was statistically significant only for patient perceived occupational performance (p = 0.008) and satisfaction (p = 0.015). Lastly, 72% of patients preferred the custom-made leather splint compared to the commercially available splint. Conclusion Leather wrist splints were superior to a commercially available fabric splint for the short-term relief of pain and dysfunction. PMID:19843345

  4. Are placebo-controlled trials of creams for athlete's foot still justified?

    PubMed

    Crawford, F; Harris, R; Williams, H C

    2008-09-01

    Placebo-controlled trials are useful in identifying effective treatments where none has existed, but their continued use once efficacy is established arguably contravenes ethical standards for medical research. To consider whether sufficient evidence exists to recommend the abandonment of vehicle-controlled studies in trials of topical treatments for athlete's foot. We searched nine electronic databases and bibliographies of review articles as part of an ongoing Cochrane systematic review from 1966 to 2007. Randomized controlled trials (RCTs) using a vehicle control design involving participants with a mycological diagnosis of a dermatophyte infection of the skin of the foot were included. Allylamines, azoles, ciclopiroxolamine, tolnaftate, butenafine and undecanoates were all more effective than vehicle controls. Evidence of the superiority of azole creams over vehicle controls was fairly consistent from 1975 onwards. Data from patients treated with allylamines have shown their superior effects relative to vehicle controls since 1991 for even short-term outcomes. The superiority of allylamines and azoles over vehicle in vehicle-controlled trials has been well established, and data demonstrating this fact have been available since the completion of early RCTs. These preparations are effective and safe, and investigators of RCTs evaluating topical treatments for athlete's foot need to choose potential comparators as control interventions in the light of this knowledge and to consider the ethics of withholding effective treatment from patients who seek treatment for this common foot infection.

  5. The Development of the Picture-Superiority Effect

    ERIC Educational Resources Information Center

    Whitehouse, Andrew J. O.; Maybery, Murray T.; Durkin, Kevin

    2006-01-01

    When pictures and words are presented serially in an explicit memory task, recall of the pictures is superior. While this effect is well established in the adult population, little is known of the development of this picture-superiority effect in typical development. This task was administered to 80 participants from middle childhood to…

  6. Trait valence and the better-than-average effect.

    PubMed

    Gold, Ron S; Brown, Mark G

    2011-12-01

    People tend to regard themselves as having superior personality traits compared to their average peer. To test whether this "better-than-average effect" varies with trait valence, participants (N = 154 students) rated both themselves and the average student on traits constituting either positive or negative poles of five trait dimensions. In each case, the better-than-average effect was found, but trait valence had no effect. Results were discussed in terms of Kahneman and Tversky's prospect theory.

  7. A comparison of position and rate control for telemanipulations with consideration of manipulator system dynamics

    NASA Technical Reports Server (NTRS)

    Kim, Won S.; Tendick, Frank; Stark, Lawrence W.; Ellis, Stephen R.

    1987-01-01

    Position and rate control are the two common manual control modes in teleoperations. Human operator performance using the two modes is evaluated and compared. Simulated three-axis pick-and-place operations are used as the primary task for evaluation. First, ideal position and rate control are compared by considering several factors, such as joystick gain, joystick type, display mode, task, and manipulator work space size. Then the effects of the manipulator system dynamics are investigated by varying the natural frequency and speed limit. Experimental results show that ideal position control is superior to ideal rate control, regardless of joystick type or display mode, when the manipulation work space is small or comparable to the human operator's control space. Results also show that when the manipulator system is slow, the superiority of position control disappears. Position control is recommended for small-work-space telemanipulation tasks, while rate control is recommended for slow wide-work-space telemanipulation tasks.

  8. Task switching in video game players: Benefits of selective attention but not resistance to proactive interference.

    PubMed

    Karle, James W; Watter, Scott; Shedden, Judith M

    2010-05-01

    Research into the perceptual and cognitive effects of playing video games is an area of increasing interest for many investigators. Over the past decade, expert video game players (VGPs) have been shown to display superior performance compared to non-video game players (nVGPs) on a range of visuospatial and attentional tasks. A benefit of video game expertise has recently been shown for task switching, suggesting that VGPs also have superior cognitive control abilities compared to nVGPs. In two experiments, we examined which aspects of task switching performance this VGP benefit may be localized to. With minimal trial-to-trial interference from minimally overlapping task set rules, VGPs demonstrated a task switching benefit compared to nVGPs. However, this benefit disappeared when proactive interference between tasks was increased, with substantial stimulus and response overlap in task set rules. We suggest that VGPs have no generalized benefit in task switching-related cognitive control processes compared to nVGPs, with switch cost reductions due instead to a specific benefit in controlling selective attention. Copyright 2009 Elsevier B.V. All rights reserved.

  9. The hubris hypothesis: you can self-enhance, but you'd better not show it.

    PubMed

    Hoorens, Vera; Pandelaere, Mario; Oldersma, Frans; Sedikides, Constantine

    2012-10-01

    We tested whether and why observers dislike individuals who convey self-superiority through blatant social comparison (the hubris hypothesis). Participants read self-superiority claims ("I am better than others"; Experiments 1-7), noncomparative positive claims ("I am good"; Experiments 1-2, 4), self-equality claims ("I am as good as others"; Experiments 3-4, 6), temporally comparative self-superiority claims ("I am better than I used to be"; Experiment 5), other-superiority claims ("S/he is better than others"; Experiment 6), and self-superiority claims accompanied by persistent disclaimers (Experiment 7). They judged the claim and the claimant (Experiments 1-7) and made inferences about the claimant's self-view and view of others (Experiments 4-7) as well as the claimant's probable view of them (Experiment 7). Self-superiority claims elicited unfavorable evaluations relative to all other claims. Evaluation unfavorability was accounted for by the perception that the claimant implied a negative view of others (Experiments 4-6) and particularly of the observer (Experiment 7). Supporting the hubris hypothesis, participants disliked individuals who communicated self-superiority beliefs in an explicitly comparative manner. Self-superiority beliefs may provoke undesirable interpersonal consequences when they are explicitly communicated to others but not when they are disguised as noncomparative positive self-claims or self-improvement claims. © 2011 The Authors. Journal of Personality © 2011, Wiley Periodicals, Inc.

  10. Efficacy and safety of dronedarone: a review of randomized trials.

    PubMed

    Christiansen, Christine Benn; Torp-Pedersen, Christian; Køber, Lars

    2010-01-01

    Dronedarone is developed for treatment of atrial fibrillation (AF) or flutter (AFL). It is a noniodinized amiodarone analogue and believed to be without the adverse effects of amiodarone. However, long-term adverse effects are not yet well investigated. This is a review of seven studies on dronedarone. DAFNE established an effective dose to be 400 mg b.i.d. ADONIS and EURIDIS showed significant prevention of AF/AFL recurrence hazard ratio (HR 0.78 and 0.73) compared to placebo. In ATHENA, cardiovascular death/hospitalization was significantly reduced (HR 0.76) in patients with AF and additional risk factors. ANDROMEDA was stopped because dronedarone increased early mortality (HR 2.13) in advanced heart failure (HF). ERATO found that dronedarone significantly reduced heart rate compared to placebo in patients with AF. DIONYSOS showed that amiodarone was superior to dronedarone to maintain sinus rhythm in patients with AF/AFL. Dronedarone is superior to placebo but less efficient than amiodarone in maintaining sinus rhythm in patients with a history of AF. In patients with AF and risk factors dronedarone reduces cardiovascular mortality and morbidity, but in patients with severe HF dronedarone significantly increases mortality.

  11. Superiorization-based multi-energy CT image reconstruction

    PubMed Central

    Yang, Q; Cong, W; Wang, G

    2017-01-01

    The recently-developed superiorization approach is efficient and robust for solving various constrained optimization problems. This methodology can be applied to multi-energy CT image reconstruction with the regularization in terms of the prior rank, intensity and sparsity model (PRISM). In this paper, we propose a superiorized version of the simultaneous algebraic reconstruction technique (SART) based on the PRISM model. Then, we compare the proposed superiorized algorithm with the Split-Bregman algorithm in numerical experiments. The results show that both the Superiorized-SART and the Split-Bregman algorithms generate good results with weak noise and reduced artefacts. PMID:28983142

  12. A superior edge preserving filter with a systematic analysis

    NASA Technical Reports Server (NTRS)

    Holladay, Kenneth W.; Rickman, Doug

    1991-01-01

    A new, adaptive, edge preserving filter for use in image processing is presented. It had superior performance when compared to other filters. Termed the contiguous K-average, it aggregates pixels by examining all pixels contiguous to an existing cluster and adding the pixel closest to the mean of the existing cluster. The process is iterated until K pixels were accumulated. Rather than simply compare the visual results of processing with this operator to other filters, some approaches were developed which allow quantitative evaluation of how well and filter performs. Particular attention is given to the standard deviation of noise within a feature and the stability of imagery under iterative processing. Demonstrations illustrate the performance of several filters to discriminate against noise and retain edges, the effect of filtering as a preprocessing step, and the utility of the contiguous K-average filter when used with remote sensing data.

  13. Lake Superior Zooplankton Biomass Predictions from LOPC Tow Surveys Compare Well with a Probability Based Net Survey

    EPA Science Inventory

    We conducted a probability-based sampling of Lake Superior in 2006 and compared the zooplankton biomass estimate with laser optical plankton counter (LOPC) predictions. The net survey consisted of 52 sites stratified across three depth zones (0-30, 30-150, >150 m). The LOPC tow...

  14. Effects of Hand Proximity and Movement Direction in Spatial and Temporal Gap Discrimination.

    PubMed

    Wiemers, Michael; Fischer, Martin H

    2016-01-01

    Previous research on the interplay between static manual postures and visual attention revealed enhanced visual selection near the hands (near-hand effect). During active movements there is also superior visual performance when moving toward compared to away from the stimulus (direction effect). The "modulated visual pathways" hypothesis argues that differential involvement of magno- and parvocellular visual processing streams causes the near-hand effect. The key finding supporting this hypothesis is an increase in temporal and a reduction in spatial processing in near-hand space (Gozli et al., 2012). Since this hypothesis has, so far, only been tested with static hand postures, we provide a conceptual replication of Gozli et al.'s (2012) result with moving hands, thus also probing the generality of the direction effect. Participants performed temporal or spatial gap discriminations while their right hand was moving below the display. In contrast to Gozli et al. (2012), temporal gap discrimination was superior at intermediate and not near hand proximity. In spatial gap discrimination, a direction effect without hand proximity effect suggests that pragmatic attentional maps overshadowed temporal/spatial processing biases for far/near-hand space.

  15. An auditory analog of the picture superiority effect.

    PubMed

    Crutcher, Robert J; Beer, Jenay M

    2011-01-01

    Previous research has found that pictures (e.g., a picture of an elephant) are remembered better than words (e.g., the word "elephant"), an empirical finding called the picture superiority effect (Paivio & Csapo. Cognitive Psychology 5(2):176-206, 1973). However, very little research has investigated such memory differences for other types of sensory stimuli (e.g. sounds or odors) and their verbal labels. Four experiments compared recall of environmental sounds (e.g., ringing) and spoken verbal labels of those sounds (e.g., "ringing"). In contrast to earlier studies that have shown no difference in recall of sounds and spoken verbal labels (Philipchalk & Rowe. Journal of Experimental Psychology 91(2):341-343, 1971; Paivio, Philipchalk, & Rowe. Memory & Cognition 3(6):586-590, 1975), the experiments reported here yielded clear evidence for an auditory analog of the picture superiority effect. Experiments 1 and 2 showed that sounds were recalled better than the verbal labels of those sounds. Experiment 2 also showed that verbal labels are recalled as well as sounds when participants imagine the sound that the word labels. Experiments 3 and 4 extended these findings to incidental-processing task paradigms and showed that the advantage of sounds over words is enhanced when participants are induced to label the sounds.

  16. Kinesio taping in musculoskeletal pain and disability that lasts for more than 4 weeks: is it time to peel off the tape and throw it out with the sweat? A systematic review with meta-analysis focused on pain and also methods of tape application.

    PubMed

    Lim, Edwin Choon Wyn; Tay, Mathew Guo Xiang

    2015-12-01

    In recent years, Kinesio tape has been used to support injured muscle and joints, and relieve pain. We compared the pain and disability in individuals with chronic musculoskeletal pain who were treated with Kinesio taping with those using minimal or other treatment approaches. Searches of eight major electronic databases were conducted. Data for pain and disability scores were extracted. Meta-analyses (wherever possible) with either a fixed or random effect(s) model, standardised mean differences (SMDs) and tests of heterogeneity were performed. Seventeen clinical-controlled trials were identified and included in the meta-analyses. When compared to minimal intervention, Kinesio taping provided superior pain relief (pooled SMD=-0.36, 95% CI -0.64 to -0.09, p=0.009) but the pooled disability scores were not significantly different (pooled SMD=-0.41, 95% CI -0.83 to 0.01, p=0.05). No significant differences were found when comparing Kinesio taping to other treatment approaches for pain (pooled SMD=-0.44, 95% CI -1.69 to 0.82, p=0.49) and disability (pooled SMD=0.08, 95% CI -0.27 to 0.43, p=0.65). Kinesio taping is superior to minimal intervention for pain relief. Existing evidence does not establish the superiority of Kinesio taping to other treatment approaches to reduce pain and disability for individuals with chronic musculoskeletal pain. 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/

  17. [Guiding-qi acupuncture for dry eye syndrome].

    PubMed

    Xie, Wenzhang; Zeng, Liang; Tao, Ying; Zhou, Yingfan; Zhao, Ran; Huang, Xinyun; Hou, Wenguang; Zhang, Ren; Zong, Lei

    2018-02-12

    To observe the clinical efficacy differences between different needling methods for dry eye syndrome. Sixty patients of dry eye syndrome were randomly divided into an observation group and a control group, 30 cases (60 eyes) in each group. Shangjingming (Extra), Xiajingming (Extra), Tongziliao (GB 1), Cuanzhu (BL 2), Fengchi (GB 20), Hegu (LI 4), Sanyinjiao (SP 6), Taixi (KI 3) and Taichong (LR 3) were selected in the two groups. The control group was treated with conventional acupuncture, while the observation group was treated with guiding- qi acupuncture. Electroacupuncture (EA) was used at bilateral Tongziliao (GB1) and Cuanzhu (BL 2), 30 min per treatment. The treatment was given three times per week. Totally 1-month treatment (12 treatments) was given. The eye symptom score, breakup time of tear film (BUT), Schirmer Ⅰ test (SⅠT) and visual analogue scale (VAS) score were compared before and after treatment in the two groups. The clinical efficacy was compared between the two groups. Compared before treatment, the eye symptom score, BUT, SⅠT and VAS score were improved after treatment in the two groups (all P <0.001); the improvements of eye symptom score and SⅠT in the observation group were superior to those in the control group (both P <0.05). The differences of BUT and VSA score between the two groups were not significant (both P >0.05). The total effective rate was 86.7% (52/60) in the observation group, which was superior to 73.3% (44/60) in the control group ( P <0.05). . The conventional EA and guiding- qi acupuncture combined with EA are both effective for dry eye syndrome, and the efficacy of guiding- qi acupuncture combined with EA is superior to that of conventional EA.

  18. Finding a Face in the Crowd: Testing the Anger Superiority Effect in Asperger Syndrome

    ERIC Educational Resources Information Center

    Ashwin, Chris; Wheelwright, Sally; Baron-Cohen, Simon

    2006-01-01

    Social threat captures attention and is processed rapidly and efficiently, with many lines of research showing involvement of the amygdala. Visual search paradigms looking at social threat have shown angry faces "pop-out" in a crowd, compared to happy faces. Autism and Asperger Syndrome (AS) are neurodevelopmental conditions…

  19. A liposomal steroid nano-drug for treating systemic lupus erythematosus.

    PubMed

    Moallem, E; Koren, E; Ulmansky, R; Pizov, G; Barlev, M; Barenholz, Y; Naparstek, Y

    2016-10-01

    Glucocorticoids have been known for years to be the most effective therapy in systemic lupus erythematosus. Their use, however, is limited by the need for high doses due to their unfavorable pharmacokinetics and biodistribution. We have previously developed a novel liposome-based steroidal (methylprednisolone hemisuccinate (MPS)) nano-drug and demonstrated its specific accumulation in inflamed tissues, as well as its superior therapeutic efficacy over that of free glucocorticoids (non-liposomal) in the autoimmune diseases, including the adjuvant arthritis rat model and the experimental autoimmune encephalomyelitis mouse model. In the present work we have evaluated the therapeutic effect of the above liposome-based steroidal (MPS) nano-drug in the MRL-lpr/lpr murine model of SLE and compared it with similar doses of the free MPS. MRL-lpr/lpr mice were treated with daily injections of free MPS or weekly injections of 10% dextrose, empty nano-liposomes or the steroidal nano-drug and the course of their disease was followed up to the age of 24 weeks. Treatment with the steroidal nano-drug was found to be significantly superior to the free MPS in suppressing anti-dsDNA antibody levels, proliferation of lymphoid tissue and renal damage, and in prolonging survival of animals. This significant superiority of our liposome based steroidal nano-drug administered weekly compared with daily injections of free methylprednisolone hemisuccinate in suppressing murine lupus indicates this glucocorticoid nano-drug formulation may be a good candidate for the treatment of human SLE. © The Author(s) 2016.

  20. Dissociable effects of prefrontal and anterior temporal cortical lesions on stereotypical gender attitudes.

    PubMed

    Gozzi, Marta; Raymont, Vanessa; Solomon, Jeffrey; Koenigs, Michael; Grafman, Jordan

    2009-08-01

    Clinical observations of patients with ventral frontal and anterior temporal cortical lesions reveal marked abnormalities in social attitudes. A previous study in seven patients with ventral prefrontal lesions provided the first direct experimental evidence for abnormalities in social attitudes using a well-established measure of gender stereotypes, the Implicit Association Test (IAT). Here, we were able to test whether these first findings could be reproduced in a larger sample of 154 patients with penetrating head injuries, and to determine the differential effects of ventromedial prefrontal (vmPFC) and ventrolateral prefrontal (vlPFC) cortical lesions on IAT performance. In addition, we investigated the role of the superior anterior temporal lobe (aTL), recently shown to represent conceptual social knowledge. First, we used a linear regression model to identify the role of each of the three regions, while controlling for the extent of damage to other regions. We found that larger lesions in either the vmPFC or the superior aTL were associated with increased stereotypical attitudes, whereas larger lesions in the vlPFC were associated with decreased stereotypical attitudes. Second, in a confirmatory analysis, we grouped patients by lesion location and compared their performance on the IAT with that of healthy volunteers. Compared to controls, patients with lesions in either the vmPFC or the superior aTL showed increased stereotypical attitudes, whereas patients with lesions in the vlPFC showed decreased stereotypical attitudes. The functional contributions of these regions in social attitudes are discussed.

  1. To compare the effect of dextromethorphan, promethazine and placebo on nocturnal cough in children aged 1-12 y with upper respiratory infections: a randomized controlled trial.

    PubMed

    Bhattacharya, Malobika; Joshi, Neha; Yadav, Sangita

    2013-11-01

    To evaluate whether promethazine and dextromethorphan reduce nocturnal cough and improve sleep quality in children aged 1-12 y with upper respiratory tract infection (URI). This randomised double-blinded placebo-controlled trial was conducted in Pediatric outpatient department of Lok Nayak Hospital, Delhi. After randomization into promethazine, dextromethorphan and placebo groups, parental assessment of 120 children with URI for nocturnal cough severity (child), post-tussive vomiting (child) and sleep quality (child and parent) on the night before enrolment and after 3 d of assigned medication was measured using an internally validated indigenously prepared ordinal scale. Entire cohort improved in all the study parameters after 3 d. However, no superior benefit was noted when individual parameters were compared in the promethazine and dextromethorphan groups with the placebo group. Adverse effects were more frequent in the dextromethorphan and promethazine groups although the difference was not statistically significant. Nocturnal cough in URI is self-resolving and dextromethorphan and promethazine prescribed for the same are not superior to placebo.

  2. Patients With Newly Diagnosed Hypertension Treated With the Renin Angiotensin Receptor Blocker Azilsartan Medoxomil vs Angiotensin-Converting Enzyme Inhibitors: The Prospective EARLY Registry.

    PubMed

    Schmieder, Roland E; Potthoff, Sebastian A; Bramlage, Peter; Baumgart, Peter; Mahfoud, Felix; Buhck, Hartmut; Ouarrak, Taoufik; Ehmen, Martina; Senges, Jochen; Gitt, Anselm K

    2015-12-01

    For patients with newly diagnosed hypertension, angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are usually the first-line therapies. There is, however, no real-life data regarding the relative clinical effectiveness and tolerability of either drug class. The prospective registry, Treatment With Azilsartan Compared to ACE Inhibitors in Antihypertensive Therapy (EARLY), was conducted to evaluate the effectiveness of the ARB azilsartan medoxomil (AZL-M) vs ACE inhibitors in real-world patients. Of the 1153 patients with newly diagnosed hypertension who were included in the registry, 789 were prescribed AZL-M and 364 were prescribed an ACE inhibitor. After multivariate adjustment, AZL-M was found to provide superior blood pressure reduction and better target blood pressure (<140/90 mm Hg) achievement. The proportion of patients with adverse events was not statistically different between groups. The authors conclude that in newly diagnosed hypertensive patients, AZL-M provides superior blood pressure control with a similar safety profile compared with ACE inhibitors. © 2015 Wiley Periodicals, Inc.

  3. The picture superiority effect in conceptual implicit memory: a conceptual distinctiveness hypothesis.

    PubMed

    Hamilton, Maryellen; Geraci, Lisa

    2006-01-01

    According to leading theories, the picture superiority effect is driven by conceptual processing, yet this effect has been difficult to obtain using conceptual implicit memory tests. We hypothesized that the picture superiority effect results from conceptual processing of a picture's distinctive features rather than a picture's semantic features. To test this hypothesis, we used 2 conceptual implicit general knowledge tests; one cued conceptually distinctive features (e.g., "What animal has large eyes?") and the other cued semantic features (e.g., "What animal is the figurehead of Tootsie Roll?"). Results showed a picture superiority effect only on the conceptual test using distinctive cues, supporting our hypothesis that this effect is mediated by conceptual processing of a picture's distinctive features.

  4. Superior Temporal Activation as a Function of Linguistic Knowledge: Insights from Deaf Native Signers Who Speechread

    ERIC Educational Resources Information Center

    Capek, Cheryl M.; Woll, Bencie; MacSweeney, Mairead; Waters, Dafydd; McGuire, Philip K.; David, Anthony S.; Brammer, Michael J.; Campbell, Ruth

    2010-01-01

    Studies of spoken and signed language processing reliably show involvement of the posterior superior temporal cortex. This region is also reliably activated by observation of meaningless oral and manual actions. In this study we directly compared the extent to which activation in posterior superior temporal cortex is modulated by linguistic…

  5. Differential Response of Slash Pine Families to Drought

    Treesearch

    Robert P. Schultz; Lawrence P. Wilhite

    1969-01-01

    First-year survival and growth of superior and commercial slash pine seedlings, grown on both high and low beds, were compared on a typical north Florida flatwoods site. Average survival of the commercial seedlings was 80 percent, and that of the superior seedlings was 60 percent. Four of the fourteen superior families survived better than did the commercial seedlings...

  6. Treatment for unicameral bone cysts in long bones: an evidence based review.

    PubMed

    Donaldson, Sandra; Chundamala, Josie; Yandow, Suzanne; Wright, James G

    2010-03-20

    The purpose of this paper is to perform an evidence based review for treatment of unicameral bone cysts. A search of MEDLINE (1966 to 2009) was conducted and the studies were classified according to levels of evidence. This review includes only comparative Level I-III studies. The systematic review identified 16 studies. There is one level I study, one level II study and the remaining 14 studies are level III. Seven of the sixteen studies had statistically different results: three studies indicated that steroid injection was superior to bone marrow injection or curettage and bone grafting; one study indicated that cannulated screws were superior to steroid injections; one study indicated resection and myoplasty was superior to steroid injection; one study indicated a combination of steroid, demineralized bone matrix and bone marrow aspirate, and curettage and bone grafting were superior to steroid injection; and one study indicated that curettage and bone grafting was superior to non-operative immobilization. Based on one Level I study, including a limited number of individuals, steroid injection seems to be superior to bone marrow injection. As steroid injections have already demonstrated superiority over bone marrow injections in a randomized clinical trial, the next step would be a prospective trial comparing steroid injections with other treatments.

  7. Treatment for unicameral bone cysts in long bones: an evidence based review

    PubMed Central

    Donaldson, Sandra; Chundamala, Josie; Yandow, Suzanne; Wright, James G.

    2010-01-01

    The purpose of this paper is to perform an evidence based review for treatment of unicameral bone cysts. A search of MEDLINE (1966 to 2009) was conducted and the studies were classified according to levels of evidence. This review includes only comparative Level I-III studies. The systematic review identified 16 studies. There is one level I study, one level II study and the remaining 14 studies are level III. Seven of the sixteen studies had statistically different results: three studies indicated that steroid injection was superior to bone marrow injection or curettage and bone grafting; one study indicated that cannulated screws were superior to steroid injections; one study indicated resection and myoplasty was superior to steroid injection; one study indicated a combination of steroid, demineralized bone matrix and bone marrow aspirate, and curettage and bone grafting were superior to steroid injection; and one study indicated that curettage and bone grafting was superior to non-operative immobilization. Based on one Level I study, including a limited number of individuals, steroid injection seems to be superior to bone marrow injection. As steroid injections have already demonstrated superiority over bone marrow injections in a randomized clinical trial, the next step would be a prospective trial comparing steroid injections with other treatments. PMID:21808696

  8. Ordinal probability effect measures for group comparisons in multinomial cumulative link models.

    PubMed

    Agresti, Alan; Kateri, Maria

    2017-03-01

    We consider simple ordinal model-based probability effect measures for comparing distributions of two groups, adjusted for explanatory variables. An "ordinal superiority" measure summarizes the probability that an observation from one distribution falls above an independent observation from the other distribution, adjusted for explanatory variables in a model. The measure applies directly to normal linear models and to a normal latent variable model for ordinal response variables. It equals Φ(β/2) for the corresponding ordinal model that applies a probit link function to cumulative multinomial probabilities, for standard normal cdf Φ and effect β that is the coefficient of the group indicator variable. For the more general latent variable model for ordinal responses that corresponds to a linear model with other possible error distributions and corresponding link functions for cumulative multinomial probabilities, the ordinal superiority measure equals exp(β)/[1+exp(β)] with the log-log link and equals approximately exp(β/2)/[1+exp(β/2)] with the logit link, where β is the group effect. Another ordinal superiority measure generalizes the difference of proportions from binary to ordinal responses. We also present related measures directly for ordinal models for the observed response that need not assume corresponding latent response models. We present confidence intervals for the measures and illustrate with an example. © 2016, The International Biometric Society.

  9. The efficacy of psychotherapy, pharmacotherapy and their combination on functioning and quality of life in depression: a meta-analysis.

    PubMed

    Kamenov, K; Twomey, C; Cabello, M; Prina, A M; Ayuso-Mateos, J L

    2017-02-01

    There is growing recognition of the importance of both functioning and quality of life (QoL) outcomes in the treatment of depressive disorders, but the meta-analytic evidence is scarce. The objective of this meta-analysis of randomized controlled trials (RCTs) was to determine the absolute and relative effects of psychotherapy, pharmacotherapy and their combination on functioning and QoL in patients with depression. One hundred and fifty-three outcome trials involving 29 879 participants with depressive disorders were identified through database searches in Pubmed, PsycINFO and the Cochrane Central Register of Controlled Trials. Compared to control conditions, psychotherapy and pharmacotherapy yielded small to moderate effect sizes for functioning and QoL, ranging from g = 0.31 to g = 0.43. When compared directly, initial analysis yielded no evidence that one of them was superior. After adjusting for publication bias, psychotherapy was more efficacious than pharmacotherapy (g = 0.21) for QoL. The combination of psychotherapy and medication performed significantly better for both outcomes compared to each treatment alone yielding small effect sizes (g = 0.32 to g = 0.39). Both interventions improved depression symptom severity more than functioning and QoL. Despite the small number of comparative trials for some of the analyses, this study reveals that combined treatment is superior, but psychotherapy and pharmacotherapy alone are also efficacious for improving functioning and QoL. The overall relatively modest effects suggest that future tailoring of therapies could be warranted to better meet the needs of individuals with functioning and QoL problems.

  10. Uncovering the Forgotten Effect of Superior Cervical Ganglia on Pupil Diameter in Subarachnoid Hemorrhage: An Experimental Study.

    PubMed

    Onen, Mehmet Resid; Yilmaz, Ilhan; Ramazanoglu, Leyla; Aydin, Mehmet Dumlu; Keles, Sadullah; Baykal, Orhan; Aydin, Nazan; Gundogdu, Cemal

    2018-01-01

    To investigate the relationship between neuron density of the superior cervical sympathetic ganglia and pupil diameter in subarachnoid hemorrhage. This study was conducted on 22 rabbits; 5 for the baseline control group, 5 for the SHAM group and 12 for the study group. Pupil diameters were measured via sunlight and ocular tomography on day 1 as the control values. Pupil diameters were re-measured after injecting 0.5 cc saline to the SHAM group, and autologous arterial blood into the cisterna magna of the study group. After 3 weeks, the brain, superior cervical sympathetic ganglia and ciliary ganglia were extracted with peripheral tissues bilaterally and examined histopathologically. Pupil diameters were compared with neuron densities of the sympathetic ganglia and ciliary ganglia which were examined using stereological methods. Baseline values were; normal pupil diameter 7.180±620 ?m and mean neuron density of the superior cervical sympathetic ganglia 6.321±510/mm3, degenerated neuron density of ciliary ganglia was 5±2/mm3 after histopathological examination in the control group. These values were measured as 6.850±578 ?m, 5.950±340/mm3 and 123±39/mm3 in the SHAM group and 9.910±840 ?m, 7.950±764/mm3 and 650±98/mm3 in the study group. A linear relationship was determined between neuron density of the superior cervical sympathetic ganglia and pupil diameters (p < 0.005). Degenerated ciliary ganglia neuron density had an inverse effect on pupil diameters in all groups (p < 0.0001). Highly degenerated neuron density of the ciliary ganglion is not responsible for pupil dilatation owing to parasympathetic pupilloconstrictor palsy, but high neuron density of the pupillodilatatory superior cervical sympathetic ganglia should be considered an important factor for pupil dilatation.

  11. [In vitro and in vivo activities of sulopenem compared with those of imipenem and cephalosporins].

    PubMed

    Nagashima, M; Goto, S; Yoshida, T; Matsunaga, T; Shimohira, H; Ogawa, M

    1996-04-01

    The in vitro and in vivo antibacterial activities of sulopenem (CP-70,429),a new parenteral penem antibiotic, were compared with those of imipenem (IPM), flomoxef, cefuzonam (CZON) and cefotaxime. Sulopenem possessed broad-spectrum activities against Gram-positive bacteria and Gram-negative bacteria. Antibacterial activities of sulopenem against methicillin-sensitive Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis, Streptococcus pyogenes and Streptococcus pneumoniae were equivalent to or somewhat superior to those of IPM. Against members of the family Enterobacteriaceae, sulopenem was 4- to 260-fold more active than reference antibiotics with broad-spectra. In a killing kinetics study for Haemophilus influenzae, sulopenem showed a 99.9% decrease of viable cells after 8 hours at a concentration of 0.20 micrograms/ml. This effect was obtained at a concentration 8-fold lower than that of IPM. The protective effects of sulopenem in murine experimental systemic infections were superior to those of imipenem/cilastatin. In murine experimental mixed infection with Escherichia coli and Bacteroides fragilis, sulopenem had lower ED50, in other words stronger antimicrobial activities than IPM. The therapeutic effect of sulopenem are related well with its MIC value. In guinea pigs experimental lung infection with Klebsiella pneumoniae, sulopenem was more effective than CZON or cefotiam.

  12. Effects of Time-Compressed Speech Training on Multiple Functional and Structural Neural Mechanisms Involving the Left Superior Temporal Gyrus.

    PubMed

    Maruyama, Tsukasa; Takeuchi, Hikaru; Taki, Yasuyuki; Motoki, Kosuke; Jeong, Hyeonjeong; Kotozaki, Yuka; Nakagawa, Seishu; Nouchi, Rui; Iizuka, Kunio; Yokoyama, Ryoichi; Yamamoto, Yuki; Hanawa, Sugiko; Araki, Tsuyoshi; Sakaki, Kohei; Sasaki, Yukako; Magistro, Daniele; Kawashima, Ryuta

    2018-01-01

    Time-compressed speech is an artificial form of rapidly presented speech. Training with time-compressed speech (TCSSL) in a second language leads to adaptation toward TCSSL. Here, we newly investigated the effects of 4 weeks of training with TCSSL on diverse cognitive functions and neural systems using the fractional amplitude of spontaneous low-frequency fluctuations (fALFF), resting-state functional connectivity (RSFC) with the left superior temporal gyrus (STG), fractional anisotropy (FA), and regional gray matter volume (rGMV) of young adults by magnetic resonance imaging. There were no significant differences in change of performance of measures of cognitive functions or second language skills after training with TCSSL compared with that of the active control group. However, compared with the active control group, training with TCSSL was associated with increased fALFF, RSFC, and FA and decreased rGMV involving areas in the left STG. These results lacked evidence of a far transfer effect of time-compressed speech training on a wide range of cognitive functions and second language skills in young adults. However, these results demonstrated effects of time-compressed speech training on gray and white matter structures as well as on resting-state intrinsic activity and connectivity involving the left STG, which plays a key role in listening comprehension.

  13. Trauma Resuscitation Evaluation Times and Correlating Human Patient Simulation Training Differences-What is the Standard?

    PubMed

    Bonjour, Timothy J; Charny, Grigory; Thaxton, Robert E

    2016-11-01

    Rapid effective trauma resuscitations (TRs) decrease patient morbidity and mortality. Few studies have evaluated TR care times. Effective time goals and superior human patient simulator (HPS) training can improve patient survivability. The purpose of this study was to compare live TR to HPS resuscitation times to determine mean incremental resuscitation times and ascertain if simulation was educationally equivalent. The study was conducted at San Antonio Military Medical Center, Department of Defense Level I trauma center. This was a prospective observational study measuring incremental step times by trauma teams during trauma and simulation patient resuscitations. Trauma and simulation patient arms had 60 patients for statistical significance. Participants included Emergency Medicine residents and Physician Assistant residents as the trauma team leader. The trauma patient arm revealed a mean evaluation time of 10:33 and simulation arm 10:23. Comparable time characteristics in the airway, intravenous access, blood sample collection, and blood pressure data subsets were seen. TR mean times were similar to the HPS arm subsets demonstrating simulation as an effective educational tool. Effective stepwise approaches, incremental time goals, and superior HPS training can improve patient survivability and improved departmental productivity using TR teams. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  14. Brain regions sensitive to the face inversion effect: a functional magnetic resonance imaging study in humans.

    PubMed

    Leube, Dirk T; Yoon, Hyo Woon; Rapp, Alexander; Erb, Michael; Grodd, Wolfgang; Bartels, Mathias; Kircher, Tilo T J

    2003-05-22

    Perception of upright faces relies on configural processing. Therefore recognition of inverted, compared to upright faces is impaired. In a functional magnetic resonance imaging experiment we investigated the neural correlate of a face inversion task. Thirteen healthy subjects were presented with a equal number of upright and inverted faces alternating with a low level baseline with an upright and inverted picture of an abstract symbol. Brain activation was calculated for upright minus inverted faces. For this differential contrast, we found a signal change in the right superior temporal sulcus and right insula. Configural properties are processed in a network comprising right superior temporal and insular cortex.

  15. Informed Consent to Study Purpose in Randomized Clinical Trials of Antibiotics, 1991 Through 2011.

    PubMed

    Doshi, Peter; Hur, Peter; Jones, Mark; Albarmawi, Husam; Jefferson, Tom; Morgan, Daniel J; Spears, Patricia A; Powers, John H

    2017-10-01

    Potential research participants may assume that randomized trials comparing new interventions with older interventions always hypothesize greater efficacy for the new intervention, as in superiority trials. However, antibiotic trials frequently use "noninferiority" hypotheses allowing a degree of inferior efficacy deemed "clinically acceptable" compared with an older effective drug, in exchange for nonefficacy benefits (eg, decreased adverse effects). Considering these different benefit-harm trade-offs, proper informed consent necessitates supplying different information on the purposes of superiority and noninferiority trials. To determine the degree to which the study purpose is explained to potential participants in randomized clinical trials of antibiotics and the degree to which study protocols justify their selection of noninferiority hypotheses and amount of "clinically acceptable" inferiority. Cross-sectional analysis of study protocols, statistical analysis plans (SAPs), and informed consent forms (ICFs) from clinical study reports submitted to the European Medicines Agency. The ICFs were read by both methodologists and patient investigators. Protocols and SAPs were used as the reference standard to determine prespecified primary hypothesis and record rationale for selection of noninferiority hypotheses and noninferiority margins. This information was cross-referenced against ICFs to determine whether ICFs explained the study purpose. We obtained trial documents from 78 randomized trials with prespecified efficacy hypotheses (6 superiority, 72 noninferiority) for 17 antibiotics conducted between 1991 and 2011 that enrolled 39 407 patients. Fifty were included in the ICF analysis. All ICFs contained sections describing study purpose; however, none consistently conveyed study hypothesis to both methodologists and patient investigators. Methodologists found that 1 of 50 conveyed a study purpose. Patient investigators found that 11 of 50 conveyed a study purpose, 7 accurately and 4 inaccurately compared with the reference standard. Seventy-one of 72 noninferiority trial protocols or SAPs provided no rationale for selection of noninferiority hypothesis. None provided a clinical rationale for the chosen amount of decreased efficacy. Patients were not accurately informed of study purpose, which raises questions regarding the ethics of informed consent in antibiotic trials. Noninferiority and superiority trials entail different benefit-harm trade-offs that must be conveyed for ethical informed consent.

  16. The contribution of Raman spectroscopy to the analytical quality control of cytotoxic drugs in a hospital environment: eliminating the exposure risks for staff members and their work environment.

    PubMed

    Bourget, Philippe; Amin, Alexandre; Vidal, Fabrice; Merlette, Christophe; Troude, Pénélope; Baillet-Guffroy, Arlette

    2014-08-15

    The purpose of the study was to perform a comparative analysis of the technical performance, respective costs and environmental effect of two invasive analytical methods (HPLC and UV/visible-FTIR) as compared to a new non-invasive analytical technique (Raman spectroscopy). Three pharmacotherapeutic models were used to compare the analytical performances of the three analytical techniques. Statistical inter-method correlation analysis was performed using non-parametric correlation rank tests. The study's economic component combined calculations relative to the depreciation of the equipment and the estimated cost of an AQC unit of work. In any case, analytical validation parameters of the three techniques were satisfactory, and strong correlations between the two spectroscopic techniques vs. HPLC were found. In addition, Raman spectroscopy was found to be superior as compared to the other techniques for numerous key criteria including a complete safety for operators and their occupational environment, a non-invasive procedure, no need for consumables, and a low operating cost. Finally, Raman spectroscopy appears superior for technical, economic and environmental objectives, as compared with the other invasive analytical methods. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. No Small Matter? An Increase of 30 Trillion Amphipods (plus or minus a few) in Lake Superior between 1973 and 2005

    EPA Science Inventory

    We compared a lakewide biological sampling in 2005 with the other lakewide biological sampling of Lake Superior in 1973...Lakewide, there were 40 trillion Diporeia in 2005, an increase of approx. 30 trillion compared with 1973. The open questions: what caused this apparen...

  18. Methotrexate monotherapy and methotrexate combination therapy with traditional and biologic disease modifying antirheumatic drugs for rheumatoid arthritis: abridged Cochrane systematic review and network meta-analysis

    PubMed Central

    Barnabe, Cheryl; Tomlinson, George; Marshall, Deborah; Devoe, Dan; Bombardier, Claire

    2016-01-01

    Objective To compare methotrexate based disease modifying antirheumatic drug (DMARD) treatments for rheumatoid arthritis in patients naive to or with an inadequate response to methotrexate. Design Systematic review and Bayesian random effects network meta-analysis of trials assessing methotrexate used alone or in combination with other conventional synthetic DMARDs, biologic drugs, or tofacitinib in adult patients with rheumatoid arthritis. Data sources Trials were identified from Medline, Embase, and Central databases from inception to 19 January 2016; abstracts from two major rheumatology meetings from 2009 to 2015; two trial registers; and hand searches of Cochrane reviews. Study selection criteria Randomized or quasi-randomized trials that compared methotrexate with any other DMARD or combination of DMARDs and contributed to the network of evidence between the treatments of interest. Main outcomes American College of Rheumatology (ACR) 50 response (major clinical improvement), radiographic progression, and withdrawals due to adverse events. A comparison between two treatments was considered statistically significant if its credible interval excluded the null effect, indicating >97.5% probability that one treatment was superior. Results 158 trials were included, with between 10 and 53 trials available for each outcome. In methotrexate naive patients, several treatments were statistically superior to oral methotrexate for ACR50 response: sulfasalazine and hydroxychloroquine (“triple therapy”), several biologics (abatacept, adalimumab, etanercept, infliximab, rituximab, tocilizumab), and tofacitinib. The estimated probability of ACR50 response was similar between these treatments (range 56-67%), compared with 41% with methotrexate. Methotrexate combined with adalimumab, etanercept, certolizumab, or infliximab was statistically superior to oral methotrexate for inhibiting radiographic progression, but the estimated mean change over one year with all treatments was less than the minimal clinically important difference of 5 units on the Sharp-van der Heijde scale. Triple therapy had statistically fewer withdrawals due to adverse events than methotrexate plus infliximab. After an inadequate response to methotrexate, several treatments were statistically superior to oral methotrexate for ACR50 response: triple therapy, methotrexate plus hydroxychloroquine, methotrexate plus leflunomide, methotrexate plus intramuscular gold, methotrexate plus most biologics, and methotrexate plus tofacitinib. The probability of response was 61% with triple therapy and ranged widely (27-70%) with other treatments. No treatment was statistically superior to oral methotrexate for inhibiting radiographic progression. Methotrexate plus abatacept had a statistically lower rate of withdrawals due to adverse events than several treatments. Conclusions Triple therapy (methotrexate plus sulfasalazine plus hydroxychloroquine) and most regimens combining biologic DMARDs with methotrexate were effective in controlling disease activity, and all were generally well tolerated in both methotrexate naive and methotrexate exposed patients. PMID:27102806

  19. Comparative effects of valsartan in combination with cilnidipine or amlodipine on cardiac remodeling and diastolic dysfunction in Dahl salt-sensitive rats.

    PubMed

    Nagasawa, Kai; Takahashi, Keiji; Matsuura, Natsumi; Takatsu, Miwa; Hattori, Takuya; Watanabe, Shogo; Harada, Eri; Niinuma, Kazumi; Murohara, Toyoaki; Nagata, Kohzo

    2015-01-01

    Angiotensin receptor blockers (ARBs) are often supplemented with calcium channel blockers (CCBs) for treatment of hypertension. We recently showed that the L/N-type CCB cilnidipine has superior cardioprotective effects compared with the L-type CCB amlodipine in Dahl salt-sensitive (DS) rats. We have now compared the effects of the ARB valsartan combined with cilnidipine or amlodipine on cardiac pathophysiology in DS rats. DS rats fed a high-salt diet from 6 weeks of age were treated with vehicle, valsartan alone (10 mg kg(-1) per day), or valsartan combined with either cilnidipine (1 mg kg(-1) per day) or amlodipine (1 mg kg(-1) per day) from 7 to 11 weeks. The salt-induced increase in systolic blood pressure apparent in the vehicle group was attenuated similarly in the three drug treatment groups. Valsartan-cilnidipine attenuated left ventricular (LV) fibrosis and diastolic dysfunction as well as cardiac oxidative stress and inflammation to a greater extent than did valsartan alone or valsartan-amlodipine. In addition, the increases in urinary excretion of dopamine and epinephrine as well as in cardiac renin-angiotensin-aldosterone-system (RAAS) gene expression apparent in vehicle-treated rats were attenuated to a greater extent by valsartan-cilnidipine than by the other two treatments. Valsartan-cilnidipine thus attenuated LV remodeling and diastolic dysfunction more effectively than did valsartan or valsartan-amlodipine in rats with salt-sensitive hypertension, and this superior cardioprotective action of valsartan-cilnidipine compared with valsartan-amlodipine is likely attributable, at least in part, to the greater antioxidant and antiinflammatory effects associated with both greater inhibition of cardiac RAAS gene expression and N-type calcium channel blockade.

  20. Orally administered rapamycin, dacarbazine or both for treatment of human melanoma evaluated in severe combined immunodeficiency mice.

    PubMed

    Thallinger, Christiane; Skorjanec, Sophie; Soleiman, Afschin; Tzaneva, Stanislava; Griss, Johannes; Rous, Wolfgang; Poeppl, Wolfgang; Weinlich, Georg; Karimian-Teherani, Daniela; Joukhadar, Christian

    2008-01-01

    In this experimental study, the antineoplastic potential of orally administered rapamycin in human melanoma was evaluated and compared with dacarbazine (DTIC) as well as with the antineoplastic effect of the combination of both drugs. The substances were tested using 2 human melanoma cell lines, 518A2, which is highly susceptible to DTIC, and 607B, which is moderately susceptible. A human melanoma severe combined immunodeficiency mouse xenotransplantation model was used. After development of palpable tumors, mice received oral rapamycin or saline over 18 days. Additionally, from treatment day 4 to 8, mice were randomly chosen to receive either DTIC or saline treatment. The oral rapamycin treatment (1.5, 7.5, 15 and 30 mg/kg body weight) had an antineoplastic effect, ranging from 35 to 78% tumor weight reduction compared with the saline group. In DTIC less sensitive 607B tumors, rapamycin treatment (15 and 30 mg/kg body weight) was superior to DTIC treatment (p < 0.05). DTIC monotreatment reduced tumor weight in 518A2 tumors by 85% on average, whereas in 607B xenografts, no significant tumor weight reduction was observed compared with the saline group (p > 0.05). The combination of rapamycin and DTIC was not superior to rapamycin monotreatment in any cell line. These data indicate that oral rapamycin exerts a relevant antineoplastic effect on human melanoma cells. This effect appeared to be more pronounced in DTIC less sensitive melanoma xenografts. Copyright 2008 S. Karger AG, Basel.

  1. Ultrasound- versus Palpation-Guided Injection of Corticosteroid for Plantar Fasciitis: A Meta-Analysis

    PubMed Central

    Yu, Aixi; Qi, Baiwen

    2014-01-01

    Background It is controversial whether ultrasound-guided injection of corticosteroid is superior to palpation-guided injection for plantar fasciitis. This meta-analysis was performed to compare the effectiveness of ultrasound-guided and palpation-guided injection of corticosteroid for the treatment of plantar fasciitis. Methods Databases (MEDLINE, Cochrane library and EMBASE) and reference lists were searched from their establishment to August 30, 2013 for randomized controlled trials (RCTs) comparing ultrasound-guided with palpation-guided injection for plantar fasciitis. The Cochrane risk of bias (ROB) tool was used to assess the methodological quality. Outcome measurements were visual analogue scale (VAS), tenderness threshold (TT), heel tenderness index (HTI), response rate, plantar fascia thickness (PFT), hypoechogenicity and heel pad thickness (HPT). The statistical analysis was performed with software RevMan 5.2 and Stata 12.0. When I2<50%, the fixed-effects model was adopted. Otherwise the randomized-effects model was adopted. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to assess the quality of evidence. Results Five RCTs with 149 patients were identified and analyzed. Compared with palpation-guided injection, ultrasound-guided injection was superior with regard to VAS, TT, response rate, PFT and hypoechogenicity. However, there was no statistical significance between the two groups for HPT and HTI. Conclusion Ultrasound-guided injection of corticosteroid tends to be more effective than palpation-guided injection. However, it needs to be confirmed by further research. PMID:24658102

  2. Radiation Sickness: An Analysis of Over 1000 Controlled Drug Trials

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

    Stoll, B A

    1962-08-25

    In 1042 irradiated patients drug trials were conducted in attempts to assess the relative value of central sedatives (mainly phenothiazines) as compared with pyridoxine and a relatively inert group of drugs. The phenothiazines used were of the older type (chlorpromazine, prochlorperazine, thiopropazate, fluopromazine, pecazine) as well as of the newer type (trifluoperazine, haloperidol). The relatively inert drugs included cyclazine, amphetamine, diphenylhydramine, and lactose. For nausea, the predominant symptom, pyridoxine, the older phenothiazines, and the newer tranquilizer groups are all significantly superior to the inert drugs. The newer tranquilizers are superior to all others, but there is no statistical difference betweenmore » pyridoxine and the older phenothiazines in the relief of nausea. For vomiting and listlessness, a similar superiority of the newer tranquilizers is shown. In the case of anorexia, however, pyridoxine and the older phenothiazines are superior to the inert group but the newer tranquilizers are relatively less effective. For all drugs used in radiation sickness, anorexia is the most difficult symptom to relieve possibly because its control lies in the appetite center, separate from the vomiting center. Possibly some other factor also enters into its control, such as the loss of taste. Haloperidol and trifluoperazine assessed separately showed no statistical difference in their relative efficacy in any symptom including anorexia. Radiation of the abdomen and pelvis causes more severe radiation sickness, and inert drugs give, in general, less relief of symptoms arising from radiation of this area than of other parts. All the drugs were less efficacious when radiation is given to the abdomen and pelvis, although not at a significantly statistical level. In comparison of the efficacy of each group for irradiation both above and below the diaphragm, the newer tranquilizers appear significantly superior to all others. For nausea arising in 265 cases of breast irradiation, the new tranquilizers are significantly superior to all others. Anorexia after irradiation may originate in the appetite center or have a different cause such as delayed gastric emptying. Separate origins for vomiting and for anorexia may account for the superior effect noted with the newer tranquilizers on the symptoms of nausea and vomiting and the greatly inferior effect on anorexia. The tranquilizers may act by sedating the vomiting center. Evidence was found for a specific deficiency of pyridoxine in some cases of radiation sickness. Whether this is a direct effect on enzymes, an effect on the bowel, or a result of metabolic changes associated with vomiting is uncertain. Nevertheless pyridoxine may be of value even if other anti-emetic drugs fail to control the symptoms of radiation sickness.« less

  3. [Analgesic effect of acupuncture at Neimadian(Extra) in postoperation of abdominal surgery].

    PubMed

    Ding, Liu-Xin; Xing, Qun-Zhi; Sun, Jun-Jun; Li, Yu

    2011-08-01

    To observe the analgesia effectiveness and safety of electroacupuncture at Neimadian(Extra) for postoperation of abdominal surgery. One hundred and twenty patients with routine abdominal surgery were randomly divided into an acupuncture group and a medication group, 60 cases in each group. The acupuncture group was treated with electroacupuncture at Neimadian(Extra), which was located on the inside of lower leg, 7 cun above the internal malleolus and 0.5 cun from post edge of tibial. The medication group was treated with patient-controlled intravenous analgesia (PCIA) with Sufentanil. After the treatment, the Visual Analogue Scale (VAS), the security, the analgesic effect and beta-endorphin content were compared. The postoperative VAS score at 2, 4, 8, 16, 24 and 48 h in the acupuncture group was lower than those in the medication group (all P < 0.05). The analgesic effect at 2, 4, 16 and 24 h after surgery in the acupuncture group were superior to those in the medication group (P < 0.05, P < 0.01). The beta-endorphin content at 0, 8, 16 and 48 h after surgery in both groups were increased, and the acupuncture group was superior to the medication group (all P < 0.05). The security class after surgery in the acupuncture group was higher than that in the medication group (P < 0.05). The analgesic effect and safety of electroacupuncture at Neimadian(Extra) in postoperation of abdominal surgery are superior to those of the PCIA with Sufentanil.

  4. [Controlled observation of non-blister acupoint sticking and electroacupuncture for bronchial asthma].

    PubMed

    Tian, Hai-Yan; Hu, Jia; Wang, Lin

    2013-06-01

    To compare the differences of clinical efficacy for bronchial asthma between acupoint sticking combined with ginger-separated moxibustion and electroacupuncture combined with ginger-separated moxibustion. With a randomized and controlled method, one hundred cases were divided into an acupoint sticking + ginger-separated moxibustion group (group A) and an electroacupuncture + ginger-separated moxibustion group (group E), 50 cases in each one. The Dazhui (GV 14), Feishu (BL 13), Tiantu (CV 22) and so on were selected in both groups. The treatment was given on the 1st day of each dog-day period and each nine-day period after the winter solstice separately. The ginger-separated moxibustion was applied in the group A, which was followed by plaster sticking that was made with Chinese herbs (including white mustard seed, rhizoma corydalis, euphorbia kansui, asarum), glycerin and warm ginger juice. The regular acupuncture, electroacupuncture and ginger-separated moxibustion were applied in the group E. The scores of recovery cough, control asthma, respiratory frequency, stuffiness chest, wheezing and markedly and cured effective rate were compared in two groups before and after the treatment. The markedly and cured effective rate was 72.0% (36/50) in the group A, which was superior to 46.0% (23/50) in the group E (P < 0.05). All the symptom scores in two groups were obviously improved after the treatment, in which group A was superior to group E (all P < 0.05). The acupoint sticking and ginger-separated moxibustion could obviously improve clinical symptoms in patients with bronchial asthma, and reduce skin irritation of medicine to avoid the blister and relive patients' suffer, which has superior effect to electroacupuncture combined with ginger-separated moxibustion.

  5. Letrozole in the neoadjuvant setting: the P024 trial

    PubMed Central

    Ma, Cynthia

    2007-01-01

    Neoadjuvant chemotherapy trials have consistently reported lower response rates in hormone receptor-positive (HR+) breast cancer when compared with HR− cases. Preoperative endocrine therapy has therefore become a logical alternative and has gained considerable momentum from the finding that aromatase inhibitors (AIs) are more effective than tamoxifen for HR+ breast cancer in both the neoadjuvant and adjuvant settings. The most convincing neoadjuvant trial to demonstrate the superiority of an AI versus tamoxifen was the P024 study, a large multinational double-blind trial in postmenopausal women with HR+ breast cancer ineligible for breast-conserving surgery. The overall response rate (ORR) was 55% for letrozole and 36% for tamoxifen (P < 0.001). Significantly more letrozole-treated patients underwent breast-conserving surgery (45 vs. 35%, respectively; P = 0.022). In addition, ORR was significantly higher with letrozole than tamoxifen in the human epidermal growth factor receptor HER1/HER2+ subgroup (P = 0.0004). The clinical efficacy of letrozole in HER2+ breast cancer was confirmed by fluorescent in situ hybridization analysis and was found to be comparable to that of HER2− cases (ORR 71% in both subsets). Biomarker studies confirmed the superiority of letrozole in centrally assessed estrogen receptor-positive (ER+) tumors and found a strong relationship with the degree of ER positivity for both agents. Interestingly, letrozole was effective even in marginally ER+ tumors and, unlike tamoxifen, consistently reduced the expression from estrogen-regulated genes (progesterone receptor and trefoil factor 1). Furthermore, when analyzed by Ki67 immunohistochemistry, letrozole was significantly more effective than tamoxifen in reducing tumor proliferation (P = 0.0009). Thus, neoadjuvant letrozole is safe and superior to tamoxifen in the treatment of postmenopausal women with HR+ locally advanced breast cancer. PMID:17912634

  6. Effects of sertraline on brain current source of the high beta frequency band: analysis of electroencephalography during audiovisual erotic stimulation in males with premature ejaculation.

    PubMed

    Kwon, O Y; Kam, S C; Choi, J H; Do, J M; Hyun, J S

    2011-01-01

    To identify the effects of sertraline, a selective serotonin reuptake inhibitor, for the treatment of premature ejaculation (PE), changes in brain current-source density (CSD) of the high beta frequency band (22-30 Hz) induced by sertraline administration were investigated during audiovisual erotic stimulation. Eleven patients with PE (36.9±7.8 yrs) and 11 male volunteers (24.2±1.9 years) were enrolled. Scalp electroencephalography (EEG) was conducted twice: once before sertraline administration and then again 4 h after the administration of 50 mg sertraline. Statistical non-parametric maps were obtained using the EEG segments to detect the current-density differences in the high beta frequency bands (beta-3, 22-30 Hz) between the EEGs before and after sertraline administration in the patient group and between the patient group and controls after the administration of sertraline during the erotic video sessions. Comparing between before and after sertraline administration in the patients with PE, the CSD of the high beta frequency band at 4 h after sertraline administration increased significantly in both superior frontal gyri and the right medial frontal gyrus (P<0.01). The CSD of the beta-3 band of the patients with PE were less activated significantly in the middle and superior temporal gyrus, lingual and fusiform gyrus, inferior occipital gyrus and cuneus of the right cerebral hemisphere compared with the normal volunteers 4 h after sertraline administration (P<0.01). In conclusion, sertraline administration increased the CSD in both the superior frontal and right middle temporal gyrus in patients with PE. The results suggest that the increased neural activity in these particular cerebral regions after sertraline administration may be associated with inhibitory effects on ejaculation in patients with PE.

  7. Cognitive-behavioral therapy for panic disorder with agoraphobia in older people: a comparison with younger patients.

    PubMed

    Hendriks, Gert-Jan; Kampman, Mirjam; Keijsers, Ger P J; Hoogduin, Cees A L; Voshaar, Richard C Oude

    2014-08-01

    Older adults with panic disorder and agoraphobia (PDA) are underdiagnosed and undertreated, while studies of cognitive-behavioral therapy (CBT) are lacking. This study compares the effectiveness of CBT for PDA in younger and older adults. A total of 172 patients with PDA (DSM-IV) received manualized CBT. Primary outcome measures were avoidance behavior (Mobility Inventory Avoidance scale) and agoraphobic cognitions (Agoraphobic Cognitions Questionnaire), with values of the younger (18-60 years) and older (≥ 60 years) patients being compared using mixed linear models adjusted for baseline inequalities, and predictive effects of chronological age, age at PDA onset and duration of illness (DOI) being examined using multiple linear regressions. Attrition rates were 2/31 (6%) for the over-60s and 31/141 (22%) for the under-60s group (χ(2) = 3.43, df = 1, P = .06). Patients in both age groups improved on all outcome measures with moderate-to-large effect sizes. Avoidance behavior had improved significantly more in the 60+ group (F = 4.52, df = 1,134, P = .035), with agoraphobic cognitions showing no age-related differences. Baseline severity of agoraphobic avoidance and agoraphobic cognitions were the most salient predictors of outcome (range standardized betas 0.59 through 0.76, all P-values < .001). Apart from a superior reduction of agoraphobic avoidance in the 60+ participants (β = -0.30, P = .037), chronological age was not related to outcome, while in the older patients higher chronological age, late-onset type and short DOI were linked to superior improvement of agoraphobic avoidance. CBT appears feasible for 60+ PDA-patients, yielding outcomes that are similar and sometimes even superior to those obtained in younger patients. © 2014 Wiley Periodicals, Inc.

  8. Formulating appropriate statistical hypotheses for treatment comparison in clinical trial design and analysis.

    PubMed

    Huang, Peng; Ou, Ai-hua; Piantadosi, Steven; Tan, Ming

    2014-11-01

    We discuss the problem of properly defining treatment superiority through the specification of hypotheses in clinical trials. The need to precisely define the notion of superiority in a one-sided hypothesis test problem has been well recognized by many authors. Ideally designed null and alternative hypotheses should correspond to a partition of all possible scenarios of underlying true probability models P={P(ω):ω∈Ω} such that the alternative hypothesis Ha={P(ω):ω∈Ωa} can be inferred upon the rejection of null hypothesis Ho={P(ω):ω∈Ω(o)} However, in many cases, tests are carried out and recommendations are made without a precise definition of superiority or a specification of alternative hypothesis. Moreover, in some applications, the union of probability models specified by the chosen null and alternative hypothesis does not constitute a completed model collection P (i.e., H(o)∪H(a) is smaller than P). This not only imposes a strong non-validated assumption of the underlying true models, but also leads to different superiority claims depending on which test is used instead of scientific plausibility. Different ways to partition P fro testing treatment superiority often have different implications on sample size, power, and significance in both efficacy and comparative effectiveness trial design. Such differences are often overlooked. We provide a theoretical framework for evaluating the statistical properties of different specification of superiority in typical hypothesis testing. This can help investigators to select proper hypotheses for treatment comparison inclinical trial design. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Preservation of corals in salt-saturated DMSO buffer is superior to ethanol for PCR experiments

    NASA Astrophysics Data System (ADS)

    Gaither, M. R.; Szabó, Z.; Crepeau, M. W.; Bird, C. E.; Toonen, R. J.

    2011-06-01

    Specimen collection is time consuming and expensive, yet few laboratories test preservation methods before setting out on field expeditions. The most common preservation buffer used for coral specimens is >70% EtOH. However, alternatives exist that are less flammable, easier to ship, and are widely used in other taxa. Here, we compare the effects of salt-saturated DMSO (SSD) and EtOH preservation buffers on post-extraction DNA quantity and quality. We found that soft tissue integrity was better maintained and higher quantities of DNA were extracted from EtOH-preserved specimens; however, by all other measures, SSD was a superior preservative to EtOH. Extractions of SSD-preserved specimens resulted in higher molecular weight DNA, higher PCR success, and more efficient amplification than specimens preserved in EtOH. Our results show that SSD is generally a superior preservative to EtOH for specimens destined for PCR studies, but species-specific differences indicate that preservation comparisons should be undertaken before collection and storage of samples.

  10. Super-recognition in development: A case study of an adolescent with extraordinary face recognition skills.

    PubMed

    Bennetts, Rachel J; Mole, Joseph; Bate, Sarah

    2017-09-01

    Face recognition abilities vary widely. While face recognition deficits have been reported in children, it is unclear whether superior face recognition skills can be encountered during development. This paper presents O.B., a 14-year-old female with extraordinary face recognition skills: a "super-recognizer" (SR). O.B. demonstrated exceptional face-processing skills across multiple tasks, with a level of performance that is comparable to adult SRs. Her superior abilities appear to be specific to face identity: She showed an exaggerated face inversion effect and her superior abilities did not extend to object processing or non-identity aspects of face recognition. Finally, an eye-movement task demonstrated that O.B. spent more time than controls examining the nose - a pattern previously reported in adult SRs. O.B. is therefore particularly skilled at extracting and using identity-specific facial cues, indicating that face and object recognition are dissociable during development, and that super recognition can be detected in adolescence.

  11. Sacroiliac joint stability: Finite element analysis of implant number, orientation, and superior implant length.

    PubMed

    Lindsey, Derek P; Kiapour, Ali; Yerby, Scott A; Goel, Vijay K

    2018-03-18

    To analyze how various implants placement variables affect sacroiliac (SI) joint range of motion. An experimentally validated finite element model of the lumbar spine and pelvis was used to simulate a fusion of the SI joint using various placement configurations of triangular implants (iFuse Implant System ® ). Placement configurations were varied by changing implant orientation, superior implant length, and number of implants. The range of motion of the SI joint was calculated using a constant moment of 10 N-m with a follower load of 400 N. The changes in motion were compared between the treatment groups to assess how the different variables affected the overall motion of the SI joint. Transarticular placement of 3 implants with superior implants that end in the middle of the sacrum resulted in the greatest reduction in range of motion (flexion/extension = 73%, lateral bending = 42%, axial rotation = 72%). The range of motions of the SI joints were reduced with use of transarticular orientation (9%-18%) when compared with an inline orientation. The use of a superior implant that ended mid-sacrum resulted in median reductions of (8%-14%) when compared with a superior implant that ended in the middle of the ala. Reducing the number of implants, resulted in increased SI joint range of motions for the 1 and 2 implant models of 29%-133% and 2%-39%, respectively, when compared with the 3 implant model. Using a validated finite element model we demonstrated that placement of 3 implants across the SI joint using a transarticular orientation with superior implant reaching the sacral midline resulted in the most stable construct. Additional clinical studies may be required to confirm these results.

  12. Sacroiliac joint stability: Finite element analysis of implant number, orientation, and superior implant length

    PubMed Central

    Lindsey, Derek P; Kiapour, Ali; Yerby, Scott A; Goel, Vijay K

    2018-01-01

    AIM To analyze how various implants placement variables affect sacroiliac (SI) joint range of motion. METHODS An experimentally validated finite element model of the lumbar spine and pelvis was used to simulate a fusion of the SI joint using various placement configurations of triangular implants (iFuse Implant System®). Placement configurations were varied by changing implant orientation, superior implant length, and number of implants. The range of motion of the SI joint was calculated using a constant moment of 10 N-m with a follower load of 400 N. The changes in motion were compared between the treatment groups to assess how the different variables affected the overall motion of the SI joint. RESULTS Transarticular placement of 3 implants with superior implants that end in the middle of the sacrum resulted in the greatest reduction in range of motion (flexion/extension = 73%, lateral bending = 42%, axial rotation = 72%). The range of motions of the SI joints were reduced with use of transarticular orientation (9%-18%) when compared with an inline orientation. The use of a superior implant that ended mid-sacrum resulted in median reductions of (8%-14%) when compared with a superior implant that ended in the middle of the ala. Reducing the number of implants, resulted in increased SI joint range of motions for the 1 and 2 implant models of 29%-133% and 2%-39%, respectively, when compared with the 3 implant model. CONCLUSION Using a validated finite element model we demonstrated that placement of 3 implants across the SI joint using a transarticular orientation with superior implant reaching the sacral midline resulted in the most stable construct. Additional clinical studies may be required to confirm these results. PMID:29564210

  13. Efficacy of nystatin for the treatment of oral candidiasis: a systematic review and meta-analysis.

    PubMed

    Lyu, Xin; Zhao, Chen; Yan, Zhi-Min; Hua, Hong

    2016-01-01

    To systematically review and assess the efficacy, different treatment protocols (formulation, dosage, and duration), and safety of nystatin for treating oral candidiasis. Four electronic databases were searched for trials published in English till July 1, 2015. Randomized controlled trials comparing nystatin with other antifungal therapies or a placebo were included. Clinical and/or mycological cure was the outcome evaluation. A meta-analysis or descriptive study on the efficacy, treatment protocols, and safety of nystatin was conducted. The meta-analysis showed that nystatin pastille was significantly superior to placebo in treating denture stomatitis. Nystatin suspension was not superior to fluconazole in treating oral candidiasis in infants, children, or HIV/AIDS patients. The descriptive investigations showed that administration of nystatin suspension and pastilles in combination for 2 weeks might achieve a higher clinical and mycological cure rate, and using the nystatin pastilles alone might have a higher mycological cure rate, when compared with using nystatin suspensions alone. Nystatin pastilles at a dose of 400,000 IU resulted in a significantly higher mycological cure rate than that administrated at a dose of 200,000 IU. Furthermore, treatment with nystatin pastilles for 4 weeks seemed to have better clinical efficacy than treatment for 2 weeks. Descriptive safety assessment showed that poor taste and gastrointestinal adverse reaction are the most common adverse effects of nystatin. Nystatin pastille was significantly superior to placebo in treating denture stomatitis, while nystatin suspension was not superior to fluconazole in treating oral candidiasis in infants, children, or HIV/AIDS patients. Indirect evidence from a descriptive study demonstrated that administration of nystatin pastille alone or pastille and suspension in combination is more effective than that of suspension alone; prolonged treatment duration for up to 4 weeks can increase the efficacy of nystatin. More well designed and high quality randomized control studies are needed to confirm these findings.

  14. Efficacy of nystatin for the treatment of oral candidiasis: a systematic review and meta-analysis

    PubMed Central

    Lyu, Xin; Zhao, Chen; Yan, Zhi-min; Hua, Hong

    2016-01-01

    Objective To systematically review and assess the efficacy, different treatment protocols (formulation, dosage, and duration), and safety of nystatin for treating oral candidiasis. Methods Four electronic databases were searched for trials published in English till July 1, 2015. Randomized controlled trials comparing nystatin with other antifungal therapies or a placebo were included. Clinical and/or mycological cure was the outcome evaluation. A meta-analysis or descriptive study on the efficacy, treatment protocols, and safety of nystatin was conducted. Results The meta-analysis showed that nystatin pastille was significantly superior to placebo in treating denture stomatitis. Nystatin suspension was not superior to fluconazole in treating oral candidiasis in infants, children, or HIV/AIDS patients. The descriptive investigations showed that administration of nystatin suspension and pastilles in combination for 2 weeks might achieve a higher clinical and mycological cure rate, and using the nystatin pastilles alone might have a higher mycological cure rate, when compared with using nystatin suspensions alone. Nystatin pastilles at a dose of 400,000 IU resulted in a significantly higher mycological cure rate than that administrated at a dose of 200,000 IU. Furthermore, treatment with nystatin pastilles for 4 weeks seemed to have better clinical efficacy than treatment for 2 weeks. Descriptive safety assessment showed that poor taste and gastrointestinal adverse reaction are the most common adverse effects of nystatin. Conclusion Nystatin pastille was significantly superior to placebo in treating denture stomatitis, while nystatin suspension was not superior to fluconazole in treating oral candidiasis in infants, children, or HIV/AIDS patients. Indirect evidence from a descriptive study demonstrated that administration of nystatin pastille alone or pastille and suspension in combination is more effective than that of suspension alone; prolonged treatment duration for up to 4 weeks can increase the efficacy of nystatin. More well designed and high quality randomized control studies are needed to confirm these findings. PMID:27042008

  15. [Clinical observation of post-herpetic neuralgia treated with TCM herbal cupping therapy].

    PubMed

    Wu, Xi; Hu, Hui; Guo, Liang; Wang, Hui

    2013-02-01

    To compare the difference in the efficacy on post-herpetic neuralgia among TCM herbal cupping therapy, Chinese medicine thermal compressing therapy and mecobalamine. Fifty-seven cases were randomized into a TCM herbal cupping group, a thermal compressing group and a western medicine group, 19 cases in each one. The oral administration of ibuprofen was applied in every group. In the herbal cupping group, the bamboo cups soaked in the boiled Chinese herbal decoction were sucked on the most significant painful area. In the thermal compressing group, the towel soaked in the boiled Chinese herbal decoction was compressed on the most significant painful area. In the medication group, the muscular injection of mecobalamine was adopted. The treatment was given once a day, for 2 weeks totally in each group. SF-MPQ score and clinical efficacy before and after treatment were observed in each group. The remarkable effective rates were 78.9% (15/19), 36.8% (7/19) and 5.3% (1/19) in the TCM herbal cupping group, thermal compressing group and western medicine group separately. The efficacy in the TCM herbal cupping group was significantly superior to the thermal compressing group and western medicine group (all P < 0.05), and that in the thermal compressing group was superior to the western medicine group (P < 0.05). After treatment, SF-MPQ score was reduced significantly in each group (P < 0.001, P < 0.01). The score in the herbal cupping group was reduced more significantly as compared with the thermal compressing group and western medicine group (all P < 0.01). The improvement in pain in the thermal compressing group was superior to the western medicine group (P < 0.01). TCM herbal cupping therapy achieves the superior efficacy for post-herpetic neuralgia and relieves pain effectively of the patients, which is more advantageous than CM herbal thermal compressing therapy and Mecobalamine.

  16. Young children's recall and reconstruction of audio and audiovisual narratives.

    PubMed

    Gibbons, J; Anderson, D R; Smith, R; Field, D E; Fischer, C

    1986-08-01

    It has been claimed that the visual component of audiovisual media dominates young children's cognitive processing. This experiment examines the effects of input modality while controlling the complexity of the visual and auditory content and while varying the comprehension task (recall vs. reconstruction). 4- and 7-year-olds were presented brief stories through either audio or audiovisual media. The audio version consisted of narrated character actions and character utterances. The narrated actions were matched to the utterances on the basis of length and propositional complexity. The audiovisual version depicted the actions visually by means of stop animation instead of by auditory narrative statements. The character utterances were the same in both versions. Audiovisual input produced superior performance on explicit information in the 4-year-olds and produced more inferences at both ages. Because performance on utterances was superior in the audiovisual condition as compared to the audio condition, there was no evidence that visual input inhibits processing of auditory information. Actions were more likely to be produced by the younger children than utterances, regardless of input medium, indicating that prior findings of visual dominance may have been due to the salience of narrative action. Reconstruction, as compared to recall, produced superior depiction of actions at both ages as well as more constrained relevant inferences and narrative conventions.

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

    PubMed Central

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

    2006-01-01

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

  18. Dual Energy X-Ray Absorptiometry Compared with Anthropometry in Relation to Cardio-Metabolic Risk Factors in a Young Adult Population: Is the 'Gold Standard' Tarnished?

    PubMed

    Demmer, Denise L; Beilin, Lawrence J; Hands, Beth; Burrows, Sally; Pennell, Craig E; Lye, Stephen J; Mountain, Jennifer A; Mori, Trevor A

    2016-01-01

    Assessment of adiposity using dual energy x-ray absorptiometry (DXA) has been considered more advantageous in comparison to anthropometry for predicting cardio-metabolic risk in the older population, by virtue of its ability to distinguish total and regional fat. Nonetheless, there is increasing uncertainty regarding the relative superiority of DXA and little comparative data exist in young adults. This study aimed to identify which measure of adiposity determined by either DXA or anthropometry is optimal within a range of cardio-metabolic risk factors in young adults. 1138 adults aged 20 years were assessed by DXA and standard anthropometry from the Western Australian Pregnancy Cohort (Raine) Study. Cross-sectional linear regression analyses were performed. Waist to height ratio was superior to any DXA measure with HDL-C. BMI was the superior model in relation to blood pressure than any DXA measure. Midriff fat mass (DXA) and waist circumference were comparable in relation to glucose. For all the other cardio-metabolic variables, anthropometric and DXA measures were comparable. DXA midriff fat mass compared with BMI or waist hip ratio was the superior measure for triglycerides, insulin and HOMA-IR. Although midriff fat mass (measured by DXA) was the superior measure with insulin sensitivity and triglycerides, the anthropometric measures were better or equal with various DXA measures for majority of the cardio-metabolic risk factors. Our findings suggest, clinical anthropometry is generally as useful as DXA in the evaluation of the individual cardio-metabolic risk factors in young adults.

  19. Effects of Asymmetric Superior Laryngeal Nerve Stimulation on Glottic Posture, Acoustics, Vibration

    PubMed Central

    Chhetri, Dinesh K.; Neubauer, Juergen; Bergeron, Jennifer L.; Sofer, Elazar; Peng, Kevin A.; Jamal, Nausheen

    2013-01-01

    Objectives Evaluate the effects of asymmetric superior laryngeal nerve stimulation on the vibratory phase, laryngeal posture, and acoustics. Study Design Basic science study using an in vivo canine model. Methods The superior laryngeal nerves were symmetrically and asymmetrically stimulated over eight activation levels to mimic laryngeal asymmetries representing various levels of superior laryngeal nerve paresis and paralysis conditions. Glottal posture change, vocal fold speed, and vibration of these 64 distinct laryngeal activation conditions were evaluated by high speed video and concurrent acoustic and aerodynamic recordings. Assessments were made at phonation onset. Results Vibratory phase was symmetric in all symmetric activation conditions but consistent phase asymmetry towards the vocal fold with higher superior laryngeal nerve activation was observed. Superior laryngeal nerve paresis and paralysis conditions had reduced vocal fold strain and fundamental frequency. Superior laryngeal nerve activation increased vocal fold closure speed, but this effect was more pronounced for the ipsilateral vocal fold. Increasing asymmetry led to aperiodic and chaotic vibration. Conclusions This study directly links vocal fold tension asymmetry with vibratory phase asymmetry; in particular the side with greater tension leads in the opening phase. The clinical observations of vocal fold lag, reduced vocal range, and aperiodic voice in superior laryngeal paresis and paralysis is also supported. PMID:23712542

  20. Which Extreme Variant of the Problem-Solving Method of Teaching Should Be More Characteristic of the Many Teacher Variations of Problem-Solving Teaching?

    ERIC Educational Resources Information Center

    Mahan, Luther A.

    1970-01-01

    Compares the effects of two problem-solving teaching approaches. Lower ability students in an activity group demonstrated superior growth in basic science understanding, &roblem-solving skills, science interests, personal adjustment, and school attitudes. Neither method favored cognitive learning by higher ability students. (PR)

  1. Soluble Ions with ICP-MS are Superior to Total Elements with XRF in Assessing Component-specific Cardiovascular Effects of Fine Particulate Matter

    EPA Science Inventory

    Background: We previously reported that total fine particulate matter (PM2.5) was associated with flow-mediated dilation (FMD), interleukin-6 (lL-6) and tumor-necrosisfactor-alpha (TNFa) in 22 individuals with type 2 diabetes. Objectives: We now compare two laboratory methods of ...

  2. Acetophenone superior to verbenone for reducing attraction of western pine beetle Dendroctonus brevicomis to its aggregation pheromone

    Treesearch

    Nadir Erbilgin; Nancy E. Gillette; Donald R. Owen; Sylvia R. Mori; Andrew S. Nelson; Fabian C.C. Uzoh; David L. Wood

    2008-01-01

    The western pine beetle Dendroctonus brevicomis LeConte (Coleoptera: Scolytidae) is one of the most damaging insect pests of ponderosa pines Pinus ponderosa Douglas ex P. & C. Lawson in Western U.S.A. We compared the effect of verbenone, a well known bark beetle anti-aggregation pheromone, with that...

  3. Efficacy and safety of curcumin and its combination with boswellic acid in osteoarthritis: a comparative, randomized, double-blind, placebo-controlled study.

    PubMed

    Haroyan, Armine; Mukuchyan, Vahan; Mkrtchyan, Nana; Minasyan, Naira; Gasparyan, Srbuhi; Sargsyan, Aida; Narimanyan, Mikael; Hovhannisyan, Areg

    2018-01-09

    The aim of this clinical trial was to assess the efficacy and safety of curcuminoid complex extract from turmeric rhizome with turmeric volatile oil (CuraMed®) and its combination with boswellic acid extract from Indian frankincense root (Curamin®) vs placebo for the treatment of 40- to 70-year-old patients with osteoarthritis (OA). The effects of CuraMed® 500-mg capsules (333 mg curcuminoids) and Curamin® 500-mg capsules (350 mg curcuminoids and 150 mg boswellic acid) taken orally three times a day for 12 weeks in 201 patients was investigated in a three-arm, parallel-group, randomized, double-blinded, placebo-controlled trial. Primary outcome efficacy measures included OA physical function performance-based tests, the WOMAC recommended index of joint pain, morning stiffness, limitations of physical function, and the patients' global assessment of disease severity. Favorable effects of both preparations compared to placebo were observed after only 3 months of continuous treatment. A significant effect of Curamin® compared to placebo was observed both in physical performance tests and the WOMAC joint pain index, while superior efficacy of CuraMed vs placebo was observed only in physical performance tests. The effect size compared to placebo was comparable for both treatment groups but was superior in the Curamin® group. The treatments were well tolerated. Twelve-week use of curcumin complex or its combination with boswellic acid reduces pain-related symptoms in patients with OA. Curcumin in combination with boswellic acid is more effective. Combining Curcuma longa and Boswellia serrata extracts in Curamin® increases the efficacy of OA treatment presumably due to synergistic effects of curcumin and boswellic acid. This trial is registered at the database www.clinicaltrials.gov . https://clinicaltrials.gov/ct2/show/NCT02390349?term=EuroPharma&rank=1 . Study registration number: NCT02390349 .

  4. Lateral clavicle fracture with coracoclavicular ligament injury: a biomechanical study of 4 different repair techniques.

    PubMed

    Alaee, Farhang; Apostolakos, John; Singh, Hardeep; Holwein, Christian; Diermeier, Theresa; Cote, Mark P; Beitzel, Knut; Imhoff, Andreas B; Mazzocca, Augustus D; Voss, Andreas

    2017-07-01

    To investigate the biomechanical performance of four different methods used for coracoclavicular (CC) ligament reconstruction in a lateral clavicle fracture repair. Native displacement, translation, and rotation at the acromioclavicular joint of 24 fresh-frozen cadaveric shoulders were tested. A reproducible fracture in the lateral third of the clavicle was created by dissecting both CC ligaments. Each specimen was then repaired with plate fixation of the fracture and the following CC repair technique: (1) Cortical button. (2) Suture anchor and plate button. (3) Suture anchor no plate button, and (4) Suture around coracoid. All reconstructed specimens were then re-tested for displacement, translation, and load to failure, and compared to their native results. Groups 1 and 3 were investigated for rotational load. There was no difference in load to failure between the repaired groups (p: ns). Group 1 showed less superior and anterior translations (p < 0.05). Group 2 showed significantly less superior translation (p = 0.003), but no significance with anterior and posterior translations to the native joint. Group 3 showed less superior and posterior translations (p = 0.005 and p = 0.039). Anterior and posterior translations were increased in group 4 (p < 0.05). The biomechanical analyses did not show any significance in load to failure or displacement after cyclic loading among the study groups. All repairs were effective in preventing superior translation. Groups 1 and 2 demonstrated increased horizontal stability compared to the native state. All 4 methods are clinically viable options for CC ligament repair.

  5. [Observation of curative effect of herpes zoster treated with acupuncture based on syndrome differentiation combined with pricking and cupping].

    PubMed

    Pan, Hua

    2011-10-01

    To compare the differences of curative effects of herpes zoster treated with acupuncture based on syndrome differentiation combined with pricking and cupping and simple pricking and cupping. Eighty-six cases were randomly divided into an observation group (43 cases) and a control group (43 cases). In observation group, acupoints selection based on syndrome differentiation i.e. Quchi (LI 11), Zusanli (ST 36), Sanyinjiao (SP 6), etc. were selected and pricking and cupping at affected parts were applied, and the cases were classified into damp heat in liver and gallbladder, damp retention and spleen deficiency, and qi deficiency and blood stasis. In control group, all the cases were simplely treated with pricking and cupping at affected parts. The treatment was given once a day, and seven days were made one session. The curative effect was evaluated after 2 courses, and the follow-up was carried on after 1 month. The cured and markedly effective rate was 93.0% (40/43) in observation group, superior to that of 67.4% (29/43) in control group (P < 0.01). Postherpetic neuralgia: there was 2.3% (1/43) in observation group, inferior to that of 14.0% (6/43) in control group. Comparison in 3 types: the cured and markedly effective rate of damp heat in liver and gallbladder: 94.7% (18/19) in observation group, and 85.7% (18/21) in control group, showing no significant difference between groups (P > 0.05). The cured and markedly effective rate of damp retention and spleen deficiency: 93.8% (15/16) in observation group, superior to that of 60.0% (9/15) in control group (P < 0. 05). The cured and markedly effective rate of qi deficiency and blood stasis: 87.5% (7/8) in observation group, superior to that of 28.6% (2/7) in control group (P < 0.05). For herpes zoster, acupoints selection based on syndrome differentiation combined with pricking and cupping therapy is high pertinent and effective, the postherpetic neuralgia can be reduced significantly and the curative effect is superior to that of simple pricking and cupping.

  6. A vanadium alloy for the application in a liquid metal blanket of a fusion reactor

    NASA Astrophysics Data System (ADS)

    Borgstedt, H. U.; Grundmann, M.; Konys, J.; Perić, Z.

    1988-07-01

    The vanadium alloy V3Ti1Si has been corrosion tested in liquid lithium and the eutectic alloy Pb-17Li at 550°C. This alloy has a comparable corrosion resistance to the alloy V15Cr5Ti in lithium. In this molten metal it is superior to stainless steel AISI 316. In the Pb-17Li melt it is even superior to martensitic steels. The alloy has only a weak tendency to be dissolved. It is sensitive to an exchange of non-metallic elements, which causes the formation of a hardened surface layer. These chemical effects are influenced by the mass and surface ratios of the vanadium alloy to the molten metals and other structural materials. These ratios are unfavorable in the two test loops. The effects might be less pronounced in a vanadium alloy/liquid metal fusion reactor blanket.

  7. The effect of a mouthrinse containing chlorine dioxide in the clinical reduction of volatile sulfur compounds.

    PubMed

    Soares, Leo Guimaraes; Guaitolini, Roberto Luiz; Weyne, Sergio de Carvalho; Falabella, Marcio Eduardo Vieira; Tinoco, Eduardo Muniz Barretto; da Silva, Denise Gomes

    2013-07-01

    This study sought to evaluate the clinical effect of a mouthrinse containing 0.3% chlorine dioxide (ClO2) in reducing oral volatile sulfur compounds (VSC). Halitosis was induced by L-cysteine in 11 volunteers, and 4 solutions were compared: a test solution containing 0.3% ClO2, 0.07% cetylpyridinium chloride (CPC), and 0.05% sodium fluoride; a placebo; a solution containing 0.05% CPC; and a control solution of 0.2% chlorhexidine gluconate (CHX). VSC levels were assessed using a Halimeter, and 6 measurements were made from baseline to 3 hours postrinse. The VSC reduction rate of the test mouthrinse was superior to the placebo and the CPC solution. There was no difference between the test solution and the CHX solution in VSC reduction rates immediately postrinse, or at 2 and 3 hours postrinse; both solutions were statistically superior to the placebo and the CPC solution.

  8. Presentation format effects in a levels-of-processing task.

    PubMed

    Foos, Paul W; Goolkasian, Paula

    2008-01-01

    Three experiments were conducted to examine better performance in long-term memory when stimulus items are pictures or spoken words compared to printed words. Hypotheses regarding the allocation of attention to printed words, the semantic link between pictures and processing, and a rich long-term representation for pictures were tested. Using levels-of-processing tasks eliminated format effects when no memory test was expected and processing was deep (El), and when study and test formats did not match (E3). Pictures produced superior performance when a memory test was expected (El & 2) and when study and test formats were the same (E3). Results of all experiments support the attenuation of attention model and that picture superiority is due to a more direct access to semantic processing and a richer visual code. General principles to guide the processing of stimulus information are discussed.

  9. Evidence for superior neurobiological and behavioral inhibitory control abilities in non-offending as compared to offending pedophiles.

    PubMed

    Kärgel, Christian; Massau, Claudia; Weiß, Simone; Walter, Martin; Borchardt, Viola; Krueger, Tillmann H C; Tenbergen, Gilian; Kneer, Jonas; Wittfoth, Matthias; Pohl, Alexander; Gerwinn, Hannah; Ponseti, Jorge; Amelung, Till; Beier, Klaus M; Mohnke, Sebastian; Walter, Henrik; Schiffer, Boris

    2017-02-01

    Neurobehavioral models of pedophilia and child sexual offending suggest a pattern of temporal and in particular prefrontal disturbances leading to inappropriate behavioral control and subsequently an increased propensity to sexually offend against children. However, clear empirical evidence for such mechanisms is still missing. Using a go/nogo paradigm in combination with functional magnetic resonance imaging (fMRI) we compared behavioral performance and neural response patterns among three groups of men matched for age and IQ: pedophiles with (N = 40) and without (N = 37) a history of hands-on sexual offences against children as well as healthy non-offending controls (N = 40). As compared to offending pedophiles, non-offending pedophiles exhibited superior inhibitory control as reflected by significantly lower rate of commission errors. Group-by-condition interaction analysis also revealed inhibition-related activation in the left posterior cingulate and the left superior frontal cortex that distinguished between offending and non-offending pedophiles, while no significant differences were found between pedophiles and healthy controls. Both areas showing distinct activation pattern among pedophiles play a critical role in linking neural networks that relate to effective cognitive functioning. Data therefore suggest that heightened inhibition-related recruitment of these areas as well as decreased amount of commission errors is related to better inhibitory control in pedophiles who successfully avoid committing hands-on sexual offences against children. Hum Brain Mapp 38:1092-1104, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  10. Locally advanced rectal cancer: diffusion-weighted MR tumour volumetry and the apparent diffusion coefficient for evaluating complete remission after preoperative chemoradiation therapy.

    PubMed

    Ha, Hong Il; Kim, Ah Young; Yu, Chang Sik; Park, Seong Ho; Ha, Hyun Kwon

    2013-12-01

    To evaluate DW MR tumour volumetry and post-CRT ADC in rectal cancer as predicting factors of CR using high b values to eliminate perfusion effects. One hundred rectal cancer patients who underwent 1.5-T rectal MR and DW imaging using three b factors (0, 150, and 1,000 s/mm(2)) were enrolled. The tumour volumes of T2-weighted MR and DW images and pre- and post-CRT ADC150-1000 were measured. The diagnostic accuracy of post-CRT ADC, T2-weighted MR, and DW tumour volumetry was compared using ROC analysis. DW MR tumour volumetry was superior to T2-weighted MR volumetry comparing the CR and non-CR groups (P < 0.001). Post-CRT ADC showed a significant difference between the CR and non-CR groups (P = 0.001). The accuracy of DW tumour volumetry (Az = 0.910) was superior to that of T2-weighed MR tumour volumetry (Az = 0.792) and post-CRT ADC (Az = 0.705) in determining CR (P = 0.015). Using a cutoff value for the tumour volume reduction rate of more than 86.8 % on DW MR images, the sensitivity and specificity for predicting CR were 91.4 % and 80 %, respectively. DW MR tumour volumetry after CRT showed significant superiority in predicting CR compared with T2-weighted MR images and post-CRT ADC.

  11. Extensions of the picture superiority effect in associative recognition.

    PubMed

    Hockley, William E; Bancroft, Tyler

    2011-12-01

    Previous research has shown that the picture superiority effect (PSE) is seen in tests of associative recognition for random pairs of line drawings compared to pairs of concrete words (Hockley, 2008). In the present study we demonstrated that the PSE for associative recognition is still observed when subjects have correctly identified the individual items of each pair as old (Experiment 1), and that this effect is not due to rehearsal borrowing (Experiment 2). The PSE for associative recognition also is shown to be present but attenuated for mixed picture-word pairs (Experiment 3), and similar in magnitude for pairs of simple black and white line drawings and coloured photographs of detailed objects (Experiment 4). The results are consistent with the view that the semantic meaning of nameable pictures is activated faster than that of words thereby affording subjects more time to generate and elaborate meaningful associations between items depicted in picture form. PsycINFO Database Record (c) 2011 APA, all rights reserved.

  12. Effective media properties of hyperuniform disordered composite materials

    PubMed Central

    Sheng, Xin-Qing

    2017-01-01

    The design challenge of new functional composite materials consisting of multiphase materials has attracted an increasing interest in recent years. In particular, understanding the role of distributions of ordered and disordered particles in a host media is scientifically and technologically important for designing novel materials and devices with superior spectral and angular properties. In this work, the effective medium property of disordered composite materials consisting of hyperuniformly distributed hard particles at different filling fractions is investigated. To accurately extract effective permittivity of a disordered composite material, a full-wave finite element method and the transmission line theory are used. Numerical results show that the theory of hyperuniformity can be conveniently used to design disordered composite materials with good accuracy compared with those materials with randomly dispersed particles. Furthermore, we demonstrate that a Luneburg lens based on the proposed hyperuniform media has superior radiation properties in comparison with previously reported metamaterial designs and it may open up a new avenue in electromagnetic materials-by-design. PMID:28982118

  13. A comparison of the effects of citalopram and moclobemide on resting brain perfusion in social anxiety disorder.

    PubMed

    Warwick, J M; Carey, P; Van der Linden, G; Prinsloo, C; Niehaus, D; Seedat, S; Dupont, P; Stein, D J

    2006-09-01

    The serotonin specific reuptake inhibitor (SSRI) citalopram and the reversible mono-amine oxidase-A inhibitor (RIMA) moclobemide have both been used successfully for the treatment of social anxiety disorder (SAD). In this study we investigate the effects of these compounds on resting brain function using single photon emission computed tomography (SPECT). Subjects meeting DSM-IV criteria for SAD underwent regional cerebral blood flow (rCBF) SPECT using Tc-HMPAO at baseline and after 8 weeks of treatment with either citalopram or moclobemide. Using statistical parametric mapping brain SPECT studies were analysed to determine the effects of treatment on rCBF, to compare the effects of citalopram and moclobemide, and to detect correlations between changes in rCBF and clinical response. Subjects received citalopram (n=17) or moclobemide (n=14) as therapy. Subjects in both treatment groups demonstrated a significant improvement of SAD symptoms as measured by the Liebowitz Social Anxiety Scale total score. All subjects demonstrated a decrease in rCBF in the insulae post therapy. Subjects receiving citalopram had decreased superior cingulate rCBF after therapy compared to those receiving moclobemide. Both SSRI's and RIMA's decreased rCBF in the insulae during treatment of SAD; an effect that may be consistent with the role of these regions in processing internal somatic cues evoked by emotional stimuli. Citalopram had a greater effect on superior cingulate perfusion, an effect that is consistent with evidence of high levels of 5-HT transporters in this region.

  14. Cell attachment functionality of bioactive conducting polymers for neural interfaces.

    PubMed

    Green, Rylie A; Lovell, Nigel H; Poole-Warren, Laura A

    2009-08-01

    Bioactive coatings for neural electrodes that are tailored for cell interactions have the potential to produce superior implants with improved charge transfer capabilities. In this study synthetically produced anionically modified laminin peptides DEDEDYFQRYLI and DCDPGYIGSR were used to dope poly(3,4-ethylenedioxythiophene) (PEDOT) electrodeposited on platinum (Pt) electrodes. Performance of peptide doped films was compared to conventional polymer PEDOT/paratoluene sulfonate (pTS) films using SEM, XPS, cyclic voltammetry, impedance spectroscopy, mechanical hardness and adherence. Bioactivity of incorporated peptides and their affect on cell growth was assessed using a PC12 neurite outgrowth assay. It was demonstrated that large peptide dopants produced softer PEDOT films with a minimal decrease in electrochemical stability, compared to the conventional dopant, pTS. Cell studies revealed that the YFQRYLI ligand retained neurite outgrowth bioactivity when DEDEDYFQRYLI was used as a dopant, but the effect was strongly dependant on initial cell attachment. Alternate peptide dopant, DCDPGYIGSR was found to impart superior cell attachment properties when compared to DEDEDYFQRYLI, but attachment on both peptide doped polymers could be enhanced by coating with whole native laminin.

  15. Microbiologic evaluation of microfiber mops for surface disinfection.

    PubMed

    Rutala, William A; Gergen, Maria F; Weber, David J

    2007-11-01

    Recently, health care facilities have started to use a microfiber mopping technique rather than a conventional, cotton string mop to clean floors. The effectiveness of microfiber mops to reduce microbial levels on floors was investigated. We compared the efficacy of microfiber mops with that of conventional, cotton string mops in 3 test conditions (cotton mop and standard wringer bucket, microfiber mop and standard wringer bucket, microfiber system). Twenty-four rooms were evaluated for each test condition. RODAC plates containing D/E Neutralizing Agar were used to assess "precleaning" and "postcleaning" microbial levels. The microfiber system demonstrated superior microbial removal compared with cotton string mops when used with a detergent cleaner (95% vs 68%, respectively). The use of a disinfectant did not improve the microbial elimination demonstrated by the microfiber system (95% vs 95%, respectively). However, use of disinfectant did significantly improve microbial removal when a cotton string mop was used (95% vs 68%, respectively). The microfiber system demonstrated superior microbial removal compared with cotton string mops when used with a detergent cleaner. The use of a disinfectant did not improve the microbial elimination demonstrated by the microfiber system.

  16. Application of Poisson random effect models for highway network screening.

    PubMed

    Jiang, Ximiao; Abdel-Aty, Mohamed; Alamili, Samer

    2014-02-01

    In recent years, Bayesian random effect models that account for the temporal and spatial correlations of crash data became popular in traffic safety research. This study employs random effect Poisson Log-Normal models for crash risk hotspot identification. Both the temporal and spatial correlations of crash data were considered. Potential for Safety Improvement (PSI) were adopted as a measure of the crash risk. Using the fatal and injury crashes that occurred on urban 4-lane divided arterials from 2006 to 2009 in the Central Florida area, the random effect approaches were compared to the traditional Empirical Bayesian (EB) method and the conventional Bayesian Poisson Log-Normal model. A series of method examination tests were conducted to evaluate the performance of different approaches. These tests include the previously developed site consistence test, method consistence test, total rank difference test, and the modified total score test, as well as the newly proposed total safety performance measure difference test. Results show that the Bayesian Poisson model accounting for both temporal and spatial random effects (PTSRE) outperforms the model that with only temporal random effect, and both are superior to the conventional Poisson Log-Normal model (PLN) and the EB model in the fitting of crash data. Additionally, the method evaluation tests indicate that the PTSRE model is significantly superior to the PLN model and the EB model in consistently identifying hotspots during successive time periods. The results suggest that the PTSRE model is a superior alternative for road site crash risk hotspot identification. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Application of Support Vector Machine to Forex Monitoring

    NASA Astrophysics Data System (ADS)

    Kamruzzaman, Joarder; Sarker, Ruhul A.

    Previous studies have demonstrated superior performance of artificial neural network (ANN) based forex forecasting models over traditional regression models. This paper applies support vector machines to build a forecasting model from the historical data using six simple technical indicators and presents a comparison with an ANN based model trained by scaled conjugate gradient (SCG) learning algorithm. The models are evaluated and compared on the basis of five commonly used performance metrics that measure closeness of prediction as well as correctness in directional change. Forecasting results of six different currencies against Australian dollar reveal superior performance of SVM model using simple linear kernel over ANN-SCG model in terms of all the evaluation metrics. The effect of SVM parameter selection on prediction performance is also investigated and analyzed.

  18. Sexual dimorphism of the planum temporale in schizophrenia: A MRI study.

    PubMed

    Delvecchio, Giuseppe; Pigoni, Alessandro; Perlini, Cinzia; Barillari, Marco; Ruggeri, Mirella; Altamura, Alfredo Carlo; Bellani, Marcella; Brambilla, Paolo

    2017-10-01

    Anatomical alterations in the superior temporal gyrus have been consistently reported in patients with schizophrenia, and they have mostly been linked to positive symptoms, including hallucinations and thought disorders. The superior temporal gyrus is considered one of the most asymmetric and lateralized structure of the human brain, and the process of lateralization seems to vary according to gender in the normal population. However, although it has been consistently suggested that patients with schizophrenia did not show normal brain lateralization in several regions, only few studies investigated it in the superior temporal gyrus and its sub-regions considering the effects of gender. In this context, the aim of this study was to evaluate sexual dimorphism in superior temporal gyrus volumes in a sample of patients with schizophrenia compared to age- and gender-matched healthy controls. A total of 72 right/left-handed males (40 schizophrenia patients and 32 healthy controls) and 45 right/left-handed females (18 schizophrenia patients and 27 healthy controls) underwent clinical evaluation and a 1.5T magnetic resonance imaging scan. Gray and white matter volumes of regions of interest within the superior temporal gyrus were manually detected, including the Heschl's gyrus and the planum temporale. Female patients with schizophrenia presented a reduction in left planum temporale gray matter volumes ( F = 4.58, p = 0.03) and a lack of the normal planum temporale asymmetry index ( t = 0.27; p = 0.79) compared to female controls ( t = 5.47; p = 0.001). No differences were found between males for any volumes or laterality indices. Finally, in female patients with schizophrenia, Heschl's gyrus gray and white matter volumes negatively correlated with positive symptoms ( r = -0.56, p = 0.01). Our results showed that sexual dimorphism plays a key role on planum temporale in schizophrenia, underlining the importance of gender as a modulator of brain morphology and lateralization of schizophrenia.

  19. In search of the emotional face: anger versus happiness superiority in visual search.

    PubMed

    Savage, Ruth A; Lipp, Ottmar V; Craig, Belinda M; Becker, Stefanie I; Horstmann, Gernot

    2013-08-01

    Previous research has provided inconsistent results regarding visual search for emotional faces, yielding evidence for either anger superiority (i.e., more efficient search for angry faces) or happiness superiority effects (i.e., more efficient search for happy faces), suggesting that these results do not reflect on emotional expression, but on emotion (un-)related low-level perceptual features. The present study investigated possible factors mediating anger/happiness superiority effects; specifically search strategy (fixed vs. variable target search; Experiment 1), stimulus choice (Nimstim database vs. Ekman & Friesen database; Experiments 1 and 2), and emotional intensity (Experiment 3 and 3a). Angry faces were found faster than happy faces regardless of search strategy using faces from the Nimstim database (Experiment 1). By contrast, a happiness superiority effect was evident in Experiment 2 when using faces from the Ekman and Friesen database. Experiment 3 employed angry, happy, and exuberant expressions (Nimstim database) and yielded anger and happiness superiority effects, respectively, highlighting the importance of the choice of stimulus materials. Ratings of the stimulus materials collected in Experiment 3a indicate that differences in perceived emotional intensity, pleasantness, or arousal do not account for differences in search efficiency. Across three studies, the current investigation indicates that prior reports of anger or happiness superiority effects in visual search are likely to reflect on low-level visual features associated with the stimulus materials used, rather than on emotion. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  20. Anticarcinogenic effects of polyphenolics from mango (Mangifera indica) varieties.

    PubMed

    Noratto, Giuliana D; Bertoldi, Michele C; Krenek, Kimberley; Talcott, Stephen T; Stringheta, Paulo C; Mertens-Talcott, Susanne U

    2010-04-14

    Many polyphenolics contained in mango have shown anticancer activity. The objective of this study was to compare the anticancer properties of polyphenolic extracts from several mango varieties (Francis, Kent, Ataulfo, Tommy Atkins, and Haden) in cancer cell lines, including Molt-4 leukemia, A-549 lung, MDA-MB-231 breast, LnCap prostate, and SW-480 colon cancer cells and the noncancer colon cell line CCD-18Co. Cell lines were incubated with Ataulfo and Haden extracts, selected on the basis of their superior antioxidant capacity compared to the other varieties, where SW-480 and MOLT-4 were statistically equally most sensitive to both cultivars followed by MDA-MB-231, A-549, and LnCap in order of decreasing efficacy as determined by cell counting. The efficacy of extracts from all mango varieties in the inhibition of cell growth was tested in SW-480 colon carcinoma cells, where Ataulfo and Haden demonstrated superior efficacy, followed by Kent, Francis, and Tommy Atkins. At 5 mg of GAE/L, Ataulfo inhibited the growth of colon SW-480 cancer cells by approximately 72% while the growth of noncancer colonic myofibroblast CCD-18Co cells was not inhibited. The growth inhibition exerted by Ataulfo and Haden polyphenolics in SW-480 was associated with an increased mRNA expression of pro-apoptotic biomarkers and cell cycle regulators, cell cycle arrest, and a decrease in the generation of reactive oxygen species. Overall, polyphenolics from several mango varieties exerted anticancer effects, where compounds from Haden and Ataulfo mango varieties possessed superior chemopreventive activity.

  1. Internet-based treatment for panic disorder: A three-arm randomized controlled trial comparing guided (via real-time video sessions) with unguided self-help treatment and a waitlist control. PAXPD study results.

    PubMed

    Ciuca, Amalia M; Berger, Thomas; Crişan, Liviu G; Miclea, Mircea

    2018-05-01

    A growing body of evidence suggests that Internet-based cognitive behavioral treatments (ICBT) are effective to treat anxiety disorders. However, the effect of therapist guidance in ICBT is still under debate and guided ICBT offered in a real-time audio-video communication format has not yet been systematically investigated. This three-arm RCT compared the efficacy of guided with unguided ICBT (12 weeks intervention) and a waitlist (WL). A total of 111 individuals meeting the diagnostic criteria for panic disorder (PD) were randomly assigned to one of three conditions. Primary outcomes were the severity of self-report panic symptoms and diagnostic status. Secondary outcomes were symptoms of depression, functional impairment, catastrophic cognitions, fear of sensations and body vigilance. At post-treatment, both active conditions showed superior outcomes regarding PD and associated symptoms (guided ICBT vs. WL: d = 1.04-1.36; unguided ICBT vs. WL: d = 0.70-1.06). At post-treatment, the two active conditions did not differ significantly in self-reported symptom reduction (d = 0.21-0.54, all ps > 0.05), but the guided treatment was superior to the unguided treatment in terms of diagnostic status (χ 2 (1) = 13.15, p < 0.01). Treatment gains were maintained at successive follow-ups and the guided treatment became superior to the unguided treatment at 6 months follow-up (d = 0.72-1.05, all ps < 0.05). Copyright © 2018 Elsevier Ltd. All rights reserved.

  2. Differences in the dynamics of serotonin reuptake transporter occupancy may explain superior clinical efficacy of escitalopram versus citalopram.

    PubMed

    Kasper, Siegfried; Sacher, Julia; Klein, Nikolas; Mossaheb, Nilufar; Attarbaschi-Steiner, Trawat; Lanzenberger, Rupert; Spindelegger, Christoph; Asenbaum, Susanne; Holik, Alexander; Dudczak, Robert

    2009-05-01

    Escitalopram the S-enantiomer of the racemate citalopram, is clinically more effective than citalopram in the treatment of major depressive disorder. However, the precise mechanism by which escitalopram achieves superiority over citalopram is yet to be determined. It has been hypothesized that the therapeutically inactive R-enantiomer competes with the serotonin-enhancing S-enantiomer at a low-affinity allosteric site on serotonin reuptake transporters (SERTs), and reduces the effectiveness of the S-enantiomer at the primary, high-affinity serotonin-binding site. This study summarizes the results of two recent single-photon emission computerized tomography studies measuring SERT occupancy in citalopram-treated and escitalopram-treated healthy volunteers, after a single dose and multiple doses (i.e. under steady-state conditions). The single-dose study showed no attenuating effect of R-citalopram. After multiple dosing, however, SERT occupancy was significantly reduced in the presence of R-citalopram. Under steady-state conditions, R-enantiomer concentrations were greater than for the S-enantiomer because of slower clearance of R-citalopram. A pooled analysis suggests that build-up of the R-enantiomer after repeated citalopram dosing may lead to increased inhibition of S-enantiomer occupancy of SERT. This review adds to the growing body of evidence regarding differences in the dynamics of SERT occupancy, that is, molecular mechanisms underlying the often-observed superior clinical efficacy of escitalopram compared with citalopram in major depressive disorder.

  3. Effectiveness of small-group interactive education vs. lecture-based information-only programs on motivation to change and lifestyle behaviours. A prospective controlled trial of rehabilitation inpatients.

    PubMed

    Reusch, Andrea; Ströbl, Veronika; Ellgring, Heiner; Faller, Hermann

    2011-02-01

    Although patient education may promote motivation to change health behaviours, the most effective method has not yet been determined. This prospective, controlled trial compared an interactive, patient-oriented group program with lectures providing only information. We evaluated motivational stages of change and self-reported behaviours in three domains (sports, diet, relaxation) at four times up to one year (60% complete data) among 753 German rehabilitation inpatients (mean age 50 years, 52% male) with orthopaedic (59%) or cardiologic disorders (10%) or diabetes mellitus (31%). We found improvements between baseline and follow up regarding each outcome (p<.001) in both groups. At the end of rehabilitation, participants of the interactive group, as compared to the lectures, showed more advanced motivation regarding diet (p<.10) and sports (p=.006). Interactive group patients reported healthier diets both after 3 months (p=0.013) and 12 months (p=0.047), more relaxation behaviours (p=.029) after 3 months and higher motivation for sports after 12 months (p=.08). The superior effectiveness of the interactive group was only partly confirmed. This short, 5-session interactive program may not be superior to lectures to induce major sustainable changes in motivation. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  4. On the Effect of Nb on the Microstructure and Properties of Next Generation Polycrystalline Powder Metallurgy Ni-Based Superalloys

    NASA Astrophysics Data System (ADS)

    Christofidou, Katerina A.; Hardy, Mark C.; Li, Hang-Yue; Argyrakis, Christos; Kitaguchi, Hiroto; Jones, Nicholas G.; Mignanelli, Paul M.; Wilson, Alison S.; Messé, Olivier M. D. M.; Pickering, Ed J.; Gilbert, Robert J.; Rae, Cathie M. F.; Yu, Suyang; Evans, Alex; Child, Daniel; Bowen, Paul; Stone, Howard J.

    2018-05-01

    The effect of Nb on the properties and microstructure of two novel powder metallurgy (P/M) Ni-based superalloys was evaluated, and the results critically compared with the Rolls-Royce alloy RR1000. The Nb-containing alloy was found to exhibit improved tensile and creep properties as well as superior oxidation resistance compared with both RR1000 and the Nb-free variant tested. The beneficial effect of Nb on the tensile and creep properties was due to the microstructures obtained following the post-solution heat treatments, which led to a higher γ' volume fraction and a finer tertiary γ' distribution. In addition, an increase in the anti-phase-boundary energy of the γ' phase is also expected with the addition of Nb, further contributing to the strength of the material. However, these modifications in the γ' distribution detrimentally affect the dwell fatigue crack-growth behavior of the material, although this behavior can be improved through modified heat treatments. The oxidation resistance of the Nb-containing alloy was also enhanced as Nb is believed to accelerate the formation of a defect-free Cr2O3 scale. Overall, both developmental alloys, with and without the addition of Nb, were found to exhibit superior properties than RR1000.

  5. Long-term effect of the combined use of powered toothbrush and triclosan dentifrice in periodontal maintenance patients.

    PubMed

    Bogren, Anna; Teles, Ricardo P; Torresyap, Gay; Haffajee, Anne D; Socransky, Sigmund S; Jönsson, Kerstin; Wennström, Jan L

    2008-02-01

    To test the hypothesis of a superior clinical and microbiological effect of the combined use of powered toothbrush+triclosan-containing dentifrice compared with manual toothbrush+regular fluoride-containing dentifrice in periodontal maintenance patients. A total of 128 periodontitis subjects involved in recall programmes were randomized to use either powered toothbrush with triclosan-dentifrice (test) or manual toothbrush and standard dentifrice (control). Supportive periodontal treatment was provided at baseline and every 6 months. Plaque, bleeding on probing (BoP), probing pocket depth (PPD) and relative attachment level (RAL) were scored at baseline, 1, 2 and 3 years. Subgingival plaque samples were taken and analysed for their content of 40 bacterial species at each examination interval. All analyses were performed by "intention-to-treat" protocol. Both groups showed significant reduction in BoP, PPD and in mean total counts of the 40 bacterial species between baseline and 3 years, while plaque score and RAL remained almost unchanged. No significant differences between the two prevention programmes were found for any of the clinical outcome variables or in mean counts of the various bacterial species. The study failed to demonstrate superior clinical and microbiological effects of powered toothbrush+triclosan dentifrice compared with manual toothbrush+standard fluoride-dentifrice in periodontitis-susceptible patients on regular maintenance therapy.

  6. Images of liposarcoma using technetium-99m bleomycin and technetium (V)-99m DMSA

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

    Ohta, H.; Shane, F.I.; Endo, K.

    1986-12-01

    The effectiveness of Tc-99m bleomycin (BLM) and Tc(V)-99m DMSA are compared with that of Ga-67 citrate, which is currently the most widely used agent. In four patients with lipomatous tumors, the clinical significance of tumor imaging with each of these three agents is discussed and compared. Results indicate that both Tc-99m BLM and Tc(V)-99m DMSA are superior in detecting the extension or localization of liposarcomas.

  7. Psychological interventions for antisocial personality disorder

    PubMed Central

    Gibbon, Simon; Duggan, Conor; Stoffers, Jutta; Huband, Nick; Völlm, Birgit A; Ferriter, Michael; Lieb, Klaus

    2014-01-01

    Background Antisocial personality disorder (AsPD) is associated with a wide range of disturbance including persistent rule-breaking, criminality, substance use, unemployment, homelessness and relationship difficulties. Objectives To evaluate the potential beneficial and adverse effects of psychological interventions for people with AsPD. Search methods Our search included CENTRAL Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, PsycINFO, ASSIA, BIOSIS and COPAC. Selection criteria Prospective, controlled trials in which participants with AsPD were randomly allocated to a psychological intervention and a control condition (either treatment as usual, waiting list or no treatment). Data collection and analysis Three authors independently selected studies. Two authors independently extracted data. We calculated mean differences, with odds ratios for dichotomous data. Main results Eleven studies involving 471 participants with AsPD met the inclusion criteria, although data were available from only five studies involving 276 participants with AsPD. Only two studies focused solely on an AsPD sample. Eleven different psychological interventions were examined. Only two studies reported on reconviction, and only one on aggression. Compared to the control condition, cognitive behaviour therapy (CBT) plus standard maintenance was superior for outpatients with cocaine dependence in one study, but CBT plus treatment as usual was not superior for male outpatients with recent verbal/physical violence in another. Contingency management plus standard maintenance was superior for drug misuse for outpatients with cocaine dependence in one study but not in another, possibly because of differences in the behavioural intervention. However, contingency management was superior in social functioning and counselling session attendance in the latter. A multi-component intervention utilising motivational interviewing principles, the ‘Driving Whilst Intoxicated program’, plus incarceration was superior to incarceration alone for imprisoned drink-driving offenders. Authors’ conclusions Results suggest that there is insufficient trial evidence to justify using any psychological intervention for adults with AsPD. Disappointingly few of the included studies addressed the primary outcomes defined in this review (aggression, reconviction, global functioning, social functioning, adverse effects). Three interventions (contingency management with standard maintenance; CBT with standard maintenance; ‘Driving Whilst Intoxicated program’ with incarceration) appeared effective, compared to the control condition, in terms of improvement in at least one outcome in at least one study. Each of these interventions had been originally developed for people with substance misuse problems. Significant improvements were mainly confined to outcomes related to substance misuse. No study reported significant change in any specific antisocial behaviour. Further research is urgently needed for this prevalent and costly condition. PMID:20556783

  8. Superior Potential of CD34-Positive Cells Compared to Total Mononuclear Cells for Healing of Nonunion Following Bone Fracture.

    PubMed

    Fukui, Tomoaki; Mifune, Yutaka; Matsumoto, Tomoyuki; Shoji, Taro; Kawakami, Yohei; Kawamoto, Atsuhiko; Ii, Masaaki; Akimaru, Hiroshi; Kuroda, Tomoya; Horii, Miki; Yokoyama, Ayumi; Alev, Cantas; Kuroda, Ryosuke; Kurosaka, Masahiro; Asahara, Takayuki

    2015-01-01

    We recently demonstrated that the local transplantation of human peripheral blood (PB) CD34(+) cells, an endothelial/hematopoietic progenitor cell-rich population, contributes to fracture repair via vasculogenesis/angiogenesis and osteogenesis. Human PB mononuclear cells (MNCs) are also considered a potential cell fraction for neovascularization. We have previously shown the feasibility of human PB MNCs to enhance fracture healing. However, there is no report directly comparing the efficacy for fracture repair between CD34(+) cells and MNCs. In addition, an unhealing fracture model, which does not accurately resemble a clinical setting, was used in our previous studies. To overcome these issues, we compared the capacity of human granulocyte colony-stimulating factor-mobilized PB (GM-PB) CD34(+) cells and human GM-PB MNCs in a nonunion model, which more closely resembles a clinical setting. First, the effect of local transplantation of 1 × 10(5) GM-PB CD34(+) cells (CD34(+) group), 1 × 10(7) GM-PB MNCs (containing approximately 1 × 10(5) GM-PB CD34(+) cells) (MNC group), and phosphate-buffered saline (PBS) (PBS group) on nonunion healing was compared. Similar augmentation of blood flow recovery at perinonunion sites was observed in the CD34(+) and MNC groups. Meanwhile, a superior effect on nonunion repair was revealed by radiological, histological, and functional assessment in the CD34(+) group compared with the other groups. Moreover, through in vivo and in vitro experiments, excessive inflammation induced by GM-PB MNCs was confirmed and believed to be one of the mechanisms underlying this potency difference. These results strongly suggest that local transplantation of GM-PB CD34(+) cells is a practical and effective strategy for treatment of nonunion after fracture.

  9. Apixaban for stroke prevention in atrial fibrillation: a review of the clinical trial evidence.

    PubMed

    Yates, Scott W

    2011-10-01

    The objective of this review is to summarize data from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) and Apixaban Versus Acetylsalicylic Acid to Prevent Stroke in Atrial Fibrillation Patients Who Have Failed or Are Unsuitable for Vitamin K Antagonist Treatment (AVERROES) trials of apixaban for stroke prevention in patients with atrial fibrillation (AF). The ARISTOTLE trial compared apixaban with warfarin in 18 201 patients with AF and ≥ 1 additional risk factor for stroke. The AVERROES trial compared apixaban with aspirin in 5599 patients with AF who were at increased risk of stroke and for whom vitamin K antagonists were unsuitable. In ARISTOTLE, apixaban reduced the risk of stroke or systemic embolism by 21% compared with warfarin (1.27% vs 1.60% per year; hazard ratio, 0.79; 95% confidence interval, 0.66-0.95). The reduction was significant and demonstrated the superiority of apixaban over warfarin for the primary outcome of preventing stroke or systemic embolism (P = 0.01 for superiority). Apixaban also reduced all-cause mortality by 11% (P = 0.047) and major bleeding by 31% (P < 0.001) compared with warfarin. The benefits of apixaban observed in ARISTOTLE are further supported by the results from AVERROES, which demonstrated a 55% reduction in the risk of stroke or systemic embolism compared with aspirin. Risk of major bleeding was not significantly different between apixaban and aspirin. Subgroup analyses in both trials demonstrated that the effects of apixaban are highly consistent across various patient subpopulations. Discontinuation of study medication was significantly lower with apixaban than with either warfarin in ARISTOTLE or aspirin in AVERROES. Apixaban is the first new oral anticoagulant that has been shown to be superior to warfarin in reducing stroke or systemic embolism, all-cause mortality, and major bleeding in patients with AF. Moreover, in patients with AF who are considered unsuitable for warfarin therapy, apixaban was more effective than aspirin for stroke prevention and had a similar rate of major bleeding.

  10. Should continuous rather than single-injection interscalene block be routinely offered for major shoulder surgery? A meta-analysis of the analgesic and side-effects profiles.

    PubMed

    Vorobeichik, L; Brull, R; Bowry, R; Laffey, J G; Abdallah, F W

    2018-04-01

    Major shoulder surgery is associated with moderate-to-severe pain, but consensus on the optimal analgesic approach is lacking. Continuous catheter-based interscalene block (CISB) prolongs the analgesic benefits of its single-injection counterpart (SISB), but concerns over CISB complications and difficulties in interpreting comparative evidence examining major and minor shoulder procedures simultaneously, despite their differences in postoperative pain, have limited CISB popularity. This meta-analysis evaluates the CISB analgesic role and complications compared with SISB for major shoulder surgery. We retrieved randomised controlled trials (RCTs) comparing the effects of CISB to SISB on analgesic outcomes and side-effects after major shoulder surgery. Postoperative opioid consumption at 24 h was designated as the primary outcome. Secondary outcomes included 24-48 h opioid consumption, postoperative rest and dynamic pain scores up to 72 h, time-to-first analgesic, recovery room and hospital stay durations, patient satisfaction, postoperative nausea and vomiting, respiratory function, and block-related complications. Data from 15 RCTs were pooled using random-effects modelling. Compared with SISB, CISB reduced 24- and 48-h oral morphine consumption by a weighted mean difference [95% confidence interval] of 50.9 mg [-81.6, -20.2], (P=0.001) and 44.7 mg [-80.9, -8.7], (P<0.0001), respectively. Additionally, CISB provided superior rest and dynamic pain control beyond 48 h, prolonged time-to-first analgesic, enhanced satisfaction, and reduced postoperative nausea and vomiting without complications. CISB caused an 11.0-11.7% decrease in respiratory indices. Result heterogeneity was successfully explained. High-level evidence indicates that CISB provides superior analgesia up to 48 h after major shoulder surgery, without increasing side-effects, compared with SISB. The importance of CISB-related changes in respiratory indices is questionable. Copyright © 2017 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

  11. Comparative efficacy of golimumab, infliximab, and adalimumab for moderately to severely active ulcerative colitis: a network meta-analysis accounting for differences in trial designs.

    PubMed

    Thorlund, Kristian; Druyts, Eric; Toor, Kabirraaj; Mills, Edward J

    2015-05-01

    To conduct a network meta-analysis (NMA) to establish the comparative efficacy of infliximab, adalimumab and golimumab for the treatment of moderately to severely active ulcerative colitis (UC). A systematic literature search identified five randomized controlled trials for inclusion in the NMA. One trial assessed golimumab, two assessed infliximab and two assessed adalimumab. Outcomes included clinical response, clinical remission, mucosal healing, sustained clinical response and sustained clinical remission. Innovative methods were used to allow inclusion of the golimumab trial data given the alternative design of this trial (i.e., two-stage re-randomization). After induction, no statistically significant differences were found between golimumab and adalimumab or between golimumab and infliximab. Infliximab was statistically superior to adalimumab after induction for all outcomes and treatment ranking suggested infliximab as the superior treatment for induction. Golimumab and infliximab were associated with similar efficacy for achieving maintained clinical remission and sustained clinical remission, whereas adalimumab was not significantly better than placebo for sustained clinical remission. Golimumab and infliximab were also associated with similar efficacy for achieving maintained clinical response, sustained clinical response and mucosal healing. Finally, golimumab 50 and 100 mg was statistically superior to adalimumab for clinical response and sustained clinical response, and golimumab 100 mg was also statistically superior to adalimumab for mucosal healing. The results of our NMA suggest that infliximab was statistically superior to adalimumab after induction, and that golimumab was statistically superior to adalimumab for sustained outcomes. Golimumab and infliximab appeared comparable in efficacy.

  12. Effects of Time-Compressed Speech Training on Multiple Functional and Structural Neural Mechanisms Involving the Left Superior Temporal Gyrus

    PubMed Central

    Maruyama, Tsukasa; Taki, Yasuyuki; Motoki, Kosuke; Jeong, Hyeonjeong; Kotozaki, Yuka; Nakagawa, Seishu; Iizuka, Kunio; Yokoyama, Ryoichi; Yamamoto, Yuki; Hanawa, Sugiko; Araki, Tsuyoshi; Sakaki, Kohei; Sasaki, Yukako; Magistro, Daniele; Kawashima, Ryuta

    2018-01-01

    Time-compressed speech is an artificial form of rapidly presented speech. Training with time-compressed speech (TCSSL) in a second language leads to adaptation toward TCSSL. Here, we newly investigated the effects of 4 weeks of training with TCSSL on diverse cognitive functions and neural systems using the fractional amplitude of spontaneous low-frequency fluctuations (fALFF), resting-state functional connectivity (RSFC) with the left superior temporal gyrus (STG), fractional anisotropy (FA), and regional gray matter volume (rGMV) of young adults by magnetic resonance imaging. There were no significant differences in change of performance of measures of cognitive functions or second language skills after training with TCSSL compared with that of the active control group. However, compared with the active control group, training with TCSSL was associated with increased fALFF, RSFC, and FA and decreased rGMV involving areas in the left STG. These results lacked evidence of a far transfer effect of time-compressed speech training on a wide range of cognitive functions and second language skills in young adults. However, these results demonstrated effects of time-compressed speech training on gray and white matter structures as well as on resting-state intrinsic activity and connectivity involving the left STG, which plays a key role in listening comprehension. PMID:29675038

  13. EFFECT OF INTERNAL LIMITING MEMBRANE PEELING DURING VITRECTOMY FOR DIABETIC MACULAR EDEMA: Systematic Review and Meta-analysis.

    PubMed

    Nakajima, Takuya; Roggia, Murilo F; Noda, Yasuo; Ueta, Takashi

    2015-09-01

    To evaluate the effect of internal limiting membrane (ILM) peeling during vitrectomy for diabetic macular edema. MEDLINE, EMBASE, and CENTRAL were systematically reviewed. Eligible studies included randomized or nonrandomized studies that compared surgical outcomes of vitrectomy with or without ILM peeling for diabetic macular edema. The primary and secondary outcome measures were postoperative best-corrected visual acuity and central macular thickness. Meta-analysis on mean differences between vitrectomy with and without ILM peeling was performed using inverse variance method in random effects. Five studies (7 articles) with 741 patients were eligible for analysis. Superiority (95% confidence interval) in postoperative best-corrected visual acuity in ILM peeling group compared with nonpeeling group was 0.04 (-0.05 to 0.13) logMAR (equivalent to 2.0 ETDRS letters, P = 0.37), and superiority in best-corrected visual acuity change in ILM peeling group was 0.04 (-0.02 to 0.09) logMAR (equivalent to 2.0 ETDRS letters, P = 0.16). There was no significant difference in postoperative central macular thickness and central macular thickness reduction between the two groups. The visual acuity outcomes using pars plana vitrectomy with ILM peeling versus no ILM peeling were not significantly different. A larger randomized prospective study would be necessary to adequately address the effectiveness of ILM peeling on visual acuity outcomes.

  14. Decreased functional brain activation in Friedreich ataxia using the Simon effect task.

    PubMed

    Georgiou-Karistianis, N; Akhlaghi, H; Corben, L A; Delatycki, M B; Storey, E; Bradshaw, J L; Egan, G F

    2012-08-01

    The present study applied the Simon effect task to examine the pattern of functional brain reorganization in individuals with Friedreich ataxia (FRDA), using functional magnetic resonance imaging (fMRI). Thirteen individuals with FRDA and 14 age and sex matched controls participated, and were required to respond to either congruent or incongruent arrow stimuli, presented either to the left or right of a screen, via laterally-located button press responses. Although the Simon effect (incongruent minus congruent stimuli) showed common regions of activation in both groups, including the superior and middle prefrontal cortices, insulae, superior and inferior parietal lobules (LPs, LPi), occipital cortex and cerebellum, there was reduced functional activation across a range of brain regions (cortical, subcortical and cerebellar) in individuals with FRDA. The greater Simon effect behaviourally in individuals with FRDA, compared with controls, together with concomitant reductions in functional brain activation and reduced functional connectivity between cortical and sub-cortical regions, implies a likely disruption of cortico-cerebellar loops and ineffective engagement of cognitive/attention regions required for response suppression. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Dual Energy X-Ray Absorptiometry Compared with Anthropometry in Relation to Cardio-Metabolic Risk Factors in a Young Adult Population: Is the ‘Gold Standard’ Tarnished?

    PubMed Central

    Hands, Beth; Pennell, Craig E.; Lye, Stephen J.; Mountain, Jennifer A.

    2016-01-01

    Background and Aims Assessment of adiposity using dual energy x-ray absorptiometry (DXA) has been considered more advantageous in comparison to anthropometry for predicting cardio-metabolic risk in the older population, by virtue of its ability to distinguish total and regional fat. Nonetheless, there is increasing uncertainty regarding the relative superiority of DXA and little comparative data exist in young adults. This study aimed to identify which measure of adiposity determined by either DXA or anthropometry is optimal within a range of cardio-metabolic risk factors in young adults. Methods and Results 1138 adults aged 20 years were assessed by DXA and standard anthropometry from the Western Australian Pregnancy Cohort (Raine) Study. Cross-sectional linear regression analyses were performed. Waist to height ratio was superior to any DXA measure with HDL-C. BMI was the superior model in relation to blood pressure than any DXA measure. Midriff fat mass (DXA) and waist circumference were comparable in relation to glucose. For all the other cardio-metabolic variables, anthropometric and DXA measures were comparable. DXA midriff fat mass compared with BMI or waist hip ratio was the superior measure for triglycerides, insulin and HOMA-IR. Conclusion Although midriff fat mass (measured by DXA) was the superior measure with insulin sensitivity and triglycerides, the anthropometric measures were better or equal with various DXA measures for majority of the cardio-metabolic risk factors. Our findings suggest, clinical anthropometry is generally as useful as DXA in the evaluation of the individual cardio-metabolic risk factors in young adults. PMID:27622523

  16. Drop-Off Detection with the Long Cane: Effects of Different Cane Techniques on Performance

    ERIC Educational Resources Information Center

    Kim, Dae Shik; Emerson, Robert Wall; Curtis, Amy

    2009-01-01

    This study compared the drop-off detection performance with the two-point touch and constant contact cane techniques using a repeated-measures design with a convenience sample of 15 cane users with visual impairments. The constant contact technique was superior to the two-point touch technique in the drop-off detection rate and the 50% detection…

  17. Reducing dietary protein in pond production of hybrid striped bass (Morone chrysops x M. saxatilis): Effects on fish performance and water quality dynamics

    USDA-ARS?s Scientific Manuscript database

    In previous work, we demonstrated that diets containing 40% digestible protein (DP) (45% crude protein) and 18 %lipid supplemented with Met and Lys resulted in superior performance and nutrient retentions in hybrid striped bass compared to less energy-dense diets when rearing hybrid striped bass at ...

  18. Comparing the Effects of Unknown-Known Ratios on Word Reading Learning versus Learning Rates

    ERIC Educational Resources Information Center

    Joseph, Laurice M.; Nist, Lindsay M.

    2006-01-01

    An extension of G. L. Cates et al. (2003) investigation was conducted to determine if students' cumulative learning rates would be superior for words read under a traditional drill and practice condition (as they were for spelling in the previous study) than under interspersal conditions of varying ratios of unknown to known words. Participants…

  19. The influence of visual contextual information on the emergence of the especial skill in basketball.

    PubMed

    Stöckel, Tino; Breslin, Gavin

    2013-10-01

    We examined whether basketball throwing performance in general and motor skill specificity from the free throw distance in particular are influenced by visual contextual information. Experienced basketball players (N = 36) performed basketball set shots at five distances from the basket. Of particular interest was the performance from the free throw distance (4.23 m), at which experienced basketball players are expected to show superior performance compared with nearby locations as a result of massive amounts of practice. Whereas a control group performed the shots on a regular basketball court, the distance between the rim and the free throw line was either increased or decreased by 30 cm in two experimental groups. Findings showed that only the control group had a superior performance from the free throw distance, and the experimental groups did not. Moreover, all groups performed more accurately from the perceived free throw line (independent of its location) compared with nearby locations. The findings suggest that visual context information influences the presence of specificity effects in experienced performers. The findings have theoretical implications for explaining the memory representation underlying the especial skill effect in basketball.

  20. A comparison of debate and role play in enhancing critical thinking and communication skills of medical students during problem based learning.

    PubMed

    Latif, Rabia; Mumtaz, Sadaf; Mumtaz, Rafia; Hussain, Aamir

    2018-04-18

    Debate and role play for learning critical thinking and communication skills are being increasingly used in various undergraduate medical schools worldwide. We aim to compare students' views about effectiveness of two teaching strategies; debate and role play to exercise critical thinking and communication skills during problem-based learning (PBL). This is a comparative, cross-sectional, and questionnaire-based study. Our subjects were second year undergraduate female medical students enrolled in Imam Abdulrahman Bin Faisal University (IAU), College of Medicine from September 2014-2016, divided into 10 small PBL groups (10-13 students/group/year). Students rated role play and debate as equally effective in improving communication skills. Debate was rated superior to role play in "opening new avenues of thinking" (p-value is 0.01), whereas in "integration of knowledge of basic medical sciences with clinical skills" and "reflection of real life experience" students rated role play being superior to debate (p-value 0.01 and 0.00, respectively). Both role play and debate are well accepted by the students in PBL curriculum as an effective teaching methodology. Both are perceived equally good in improving students' communication skills. Few aspects of critical thinking are improved more by role plays compared to debate and vice versa. © 2018 by The International Union of Biochemistry and Molecular Biology, 2018. © 2018 The International Union of Biochemistry and Molecular Biology.

  1. Focus of attention and automaticity in handwriting.

    PubMed

    MacMahon, Clare; Charness, Neil

    2014-04-01

    This study investigated the nature of automaticity in everyday tasks by testing handwriting performance under single and dual-task conditions. Item familiarity and hand dominance were also manipulated to understand both cognitive and motor components of the task. In line with previous literature, performance was superior in an extraneous focus of attention condition compared to two different skill focus conditions. This effect was found only when writing with the dominant hand. In addition, performance was superior for high familiarity compared to low familiarity items. These findings indicate that motor and cognitive familiarity are related to the degree of automaticity of motor skills and can be manipulated to produce different performance outcomes. The findings also imply that the progression of skill acquisition from novel to novice to expert levels can be traced using different dual-task conditions. The separation of motor and cognitive familiarity is a new approach in the handwriting domain, and provides insight into the nature of attentional demands during performance. Copyright © 2013 Elsevier B.V. All rights reserved.

  2. Picturing survival memories: enhanced memory after fitness-relevant processing occurs for verbal and visual stimuli.

    PubMed

    Otgaar, Henry; Smeets, Tom; van Bergen, Saskia

    2010-01-01

    Recent studies have shown that processing words according to a survival scenario leads to superior retention relative to control conditions. Here, we examined whether a survival recall advantage could be elicited by using pictures. Furthermore, in Experiment 1, we were interested in whether survival processing also results in improved memory for details. Undergraduates rated the relevance of pictures in a survival, moving, or pleasantness scenario and were subsequently given a surprise free recall test. We found that survival processing yielded superior retention. We also found that distortions occurred more often in the survival condition than in the pleasantness condition. In Experiment 2, we directly compared the survival recall effect between pictures and words. A comparable survival recall advantage was found for pictures and words. The present findings support the idea that memory is enhanced by processing information in terms of fitness value, yet at the same time, the present results suggest that this may increase the risk for memory distortions.

  3. Effects of Black and White, Authentic and Contrived Color on Children's Perceptions of Dynamic Picture Content.

    ERIC Educational Resources Information Center

    Vollan, Clayton J.

    A study was devised to determine whether, if color is found superior to black-and-white for communicating dynamic picture content, that superiority can be attributed to the realism of authentic color, or whether that superiority is the effect of the simple presence of color. A sample of 90 sixth grade students were shown slides, half of which…

  4. The potential for improvement of outcomes by personalized insulin treatment of type 1 diabetes as assessed by analysis of single-patient data from a randomized controlled cross-over insulin trial.

    PubMed

    Pedersen-Bjergaard, Ulrik; Kristensen, Peter L; Beck-Nielsen, Henning; Nørgaard, Kirsten; Perrild, Hans; Christiansen, Jens S; Jensen, Tonny; Parving, Hans-Henrik; Thorsteinsson, Birger; Tarnow, Lise

    2017-01-01

    The evidence for optimal insulin treatment in type 1 diabetes is mainly based on randomised controlled trials applying a parallel-group design. Such trials yield robust general results but crucial individual treatment effects cannot be extracted. We aimed to assess the potential for further improvement of outcomes by personalized insulin therapy by analyzing data from a cross-over trial at individual level. Post hoc analysis of data from a two-year multicentre, prospective, randomised, open, blinded endpoint (PROBE) trial (the HypoAna trial). In a cross-over design 114 patients with type 1 diabetes and recurrent severe hypoglycemia were treated with basal-bolus therapy based on analog (detemir/aspart) or human (NPH/regular) insulin aiming at maintenance of baseline HbA1c levels. For each patient a superior outcome was defined as fewer events of severe hypoglycemia defined by need for third party treatment assistance or a more than 0.4% (4.4mmol/mol) lower HbA1c. Only one quarter had comparable outcome of the two treatments in terms of rate of severe hypoglycemia or HbA1c. Twice as many patients had superior outcome of analog-based as compared to human insulin-based insulin treatment. The rate of severe hypoglycemia with the superior treatment was lower compared to the rates obtained with analog insulin and with human insulin (0.67, 1.09, and 1.57 episode per patient-year, respectively (p<0.0001)). Personalized insulin treatment of type 1 diabetes based on single-patient evidence may improve outcomes significantly compared to a general treatment approach. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Hyperspectral Analysis of Soil Total Nitrogen in Subsided Land Using the Local Correlation Maximization-Complementary Superiority (LCMCS) Method.

    PubMed

    Lin, Lixin; Wang, Yunjia; Teng, Jiyao; Xi, Xiuxiu

    2015-07-23

    The measurement of soil total nitrogen (TN) by hyperspectral remote sensing provides an important tool for soil restoration programs in areas with subsided land caused by the extraction of natural resources. This study used the local correlation maximization-complementary superiority method (LCMCS) to establish TN prediction models by considering the relationship between spectral reflectance (measured by an ASD FieldSpec 3 spectroradiometer) and TN based on spectral reflectance curves of soil samples collected from subsided land which is determined by synthetic aperture radar interferometry (InSAR) technology. Based on the 1655 selected effective bands of the optimal spectrum (OSP) of the first derivate differential of reciprocal logarithm ([log{1/R}]'), (correlation coefficients, p < 0.01), the optimal model of LCMCS method was obtained to determine the final model, which produced lower prediction errors (root mean square error of validation [RMSEV] = 0.89, mean relative error of validation [MREV] = 5.93%) when compared with models built by the local correlation maximization (LCM), complementary superiority (CS) and partial least squares regression (PLS) methods. The predictive effect of LCMCS model was optional in Cangzhou, Renqiu and Fengfeng District. Results indicate that the LCMCS method has great potential to monitor TN in subsided lands caused by the extraction of natural resources including groundwater, oil and coal.

  6. The effects of lesions of the superior colliculus on locomotor orientation and the orienting reflex in the rat.

    PubMed

    Goodale, M A; Murison, R C

    1975-05-02

    The effects of bilateral removal of the superior colliculus or visual cortex on visually guided locomotor movements in rats performing a brightness discrimination task were investigated directly with the use of cine film. Rats with collicular lesions showed patterns of locomotion comparable to or more efficient than those of normal animals when approaching one of 5 small doors located at one end of a large open area. In contrast, animals with large but incomplete lesions of visual cortex were distinctly impaired in their visual control of approach responses to the same stimuli. On the other hand, rats with collicular damage showed no orienting reflex or evidence of distraction in the same task when novel visual or auditory stimuli were presented. However, both normal and visual-decorticate rats showed various components of the orienting reflex and disturbance in task performance when the same novel stimuli were presented. These results suggest that although the superior colliculus does not appear to be essential to the visual control of locomotor orientation, this midbrain structure might participate in the mediation of shifts in visual fixation and attention. Visual cortex, while contributing to visuospatial guidance of locomotor movements, might not play a significant role in the control and integration of the orienting reflex.

  7. Posterior Cruciate Ligament Retention versus Posterior Stabilization for Total Knee Arthroplasty: A Meta-Analysis.

    PubMed

    Jiang, Chao; Liu, Zhenlei; Wang, Ying; Bian, Yanyan; Feng, Bin; Weng, Xisheng

    2016-01-01

    Although being debated for many years, the superiority of posterior cruciate-retaining (CR) total knee arthroplasty (TKA) and posterior-stabilized (PS) TKA remains controversial. We compare the knee scores, post-operative knee range of motion (ROM), radiological outcomes about knee kinematic and complications between CR TKA and PS TKA. Literature published up to August 2015 was searched in PubMed, Embase and Cochrane databases, and meta-analysis was performed using the software, Review Manager version 5.3. Totally 14 random control trials (RCTs) on this topic were included for the analysis, which showed that PS and CR TKA had no significant difference in Knee Society knee Score (KSS), pain score (KSPS), Hospital for Special Surgery score (HSS), kinematic characteristics including postoperative component alignment, tibial posterior slope and joint line, and complication rate. However, PS TKA is superior to CR TKA regarding post-operative knee range of motion (ROM) [Random Effect model (RE), Mean Difference (MD) = -7.07, 95% Confidential Interval (CI) -10.50 to -3.65, p<0.0001], improvement of ROM (Fixed Effect model (FE), MD = -5.66, 95% CI -10.79 to -0.53, p = 0.03) and femoral-tibial angle [FE, MD = 0.85, 95% CI 0.46 to 1.25, p<0.0001]. There are no clinically relevant differences between CR and PS TKA in terms of clinical, functional, radiological outcome, and complications, while PS TKA is superior to CR TKA in respects of ROM, while whether this superiority matters or not in clinical practice still needs further investigation and longer follow-up.

  8. Agreement between Lake Superior State University and Lake Superior State University Faculty Association MEA-NEA. Effective Sept. 1, 1988 to August 31, 1991.

    ERIC Educational Resources Information Center

    Lake Superior State Univ., Sault Sainte Marie, MI.

    The collective bargaining agreement between Lake Superior State University (Michigan) and the Lake Superior State University Faculty Association, an affiliate of the National Education Association, covering the period September 1, 1988 to August 31, 1991 is presented. The agreement covers the following items: definitions; recognition; association…

  9. The picture superiority effect in associative recognition.

    PubMed

    Hockley, William E

    2008-10-01

    The picture superiority effect has been well documented in tests of item recognition and recall. The present study shows that the picture superiority effect extends to associative recognition. In three experiments, students studied lists consisting of random pairs of concrete words and pairs of line drawings; then they discriminated between intact (old) and rearranged (new) pairs of words and pictures at test. The discrimination advantage for pictures over words was seen in a greater hit rate for intact picture pairs, but there was no difference in the false alarm rates for the two types of stimuli. That is, there was no mirror effect. The same pattern of results was found when the test pairs consisted of the verbal labels of the pictures shown at study (Experiment 4), indicating that the hit rate advantage for picture pairs represents an encoding benefit. The results have implications for theories of the picture superiority effect and models of associative recognition.

  10. Differences in alarm events between disposable and reusable electrocardiography lead wires.

    PubMed

    Albert, Nancy M; Murray, Terri; Bena, James F; Slifcak, Ellen; Roach, Joel D; Spence, Jackie; Burkle, Alicia

    2015-01-01

    Disposable electrocardiographic lead wires (ECG-LWs) may not be as durable as reusable ones. To examine differences in alarm events between disposable and reusable ECG-LWs. Two cardiac telemetry units were randomized to reusable ECG-LWs, and 2 units alternated between disposable and reusable ECG-LWs for 4 months. A remote monitoring team, blinded to ECG-LW type, assessed frequency and type of alarm events by using total counts and rates per 100 patient days. Event rates were compared by using generalized linear mixed-effect models for differences and noninferiority between wire types. In 1611 patients and 9385.5 patient days of ECG monitoring, patient characteristics were similar between groups. Rates of alarms for no telemetry, leads fail, or leads off were lower in disposable ECG-LWs (adjusted relative risk [95% CI], 0.71 [0.53-0.96]; noninferiority P < .001; superiority P = .03) and monitoring (artifact) alarms were significantly noninferior (adjusted relative risk [95% CI]: 0.88, [0.62-1.24], P = .02; superiority P = .44). No between-group differences existed in false or true crisis alarms. Disposable ECG-LWs were noninferior to reusable ECG-LWs for all false-alarm events (N [rate per 100 patient days], disposable 2029 [79.1] vs reusable 6673 [97.9]; adjusted relative risk [95% CI]: 0.81 [0.63-1.06], P = .002; superiority P = .12.) Disposable ECG-LWs with patented push-button design had superior performance in reducing alarms created by no telemetry, leads fail, or leads off and significant noninferiority in all false-alarm rates compared with reusable ECG-LWs. Fewer ECG alarms may save nurses time, decrease alarm fatigue, and improve patient safety. ©2015 American Association of Critical-Care Nurses.

  11. Dual mini-fragment plating for midshaft clavicle fractures: a clinical and biomechanical investigation.

    PubMed

    Prasarn, Mark L; Meyers, Kathleen N; Wilkin, Geoffrey; Wellman, David S; Chan, Daniel B; Ahn, Jaimo; Lorich, Dean G; Helfet, David L

    2015-12-01

    We sought to evaluate clinical and biomechanical outcomes of dual mini-fragment plate fixation for clavicle fractures. We hypothesized that this technique would produce an anatomical reduction with good clinical outcomes, be well tolerated by patients, and demonstrate equivalent biomechanics to single plating. Dual mini-fragment plating was performed for 17 isolated, displaced midshaft clavicle fractures. Functional outcomes and complications were retrospectively reviewed. A sawbones model compared dual plating biomechanics to a (1) superior 3.5-mm locking reconstruction plate, or (2) antero-inferior 3.5-mm locking reconstruction plate. On biomechanical testing, with anterior loading, dual plating was significantly more rigid than single locked anterior-plating (p = 0.02) but less rigid than single locked superior-plating (p = 0.001). With superior loading, dual plating trended toward higher rigidity versus single locked superior-plating (p = 0.07) but was less rigid than single locked anterior-plating (p = 0.03). No statistically significant differences in axial loading (p = 0.27) or torsion (p = 0.23) were detected. Average patient follow-up was 16.1 months (12-38). Anatomic reduction was achieved and maintained through final healing (average 14.7 weeks). No patient underwent hardware removal. Average 1-year DASH score was 4.0 (completed in 88 %). Displaced midshaft clavicle fractures can be effectively managed with dual mini-fragment plating. This technique results in high union rates and excellent clinical outcomes. Compared to single plating, dual plating is biomechanically equivalent in axial loading and torsion, yet offers better multi-planar bending stiffness despite the use of smaller plates. This technique may decrease the need for secondary surgery due to implant prominence and may aid in fracture reduction by buttressing butterfly fragments in two planes.

  12. Cadexomer iodine provides superior efficacy against bacterial wound biofilms in vitro and in vivo.

    PubMed

    Fitzgerald, Daniel J; Renick, Paul J; Forrest, Emma C; Tetens, Shannon P; Earnest, David N; McMillan, Jillian; Kiedaisch, Brett M; Shi, Lei; Roche, Eric D

    2017-01-01

    Examination of clinical samples indicates bacterial biofilms are present in the majority of chronic wounds, and substantial evidence suggests biofilms contribute significantly to delayed healing. Bacteria in biofilms are highly tolerant of antimicrobials, and little data exist to guide the choice of anti-biofilm wound therapy. Cadexomer iodine (CI) was recently reported to have superior efficacy compared to diverse wound dressings against Pseudomonas aeruginosa biofilms in an ex vivo model. In the current study, the strong performance of CI vs. P. aeruginosa biofilm was confirmed using colony and colony drip-flow in vitro wound biofilm models. Similar in vitro efficacy of CI was also demonstrated against mature Staphylococcus aureus biofilms using the same models. Additionally, the rapid kill of mature S. aureus and P. aeruginosa colony biofilms was visualized by confocal microscopy using Live/Dead fluorescent stains. Superior in vitro efficacy of CI vs. staphylococcal biofilms was further demonstrated against methicillin-resistant S. aureus (MRSA) using multiple biofilm models with log reduction, Live/Dead, and metabolic endpoints. Comparator antimicrobial dressings, including silver-based dressings used throughout and other active agents used in individual models, elucidated only limited effects against the mature biofilms. Given the promising in vitro activity, CI was tested in an established mouse model of MRSA wound biofilm. CI had significantly greater impact on MRSA biofilm in mouse wounds than silver dressings or mupirocin based on Gram-stained histology sections and quantitative microbiology from biopsy samples (>4 log reduction in CFU/g vs. 0.7-1.6, p < 0.0001). The superior efficacy for CI in these in vitro and in vivo models suggests CI topical products may represent a better choice to address established bacterial biofilm in chronic wounds. © 2016 by the Wound Healing Society.

  13. Long-term effects of asenapine or olanzapine in patients with persistent negative symptoms of schizophrenia: a pooled analysis.

    PubMed

    Potkin, Steven G; Phiri, Phillip; Szegedi, Armin; Zhao, Jun; Alphs, Larry; Cazorla, Pilar

    2013-11-01

    A Phase 2 efficacy study suggested that asenapine (ASE) was superior to risperidone in decreasing negative symptoms in schizophrenia at 6 weeks, prompting design of two negative symptom studies. Two 26-week core studies with 26-week extensions compared asenapine (ASE: 5-10mg twice-daily] and olanzapine (OLA: 5-20mg once-daily) as monotherapies in reducing persistent negative symptoms (PNS). While neither study met the primary endpoint of superiority of ASE over OLA, ASE was statistically superior to OLA in one extension study. This prompted a pooled analysis of the treatment effects of both drugs. Data were pooled from two 26-week core studies and extensions. Efficacy endpoints: change in Negative Symptom Assessment scale-16 (NSA-16) total score at Week 26 (prespecified primary endpoint) and Week 52. Additional measures: change in Positive and Negative Syndrome Scale (PANSS)-total, Marder factors, negative subscale scores, Clinical Global Impression Severity of Illness score (CGI-S) assessments, NSA-16 factor domains, NSA global score, and individual items. Pooled data from the extension studies (n=502) showed no differences between ASE and OLA at Week 26. At Week 52, ASE showed superiority over OLA in NSA-16 total score, NSA global, PANSS Marder negative and PANSS negative subscales, some NSA-16 items, and four of five factor domains. In addition, pooled data for patients who entered the core trials (n=949) were analyzed over 52weeks (whether or not patients entered the extension). No significant differences between groups were observed in change in NSA-16 total score at 26-weeks. At Week 52, ASE was significantly superior over OLA in this measure, NSA global score and PANSS Marder negative factor. There were more early dropouts due to AEs, including worsening of the disease, in the ASE group. In this pooled analysis, ASE and OLA did not differ significantly over 26 weeks, but indicated a signal of superiority for ASE with continued treatment up to 52 weeks. © 2013.

  14. The potential effect of anatomic relationship between the femur and the tibia on medial meniscus tears.

    PubMed

    Bozkurt, Murat; Unlu, Serhan; Cay, Nurdan; Apaydin, Nihal; Dogan, Metin

    2014-10-01

    The anatomic and the kinematical relationships between the femur and the tibia have been previously examined in both normal and diseased knees. However, less attention has been directed to the effect of these relationships on the meniscal diseases. Therefore, we aimed to investigate the impact of femorotibial incongruence on both lateral and medial meniscal tears. A total of 100 images obtained from MRI of 100 patients (39 males and 61 females) were included in the study. Diameters of the medial and the lateral femoral condyles, thicknesses of the menisci, and diameters of the medial and the lateral tibial articular surfaces were measured. The medial meniscus tear was detected in 40 (40 %) patients. However, no lateral meniscus tear was found. Significant relationships were found between the diameters of the posterior medial femoral condyle and the medial tibial superior articular surface and between the diameters of the posterior lateral femoral condyle and the lateral tibial superior articular surface. The mean values for the diameter of the medial condyle of the femur, the lateral condyle of the femur, the medial superior articular surface of the tibia, and the lateral superior articular surface of the tibia were found to be significantly higher in cases with meniscus tear compared to cases without meniscus tear. However, no significant difference was present regarding the thicknesses of the medial and the lateral menisci. A positive relationship between the diameter of the posterior medial femoral condyle and the tibial medial superior articular surface was found in cases with (n = 40) (r (2) = 0.208, p = 0.003) and without tear (n = 60) (r (2) = 0.182, p = 0.001). In addition, a significant positive relationship was found between the diameter of the posterior medial femoral condyle and the medial tibial superior articular surface in cases with and without tear. The impact of femorotibial incongruence on the medial meniscus tear is important for the understanding of the lesions.

  15. A Randomized, Double-Blind, Placebo-Controlled Study to Investigate the Safety, Tolerability, and Pharmacokinetics of Single Enantiomer (+)-Mefloquine Compared with Racemic Mefloquine in Healthy Persons

    PubMed Central

    Tansley, Robert; Lotharius, Julie; Priestley, Anthony; Bull, Fiona; Duparc, Stephan; Möhrle, Jörg

    2010-01-01

    Racemic mefloquine is a highly effective antimalarial whose clinical utility has been compromised by its association with neuropsychiatric and gastrointestinal side effects. It is hypothesized that the cause of the side effects may reside in the (−) enantiomer. We sought to compare the safety, tolerability and pharmacokinetic profile of (+)-mefloquine with racemic mefloquine in a randomized, ascending-dose, double-blind, active and placebo-controlled, parallel cohort study in healthy male and female adult volunteers. Although differing in its manifestations, both study drugs displayed a substantially worse tolerability profile compared with placebo. The systemic clearance was slower for (−)-mefloquine than (+)-mefloquine. Thus, (+)-mefloquine has a different safety and tolerability profile compared with racemic mefloquine but its global safety profile is not superior and replacement of the currently used antimalarial drug with (+)-mefloquine is not warranted. PMID:21118921

  16. Comparative Effectiveness of Mesalamine, Sulfasalazine, Corticosteroids, and Budesonide for the Induction of Remission in Crohn's Disease: A Bayesian Network Meta-analysis.

    PubMed

    Coward, Stephanie; Kuenzig, M Ellen; Hazlewood, Glen; Clement, Fiona; McBrien, Kerry; Holmes, Rebecca; Panaccione, Remo; Ghosh, Subrata; Seow, Cynthia H; Rezaie, Ali; Kaplan, Gilaad G

    2017-03-01

    Induction treatment of mild-to-moderate Crohn's disease is controversial. To compare the induction of remission between different doses of mesalamine, sulfasalazine, corticosteroids, and budesonide for active Crohn's disease. We identified randomized controlled trials from existing Cochrane reviews and an updated literature search in Medline, EMBASE, and CENTRAL to November 2015. We included randomized controlled trials (n = 22) in adult patients with Crohn's disease that compared budesonide, sulfasalazine, mesalamine, or corticosteroids with placebo or each other, for the induction of remission (8-17 wks). Mesalamine (above and below 2.4 g/d) and budesonide (above and below 6 mg/d) were stratified into low and high doses. Our primary outcome was remission, defined as a Crohn's Disease Activity Index score <150. A Bayesian random-effects network meta-analysis was performed on the proportion in remission. Corticosteroids (odds ratio [OR] = 3.80; 95% credible interval [CrI]: 2.48-5.66), high-dose budesonide (OR = 2.96; 95% CrI: 2.06-4.30), and high-dose mesalamine (OR = 2.29; 95% CrI: 1.58-3.33) were superior to placebo. Corticosteroids were similar to high-dose budesonide (OR = 1.21; 95% CrI: 0.84-1.76), but more effective than high-dose mesalamine (OR = 1.83; 95% CrI: 1.16-2.88). Sulfasalazine was not significantly superior to any therapy including placebo. Randomized controlled trials that use a strict definition of induction of remission and disease severity at enrollment to assess effectiveness in treating mild-to-moderate Crohn's disease are limited. Corticosteroids and high-dose budesonide were effective treatments for inducing remission in mild-to-moderate Crohn's disease. High-dose mesalamine is an option among patients preferring to avoid steroids.

  17. Effects of S-citalopram, citalopram, and R-citalopram on the firing patterns of dopamine neurons in the ventral tegmental area, N-methyl-D-aspartate receptor-mediated transmission in the medial prefrontal cortex and cognitive function in the rat.

    PubMed

    Schilström, Björn; Konradsson-Geuken, Asa; Ivanov, Vladimir; Gertow, Jens; Feltmann, Kristin; Marcus, Monica M; Jardemark, Kent; Svensson, Torgny H

    2011-05-01

    Escitalopram, the S-enantiomer of citalopram, possesses superior efficacy compared to other selective serotonin reuptake inhibitors (SSRIs) in the treatment of major depression. Escitalopram binds to an allosteric site on the serotonin transporter, which further enhances the blockade of serotonin reuptake, whereas R-citalopram antagonizes this positive allosteric modulation. Escitalopram's effects on neurotransmitters other than serotonin, for example, dopamine and glutamate, are not well studied. Therefore, we here studied the effects of escitalopram, citalopram, and R-citalopram on dopamine cell firing in the ventral tegmental area, using single-cell recording in vivo and on NMDA receptor-mediated currents in pyramidal neurons in the medial prefrontal cortex using in vitro electrophysiology in rats. The cognitive effects of escitalopram and citalopram were also compared using the novel object recognition test. Escitalopram (40-640 μg/kg i.v.) increased both firing rate and burst firing of dopaminergic neurons, whereas citalopram (80-1280 μg/kg) had no effect on firing rate and only increased burst firing at high dosage. R-citalopram (40-640 μg/kg) had no significant effects. R-citalopram (320 μg/kg) antagonized the effects of escitalopram (320 μg/kg). A very low concentration of escitalopram (5 nM), but not citalopram (10 nM) or R-citalopram (5 nM), potentiated NMDA-induced currents in pyramidal neurons. Escitalopram's effect was antagonized by R-citalopram and blocked by the dopamine D(1) receptor antagonist SCH23390. Escitalopram, but not citalopram, improved recognition memory. Our data suggest that the excitatory effect of escitalopram on dopaminergic and NMDA receptor-mediated neurotransmission may have bearing on its cognitive-enhancing effect and superior efficacy compared to other SSRIs in major depression. Copyright © 2010 Wiley-Liss, Inc.

  18. Impact of remuneration and organizational factors on completing preventive manoeuvres in primary care practices.

    PubMed

    Dahrouge, Simone; Hogg, William E; Russell, Grant; Tuna, Meltem; Geneau, Robert; Muldoon, Laura K; Kristjansson, Elizabeth; Fletcher, John

    2012-02-07

    Several jurisdictions attempting to reform primary care have focused on changes in physician remuneration. The goals of this study were to compare the delivery of preventive services by practices in four primary care funding models and to identify organizational factors associated with superior preventive care. In a cross-sectional study, we included 137 primary care practices in the province of Ontario (35 fee-for-service practices, 35 with salaried physicians [community health centres], 35 practices in the new capitation model [family health networks] and 32 practices in the established capitation model [health services organizations]). We surveyed 288 family physicians. We reviewed 4108 randomly selected patient charts and assigned prevention scores based on the proportion of eligible preventive manoeuvres delivered for each patient. A total of 3284 patients were eligible for at least one of six preventive manoeuvres. After adjusting for patient profile and contextual factors, we found that, compared with prevention scores in practices in the new capitation model, scores were significantly lower in fee-for-service practices (β estimate for effect on prevention score = -6.3, 95% confidence interval [CI] -11.9 to -0.6) and practices in the established capitation model (β = -9.1, 95% CI -14.9 to -3.3) but not for those with salaried remuneration (β = -0.8, 95% CI -6.5 to 4.8). After accounting for physician characteristics and organizational structure, the type of funding model was no longer a statistically significant factor. Compared with reference practices, those with at least one female family physician (β = 8.0, 95% CI 4.2 to 11.8), a panel size of fewer than 1600 patients per full-time equivalent family physician (β = 6.8, 95% CI 3.1 to 10.6) and an electronic reminder system (β = 4.6, 95% CI 0.4 to 8.7) had superior prevention scores. The effect of these three factors was largely but not always consistent across the funding models; it was largely consistent across the preventive manoeuvres. No funding model was clearly associated with superior preventive care. Factors related to physician characteristics and practice structure were stronger predictors of performance. Practices with one or more female physicians, a smaller patient load and an electronic reminder system had superior prevention scores. Our findings raise questions about reform initiatives aimed at increasing patient numbers, but they support the adoption of information technology.

  19. Deficits in learning and memory: parahippocampal hyperactivity and frontocortical hypoactivity in cannabis users.

    PubMed

    Nestor, Liam; Roberts, Gloria; Garavan, Hugh; Hester, Robert

    2008-04-15

    The consumption of cannabis has been linked to impairments in human learning and memory, as well as aspects of executive functioning. Cannabis-related impairments in learning and memory in chronic cannabis users, it has been argued, are caused by the effects of cannabis on hippocampal functioning. The current study involved two experiments. Experiment 1 compared 35 current users of cannabis and 38 well-matched controls on a face-name task, previously shown to activate the hippocampal region. Based on the results of experiment 1, experiment 2 used fMRI and a modified version of the face-name task, to examine cortical and (para)hippocampal activity during learning and recall in 14 current users of cannabis and 14 controls. Results of experiment 1 showed that cannabis users were significantly worse with respect to learning, short and long-term memory performance. Experiment 2 showed that despite non-significant differences in learning and memory performance, cannabis users had significantly lower levels of BOLD activity in the right superior temporal gyrus, right superior frontal gyrus, right middle frontal gyrus and left superior frontal gyrus compared to controls during learning. Results also showed that cannabis users had significantly higher BOLD activity in the right parahippocampal gyrus during learning. Hypoactivity in frontal and temporal cortices, and relative hyperactivity in the parahippocampus identify functional deficits and compensatory processes in cannabis users.

  20. Ocular vestibular evoked myogenic potentials to vertex low frequency vibration as a diagnostic test for superior canal dehiscence.

    PubMed

    Verrecchia, Luca; Westin, Magnus; Duan, Maoli; Brantberg, Krister

    2016-04-01

    To explore ocular vestibular evoked myogenic potentials (oVEMP) to low-frequency vertex vibration (125 Hz) as a diagnostic test for superior canal dehiscence (SCD) syndrome. The oVEMP using 125 Hz single cycle bone-conducted vertex vibration were tested in 15 patients with unilateral superior canal dehiscence (SCD) syndrome, 15 healthy controls and in 20 patients with unilateral vestibular loss due to vestibular neuritis. Amplitude, amplitude asymmetry ratio, latency and interaural latency difference were parameters of interest. The oVEMP amplitude was significantly larger in SCD patients when affected sides (53 μVolts) were compared to non-affected (17.2 μVolts) or compared to healthy controls (13.6 μVolts). Amplitude larger than 33.8 μVolts separates effectively the SCD ears from the healthy ones with sensitivity of 87% and specificity of 93%. The other three parameters showed an overlap between affected SCD ears and non-affected as well as between SCD ears and those in the two control groups. oVEMP amplitude distinguishes SCD ears from healthy ones using low-frequency vibration stimuli at vertex. Amplitude analysis of oVEMP evoked by low-frequency vertex bone vibration stimulation is an additional indicator of SCD syndrome and might serve for diagnosing SCD patients with coexistent conductive middle ear problems. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  1. Memory traces for spoken words in the brain as revealed by the hemodynamic correlate of the mismatch negativity.

    PubMed

    Shtyrov, Yury; Osswald, Katja; Pulvermüller, Friedemann

    2008-01-01

    The mismatch negativity response, considered a brain correlate of automatic preattentive auditory processing, is enhanced for word stimuli as compared with acoustically matched pseudowords. This lexical enhancement, taken as a signature of activation of language-specific long-term memory traces, was investigated here using functional magnetic resonance imaging to complement the previous electrophysiological studies. In passive oddball paradigm, word stimuli were randomly presented as rare deviants among frequent pseudowords; the reverse conditions employed infrequent pseudowords among word stimuli. Random-effect analysis indicated clearly distinct patterns for the different lexical types. Whereas the hemodynamic mismatch response was significant for the word deviants, it did not reach significance for the pseudoword conditions. This difference, more pronounced in the left than right hemisphere, was also assessed by analyzing average parameter estimates in regions of interests within both temporal lobes. A significant hemisphere-by-lexicality interaction confirmed stronger blood oxygenation level-dependent mismatch responses to words than pseudowords in the left but not in the right superior temporal cortex. The increased left superior temporal activation and the laterality of cortical sources elicited by spoken words compared with pseudowords may indicate the activation of cortical circuits for lexical material even in passive oddball conditions and suggest involvement of the left superior temporal areas in housing such word-processing neuronal circuits.

  2. Treating Anxiety Disorders in Inner City Schools: Results from a Pilot Randomized Controlled Trial Comparing CBT and Usual Care

    PubMed Central

    Becker, Kimberly D.; Drazdowski, Tess K.; Tein, Jenn-Yun

    2012-01-01

    Background The effectiveness of cognitive-behavioral treatment (CBT) in inner city schools, when delivered by novice CBT clinicians, and compared to usual care (UC), is unknown. Objective This pilot study addressed this issue by comparing a modular CBT for anxiety disorders to UC in a sample of 32 volunteer youth (mean age 10.28 years, 63% female, 84% African American) seen in school-based mental health programs. Methods Youth were randomly assigned to CBT (n = 17) or UC (n = 15); independent evaluators conducted diagnostic interviews with children and parents at pre- and post-intervention, and at a one-month follow-up. Results Based on intent-to-treat analyses, no differences were found in response rates between groups with 50 and 42% of the children in CBT, compared to 46 and 57% in UC no longer meeting criteria for an anxiety disorder at post-treatment and follow-up respectively. Similar improvements in global functioning were also found in both treatment groups. Baseline predictors of a positive treatment response included lower anxiety, fewer maladaptive thoughts, less exposure to urban hassles, and lower levels of parenting stress. Therapist use of more CBT session structure elements and greater competence in implementing these elements was also related to a positive treatment response. Conclusions Findings from this small pilot failed to show that CBT was superior to UC when delivered by school-based clinicians. Large scale comparative effectiveness trials are needed to determine whether CBT leads to superior clinical outcomes prior to dissemination. PMID:22701295

  3. Comparative analysis of hole transport in compressively strained InSb and Ge quantum well heterostructures

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

    Agrawal, Ashish; Barth, Michael; Madan, Himanshu

    2014-08-04

    Compressively strained InSb (s-InSb) and Ge (s-Ge) quantum well heterostructures are experimentally studied, with emphasis on understanding and comparing hole transport in these two-dimensional confined heterostructures. Magnetotransport measurements and bandstructure calculations indicate 2.5× lower effective mass for s-InSb compared to s-Ge quantum well at 1.9 × 10{sup 12} cm{sup –2}. Advantage of strain-induced m* reduction is negated by higher phonon scattering, degrading hole transport at room temperature in s-InSb quantum well compared to s-Ge heterostructure. Consequently, effective injection velocity is superior in s-Ge compared to s-InSb. These results suggest s-Ge quantum well heterostructure is more favorable and promising p-channel candidate compared to s-InSbmore » for future technology node.« less

  4. Premedication with oral alprazolam and melatonin combination: a comparison with either alone--a randomized controlled factorial trial.

    PubMed

    Pokharel, Krishna; Tripathi, Mukesh; Gupta, Pramod Kumar; Bhattarai, Balkrishna; Khatiwada, Sindhu; Subedi, Asish

    2014-01-01

    We assessed if the addition of melatonin to alprazolam has superior premedication effects compared to either drug alone. A prospective, double blind placebo controlled trial randomly assigned 80 adult patients (ASA 1&2) with a Visual Analogue Score (VAS) for anxiety ≥ 3 to receive a tablet containing a combination of alprazolam 0.5 mg and melatonin 3 mg, alprazolam 0.5 mg, melatonin 3 mg, or placebo orally 90 min before a standard anesthetic. Primary end points were change in anxiety and sedation score at 15, 30, and 60 min after premedication, and number of patients with loss of memory for the five pictures shown at various time points when assessed after 24 h. One-way ANOVA, Friedman repeated measures analysis of variance, Kruskal Wallis and chi square tests were used as relevant. Combination drug produced the maximum reduction in anxiety VAS (3 (1.0-4.3)) from baseline at 60 min (P < 0.05). Sedation scores at various time points and number of patients not recognizing the picture shown at 60 min after premedication were comparable between combination drug and alprazolam alone. Addition of melatonin to alprazolam had superior anxiolysis compared with either drugs alone or placebo. Adding melatonin neither worsened sedation score nor the amnesic effect of alprazolam alone. This study was registered, approved, and released from ClinicalTrials.gov. Identifier number: NCT01486615.

  5. The effect of negative pressure wound therapy with antibacterial dressings or antiseptics on an in vitro wound model.

    PubMed

    Matiasek, J; Domig, K J; Djedovic, G; Babeluk, R; Assadian, O

    2017-05-02

    The aim of this study was to investigate the bacterial bioburden in experimental in vitro wounds during the application of conventional negative pressure wound therapy (NPWT), with and without antimicrobial dressings (polyhexanide, silver), against NPWT instillation of octenidine. Experimental wounds produced in an in vitro porcine wound model were homogenously contaminated with bacterial suspension and treated with NPWT and different options. Group A: non-antimicrobial polyurethane foam dressing; group B: antimicrobial polyurethane foam dressing containing silver; group C: antimicrobial gauze dressing containing polyhexanide; group D: non-antimicrobial polyurethane foam dressing intermittently irrigated with octenidine; group E: negative control (non-antimicrobial polyurethane foam dressing without NPWT). Standard biopsies were harvested after 24 and 28 hours. This study demonstrated that the use of NPWT with intermitted instillation of octenidine (group D) or application of silver-based polyurethane foam dressings (group B) is significantly superior against Staphylococcus aureus colonisation in experimental wounds compared with non-antimicrobial polyurethane foam dressing (group A) after 48 hours. Surprisingly, the polyhexanide-based dressing (group C) used in this model showed no statistical significant effect compared with the control group (group E) after 24 or 48 hours of treatment. Both intermitted instillation of octenidine and silver-based dressings in standard NPWT were significantly superior compared with non-antimicrobial polyurethane foam dressings or PHMB coated gauze dressing after 48 hours.

  6. Intravenous Dexmedetomidine Provides Superior Patient Comfort and Tolerance Compared to Intravenous Midazolam in Patients Undergoing Flexible Bronchoscopy

    PubMed Central

    Goneppanavar, Umesh; Periyadka Janardhana, Bhavya; Krishna Achar, Shreepathi

    2015-01-01

    Dexmedetomidine, an α 2 agonist, has demonstrated its effectiveness as a sedative during awake intubation, but its utility in fiberoptic bronchoscopy (FOB) is not clear. We evaluated the effects of midazolam and dexmedetomidine on patient's response to FOB. The patients received either midazolam, 0.02 mg/kg (group M, n = 27), or dexmedetomidine, 1 µg/kg (group D, n = 27). A composite score of five different parameters and a numerical rating scale (NRS) for pain intensity and distress were used to assess patient response during FOB. Patients rated the quality of sedation and level of discomfort 24 h after the procedure. Ease of bronchoscopy, rescue medication requirement, and haemodynamic variables were noted. Ideal or acceptable composite score was observed in 15 and 26 patients, respectively, in group M (14.48 ± 3.65) and group D (9.41 ± 3.13), p < 0.001. NRS showed that 11 patients in group M had severe pain and discomfort as compared to one patient with severe pain and two with severe discomfort in group D during the procedure, p < 0.001. Rescue midazolam requirement was significantly higher in group M (p = 0.023). We conclude that during FOB, under topical airway anaesthesia, IV dexmedetomidine (1 µg/kg) provides superior patient comfort and tolerance as compared to IV midazolam (0.02 mg/kg). PMID:26543645

  7. Role of Periarticular Liposomal Bupivacaine Infiltration in Patients Undergoing Total Knee Arthroplasty-A Meta-analysis of Comparative Trials.

    PubMed

    Singh, Preet Mohinder; Borle, Anuradha; Trikha, Anjan; Michos, Lia; Sinha, Ashish; Goudra, Basavana

    2017-02-01

    Over last 2 years, many trials have evaluated newly approved liposomal bupivacaine for periarticular infiltration in total knee arthroplasty (TKA) with mixed results. Our meta-analysis attempts to consolidate the results and make evidence-based conclusions. Trails comparing periarticular infiltration of liposomal bupivacaine to conventional analgesic regimens for total knee arthroplasty published till June 2016 were searched in medical database. Comparisons were made for length of stay (LOS), postoperative pain scores, range of motion, and opioid consumption. Meta-regression was performed for LOS to evaluate various analgesic control subgroups. Sixteen trials were included in the final analysis. Liposomal bupivacaine group showed a shorter LOS (reported in 13 subgroups) than control group by 0.17 ± 0.04 days (random effects, P < .001, I 2  = 84.66%). Meta-regression for various types of control showed a predictability (R 2 ) of 73%, τ 2  = 0.013 (random effects, P < .001, I 2  = 45.16). Only femoral block subgroup attained statistically significant shorter LOS on splitting the control group. Numeric pain scores were lower for pooled control group and local anesthetic infiltration subgroup in immediate postoperative phase. Second postoperative day analgesia was statistically superior to overall clubbed controls and femoral block subgroup. Superiority and/or inferiority of liposomal bupivacaine could not be proven for opioid consumption and range of motion because of a small pooled sample size. Publication bias is likely for LOS (Egger test, X intercept = 2.42, P < .001). Liposomal bupivacaine infiltration has questionable clinical advantage, as it marginally shortens patient's hospital stay especially in comparison with patients receiving analgesic femoral nerve block. Compared with conventional regimens, it can provide slightly superior yet sustained (till second postoperative day) perioperative analgesia. High heterogeneity suggests need for standardization of infiltration techniques for better predictability of results. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Is Taurolidine-citrate an effective and cost-effective hemodialysis catheter lock solution? A systematic review and cost- effectiveness analysis.

    PubMed

    Kavosi, Zahra; Sarikhani Khorrami, Maryam; Keshavarz, Khosro; Jafari, Abdosaleh; Hashemi Meshkini, Amir; Safaei, Hamid Reza; Nikfar, Shekoufeh

    2016-01-01

    Prevention of catheter-related infection is of prime importance,. However, because of the risks caused by the leakage of circulating antibiotics and development of resistance to antibiotics, they are replaced by lock solutions. The aim of this study was to evaluate the efficacy and cost- effectiveness of taurolidine-citrate as a hemodialysis catheter lock solution compared to other common alternatives in Iran. To evaluate the efficacy of taurolidine-citrate, a systematic review was conducted by searching electronic databases. The outcomes of interest for cost-effectiveness analysis were as follows: "Catheter-related bacteremia episodes"; "catheter-related bacteremia-free survival"; "catheter thrombosis rate" for efficacy evaluation and "reduction of catheter-related infection". For evidence synthesis, a meta-analysis was conducted on the extracted efficacy data. To evaluate the cost of treatments, direct medical costs were included, and the incremental cost-effectiveness ratio was calculated for each comparison. The payers' (patients and insurance companies) perspectives were used for cost analysis. After carrying out the systematic process, three articles were included in the analysis. Considering 95% confidence interval, the relative difference was -0.16 (-0.25 to -0.07) for catheterrelated bacteremia episode, indicating that the rate of catheter-related infections in hemodialysis patients who used taurolidine-citrate was 16% less than in those hemodialysis patients who received heparin. Considering 95% confidence interval, the relative difference was 0.13 (-0.06 0.32) for catheter thrombosis, showing that the rate of catheter-related thrombosis in hemodialysis patients who used taurolidine-citrate was 13% more than in hemodialysis patients who received heparin. The results of this analysis indicated that taurolidine-citrate, compared to heparin, was more effective in preventing catheter-related infection; therefore, it could be considered as a superior strategy. Nevertheless, compared to heparin-gentamicin combination, taurolidine-citrate is an inferior strategy because of its higher cost and lower infection prevention. Compared to heparin, taurolidine-citrate is a superior option, but it is an inferior strategy compared to heparin-gentamicin combination. The clinical evidences on taurolidine-citrate, heparin and gentamicin/heparin are not sufficient for making confident decisions.

  9. Auditory Perceptual Abilities Are Associated with Specific Auditory Experience

    PubMed Central

    Zaltz, Yael; Globerson, Eitan; Amir, Noam

    2017-01-01

    The extent to which auditory experience can shape general auditory perceptual abilities is still under constant debate. Some studies show that specific auditory expertise may have a general effect on auditory perceptual abilities, while others show a more limited influence, exhibited only in a relatively narrow range associated with the area of expertise. The current study addresses this issue by examining experience-dependent enhancement in perceptual abilities in the auditory domain. Three experiments were performed. In the first experiment, 12 pop and rock musicians and 15 non-musicians were tested in frequency discrimination (DLF), intensity discrimination, spectrum discrimination (DLS), and time discrimination (DLT). Results showed significant superiority of the musician group only for the DLF and DLT tasks, illuminating enhanced perceptual skills in the key features of pop music, in which miniscule changes in amplitude and spectrum are not critical to performance. The next two experiments attempted to differentiate between generalization and specificity in the influence of auditory experience, by comparing subgroups of specialists. First, seven guitar players and eight percussionists were tested in the DLF and DLT tasks that were found superior for musicians. Results showed superior abilities on the DLF task for guitar players, though no difference between the groups in DLT, demonstrating some dependency of auditory learning on the specific area of expertise. Subsequently, a third experiment was conducted, testing a possible influence of vowel density in native language on auditory perceptual abilities. Ten native speakers of German (a language characterized by a dense vowel system of 14 vowels), and 10 native speakers of Hebrew (characterized by a sparse vowel system of five vowels), were tested in a formant discrimination task. This is the linguistic equivalent of a DLS task. Results showed that German speakers had superior formant discrimination, demonstrating highly specific effects for auditory linguistic experience as well. Overall, results suggest that auditory superiority is associated with the specific auditory exposure. PMID:29238318

  10. A newly developed silymarin nanoformulation as a potential antidiabetic agent in experimental diabetes.

    PubMed

    El-Far, Yousra M; Zakaria, Mahmoud M; Gabr, Mahmoud M; El Gayar, Amal M; El-Sherbiny, Ibrahim M; Eissa, Laila A

    2016-10-01

    This study aimed to develop a new stable nanoformulation of silymarin (SM) with optimum enhanced oral bioavailability and to evaluate its effect as well as mechanism of action as a superior antidiabetic agent over native SM using streptozotocin-induced diabetic rats. SM-loaded pluronic nanomicelles (SMnp) were prepared and fully characterized. Biochemical parameters were performed as well as histological, confocal and reverse-transcription polymerase chain reaction studies on pancreatic target tissues. SMnp were found to improve significantly the antihyperglycemic, antioxidant and antihyperlipidemic properties as compared with native SM. In addition, SMnp was found to be a more efficient agent over SM in the management of diabetes and its associated complications due to its superior bioavailability in vivo, and the controlled release profile of SM. [Formula: see text].

  11. Evaluation of Ca3Co2O6 as cathode material for high-performance solid-oxide fuel cell

    PubMed Central

    Wei, Tao; Huang, Yun-Hui; Zeng, Rui; Yuan, Li-Xia; Hu, Xian-Luo; Zhang, Wu-Xing; Jiang, Long; Yang, Jun-You; Zhang, Zhao-Liang

    2013-01-01

    A cobalt-based thermoelectric compound Ca3Co2O6 (CCO) has been developed as new cathode material with superior performance for intermediate-temperature (IT) solid-oxide fuel cell (SOFC). Systematic evaluation has been carried out. Measurement of thermal expansion coefficient (TEC), thermal-stress (σ) and interfacial shearing stress (τ) with the electrolyte show that CCO matches well with several commonly-used IT electrolytes. Maximum power density as high as 1.47 W cm−2 is attained at 800°C, and an additional thermoelectric voltage of 11.7 mV is detected. The superior electrochemical performance, thermoelectric effect, and comparable thermal and mechanical behaviors with the electrolytes make CCO to be a promising cathode material for SOFC. PMID:23350032

  12. Increased Retinal Thinning after Combination of Internal Limiting Membrane Peeling and Silicone Oil Endotamponade in Proliferative Diabetic Retinopathy.

    PubMed

    Kaneko, Hiroki; Matsuura, Toshiyuki; Takayama, Kei; Ito, Yasuki; Iwase, Takeshi; Ueno, Shinji; Nonobe, Norie; Yasuda, Shunsuke; Kataoka, Keiko; Terasaki, Hiroko

    2017-01-01

    The aim of this study was to examine the change in retinal thickness after vitrectomy with internal limiting membrane (ILM) peeling and/or silicone oil (SO) endotamponade in proliferative diabetic retinopathy (PDR). The actual amount and ratio of changes in the retinal thickness were calculated. Compared to control eyes in the ILM peeling (-)/SO (-) group, the central, superior inner, and temporal inner retina in the ILM peeling (+)/SO (-) group, the central and superior inner retina in the ILM peeling (-)/SO (+) group, and the central, inferior inner, temporal inner, and nasal inner retina in the ILM peeling (+)/SO (+) group showed a significant reduction of the retinal thickness. The central, superior inner, and temporal inner retina in the ILM peeling (+)/SO (-) group, the central and superior inner retina in the ILM peeling (-)/SO (+) group, and the central, superior inner, inferior inner, and temporal inner retina in the ILM peeling (+)/SO (+) group showed a significantly increased reduction rate of the retinal thickness compared to the control group. Macular retinal thinning in PDR was observed after ILM peeling and SO endotamponade, and it was increased by the combination of these 2 factors. © 2017 S. Karger AG, Basel.

  13. Spontaneous Swallow Frequency Compared with Clinical Screening in the Identification of Dysphagia in Acute Stroke

    PubMed Central

    Crary, Michael A.; Carnaby, Giselle D.; Sia, Isaac

    2017-01-01

    Background The aim of this study was to compare spontaneous swallow frequency analysis (SFA) with clinical screening protocols for identification of dysphagia in acute stroke. Methods In all, 62 patients with acute stroke were evaluated for spontaneous swallow frequency rates using a validated acoustic analysis technique. Independent of SFA, these same patients received a routine nurse-administered clinical dysphagia screening as part of standard stroke care. Both screening tools were compared against a validated clinical assessment of dysphagia for acute stroke. In addition, psychometric properties of SFA were compared against published, validated clinical screening protocols. Results Spontaneous SFA differentiates patients with versus without dysphagia after acute stroke. Using a previously identified cut point based on swallows per minute, spontaneous SFA demonstrated superior ability to identify dysphagia cases compared with a nurse-administered clinical screening tool. In addition, spontaneous SFA demonstrated equal or superior psychometric properties to 4 validated, published clinical dysphagia screening tools. Conclusions Spontaneous SFA has high potential to identify dysphagia in acute stroke with psychometric properties equal or superior to clinical screening protocols. PMID:25088166

  14. Spontaneous swallow frequency compared with clinical screening in the identification of dysphagia in acute stroke.

    PubMed

    Crary, Michael A; Carnaby, Giselle D; Sia, Isaac

    2014-09-01

    The aim of this study was to compare spontaneous swallow frequency analysis (SFA) with clinical screening protocols for identification of dysphagia in acute stroke. In all, 62 patients with acute stroke were evaluated for spontaneous swallow frequency rates using a validated acoustic analysis technique. Independent of SFA, these same patients received a routine nurse-administered clinical dysphagia screening as part of standard stroke care. Both screening tools were compared against a validated clinical assessment of dysphagia for acute stroke. In addition, psychometric properties of SFA were compared against published, validated clinical screening protocols. Spontaneous SFA differentiates patients with versus without dysphagia after acute stroke. Using a previously identified cut point based on swallows per minute, spontaneous SFA demonstrated superior ability to identify dysphagia cases compared with a nurse-administered clinical screening tool. In addition, spontaneous SFA demonstrated equal or superior psychometric properties to 4 validated, published clinical dysphagia screening tools. Spontaneous SFA has high potential to identify dysphagia in acute stroke with psychometric properties equal or superior to clinical screening protocols. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  15. Adding high-intensity interval training to conventional training modalities: optimizing health-related outcomes during chemotherapy for breast cancer: the OptiTrain randomized controlled trial.

    PubMed

    Mijwel, Sara; Backman, Malin; Bolam, Kate A; Jervaeus, Anna; Sundberg, Carl Johan; Margolin, Sara; Browall, Maria; Rundqvist, Helene; Wengström, Yvonne

    2018-02-01

    Exercise training is an effective and safe way to counteract cancer-related fatigue (CRF) and to improve health-related quality of life (HRQoL). High-intensity interval training has proven beneficial for the health of clinical populations. The aim of this randomized controlled trial was to compare the effects of resistance and high-intensity interval training (RT-HIIT), and moderate-intensity aerobic and high-intensity interval training (AT-HIIT) to usual care (UC) in women with breast cancer undergoing chemotherapy. The primary endpoint was CRF and the secondary endpoints were HRQoL and cancer treatment-related symptoms. Two hundred and forty women planned to undergo chemotherapy were randomized to supervised RT-HIIT, AT-HIIT, or UC. Measurements were performed at baseline and at 16 weeks. Questionnaires included Piper Fatigue Scale, EORTC-QLQ-C30, and Memorial Symptom Assessment Scale. The RT-HIIT group was superior to UC for CRF: total CRF (p = 0.02), behavior/daily life (p = 0.01), and sensory/physical (p = 0.03) CRF. Role functioning significantly improved while cognitive functioning was unchanged for RT-HIIT compared to declines shown in the UC group (p = 0.04). AT-HIIT significantly improved emotional functioning versus UC (p = 0.01) and was superior to UC for pain symptoms (p = 0.03). RT-HIIT reported a reduced symptom burden, while AT-HIIT remained stable compared to deteriorations shown by UC (p < 0.01). Only RT-HIIT was superior to UC for total symptoms (p < 0.01). 16 weeks of resistance and HIIT was effective in preventing increases in CRF and in reducing symptom burden for patients during chemotherapy for breast cancer. These findings add to a growing body of evidence supporting the inclusion of structured exercise prescriptions, including HIIT, as a vital component of cancer rehabilitation. Clinicaltrials.gov Registration Number: NCT02522260.

  16. Balneotherapy in fibromyalgia: a single blind randomized controlled clinical study.

    PubMed

    Ozkurt, Seçil; Dönmez, Arif; Zeki Karagülle, M; Uzunoğlu, Emel; Turan, Mustafa; Erdoğan, Nergis

    2012-07-01

    We aimed to evaluate the effectiveness of balneotherapy in fibromyalgia management. Fifty women with fibromyalgia under pharmacological treatment were randomly assigned to either the balneotherapy (25) or the control (25) group. Four patients from the balneotherapy group and one patient from the control group left the study after randomization. The patients in the balneotherapy group (21) had 2 thermomineral water baths daily for 2 weeks in Tuzla Spa Center. The patients in the control group (24) continued to have their medical treatment and routine daily life. An investigator who was blinded to the study arms assessed the patients. All patients were assessed four times; at the beginning of the study, at the end of the 2nd week, the 1st month, and the 3rd month after balneotherapy. Outcome measures of the study were pain intensity, Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), patient's global assessment, investigator's global assessment, SF-36 scores, and tender point count. Balneotherapy was found to be superior at the end of the cure period in terms of pain intensity, FIQ, Beck Depression Inventory, patient's global assessment, investigator's global assessment scores, and tender point count as compared to the control group. The superiority of balneotherapy lasted up to the end of the 3rd month, except for the Beck Depression Inventory score and the investigator's global assessment score. Significant improvements were observed in PF, GH, and MH subscales of SF-36 during the study period in the balneotherapy group; however, no such improvement was observed in the control group. Balneotherapy was superior only in VT subscale at the end of therapy and at the end of the third month after the therapy as compared to the controls. It was concluded that balneotherapy provides beneficial effects in patients with fibromyalgia.

  17. Randomized, double-blind, comparative-effectiveness study comparing pulsed radiofrequency to steroid injections for occipital neuralgia or migraine with occipital nerve tenderness.

    PubMed

    Cohen, Steven P; Peterlin, B Lee; Fulton, Larry; Neely, Edward T; Kurihara, Connie; Gupta, Anita; Mali, Jimmy; Fu, Diana C; Jacobs, Michael B; Plunkett, Anthony R; Verdun, Aubrey J; Stojanovic, Milan P; Hanling, Steven; Constantinescu, Octav; White, Ronald L; McLean, Brian C; Pasquina, Paul F; Zhao, Zirong

    2015-12-01

    Occipital neuralgia (ON) is characterized by lancinating pain and tenderness overlying the occipital nerves. Both steroid injections and pulsed radiofrequency (PRF) are used to treat ON, but few clinical trials have evaluated efficacy, and no study has compared treatments. We performed a multicenter, randomized, double-blind, comparative-effectiveness study in 81 participants with ON or migraine with occipital nerve tenderness whose aim was to determine which treatment is superior. Forty-two participants were randomized to receive local anesthetic and saline, and three 120 second cycles of PRF per targeted nerve, and 39 were randomized to receive local anesthetic mixed with deposteroid and 3 rounds of sham PRF. Patients, treating physicians, and evaluators were blinded to interventions. The PRF group experienced a greater reduction in the primary outcome measure, average occipital pain at 6 weeks (mean change from baseline -2.743 ± 2.487 vs -1.377 ± 1.970; P < 0.001), than the steroid group, which persisted through the 6-month follow-up. Comparable benefits favoring PRF were obtained for worst occipital pain through 3 months (mean change from baseline -1.925 ± 3.204 vs -0.541 ± 2.644; P = 0.043), and average overall headache pain through 6 weeks (mean change from baseline -2.738 ± 2.753 vs -1.120 ± 2.1; P = 0.037). Adverse events were similar between groups, and few significant differences were noted for nonpain outcomes. We conclude that although PRF can provide greater pain relief for ON and migraine with occipital nerve tenderness than steroid injections, the superior analgesia may not be accompanied by comparable improvement on other outcome measures.

  18. Randomized, double-blind, comparative-effectiveness study comparing pulsed radiofrequency to steroid injections for occipital neuralgia or migraine with occipital nerve tenderness

    PubMed Central

    Cohen, Steven P.; Peterlin, B. Lee; Fulton, Larry; Neely, Edward T.; Kurihara, Connie; Gupta, Anita; Mali, Jimmy; Fu, Diana C.; Jacobs, Michael B.; Plunkett, Anthony R.; Verdun, Aubrey J.; Stojanovic, Milan P.; Hanling, Steven; Constantinescu, Octav; White, Ronald L.; McLean, Brian C.; Pasquina, Paul F.; Zhao, Zirong

    2015-01-01

    Occipital neuralgia (ON) is characterized by lancinating pain and tenderness overlying the occipital nerves. Both steroid injections and pulsed radiofrequency (PRF) are used to treat ON, but few clinical trials have evaluated efficacy, and no study has compared treatments. We performed a multicenter, randomized, double-blind, comparative-effectiveness study in 81 participants with ON or migraine with occipital nerve tenderness whose aim was to determine which treatment is superior. Forty-two participants were randomized to receive local anesthetic and saline, and three 120 second cycles of PRF per targeted nerve, and 39 were randomized to receive local anesthetic mixed with deposteroid and 3 rounds of sham PRF. Patients, treating physicians, and evaluators were blinded to interventions. The PRF group experienced a greater reduction in the primary outcome measure, average occipital pain at 6 weeks (mean change from baseline −2.743 ± 2.487 vs −1.377 ± 1.970; P <0.001), than the steroid group, which persisted through the 6-month follow-up. Comparable benefits favoring PRF were obtained for worst occipital pain through 3 months (mean change from baseline−1.925 ± 3.204 vs−0.541 ± 2.644; P = 0.043), and average overall headache pain through 6 weeks (mean change from baseline −2.738 ± 2.753 vs −1.120 ± 2.1; P = 0.037). Adverse events were similar between groups, and few significant differences were noted for nonpain outcomes. We conclude that although PRF can provide greater pain relief for ON and migraine with occipital nerve tenderness than steroid injections, the superior analgesia may not be accompanied by comparable improvement on other outcome measures. PMID:26447705

  19. Picoprep-3 is a superior colonoscopy preparation to Fleet: a randomized, controlled trial comparing the two bowel preparations.

    PubMed

    Schmidt, Liu-Ming; Williams, Pamela; King, Denis; Perera, Dayashan

    2004-02-01

    Bowel preparations for colonoscopy have to balance the demand for adequate cleansing action of the bowel and patient acceptability. There has been no study comparing Picoprep-3 (sodium picosulfate), a relatively new product, to Fleet (sodium phosphate), a well-studied and widely used preparation. This study was designed to compare the efficacy and patient tolerance of these two bowel preparations for colonoscopy. A randomized, single-blinded, prospective trial was conducted. A total of 400 consecutive patients presenting for elective colonoscopy at St George Private Hospital during a 20-week period were randomly assigned to receive Picoprep-3 or Fleet. Patients were asked to record the effects of the preparation, noting tolerability, taste, and side effects. Two hundred patients were assigned to the Picoprep-3 group and 200 to the Fleet group. Surgeons were blinded to the preparation used and rated the quality of the bowel preparation on a scale of 1 to 5 (1 being the optimal score). Picoprep-3 was found to be better tolerated (P < 0.0001) and better tasting (P < 0.0001) than Fleet. Patients in the Picoprep-3 group reported significantly less nausea (P < 0.001), vomiting (P < 0.004), dizziness (P < 0.01), abdominal pains (P = 0.0005), and thirst (P < 0.0001) associated with the preparation. There was no significant difference in visualization of the colon between the two groups as judged by the two colonoscopists (P = 0.06). Colonoscopy preparation with Picoprep-3 has similar efficacy but superior taste and tolerability compared with Fleet. Picoprep-3 caused less adverse side effects in the study population.

  20. CSF neurofilament light chain and phosphorylated tau 181 predict disease progression in PSP.

    PubMed

    Rojas, Julio C; Bang, Jee; Lobach, Iryna V; Tsai, Richard M; Rabinovici, Gil D; Miller, Bruce L; Boxer, Adam L

    2018-01-23

    To determine the ability of CSF biomarkers to predict disease progression in progressive supranuclear palsy (PSP). We compared the ability of baseline CSF β-amyloid 1-42 , tau, phosphorylated tau 181 (p-tau), and neurofilament light chain (NfL) concentrations, measured by INNO-BIA AlzBio3 or ELISA, to predict 52-week changes in clinical (PSP Rating Scale [PSPRS] and Schwab and England Activities of Daily Living [SEADL]), neuropsychological, and regional brain volumes on MRI using linear mixed effects models controlled for age, sex, and baseline disease severity, and Fisher F density curves to compare effect sizes in 50 patients with PSP. Similar analyses were done using plasma NfL measured by single molecule arrays in 141 patients. Higher CSF NfL concentration predicted more rapid decline (biomarker × time interaction) over 52 weeks in PSPRS ( p = 0.004, false discovery rate-corrected) and SEADL ( p = 0.008), whereas lower baseline CSF p-tau predicted faster decline on PSPRS ( p = 0.004). Higher CSF tau concentrations predicted faster decline by SEADL ( p = 0.004). The CSF NfL/p-tau ratio was superior for predicting change in PSPRS, compared to p-tau ( p = 0.003) or NfL ( p = 0.001) alone. Higher NfL concentrations in CSF or blood were associated with greater superior cerebellar peduncle atrophy (fixed effect, p ≤ 0.029 and 0.008, respectively). Both CSF p-tau and NfL correlate with disease severity and rate of disease progression in PSP. The inverse correlation of p-tau with disease severity suggests a potentially different mechanism of tau pathology in PSP as compared to Alzheimer disease. Copyright © 2017 American Academy of Neurology.

  1. Numerical magnitude processing in abacus-trained children with superior mathematical ability: an EEG study*

    PubMed Central

    Huang, Jian; Du, Feng-lei; Yao, Yuan; Wan, Qun; Wang, Xiao-song; Chen, Fei-yan

    2015-01-01

    Distance effect has been regarded as the best established marker of basic numerical magnitude processes and is related to individual mathematical abilities. A larger behavioral distance effect is suggested to be concomitant with lower mathematical achievement in children. However, the relationship between distance effect and superior mathematical abilities is unclear. One could get superior mathematical abilities by acquiring the skill of abacus-based mental calculation (AMC), which can be used to solve calculation problems with exceptional speed and high accuracy. In the current study, we explore the relationship between distance effect and superior mathematical abilities by examining whether and how the AMC training modifies numerical magnitude processing. Thus, mathematical competencies were tested in 18 abacus-trained children (who accepted the AMC training) and 18 non-trained children. Electroencephalography (EEG) waveforms were recorded when these children executed numerical comparison tasks in both Arabic digit and dot array forms. We found that: (a) the abacus-trained group had superior mathematical abilities than their peers; (b) distance effects were found both in behavioral results and on EEG waveforms; (c) the distance effect size of the average amplitude on the late negative-going component was different between groups in the digit task, with a larger effect size for abacus-trained children; (d) both the behavioral and EEG distance effects were modulated by the notation. These results revealed that the neural substrates of magnitude processing were modified by AMC training, and suggested that the mechanism of the representation of numerical magnitude for children with superior mathematical abilities was different from their peers. In addition, the results provide evidence for a view of non-abstract numerical representation. PMID:26238541

  2. Enhanced Y1-receptor-mediated vasoconstrictive action of neuropeptide Y (NPY) in superior mesenteric arteries in portal hypertension.

    PubMed

    Wiest, Reiner; Jurzik, Lars; Moleda, Lukas; Froh, Matthias; Schnabl, Bernd; von Hörsten, Stephan; Schölmerich, Juergen; Straub, Rainer H

    2006-03-01

    Vascular hyporeactivity to catecholamines contributes to arterial vasodilation and hemodynamic dysregulation in portal hypertension. Neuropeptide Y (NPY) is a sympathetic neurotransmitter facilitating adrenergic vasoconstriction via Y1-receptors on the vascular smooth muscle. Therefore, we investigated its role for vascular reactivity in the superior mesenteric artery (SMA) of portal vein ligated (PVL) and sham operated rats. In vitro perfused SMA vascular beds of rats were tested for the cumulative dose-response to NPY dependent on the presence and level of alpha1-adrenergic vascular tone (methoxamine MT: 0.3-10 microM). Moreover, the effect of NPY (50 nM) on vascular responsiveness to alpha1-adrenergic stimulation (MT: 0.3-300 microM) was evaluated. Y1-receptor function was tested by Y1-selective inhibition using BIBP-3226 (1 microM). NPY dose-dependently and endothelium-independently enhanced MT-pre-constriction in SMA. This potentiation was increasingly effective with increasing adrenergic pre-stimulation and being more pronounced in PVL rats as compared to sham rats at high MT concentrations. NPY enhanced vascular contractility only in PVL rats correcting the adrenergic vascular hyporeactivity. Y1-receptor inhibition completely abolished NPY-evoked vasoconstrictive effects. NPY endothelium-independently potentiates adrenergic vasoconstriction via Y1-receptors being more pronounced in portal hypertension improving mesenteric vascular contractility and thereby correcting the splanchnic vascular hyporeactivity. This makes NPY a superior vasoconstrictor counterbalancing arterial vasodilation in portal hypertension.

  3. Balancing the spatial demands of the developing dentition with the mechanical demands of the catarrhine mandibular symphysis

    PubMed Central

    Cobb, Samuel N; Panagiotopoulou, Olga

    2011-01-01

    The superior transverse torus of the catarrhine mandible has been shown to effectively reduce bending at the symphysis during unilateral postcanine biting. While the adult superior transverse torus contains trabecular bone, the juvenile one is almost entirely filled by developing permanent incisors until their eruption. This study uses finite elements analysis (FEA) to investigate whether the presence of developing incisors in the juvenile symphysis increases strains on the superior transverse torus. Two FE models of a juvenile Macaca fascicularis mandible were created: one included all the developing teeth; the second was modified to remove the incisor tooth crypts by filling them with trabecular bone. The models were loaded identically to simulate static physiological unilateral biting on dp4 and strain magnitudes, patterns and distributions of the two FE models were compared. The FEA results show a notable increase in strain magnitudes by up to 40% when the developing incisors are present. The results indicate that, in order to maintain the same symphyseal strain magnitudes during chewing, the presence of the incisors in the symphysis necessitates a larger superior transverse torus in the juvenile than would be required if the superior transverse torus did not house the developing incisors. These results highlight the adaptational balance of the symphyseal morphology throughout ontogeny between biomechanics and the spatial demands of the developing dentition. Based on the findings we therefore propose that the spatial requirements of the developing incisors during ontogeny can act as a constraint on the functional adaptation and subsequent adult morphology observed in the catarrhine mandibular symphysis. PMID:21158857

  4. Evaluation of bowel distension and mural visualisation using neutral oral contrast agents for multidetector-row computed tomography.

    PubMed

    Lim, Bee Kuan; Bux, Shaik Ismail; Rahmat, Kartini; Lam, Sze Yin; Liew, Yew Wai

    2012-11-01

    We compared the effectiveness of different types of non-commercial neutral oral contrast agents for bowel distension and mural visualisation in computed tomographic (CT) enterography. 90 consecutive patients from a group of 108 were randomly assigned to receive water (n = 30), 3.8% milk (n = 30) or 0.1% gastrografin (n = 30) as oral contrast agent. The results were independently reviewed by two radiologists who were blinded to the contrast agents used. The degree of bowel distension was qualitatively scored on a four-point scale. The discrimination of bowel loops, mural visualisation and visualisation of mucosal folds were evaluated on a 'yes' or 'no' basis. Side effects of the various agents were also recorded. 3.8% milk was significantly superior to water for bowel distension (jejunum, ileum and terminal ileum), discrimination of bowel loops (jejunum and ileum), mural visualisation and visualisation of mucosal folds (ileum and terminal ileum). It was also significantly superior to 0.1% gastrografin for bowel distension, discrimination of bowel loops, mural visualisation and visualisation of mucosal folds (jejunum, ileum and terminal ileum). However, 10% of patients who received 3.8% milk reported immediate post-test diarrhoea. No side effects were documented for patients who received water and 0.1% gastrografin. 3.8% milk is an effective and superior neutral oral contrast agent for the assessment of the jejunum, ileum and terminal ileum in CT enterography. However, further studies are needed to explore other suitable oral contrast agents for CT enterography in lactose- or cow's milk-intolerant patients.

  5. Effects of lake trout refuges on lake whitefish and cisco in the Apostle Islands Region of Lake Superior

    USGS Publications Warehouse

    Zuccarino-Crowe , Chiara M.; Taylor, William W.; Hansen, Michael J.; Seider, Michael J.; Krueger, Charles C.

    2016-01-01

    Lake trout refuges in the Apostle Islands region of Lake Superior are analogous to the concept of marine protected areas. These refuges, established specifically for lake trout (Salvelinus namaycush) and closed to most forms of recreational and commercial fishing, were implicated as one of several management actions leading to successful rehabilitation of Lake Superior lake trout. To investigate the potential significance of Gull Island Shoal and Devils Island Shoal refuges for populations of not only lake trout but also other fish species, relative abundances of lake trout, lake whitefish (Coregonus clupeaformis), and cisco (Coregonus artedi) were compared between areas sampled inside versus outside of refuge boundaries. During 1982–2010, lake trout relative abundance was higher and increased faster inside the refuges, where lake trout fishing was prohibited, than outside the refuges. Over the same period, lake whitefish relative abundance increased faster inside than outside the refuges. Both evaluations provided clear evidence that refuges protected these species. In contrast, trends in relative abundance of cisco, a prey item of lake trout, did not differ significantly between areas inside and outside the refuges. This result did not suggest indirect or cascading refuge effects due to changes in predator levels. Overall, this study highlights the potential of species-specific refuges to benefit other fish species beyond those that were the refuges' original target. Improved understanding of refuge effects on multiple species of Great Lakes fishes can be valuable for developing rationales for refuge establishment and predicting associated fish community-level effects.

  6. Comparative radiation resistance, temperature dependence and performance of diffused junction indium phosphide solar cells

    NASA Technical Reports Server (NTRS)

    Weinberg, I.; Swartz, C. K.; Hart, R. E., Jr.; Ghandhi, S. K.; Borrego, J. M.

    1987-01-01

    Indium phosphide solar cells whose p-n junctions were processed by the open tube capped diffusion and by the closed tube uncapped diffusion of sulfur into Czochralski-grown p-type substrates are compared. Differences found in radiation resistance were attributed to the effects of increased base dopant concentration. Both sets of cells showed superior radiation resistance to that of gallium arsenide cells, in agreement with previous results. No correlation was, however, found between the open-circuit voltage and the temperature dependence of the maximum power.

  7. Transfer of management training from alternative perspectives.

    PubMed

    Taylor, Paul J; Russ-Eft, Darlene F; Taylor, Hazel

    2009-01-01

    One hundred seven management training evaluations were meta-analyzed to compare effect sizes for the transfer of managerial training derived from different rating sources (self, superior, peer, and subordinate) and broken down by both study- and training-related variables. For studies as a whole, and interpersonal management skills training studies in particular, transfer effects based on trainees' self-ratings, and to a lesser extent ratings from their superiors, were largest and most varied across studies. In contrast, transfer effects based on peer ratings, and particularly subordinate ratings, were substantially smaller and more homogeneous. This pattern was consistent across different sources of studies, features of evaluation design, and within a subset of 14 studies that each included all 4 rating sources. Across most rating sources, transfer of training was greatest for studies conducted in nonmilitary settings, when raters were likely to have known whether the manager being rated had attended training, when criteria were targeted to training content, when training content was derived from an analysis of tasks and skill requirements, and when training included opportunities for practice. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

  8. Recent advances in chirally pure proton pump inhibitors.

    PubMed

    Pai, Vikas; Pai, Nitin

    2007-08-01

    Chirality is a ubiquitous natural phenomenon resulting because of a differential spatial orientation of molecules around its chiral centre. This leads to the existence of two or more spatially dissimilar forms, known as stereoisomers or enantiomers, which are non-superimposable images of each other and may significantly differ from each other with respect to pharmacokinetic and pharmacodynamic properties and molecular interaction. Thus one isomer may offer significant pharmacokinetic and therapeutic advantages as compared to the other isomer or the racemic mixture (mixture containing both enantiomers). Proton pump inhibitors are a class of drugs which have been very effective in the management of acid-related disorders. The proton pumps currently available in the market including omeprazole, pantoprazole, rabeprazole and lansoprazole are racemic mixtures of the S and R isomers. Chirally pure forms of proton pump inhibitors show a superior metabolic and pharmacokinetic profile as compared to their racemates. The therapeutic efficacy is also superior to the parent racemate. This has been clearly demonstrated with the development of esomeprazole- the S-isomer of omeprazole. S-pantoprazole and dexrabeprazole also offer therapeutic advantages as compared to racemic pantoprazole and racemic rabeprazole respectively. This article reviews the chiral developments in the proton pump inhibitors and their clinical applications.

  9. The nucleus parvocellularis reticularis regulates submandibular-sublingual salivary secretion in the rat: a pharmacological study.

    PubMed

    Ramos, J M; Puerto, A

    1988-09-01

    This experiment shows that activation of the nucleus parvocellularis reticularis in the rat brainstem provokes salivary hypersecretion by the submandibular-sublingual glands. The secretory effect is mediated by cholinergic mechanisms, as the administration of atropine blocked the flow of saliva evoked by stimulation of the nucleus parvocellularis. In contrast, injection of dihydroergotamine (an alpha-blocker) and/or propranolol (a beta-blocker) failed to significantly reduce submandibular and sublingual salivary secretion when compared to a control group injected with distilled water. The cholinergic nature of the salivary response suggests that the nucleus parvocellularis reticularis exerts its secretory effect on the salivary glands parasympathetically rather than through mechanisms associated with sympathetic pathways. The area of the brainstem activated in the present study closely overlaps the region in which cell bodies of superior salivatory neurons have recently been identified with retrograde transport of peroxidase. The data presented herein represent functional proof in support of the location of the superior salivatory nucleus within the parvocellularis reticular formation.

  10. Chelation therapy of incorporated plutonium-238 and americium-241: comparison of LICAM(C), DTPA and DFOA in rats, hamsters and mice.

    PubMed

    Volf, V

    1986-03-01

    The carboxylated catechoylamide 3,4,3-LICAM(C) was tested for removal of 238Pu and 241Am from small laboratory rodents. The effectiveness of treatment was compared with that of two ligand preparations approved for clinical use: calcium-trisodium diethylenetriaminepentaacetate (DTPA) and desferrioxamine (DFOA). With early treatment and at the dosage used clinically for the decorporation of actinides with DTPA (30 mumol/kg body weight) LICAM(C) was superior to DFOA but when compared with DTPA, the effect of LICAM(C) on 238Pu was greater only in bone; as little as 1 mumol LICAM(C)/kg was as effective as 30 mumol DTPA/kg. However, in all animals treated with LICAM(C) there was a large increase in the 238Pu content of the kidney. With 241Am the effect of DTPA was always superior to that of LICAM(C). The best overall results early (1 day) after injection of 238Pu and 241Am were achieved by a combination of a single injection of LICAM(C) and DTPA with subsequent continuous administration of DTPA in drinking water. LICAM(C) affected the retention of 238Pu even if given orally; the data suggested that about 3 per cent of ingested LICAM(C) was absorbed. When the beginning of treatment was delayed, LICAM(C) became equally effective or less effective than DTPA even as far as 238Pu retention in bone was concerned, but it still increased the accumulation of 238Pu in the kidneys.

  11. Endoscopic versus Percutaneous Biliary Drainage in Palliation of Advanced Malignant Hilar Obstruction: A Meta-Analysis and Systematic Review

    PubMed Central

    Dharmapuri, Sirish; Duvvuri, Abhiram; Dharmapuri, Sowmya; Boddireddy, Raghuveer; Moole, Vishnu; Yedama, Prathyusha; Bondalapati, Naveen; Uppu, Achuta

    2016-01-01

    Background. Palliation in advanced unresectable hilar malignancies can be achieved by endoscopic (EBD) or percutaneous transhepatic biliary drainage (PTBD). It is unclear if one approach is superior to the other in this group of patients. Aims. Compare clinical outcomes of EBD versus PTBD. Methods. (i) Study Selection Criterion. Studies using PTBD and EBD for palliation of advanced unresectable hilar malignancies. (ii) Data Collection and Extraction. Articles were searched in Medline, PubMed, and Ovid journals. (iii) Statistical Method. Fixed and random effects models were used to calculate the pooled proportions. Results. Initial search identified 786 reference articles, in which 62 articles were selected and reviewed. Data was extracted from nine studies (N = 546) that met the inclusion criterion. The pooled odds ratio for successful biliary drainage in PTBD versus EBD was 2.53 (95% CI = 1.57 to 4.08). Odds ratio for overall adverse effects in PTBD versus EBD groups was 0.81 (95% CI = 0.52 to 1.26). Odds ratio for 30-day mortality rate in PTBD group versus EBD group was 0.84 (95% CI = 0.37 to 1.91). Conclusions. In patients with advanced unresectable hilar malignancies, palliation with PTBD seems to be superior to EBD. PTBD is comparable to EBD in regard to overall adverse effects and 30-day mortality. PMID:27648439

  12. Sex differences in cortical thickness and their possible genetic and sex hormonal underpinnings.

    PubMed

    Savic, I; Arver, S

    2014-12-01

    Although it has been shown that cortical thickness (Cth) differs between sexes, the underlying mechanisms are unknown. Seeing as XXY males have 1 extra X chromosome, we investigated the possible effects of X- and sex-chromosome dosage on Cth by comparing data from 31 XXY males with 39 XY and 47 XX controls. Plasma testosterone and estrogen were also measured in an effort to differentiate between possible sex-hormone and sex-chromosome gene effects. Cth was calculated with FreeSurfer software. Parietal and occipital Cth was greater in XX females than XY males. In these regions Cth was inversely correlated with z-normalized testosterone. In the motor strip, the cortex was thinner in XY males compared with both XX females and XXY males, indicating the possibility of an X-chromosome gene-dosage effect. XXY males had thinner right superior temporal and left middle temporal cortex, and a thicker right orbitofrontal cortex and lingual cortex than both control groups. Based on these data and previous reports from women with XO monosomy, it is hypothesized that programming of the motor cortex is influenced by processes linked to X-escapee genes, which do not have Y-chromosome homologs, and that programming of the superior temporal cortex is mediated by X-chromosome escapee genes with Y-homologs. © The Author 2013. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  13. Evaluating large-scale propensity score performance through real-world and synthetic data experiments.

    PubMed

    Tian, Yuxi; Schuemie, Martijn J; Suchard, Marc A

    2018-06-22

    Propensity score adjustment is a popular approach for confounding control in observational studies. Reliable frameworks are needed to determine relative propensity score performance in large-scale studies, and to establish optimal propensity score model selection methods. We detail a propensity score evaluation framework that includes synthetic and real-world data experiments. Our synthetic experimental design extends the 'plasmode' framework and simulates survival data under known effect sizes, and our real-world experiments use a set of negative control outcomes with presumed null effect sizes. In reproductions of two published cohort studies, we compare two propensity score estimation methods that contrast in their model selection approach: L1-regularized regression that conducts a penalized likelihood regression, and the 'high-dimensional propensity score' (hdPS) that employs a univariate covariate screen. We evaluate methods on a range of outcome-dependent and outcome-independent metrics. L1-regularization propensity score methods achieve superior model fit, covariate balance and negative control bias reduction compared with the hdPS. Simulation results are mixed and fluctuate with simulation parameters, revealing a limitation of simulation under the proportional hazards framework. Including regularization with the hdPS reduces commonly reported non-convergence issues but has little effect on propensity score performance. L1-regularization incorporates all covariates simultaneously into the propensity score model and offers propensity score performance superior to the hdPS marginal screen.

  14. THE INFLUENCE OF FOREST FRAGMENTATION AND OTHER ENVIRONMENTAL FACTORS ON LAKE SUPERIOR STREAM FISH ASSEMBLAGE

    EPA Science Inventory

    As part of a comparative watershed project investigating land cover/land use disturbance gradients for streams in the western Lake Superior region, we wanted to determine the relative influence of hydrogeomorphic region, forest fragmentation, watershed storage, and in-stream habi...

  15. THE INFLUENCE OF FOREST FRAGMENTATION AND OTHER ENVIRONMENTAL FACTORS ON LAKE SUPERIOR STREAM FISH ASSEMBLAGES

    EPA Science Inventory

    As part of a comparative watershed project investigation land cover/land use disturbance gradients for streams in the western Lake Superior region, we wanted to determine the relative influence of hydrogeomorphic region, forest fragmentation, watershed storage and in-stream habit...

  16. Cost-Effectiveness of Fecal Microbiota Transplantation in the Treatment of Recurrent Clostridium Difficile Infection: A Literature Review.

    PubMed

    Arbel, Leor T; Hsu, Edmund; McNally, Keegan

    2017-08-23

    Clostridium difficile ( C. difficile ) is a common cause of antibiotic--associated diarrhea (AAD), being responsible for 15--25% of all AAD cases. The purpose of this literature review is to determine the cost-effectiveness of fecal microbiota transplantation (FMT) and how it compares in this regard to the standard treatments of choice for recurrent C. difficile infection (CDI). The review of the literature along with the evaluation of three comparative cost effective analyses yielded findings consistent with the view that FMT is the most cost-effective option in treating recurrent CDI. There are some (but considerably less) data indicating that FMT may be a cost effective strategy in treating initial CDI, as well. The superior cost-effectiveness of FMT as compared to the preferred standards of treatment for recurrent CDI suggest FMT use should become more integrated in routine clinical practice. Increased utilization of FMTs would allow for better control of this increasingly problematic disease as well as lower costs associated with its management.

  17. A Randomized Controlled Trial of 7-Day Intensive and Standard Weekly Cognitive Therapy for PTSD and Emotion-Focused Supportive Therapy

    PubMed Central

    Ehlers, Anke; Hackmann, Ann; Grey, Nick; Wild, Jennifer; Liness, Sheena; Albert, Idit; Deale, Alicia; Stott, Richard; Clark, David M.

    2014-01-01

    Objective Psychological treatments for posttraumatic stress disorder (PTSD) are usually delivered once or twice weekly over several months. It is unclear whether they can be successfully delivered over a shorter period of time. This clinical trial had two goals, (1) to investigate the acceptability and efficacy of a 7-day intensive version of cognitive therapy for PTSD, and (2) to investigate whether cognitive therapy has specific treatment effects by comparing intensive and standard weekly cognitive therapy with an equally credible alternative treatment. Method Patients with chronic PTSD (N=121) were randomly allocated to 7-day intensive or standard 3-month weekly cognitive therapy for PTSD, 3-month weekly emotion-focused supportive therapy, or a 14-week waitlist condition. Primary outcomes were PTSD symptoms and diagnosis as assessed by independent assessors and self-report. Secondary outcomes were disability, anxiety, depression, and quality of life. Measures were taken at initial assessment, 6 weeks and 14 weeks (post-treatment/wait). For groups receiving treatment, measures were also taken at 3 weeks, and follow-ups at 27 and 40 weeks after randomization. All analyses were intent-to-treat. Results At post-treatment/wait assessment, 73%, 77%, 43%, 7% of the intensive cognitive therapy, standard cognitive therapy, supportive therapy, and waitlist groups, respectively, had recovered from PTSD. All treatments were well tolerated and were superior to waitlist on all outcome measures, with the exception of no difference between supportive therapy and waitlist on quality of life. For primary outcomes, disability and general anxiety, intensive and standard cognitive therapy were superior to supportive therapy. Intensive cognitive therapy achieved faster symptom reduction and comparable overall outcomes to standard cognitive therapy. Conclusions Cognitive therapy for PTSD delivered intensively over little more than a week is as effective as cognitive therapy delivered over 3 months. Both had specific effects and were superior to supportive therapy. Intensive cognitive therapy for PTSD is a feasible and promising alternative to traditional weekly treatment. PMID:24480899

  18. Acupuncture for smoking cessation.

    PubMed

    White, A R; Rampes, H; Ernst, E

    2000-01-01

    Acupuncture is promoted as a treatment for smoking cessation, and is believed to reduce withdrawal symptoms. The objective of this review is to determine the effectiveness of acupuncture in smoking cessation in comparison with: a) sham acupuncture b) other interventions c) no intervention. We searched the Cochrane Tobacco Addiction Group trials register, Medline, PsycLit, Dissertation Abstracts, Health Planning and Administration, Social SciSearch, Smoking & Health, Embase, Biological Abstracts and DRUG. Randomised trials comparing a form of acupuncture with either sham acupuncture, another intervention or no intervention for smoking cessation. We extracted data in duplicate on the type of subjects, the nature of the acupuncture and control procedures, the outcome measures, method of randomisation, and completeness of follow-up. We assessed abstinence from smoking at the earliest time-point (before 6 weeks), at six months and at one year follow-up in patients smoking at baseline. We used the most rigorous definition of abstinence for each trial, and biochemically validated rates if available. Those lost to follow-up were counted as continuing to smoke. Where appropriate, we performed meta-analysis using a fixed effects model. We identified 18 publications involving 20 comparisons. Acupuncture was not superior to sham acupuncture in smoking cessation at any time point. The odds ratio (OR) for early outcomes was 1.22 (95% confidence interval 0.99 to 1.49); the OR after 6 months was 1.38 (95% confidence interval 0.90 to 2.11) and after 12 months 1.02 (95% confidence interval 0.72 to 1.43). Similarly, when acupuncture was compared with other anti-smoking interventions, there were no differences in outcome at any time point. Acupuncture appeared to be superior to no intervention in the early results, but this difference was not sustained. The results with different acupuncture techniques do not show any one particular method (i.e. auricular acupuncture or non-auricular acupuncture) to be superior to control intervention. There is no clear evidence that acupuncture is effective for smoking cessation.

  19. The Picture Superiority Effect and Biological Education.

    ERIC Educational Resources Information Center

    Reid, D. J.

    1984-01-01

    Discusses learning behaviors where the "picture superiority effect" (PSE) seems to be most effective in biology education. Also considers research methodology and suggests a new research model which allows a more direct examination of the strategies learners use when matching up picture and text in efforts to "understand"…

  20. A crossover trial comparing wide dynamic range compression and frequency compression in hearing aids for tinnitus therapy.

    PubMed

    Hodgson, Shirley-Anne; Herdering, Regina; Singh Shekhawat, Giriraj; Searchfield, Grant D

    2017-01-01

    It has been suggested that frequency lowering may be a superior tinnitus reducing digital signal processing (DSP) strategy in hearing aids than conventional amplification. A crossover trial was undertaken to determine if frequency compression (FC) was superior to wide dynamic range compression (WDRC) in reducing tinnitus. A 6-8-week crossover trial of two digital signal-processing techniques (WDRC and 2 WDRC with FC) was undertaken in 16 persons with high-frequency sensorineural hearing loss and chronic tinnitus. WDRC resulted in larger improvements in Tinnitus Functional Index and rating scale scores than WDRC with FC. The tinnitus improvements obtained with both processing types appear to be due to reduced hearing handicap and possibly decreased tinnitus audibility. Hearing aids are useful assistive devices in the rehabilitation of tinnitus. FC was very successful in a few individuals but was not superior to WDRC across the sample. It is recommended that WDRC remain as the default first choice tinnitus hearing aid processing strategy for tinnitus. FC should be considered as one of the many other options for selection based on individual hearing needs. Implications of Rehabilitation Hearing aids can significantly reduce the effects of tinnitus after 6-8 weeks of use. Addition of frequency compression digital signal processing does not appear superior to standard amplitude compression alone. Improvements in tinnitus were correlated with reductions in hearing handicap.

  1. Characteristics of pedicle screw loading. Effect of sagittal insertion angle on intrapedicular bending moments.

    PubMed

    Youssef, J A; McKinley, T O; Yerby, S A; McLain, R F

    1999-06-01

    A bending analysis of pedicle screws inserted into vertebral body analogues. Intravertebral and intrapedicular pedicle screw bending moments were studied as a function of sagittal insertion angle. To determine how the pedicle screw bending moment is affected by changes in the insertion angle. There is a significant incidence of failure when pedicle screws are used to instrument unstable spinal segments. Extrinsic factors that affect screw bending failure have been poorly characterized. Previous work has demonstrated that intrapedicular pedicle screw bending moments are significantly affected by the sagittal location and depth of pedicle screw placement. Pedicle screw transducers were inserted in analogue vertebrae at one of three orientations: 7 degrees cephalad (toward the superior endplate), 7 degrees caudal (toward the inferior endplate), or parallel to the superior endplate (control). An axial load was applied to the superior endplate of the vertebra, and screw bending moments were recorded directly from the transducers. Screws angled 7 degrees cephalad developed significantly greater mean intrapedicular bending moments compared with screws inserted caudal or control screws. There was no significant difference in bending moments realized within the vertebral body for the three screw positions. Angulating pedicle screws toward the superior endplate increased bending moments within the pedicle. If attention to optimal screw insertion technique can reduce bending moments and potential for screw failure without increasing morbidity, surgical risk, or operative time, then proper insertion technique takes on new importance.

  2. Comparison of Surgically Induced Astigmatism and Morphologic Features Resulting From Femtosecond Laser and Manual Clear Corneal Incisions for Cataract Surgery.

    PubMed

    Ferreira, Tiago B; Ribeiro, Filomena J; Pinheiro, João; Ribeiro, Paulo; O'Neill, João G

    2018-05-01

    To compare the surgically induced astigmatism (SIA) vector, flattening effect, torque, and wound architecture following femtosecond laser and manual clear corneal incisions (CCIs). In a double-armed, randomized, prospective case series, cataract surgery was performed for 600 eyes using femtosecond laser (300 eyes) or manual (300 eyes) 2.4-mm CCIs in temporal or superior oblique locations. SIA, flattening effect, torque, and the summated vector mean for SIA were calculated. Correlation with individual features was established and incision morphology was investigated by anterior segment optical coherence tomography at 3 months of follow-up. The SIA, flattening effect, and torque were lower in the femtosecond laser group for both incision locations, although the differences were not significant (all P > .05). The femtosecond laser group showed less dispersion of SIA magnitude and flattening effect. Temporal and superior oblique incisions resulted in flattening effect values of -0.11 and -0.21 diopters (D), respectively, in the femtosecond laser group and -0.13 and -0.34 D, respectively, in the manual group. Significant correlations with individual features were only found in the femtosecond laser group, with preoperative astigmatism being the only significant SIA predictor by multiple regression analysis (P = .003). Femtosecond laser CCIs showed less deviation from the intended length, wound enlargement, endothelial misalignment, and Descemet membrane detachments (all P < .037). Femtosecond laser CCIs were more reproducible. Although SIAs were smaller in femtosecond laser CCIs than in manual CCIs for both temporal and superior oblique incisions, the difference was not statistically significant. Association with individual features is highly variable. [J Refract Surg. 2018;34(5):322-329.]. Copyright 2018, SLACK Incorporated.

  3. Minocycline as a re-purposed anti-Wolbachia macrofilaricide: superiority compared with doxycycline regimens in a murine infection model of human lymphatic filariasis

    PubMed Central

    Sharma, Raman; Jayoussi, Ghaith Al; Tyrer, Hayley E.; Gamble, Joanne; Hayward, Laura; Guimaraes, Ana F.; Davies, Jill; Waterhouse, David; Cook, Darren A. N.; Myhill, Laura J.; Clare, Rachel H.; Cassidy, Andrew; Steven, Andrew; Johnston, Kelly L.; Ford, Louise; Turner, Joseph D.; Ward, Stephen A.; Taylor, Mark J.

    2016-01-01

    Lymphatic filariasis and onchocerciasis are parasitic helminth diseases, which cause severe morbidities such as elephantiasis, skin disease and blindness, presenting a major public health burden in endemic communities. The anti-Wolbachia consortium (A·WOL: http://www.a-wol.com/) has identified a number of registered antibiotics that target the endosymbiotic bacterium, Wolbachia, delivering macrofilaricidal activity. Here we use pharmacokinetics/pharmacodynamics (PK/PD) analysis to rationally develop an anti-Wolbachia chemotherapy by linking drug exposure to pharmacological effect. We compare the pharmacokinetics and anti-Wolbachia efficacy in a murine Brugia malayi model of minocycline versus doxycycline. Doxycycline exhibits superior PK in comparison to minocycline resulting in a 3-fold greater exposure in SCID mice. Monte-Carlo simulations confirmed that a bi-daily 25–40 mg/Kg regimen is bioequivalent to a clinically effective 100–200 mg/day dose for these tetracyclines. Pharmacodynamic studies showed that minocycline depletes Wolbachia more effectively than doxycycline (99.51% vs. 90.35%) after 28 day 25 mg/Kg bid regimens with a more potent block in microfilarial production. PK/PD analysis predicts that minocycline would be expected to be 1.7 fold more effective than doxycycline in man despite lower exposure in our infection models. Our findings warrant onward clinical investigations to examine the clinical efficacy of minocycline treatment regimens against lymphatic filariasis and onchocerciasis. PMID:26996237

  4. Repetitive transcranial magnetic stimulation and transcranial direct-current stimulation in neuropathic pain due to radiculopathy: a randomized sham-controlled comparative study.

    PubMed

    Attal, Nadine; Ayache, Samar S; Ciampi De Andrade, Daniel; Mhalla, Alaa; Baudic, Sophie; Jazat, Frédérique; Ahdab, Rechdi; Neves, Danusa O; Sorel, Marc; Lefaucheur, Jean-Pascal; Bouhassira, Didier

    2016-06-01

    No study has directly compared the effectiveness of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct-current stimulation (tDCS) in neuropathic pain (NP). In this 2-centre randomised double-blind sham-controlled study, we compared the efficacy of 10-Hz rTMS and anodal 2-mA tDCS of the motor cortex and sham stimulation contralateral to the painful area (3 daily sessions) in patients with NP due to lumbosacral radiculopathy. Average pain intensity (primary outcome) was evaluated after each session and 5 days later. Secondary outcomes included neuropathic symptoms and thermal pain thresholds for the upper limbs. We used an innovative design that minimised bias by randomly assigning patients to 1 of 2 groups: active rTMS and tDCS or sham rTMS and tDCS. For each treatment group (active or sham), the order of the sessions was again randomised according to a crossover design. In total, 51 patients were screened and 35 (51% women) were randomized. Active rTMS was superior to tDCS and sham in pain intensity (F = 2.89 and P = 0.023). Transcranial direct-current stimulation was not superior to sham, but its analgesic effects were correlated to that of rTMS (P = 0.046), suggesting common mechanisms of action. Repetitive transcranial magnetic stimulation lowered cold pain thresholds (P = 0.04) and its effect on cold pain was correlated with its analgesic efficacy (P = 0.006). However, rTMS had no impact on individual neuropathic symptoms. Thus, rTMS is more effective than tDCS and sham in patients with NP due to lumbosacral radiculopathy and may modulate the sensory and affective dimensions of pain.

  5. Clinical study in genital herpes: natural Gene-Eden-VIR/Novirin versus acyclovir, valacyclovir, and famciclovir.

    PubMed

    Polansky, Hanan; Javaherian, Adrian; Itzkovitz, Edan

    2016-01-01

    This paper reports the results of a clinical study that tested the effect of suppressive treatment with the botanical product Gene-Eden-VIR/Novirin on the number of genital herpes outbreaks. The results in this study were compared to those published in clinical studies of acyclovir, valacyclovir, and famciclovir. The framework was a retrospective chart review. The population included 139 participants. The treatment was one to four capsules of Gene-Eden-VIR/Novirin per day. The duration of treatment was 2-48 months. The study included three controls recommended by the US Food and Drug Administration (FDA): baseline, no treatment, and dose response. The treatment decreased the number of outbreaks per year in 90.8% of the participants. The treatment also decreased the mean number of outbreaks per year from 7.27 and 5.5 in the control groups to 2.39 (P<0.0001 and P<0.001, respectively). The treated participants reported no adverse experiences. Out of the 15 tests that compared Gene-Eden-VIR/Novirin to the three drugs, Gene-Eden-VIR/Novirin had superior efficacy in eight tests, inferior efficacy in three tests, and comparable efficacy in four tests. Gene-Eden-VIR/Novirin also had superior safety. The clinical study showed that the natural Gene-Eden-VIR/Novirin decreases the number of genital herpes outbreaks without any side effects. The study also showed that the clinical effects reported in this study are mostly better than those reported in the reviewed studies of acyclovir, valacyclovir, and famciclovir.

  6. Effect of perturbations and a meal on superior mesenteric artery flow in patients with orthostatic hypotension

    NASA Technical Reports Server (NTRS)

    Fujimura, J.; Camilleri, M.; Low, P. A.; Novak, V.; Novak, P.; Opfer-Gehrking, T. L.

    1997-01-01

    Our aims were to evaluate to role of superior mesenteric blood flow in the pathophysiology of orthostatic hypotension in patients with generalized autonomic failure. METHODS: Twelve patients with symptomatic neurogenic orthostatic hypotension and 12 healthy controls underwent superior mesenteric artery flow measurements using Doppler ultrasonography during head-up tilt and tilt plus meal ingestion. Autonomic failure was assessed using standard tests of the function of the sympathetic adrenergic, cardiovagal and postganglionic sympathetic sudomotor function. RESULTS: Superior mesenteric flow volume and time-averaged velocity were similar in patients and controls at supine rest; however, responses to cold pressor test and upright tilt were attenuated (p < 0.05) in patients compared to controls. Head-up tilt after the meal evoked a profound fall of blood pressure and mesenteric blood flow in the patients; the reduction of mesenteric blood flow correlated (r = 0.89) with the fall of blood pressure in these patients, providing another manifestation of failed baroreflexes. We make the novel finding that the severity of postprandial orthostatic hypotension regressed negatively with the postprandial increase in mesenteric flow in patients with orthostatic hypotension. CONCLUSION: Mesenteric flow is under baroreflex control, which when defective, results in, or worsens orthostatic hypotension. Its large size and baroreflexivity renders it quantitatively important in the maintenance of postural normotension. The effects of orthostatic stress can be significantly attenuated by reducing the splanchnic-mesenteric volume increase in response to food. Evaluation of mesenteric flow in response to eating and head-up tilt provide important information on intra-abdominal sympathetic adrenergic function, and the ability of the patient to cope with orthostatic stress.

  7. A meta-analysis of hypnosis for chronic pain problems: a comparison between hypnosis, standard care, and other psychological interventions.

    PubMed

    Adachi, Tomonori; Fujino, Haruo; Nakae, Aya; Mashimo, Takashi; Sasaki, Jun

    2014-01-01

    Hypnosis is regarded as an effective treatment for psychological and physical ailments. However, its efficacy as a strategy for managing chronic pain has not been assessed through meta-analytical methods. The objective of the current study was to conduct a meta-analysis to assess the efficacy of hypnosis for managing chronic pain. When compared with standard care, hypnosis provided moderate treatment benefit. Hypnosis also showed a moderate superior effect as compared to other psychological interventions for a nonheadache group. The results suggest that hypnosis is efficacious for managing chronic pain. Given that large heterogeneity among the included studies was identified, the nature of hypnosis treatment is further discussed.

  8. When Do Individuals with Autism Spectrum Disorder Show Superiority in Visual Search?

    ERIC Educational Resources Information Center

    Shirama, Aya; Kato, Nobumasa; Kashino, Makio

    2017-01-01

    Although superior visual search skills have been repeatedly reported for individuals with autism spectrum disorder, the underlying mechanisms remain controversial. To specify the locus where individuals with autism spectrum disorder excel in visual search, we compared the performance of autism spectrum disorder adults and healthy controls in…

  9. Knowledge Transfer in Online Learning Environments

    ERIC Educational Resources Information Center

    Hansen, David E.

    2008-01-01

    Research comparing online and traditional course delivery methods has sought to demonstrate the equivalence of student performance in online and traditional courses. This study examines the unique proposition that online course delivery is superior to traditional when it comes to applied learning and is thus superior in the process of knowledge…

  10. Noise management to achieve superiority in quantum information systems

    NASA Astrophysics Data System (ADS)

    Nemoto, Kae; Devitt, Simon; Munro, William J.

    2017-06-01

    Quantum information systems are expected to exhibit superiority compared with their classical counterparts. This superiority arises from the quantum coherences present in these quantum systems, which are obviously absent in classical ones. To exploit such quantum coherences, it is essential to control the phase information in the quantum state. The phase is analogue in nature, rather than binary. This makes quantum information technology fundamentally different from our classical digital information technology. In this paper, we analyse error sources and illustrate how these errors must be managed for the system to achieve the required fidelity and a quantum superiority. This article is part of the themed issue 'Quantum technology for the 21st century'.

  11. Noise management to achieve superiority in quantum information systems.

    PubMed

    Nemoto, Kae; Devitt, Simon; Munro, William J

    2017-08-06

    Quantum information systems are expected to exhibit superiority compared with their classical counterparts. This superiority arises from the quantum coherences present in these quantum systems, which are obviously absent in classical ones. To exploit such quantum coherences, it is essential to control the phase information in the quantum state. The phase is analogue in nature, rather than binary. This makes quantum information technology fundamentally different from our classical digital information technology. In this paper, we analyse error sources and illustrate how these errors must be managed for the system to achieve the required fidelity and a quantum superiority.This article is part of the themed issue 'Quantum technology for the 21st century'. © 2017 The Author(s).

  12. Event-related potential effects of superior action anticipation in professional badminton players.

    PubMed

    Jin, Hua; Xu, Guiping; Zhang, John X; Gao, Hongwei; Ye, Zuoer; Wang, Pin; Lin, Huiyan; Mo, Lei; Lin, Chong-De

    2011-04-04

    The ability to predict the trajectory of a ball based on the opponent's body kinematics has been shown to be critical to high-performing athletes in many sports. However, little is known about the neural correlates underlying such superior ability in action anticipation. The present event-related potential study compared brain responses from professional badminton players and non-player controls when they watched video clips of badminton games and predicted a ball's landing position. Replicating literature findings, the players made significantly more accurate judgments than the controls and showed better action anticipation. Correspondingly, they showed enlarged amplitudes of two ERP components, a P300 peaking around 350ms post-stimulus with a parietal scalp distribution and a P2 peaking around 250ms with a posterior-occipital distribution. The P300 effect was interpreted to reflect primed access and/or directing of attention to game-related memory representations in the players facilitating their online judgment of related actions. The P2 effect was suggested to reflect some generic learning effects. The results identify clear neural responses that differentiate between different levels of action anticipation associated with sports expertise. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  13. Nanoliposomal Nitroglycerin Exerts Potent Anti-Inflammatory Effects.

    PubMed

    Ardekani, Soroush; Scott, Harry A; Gupta, Sharad; Eum, Shane; Yang, Xiao; Brunelle, Alexander R; Wilson, Sean M; Mohideen, Umar; Ghosh, Kaustabh

    2015-11-20

    Nitroglycerin (NTG) markedly enhances nitric oxide (NO) bioavailability. However, its ability to mimic the anti-inflammatory properties of NO remains unknown. Here, we examined whether NTG can suppress endothelial cell (EC) activation during inflammation and developed NTG nanoformulation to simultaneously amplify its anti-inflammatory effects and ameliorate adverse effects associated with high-dose NTG administration. Our findings reveal that NTG significantly inhibits human U937 cell adhesion to NO-deficient human microvascular ECs in vitro through an increase in endothelial NO and decrease in endothelial ICAM-1 clustering, as determined by NO analyzer, microfluorimetry, and immunofluorescence staining. Nanoliposomal NTG (NTG-NL) was formulated by encapsulating NTG within unilamellar lipid vesicles (DPhPC, POPC, Cholesterol, DHPE-Texas Red at molar ratio of 6:2:2:0.2) that were ~155 nm in diameter and readily uptaken by ECs, as determined by dynamic light scattering and quantitative fluorescence microscopy, respectively. More importantly, NTG-NL produced a 70-fold increase in NTG therapeutic efficacy when compared with free NTG while preventing excessive mitochondrial superoxide production associated with high NTG doses. Thus, these findings, which are the first to reveal the superior therapeutic effects of an NTG nanoformulation, provide the rationale for their detailed investigation for potentially superior vascular normalization therapies.

  14. Nanoliposomal Nitroglycerin Exerts Potent Anti-Inflammatory Effects

    NASA Astrophysics Data System (ADS)

    Ardekani, Soroush; Scott, Harry A.; Gupta, Sharad; Eum, Shane; Yang, Xiao; Brunelle, Alexander R.; Wilson, Sean M.; Mohideen, Umar; Ghosh, Kaustabh

    2015-11-01

    Nitroglycerin (NTG) markedly enhances nitric oxide (NO) bioavailability. However, its ability to mimic the anti-inflammatory properties of NO remains unknown. Here, we examined whether NTG can suppress endothelial cell (EC) activation during inflammation and developed NTG nanoformulation to simultaneously amplify its anti-inflammatory effects and ameliorate adverse effects associated with high-dose NTG administration. Our findings reveal that NTG significantly inhibits human U937 cell adhesion to NO-deficient human microvascular ECs in vitro through an increase in endothelial NO and decrease in endothelial ICAM-1 clustering, as determined by NO analyzer, microfluorimetry, and immunofluorescence staining. Nanoliposomal NTG (NTG-NL) was formulated by encapsulating NTG within unilamellar lipid vesicles (DPhPC, POPC, Cholesterol, DHPE-Texas Red at molar ratio of 6:2:2:0.2) that were ~155 nm in diameter and readily uptaken by ECs, as determined by dynamic light scattering and quantitative fluorescence microscopy, respectively. More importantly, NTG-NL produced a 70-fold increase in NTG therapeutic efficacy when compared with free NTG while preventing excessive mitochondrial superoxide production associated with high NTG doses. Thus, these findings, which are the first to reveal the superior therapeutic effects of an NTG nanoformulation, provide the rationale for their detailed investigation for potentially superior vascular normalization therapies.

  15. Ionic effect investigation of a potentiometric sensor for urea and surface morphology observation of entrapped urease/polypyrrole matrix.

    PubMed

    Syu, Mei-Jywan; Chang, Yu-Sung

    2009-04-15

    Potentio-dynamic polymerization of buffered urease and pyrrole monomer onto carbon papers was conducted to fabricate an immobilized urease electrode for measuring the urea concentration. To use carbon paper as the substrate for the electro-growth of polypyrrole matrix not only created sufficient adhesion of the conducting polymer layer but also provided superior entrapment of urease enzymes. The potentiometric response corresponding to ammonia, the product formed from the urease catalyzed urea reaction, was employed for the urea concentration measurement. Scanning electron microscopic photographs showed that the polypyrrole matrix deposited on the carbon papers appeared to be of a cylindrical nanotube shape. The charge density applied in the polymerization was found to affect the potentiometric response while the potential-scanning rate showed minor influence. The composite electrodes had high sensitivity in urea detection, showing a response linear to the logarithm of the urea concentration in the range of 10(-3) to 10 mM. The detection of urea solution prepared in water and buffer was also compared. Ionic effect on the sensing of urea solution was investigated. By comparing the data reported in literature, the urease/polypyrrole/carbon paper electrode developed in this work showed superior long-term stability and reusability. The detection of urea in serum was also well performed.

  16. Historic and modern abundance of wild lean lake trout in Michigan waters of Lake Superior: Implications for restoration goals

    USGS Publications Warehouse

    Wilberg, Michael J.; Hansen, Michael J.; Bronte, Charles R.

    2003-01-01

    Populations of lake trout Salvelinus namaycush in Lake Superior collapsed in the late 1950s due to overfishing and predation by sea lampreys Petromyzon marinus. A binational effort to restore the lean morphotype of lake trout began with the stocking of hatchery-reared fish followed by the chemical control of sea lampreys and closure of the commercial fishery. Previous comparisons of the contemporary abundance of wild lean lake trout with that from historic commercial fishery statistics indicate that abundance was higher historically. However, this conclusion may be biased because several factors—the inclusion of siscowet (the “fat” morphotype of lake trout) in the catch statistics, the soak time of nets, seasonal effects on catch per effort, and the confounding effects of effort targeted at lake whitefish Coregonus clupeaformis—were not accounted for. We developed new indices of historic lean lake trout abundance that correct for these biases and compared them with the assessment data from 1984 to 1998 in Michigan waters of Lake Superior. The modern (1984–1998) abundance of wild lean lake trout is at least as high as that during 1929–1943 in six of eight management areas but lower in one area. Measures to promote and protect naturally reproducing populations have been more successful than previously realized.

  17. Hyperspectral Analysis of Soil Total Nitrogen in Subsided Land Using the Local Correlation Maximization-Complementary Superiority (LCMCS) Method

    PubMed Central

    Lin, Lixin; Wang, Yunjia; Teng, Jiyao; Xi, Xiuxiu

    2015-01-01

    The measurement of soil total nitrogen (TN) by hyperspectral remote sensing provides an important tool for soil restoration programs in areas with subsided land caused by the extraction of natural resources. This study used the local correlation maximization-complementary superiority method (LCMCS) to establish TN prediction models by considering the relationship between spectral reflectance (measured by an ASD FieldSpec 3 spectroradiometer) and TN based on spectral reflectance curves of soil samples collected from subsided land which is determined by synthetic aperture radar interferometry (InSAR) technology. Based on the 1655 selected effective bands of the optimal spectrum (OSP) of the first derivate differential of reciprocal logarithm ([log{1/R}]′), (correlation coefficients, p < 0.01), the optimal model of LCMCS method was obtained to determine the final model, which produced lower prediction errors (root mean square error of validation [RMSEV] = 0.89, mean relative error of validation [MREV] = 5.93%) when compared with models built by the local correlation maximization (LCM), complementary superiority (CS) and partial least squares regression (PLS) methods. The predictive effect of LCMCS model was optional in Cangzhou, Renqiu and Fengfeng District. Results indicate that the LCMCS method has great potential to monitor TN in subsided lands caused by the extraction of natural resources including groundwater, oil and coal. PMID:26213935

  18. Zirconia toughened SiC whisker reinforced alumina composites small business innovation research

    NASA Technical Reports Server (NTRS)

    Loutfy, R. O.; Stuffle, K. L.; Withers, J. C.; Lee, C. T.

    1987-01-01

    The objective of this phase 1 project was to develop a ceramic composite with superior fracture toughness and high strength, based on combining two toughness inducing materials: zirconia for transformation toughening and SiC whiskers for reinforcement, in a controlled microstructure alumina matrix. The controlled matrix microstructure is obtained by controlling the nucleation frequency of the alumina gel with seeds (submicron alpha-alumina). The results demonstrate the technical feasibility of producing superior binary composites (Al2O3-ZrO2) and tertiary composites (Al2O3-ZrO2-SiC). Thirty-two composites were prepared, consolidated, and fracture toughness tested. Statistical analysis of the results showed that: (1) the SiC type is the key statistically significant factor for increased toughness; (2) sol-gel processing with a-alumina seed had a statistically significant effect on increasing toughness of the binary and tertiary composites compared to the corresponding mixed powder processing; and (3) ZrO2 content within the range investigated had a minor effect. Binary composites with an average critical fracture toughness of 6.6MPam sup 1/2, were obtained. Tertiary composites with critical fracture toughness in the range of 9.3 to 10.1 MPam sup 1/2 were obtained. Results indicate that these composites are superior to zirconia toughened alumina and SiC whisker reinforced alumina ceramic composites produced by conventional techniques with similar composition from published data.

  19. Effect of High Intensity Interval Training on Cardiac Function in Children with Obesity: A Randomised Controlled Trial.

    PubMed

    Ingul, Charlotte B; Dias, Katrin A; Tjonna, Arnt E; Follestad, Turid; Hosseini, Mansoureh S; Timilsina, Anita S; Hollekim-Strand, Siri M; Ro, Torstein B; Davies, Peter S W; Cain, Peter A; Leong, Gary M; Coombes, Jeff S

    2018-02-13

    High intensity interval training (HIIT) confers superior cardiovascular health benefits to moderate intensity continuous training (MICT) in adults and may be efficacious for improving diminished cardiac function in obese children. The aim of this study was to compare the effects of HIIT, MICT and nutrition advice interventions on resting left ventricular (LV) peak systolic tissue velocity (S') in obese children. Ninety-nine obese children were randomised into one of three 12-week interventions, 1) HIIT [n = 33, 4 × 4 min bouts at 85-95% maximum heart rate (HR max ), 3 times/week] and nutrition advice, 2) MICT [n = 32, 44 min at 60-70% HR max , 3 times/week] and nutrition advice, and 3) nutrition advice only (nutrition) [n = 34]. Twelve weeks of HIIT and MICT were equally efficacious, but superior to nutrition, for normalising resting LV S' in children with obesity (estimated mean difference 1.0 cm/s, 95% confidence interval 0.5 to 1.6 cm/s, P < 0.001; estimated mean difference 0.7 cm/s, 95% confidence interval 0.2 to 1.3 cm/s, P = 0.010, respectively). Twelve weeks of HIIT and MICT were superior to nutrition advice only for improving resting LV systolic function in obese children. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Emergency skill training--a randomized controlled study on the effectiveness of the 4-stage approach compared to traditional clinical teaching.

    PubMed

    Greif, Robert; Egger, Lars; Basciani, Reto M; Lockey, Andrew; Vogt, Andreas

    2010-12-01

    The "4-stage approach" has been widely accepted for practical skill training replacing the traditional 2 stages ("see one, do one"). However, the superior effectiveness of the 4-stage approach was never proved. To evaluate whether skill training with the 4-stage approach results in shorter performance time needed for a successful percutaneous needle-puncture cricothyroidotomy, and consequently in a reduced number of attempts needed to perform the skill in <60s compared to traditional teaching. Randomized controlled single-blinded parallel group study at the University Hospital Bern. With IRB approval and informed consent 128 undergraduate medical students were randomized in four groups: traditional teaching, no stage 2, no stage 3, and 4-stage approach for the training of cricothyroidotomy. Everyone watched a video of the cricothyroidotomy as stage 1 followed by skill training in the respective teaching group. Participants had to perform the cricothyroidotomy 10 times on skin-covered pig larynxes. Performance time was measured from skin palpation to trachea ventilation. Study participants filled out a self-rating on competency during the training. Performance time for each attempt was comparable in all groups and improved similarly to reach a performance time of <60 s. Self-rating revealed that all groups felt equally competent throughout. Even if the 4-stage approach is widely accepted and used as a didactic method for skill teaching we could not find evidence that its use or omitting stage 2 or 3 results in superior learning of an emergency skill compared to traditional teaching. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  1. Superior Patency of Upper Arm Arteriovenous Fistulae in High Risk Patients

    PubMed Central

    Chiulli, Larissa C; Vasilas, Penny; Dardik, Alan

    2011-01-01

    Background Despite an increased propensity to primary failure in forearm arteriovenous fistulae compared to upper arm fistulae, forearm fistulae remain the preferred primary access type for chronic hemodialysis patients. In a high risk patient population with multiple medical comorbidities associated with requirement for intravenous access we compared the rates of access failure in forearm and upper arm fistulae. Materials and Methods The records of all patients having primary native arteriovenous fistulae placed between 2004 and 2009 at the VA Connecticut Healthcare system were reviewed (n=118). Primary and secondary patency of upper arm and forearm fistulae were evaluated using Kaplan-Meier survival analysis. The effects of medical comorbidities on access patency were analyzed with Cox regression. Results The median time to primary failure of the vascular access was 0.288 years in the forearm group compared to 0.940 years in the upper arm group (p=0.028). Secondary patency was 52% at 4.9 years in upper arm fistulae compared to 52% at 1.1 years in the forearm group (p=0.036). There was no significant effect of patient comorbidities on fistula failure; however, there was a trend toward upper arm surgical site as a protective factor for primary fistula patency (Hazard Ratio=0.573, p=0.076). Conclusions In veterans needing hemodialysis, a high risk population with extensive comorbid factors often requiring intravascular access, upper arm fistulae are not only a viable option for primary vascular access, but are likely to be a superior option to classic forearm fistulae. PMID:21571318

  2. The influence of seat height, trunk inclination and hip posture on the activity of the superior trapezius and longissimus

    PubMed Central

    Bertolaccini, Guilherme da Silva; Nakajima, Rafael Kendi; Filho, Idinei Francisco Pires de Carvalho; Paschoarelli, Luis Carlos; Medola, Fausto Orsi

    2016-01-01

    [Purpose] This study was aimed at investigating the influence of seat height and body posture on the activity of the superior trapezius and longissimus muscles. [Subjects and Methods] Twenty two healthy subjects were instructed to perform a total of eight different body postures, varying according three main factors: seat height (low and high seat); trunk inclination (upright and leaning forward at 45°); and the hips in abduction and adduction. Electromyography of the superior trapezius and longissimus was collected bilaterally, and the average values were obtained and compared across all the postures. [Results] The activity of the superior trapezius and longissimus significantly changes according to the seat height and trunk inclination. For both seat heights, sitting with trunk leaning forward resulted in a significant increase in the activity of both muscles. When sitting in a high seat and the trunk leaning forward, the superior trapezius activity was significantly reduced when compared to the same posture in a low seat. [Conclusion] This study contributes to the knowledge on the influence of the body posture and seat configuration on the activity of postural muscles. Reducing the biomechanical loads on the postural muscles must be targeted in order to improve users’ comfort and safety. PMID:27313381

  3. Water vapor diffusion membrane development. [for water recovery purposes onboard manned spacecraft

    NASA Technical Reports Server (NTRS)

    Tan, M. K.

    1974-01-01

    The phase separator component used as a membrane in the vapor diffusion process (VRD) for the recovery of potable water from urine on manned space missions of extended duration was investigated, with particular emphasis on cation-selective membranes because of their noted mechanical strength, superior resistance to acids, oxidants, and germicides, and their potential resistance to organic foulants. Two of the membranes were tested for 700 hours continuously, and were selected on the basis of criteria deemed important to an effective water reclamation system onboard spacecraft. The samples of urine were successfully processed by removing 93 percent of their water content in 70 hours using the selected membranes. Pretreatment with an acid-oxidant formulation improved product quality. Cation exchange membranes were shown to possess superior mechanical strength and chemical resistance, as compared to cellulosic membranes.

  4. Skills training versus health education to prevent STDs/HIV in heterosexual women: a randomized controlled trial utilizing biological outcomes.

    PubMed

    Baker, Sharon A; Beadnell, Blair; Stoner, Susan; Morrison, Diane M; Gordon, Judith; Collier, Cheza; Knox, Kay; Wickizer, Lauren; Stielstra, Sorrel

    2003-02-01

    We compared the effectiveness of two different 16-session group interventions for reducing new STD infection among heterosexual women. Two hundred twenty-nine at-risk heterosexual women were randomly assigned to skills training (ST) based on the relapse prevention model or health education (HE). Participants were monitored during the year following intervention for STD acquisition, self-reports of sexual behavior, and risk reduction skills. Participants in the ST intervention were significantly less likely to be diagnosed with a STD in the year following intervention and demonstrated superior risk reduction skills at 12-month follow-up. Both conditions showed statistically significant reductions in self reports of risky sexual behavior following intervention and at 12-month follow-up. In this sample, the ST intervention was superior to HE for reducing STD acquisition.

  5. [Comparison of antibacterial effects of different antiseptics after hand washing].

    PubMed

    Buluş, Nesrin; Kaleli, Ilknur

    2004-01-01

    The aim of this study was to compare 4% chlorhexidine gluconate, 7.5% povidone iodine and liquid soap, which are used as hand washing solutions for the immediate, cumulative and residual effects in bacterial growth. For this purpose, 18 volunteers washed their hands with 7.5% povidone iodine, 4% chlorhexidine gluconate and liquid soap by applying standard hygienic hand washing technique. In order to find out the bacterial amount in the hands of study group, glove liquid test was used. For the evaluation of immediate effects, samples were collected just after the washing procedure, for the residual effects samples were collected from gloved hands after 3 hours, and for the cumulative effects, samples were collected after 5 days with daily hand washings. It is found that the immediate effects of 4% chlorhexidine gluconate was superior than others, and 7.5% povidone iodine was superior to liquid soap. There was no difference between 4% chlorhexidine gluconate and 7.5% povidone iodine for residual effects. The cumulative effects were observed for 4% chlorhexidine gluconate and 7.5% povidone iodine, while there was no cumulative effect for liquid soap. According to these results, it can be suggested that 4% chlorhexidine gluconate can be used as a reliable antiseptic agent in the hospitals, especially for laboratories, intensive care units and operating rooms, owing to its favourable immediate, residual and cumulative effects.

  6. Fibromyalgia Is Correlated with Retinal Nerve Fiber Layer Thinning.

    PubMed

    Garcia-Martin, Elena; Garcia-Campayo, Javier; Puebla-Guedea, Marta; Ascaso, Francisco J; Roca, Miguel; Gutierrez-Ruiz, Fernando; Vilades, Elisa; Polo, Vicente; Larrosa, Jose M; Pablo, Luis E; Satue, Maria

    2016-01-01

    To investigate whether fibromyalgia induces axonal damage in the optic nerve that can be detected using optical coherence tomography (OCT), as the retinal nerve fiber layer (RNFL) is atrophied in patients with fibromyalgia compared with controls. Fibromyalgia patients (n = 116) and age-matched healthy controls (n = 144) were included in this observational and prospective cohort study. All subjects underwent visual acuity measurement and structural analysis of the RNFL using two OCT devices (Cirrus and Spectralis). Fibromyalgia patients were evaluated according to Giesecke's fibromyalgia subgroups, the Fibromyalgia Impact Questionnaire (FIQ), and the European Quality of Life-5 Dimensions (EQ5D) scale. We compared the differences between fibromyalgia patients and controls, and analyzed the correlations between OCT measurements, disease duration, fibromyalgia subgroups, severity, and quality of life. The impact on quality of life in fibromyalgia subgroups and in patients with different disease severity was also analyzed. A significant decrease in the RNFL was detected in fibromyalgia patients compared with controls using the two OCT devices: Cirrus OCT ganglion cell layer analysis registered a significant decrease in the minimum thickness of the inner plexiform layer (74.99±16.63 vs 79.36±3.38 μm, respectively; p = 0.023), nasal inferior, temporal inferior and temporal superior sectors (p = 0.040; 0.011 and 0.046 respectively). The Glaucoma application of the Spectralis OCT revealed thinning in the nasal, temporal inferior and temporal superior sectors (p = 0.009, 0.006, and 0.002 respectively) of fibromyalgia patients and the Axonal application in all sectors, except the nasal superior and temporal sectors. The odds ratio (OR) to estimate the size effect of FM in RNFL thickness was 1.39. RNFL atrophy was detected in patients with FIQ scores <60 (patients in early disease stages) compared with controls in the temporal inferior sector (78.74±17.75 vs 81.65±3.61; p = 0.020) and the temporal superior sector (78.20±14.50 vs 80.74±3.88; p = 0.039) with Cirrus OCT; in the temporal inferior sector (145.85±24.32 vs 150.18±19.71; p = 0.012) and temporal superior sector (131.54±20.53 vs 138.13±16.67; p = 0.002) with the Glaucoma application of the Spectralis OCT; and in all sectors, except the average, nasal superior, and temporal sectors, and parameters with the Axonal application of the Spectralis OCT. Temporal inferior RNFL thickness was significantly reduced in patients with severe fibromyalgia (FIQ≥60) compared with patients with mild fibromyalgia (FIQ<60; 145.85±24.32 vs 138.99±18.09 μm, respectively; 145.43±13.21 vs 139.85±13.09 μm, p = 0.032 with the Glaucoma application and p = 0.021 with the Axonal application). The subgroup with biologic fibromyalgia exhibited significant thinning in the temporal inferior and superior sectors (115.17±20.82 μm and 117.05±24.19 μm, respectively) compared with the depressive (130.83±22.97 μm and 127.71±26.10 μm, respectively) and atypical (128.60±26.54 μm and 125.55±23.65 μm, respectively) subgroups (p = 0.005 and 0.001 respectively). Fibromyalgia causes subclinical axonal damage in the RNFL that can be detected using innocuous and non-invasive OCT, even in the early disease stages. The impact on the RNFL in the temporal sectors is greater in patients with biologic fibromyalgia, suggesting the presence of neurodegenerative processes in this subgroup of patients with fibromyalgia.

  7. Fibromyalgia Is Correlated with Retinal Nerve Fiber Layer Thinning

    PubMed Central

    Garcia-Martin, Elena; Garcia-Campayo, Javier; Puebla-Guedea, Marta; Ascaso, Francisco J.; Roca, Miguel; Gutierrez-Ruiz, Fernando; Vilades, Elisa; Polo, Vicente; Larrosa, Jose M.; Pablo, Luis E.; Satue, Maria

    2016-01-01

    Objective To investigate whether fibromyalgia induces axonal damage in the optic nerve that can be detected using optical coherence tomography (OCT), as the retinal nerve fiber layer (RNFL) is atrophied in patients with fibromyalgia compared with controls. Methods Fibromyalgia patients (n = 116) and age-matched healthy controls (n = 144) were included in this observational and prospective cohort study. All subjects underwent visual acuity measurement and structural analysis of the RNFL using two OCT devices (Cirrus and Spectralis). Fibromyalgia patients were evaluated according to Giesecke’s fibromyalgia subgroups, the Fibromyalgia Impact Questionnaire (FIQ), and the European Quality of Life-5 Dimensions (EQ5D) scale. We compared the differences between fibromyalgia patients and controls, and analyzed the correlations between OCT measurements, disease duration, fibromyalgia subgroups, severity, and quality of life. The impact on quality of life in fibromyalgia subgroups and in patients with different disease severity was also analyzed. Results A significant decrease in the RNFL was detected in fibromyalgia patients compared with controls using the two OCT devices: Cirrus OCT ganglion cell layer analysis registered a significant decrease in the minimum thickness of the inner plexiform layer (74.99±16.63 vs 79.36±3.38 μm, respectively; p = 0.023), nasal inferior, temporal inferior and temporal superior sectors (p = 0.040; 0.011 and 0.046 respectively). The Glaucoma application of the Spectralis OCT revealed thinning in the nasal, temporal inferior and temporal superior sectors (p = 0.009, 0.006, and 0.002 respectively) of fibromyalgia patients and the Axonal application in all sectors, except the nasal superior and temporal sectors. The odds ratio (OR) to estimate the size effect of FM in RNFL thickness was 1.39. RNFL atrophy was detected in patients with FIQ scores <60 (patients in early disease stages) compared with controls in the temporal inferior sector (78.74±17.75 vs 81.65±3.61; p = 0.020) and the temporal superior sector (78.20±14.50 vs 80.74±3.88; p = 0.039) with Cirrus OCT; in the temporal inferior sector (145.85±24.32 vs 150.18±19.71; p = 0.012) and temporal superior sector (131.54±20.53 vs 138.13±16.67; p = 0.002) with the Glaucoma application of the Spectralis OCT; and in all sectors, except the average, nasal superior, and temporal sectors, and parameters with the Axonal application of the Spectralis OCT. Temporal inferior RNFL thickness was significantly reduced in patients with severe fibromyalgia (FIQ≥60) compared with patients with mild fibromyalgia (FIQ<60; 145.85±24.32 vs 138.99±18.09 μm, respectively; 145.43±13.21 vs 139.85±13.09 μm, p = 0.032 with the Glaucoma application and p = 0.021 with the Axonal application). The subgroup with biologic fibromyalgia exhibited significant thinning in the temporal inferior and superior sectors (115.17±20.82 μm and 117.05±24.19 μm, respectively) compared with the depressive (130.83±22.97 μm and 127.71±26.10 μm, respectively) and atypical (128.60±26.54 μm and 125.55±23.65 μm, respectively) subgroups (p = 0.005 and 0.001 respectively). Conclusions Fibromyalgia causes subclinical axonal damage in the RNFL that can be detected using innocuous and non-invasive OCT, even in the early disease stages. The impact on the RNFL in the temporal sectors is greater in patients with biologic fibromyalgia, suggesting the presence of neurodegenerative processes in this subgroup of patients with fibromyalgia. PMID:27584145

  8. [Home treatment: systematic review and implementation in Germany].

    PubMed

    Gühne, Uta; Weinmann, Stefan; Arnold, Katrin; Atav, Esra-Sultan; Becker, Thomas; Riedel-Heller, Steffi

    2011-04-01

    To report about existing evidence of effectiveness of home treatment for severely mentally ill adults and implementation in Germany. Systematic electronic and manual literature search. Compared to standard care, home treatment was equally or more efficacious with respect to general state of health and mental health. Home treatment was superior with regard to other outcomes. So far, implementation in Germany is limited. Home treatment can be seen as an effective addition to existing approaches of psychiatric care. It may be cost-effective also in Germany. Reasons for limited implementation in routine care are discussed. © Georg Thieme Verlag KG Stuttgart · New York.

  9. The Effect of Adversary Unmanned Aerial Systems on the US Concept of Air Superiority

    DTIC Science & Technology

    2014-12-04

    impact on the US concept of air superiority. Politically, psychologically , and operationally, air superiority is important. UAS are capable of attack...challenge to the US concept of air superiority. Adversary drones have the potential to be a sporadic but deadly and psychologically powerful weapon that...toll they took in lives and equipment, kamikaze attacks also had a psychological impact. Dr. Alvin D. Coox, a professor of history and Asian studies

  10. The effect of corneal anterior surface eccentricity on astigmatism after cataract surgery.

    PubMed

    Park, Choul Yong; Chuck, Roy S; Channa, Prabjot; Lim, Chi-Yeon; Ahn, Byung-Jin

    2011-01-01

    To evaluate the effect of cornea eccentricity on induced astigmatism after cataract surgery. The study included 125 eyes of 87 patients. Preoperative corneal astigmatism, pachymetry, and eccentricity were measured. During cataract surgery, the location of the main incision (2.8-mm clear corneal) was selected to be either superior, superior-nasal, superior-temporal, nasal, or temporal to decrease the preexisting corneal astigmatism. Aspheric intraocular lenses were implanted. Keratometry and manifest refraction were recorded 6 months after surgery. Astigmatism was calculated using vector subtraction software. Three parameters significantly affected postoperative astigmatism: preoperative amount of corneal astigmatism, eccentricity of anterior cornea, and location of the main incision. The mean surgically induced astigmatism (SIA) was calculated to be: superior = 0.82 diopters (D), superior-nasal = 0.50 D, superior-temporal = 0.63 D, temporal = 0.45 D, and nasal = 0.55 D. Superior incision induced the greatest SIA and temporal incision induced the smallest SIA. The eccentricity of anterior cornea showed significantly positive correlation with the amount of SIA (P < .001). The preoperative corneal cylinder power showed significantly positive correlation with the amount of SIA (P < .001). Postoperative astigmatism was affected by various factors in cataract surgery. The greatest postoperative astigmatism is expected in corneas with high anterior eccentricity, high preoperative corneal astigmatism, and superior location of the main incision. Copyright 2011, SLACK Incorporated.

  11. [Observation on therapeutic effect of chronic fatigue syndrome treated with coiling dragon needling and moving cupping on back].

    PubMed

    Xu, Wei; Zhou, Ri-Hua; Li, Lei; Jiang, Ming-Wei

    2012-03-01

    To compare the differences of therapeutic effect of chronic fatigue syndrome treated with the combined therapy of coiling dragon needling and cupping on back and the western medicine therapy with Prednisone. Seventy-two cases were randomly divided into an acupuncture and cupping group (37 cases) and a Prednisone group (35 cases). In acupuncture and cupping group, Jiaji (EX-B 2) points of T1--L5 were applied with coiling dragon needling (once a day), combined with moving cupping on back (once every two days); in Prednisone group, Prednisone tablets were orally taken for 10 mg at 8:00 am. Seven days made one course, and 2 courses were carried on totally. FS-14 scale and BELL's chronic fatigue syndrome integral table were applied to evaluate the fatigue degree of patients before and after treatment, and the therapeutic effects of both groups were compared. After one course of treatment, the BELL's scores of both groups were obviously improved (both P < 0.01), but there was no significant difference between groups (P > 0.05); after two courses of treatment, the BELL's score in acupuncture and cupping group improved more obviously than that in Prednisone group, and the total effective rate of 91.9% (34/37) in acupuncture and cupping group was superior to that of 71.4% (25/35) in Prednisone group (P < 0.05). The therapeutic effect of chronic fatigue syndrome treated with coiling dragon needling and moving cupping on back is positive, superior to that of Prednisone with oral administration.

  12. Augmented superior rectus transposition procedure in Duane retraction syndrome compared with sixth nerve palsy.

    PubMed

    Akbari, Mohammadreza; Shomali, Setareh; Mirmohammadsadeghi, Arash; Fard, Masoud Aghsaei

    2018-05-01

    Superior rectus transposition (SRT) with medial rectus recession has been used for the treatment of sixth nerve palsy and esotropic Duane retraction syndrome (DRS). The purpose of this study was to compare the results of augmented SRT (with scleral fixation) without medial rectus recession in DRS and sixth nerve palsy. Patients with unilateral esotropic DRS (DRS group) and sixth nerve palsy were included in this prospective, comparative study and underwent SRT. Preoperative forced duction testing was negative or slightly positive in both groups. Prospective measurements were compared between the two groups. There were 11 patients in the DRS group and 11 patients in the sixth nerve palsy group. The mean preoperative esotropia decreased from 20.9 ± 6.0 prism diopter (PD) at far to 13.2 ± 5.8 PD in the DRS group (P = 0.003). The same measurement improved from 28.0 ± 8.5 PD to 8.4 ± 7.3 PD in the sixth nerve palsy group (P = 0.003). In the sixth nerve palsy group, the improvement in primary gaze esotropia and abnormal head posture was more than the DRS group (Both P < 0.001).The average dose effect for SRT was 7.8 ± 2.2 PD in the DRS group and 19.2 ± 4.6 PD in the sixth nerve palsy group. Although objective intorsion was significantly induced after SRT, subjective torsion was not significant after surgery in both groups. SRT appears to be more effective in improving primary gaze deviation and head posture in sixth nerve palsy compared with DRS. Subjective torsional and vertical diplopia were rare in both groups.

  13. Wound-healing potential of human umbilical cord blood-derived mesenchymal stromal cells in vitro--a pilot study.

    PubMed

    You, Hi-Jin; Namgoong, Sik; Han, Seung-Kyu; Jeong, Seong-Ho; Dhong, Eun-Sang; Kim, Woo-Kyung

    2015-11-01

    Our previous studies demonstrated that human bone marrow-derived mesenchymal stromal cells have great potential for wound healing. However, it is difficult to clinically utilize cultured stem cells. Recently, human umbilical cord blood-derived mesenchymal stromal cells (hUCB-MSCs) have been commercialized for cartilage repair as a first cell therapy product that uses allogeneic stem cells. Should hUCB-MSCs have a superior effect on wound healing as compared with fibroblasts, which are the main cell source in current cell therapy products for wound healing, they may possibly replace fibroblasts. The purpose of this in vitro study was to compare the wound-healing activity of hUCB-MSCs with that of fibroblasts. This study was particularly designed to compare the effect of hUCB-MSCs on diabetic wound healing with those of allogeneic and autologous fibroblasts. Healthy (n = 5) and diabetic (n = 5) fibroblasts were used as the representatives of allogeneic and autologous fibroblasts for diabetic patients in the control group. Human UCB-MSCs (n = 5) were used in the experimental group. Cell proliferation, collagen synthesis and growth factor (basic fibroblast growth factor, vascular endothelial growth factor and transforming growth factor-β) production were compared among the three cell groups. Human UCB-MSCs produced significantly higher amounts of vascular endothelial growth factor and basic fibroblast growth factor when compared with both fibroblast groups. Human UCB-MSCs were superior to diabetic fibroblasts but not to healthy fibroblasts in collagen synthesis. There were no significant differences in cell proliferation and transforming growth factor-β production. Human UCB-MSCs may have greater capacity for diabetic wound healing than allogeneic or autologous fibroblasts, especially in angiogenesis. Copyright © 2015 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

  14. Single site and conventional totally extraperitoneal techniques for uncomplicated inguinal hernia repair: A comparative study.

    PubMed

    de Araújo, Felipe Brandão Corrêa; Starling, Eduardo Simão; Maricevich, Marco; Tobias-Machado, Marcos

    2014-10-01

    To demonstrate the feasibility of endoscopic extraperitoneal single site (EESS) inguinal hernia repair and compare it outcomes with the conventional totally extraperitoneal (TEP) technique. TEP inguinal hernia repair is a widely accepted alternative to conventional open technique with several perioperative advantages. Transumbilical laparoendoscopic singlesite surgery (LESS) is an emerging approach and has been reported for a number of surgical procedures with superior aesthetic results but other advantages need to be proven. Thirty-eight uncomplicated inguinal hernias were repaired by EESS approach between January 2010 and January 2011. All procedures were performed through a 25 cm infraumbilical incision using the Alexis wound retractor attached to a surgical glove and three trocars. Body mass index, age, operative time, blood loss, complications, conversion rate, analgesia requirement, hospital stay, return to normal activities and patient satisfaction with aesthetic results were analysed and compared with the last 38 matched-pair group of patients who underwent a conventional TEP inguinal hernia repair by the same surgeon. All procedures were performed successfully with no conversion. In both unilateral and bilateral EESS inguinal repairs, the mean operative time was longer than conventional TEP (55± 20 vs. 40± 15 min, P = 0.049 and 70± 15 vs. 55± 10 min, P = 0.014). Aesthetic result was superior in the EESS group (2.88± 0.43 vs. 2.79± 0.51, P = 0.042). There was no difference between the two approaches regarding blood loss, complications, hospital stay, time until returns to normal activities and analgesic requirement. EESS inguinal hernia repair is safe and effective, with superior cosmetic results in the treatment of uncomplicated inguinal hernias. Other advantages of this new technique still need to be proven.

  15. Dubious space for Artelon joint resurfacing for basal thumb (trapeziometacarpal joint) osteoarthritis. A systematic review.

    PubMed

    Smeraglia, Francesco; Mariconda, Massimo; Balato, Giovanni; Di Donato, Sigismondo Luca; Criscuolo, Giovanni; Maffulli, Nicola

    2018-06-01

    Trapeziometacarpal arthritis is a common and disabling condition. There is no evidence in the literature of superiority of one surgical procedure over others. Several prosthetic implants have been introduced to preserve joint mobility. We searched the on Medline (PubMed), Web of Science and Scopus databases using the combined keywords 'artelon', 'thumb', 'carpometacarpal', 'trapeziometacarpal' and 'rhizoarthrosis'; 11 studies were identified. The use of Artelon implant is not recommended because of its high revision rate and worse outcomes compared to conventional techniques. Inert materials subjected to compressive and shearing forces could produce debris and subsequent inflammatory response. There is debate in the published scientific literature regarding the role of preoperative antibiotic profilaxis and post-surgery inflammatory response. Standard techniques such as trapeziectomy alone or combined with interposition or suspensionplasty offer effective treatment for thumb basal joint arthritis. Several prosthetic implants show promising results in terms of pain relief and functional request, but there is a need of long-term randomized controlled trials to demonstrate their equivalence, and eventually superiority, compared to standard techniques.

  16. Realization of Quasi‐Omnidirectional Solar Cells with Superior Electrical Performance by All‐Solution‐Processed Si Nanopyramids

    PubMed Central

    Zhong, Sihua; Wang, Wenjie; Tan, Miao; Zhuang, Yufeng

    2017-01-01

    Abstract Large‐scale (156 mm × 156 mm) quasi‐omnidirectional solar cells are successfully realized and featured by keeping high cell performance over broad incident angles (θ), via employing Si nanopyramids (SiNPs) as surface texture. SiNPs are produced by the proposed metal‐assisted alkaline etching method, which is an all‐solution‐processed method and highly simple together with cost‐effective. Interestingly, compared to the conventional Si micropyramids (SiMPs)‐textured solar cells, the SiNPs‐textured solar cells possess lower carrier recombination and thus superior electrical performances, showing notable distinctions from other Si nanostructures‐textured solar cells. Furthermore, SiNPs‐textured solar cells have very little drop of quantum efficiency with increasing θ, demonstrating the quasi‐omnidirectional characteristic. As an overall result, both the SiNPs‐textured homojunction and heterojunction solar cells possess higher daily electric energy production with a maximum relative enhancement approaching 2.5%, when compared to their SiMPs‐textured counterparts. The quasi‐omnidirectional solar cell opens a new opportunity for photovoltaics to produce more electric energy with a low cost. PMID:29201616

  17. Realization of Quasi-Omnidirectional Solar Cells with Superior Electrical Performance by All-Solution-Processed Si Nanopyramids.

    PubMed

    Zhong, Sihua; Wang, Wenjie; Tan, Miao; Zhuang, Yufeng; Shen, Wenzhong

    2017-11-01

    Large-scale (156 mm × 156 mm) quasi-omnidirectional solar cells are successfully realized and featured by keeping high cell performance over broad incident angles (θ), via employing Si nanopyramids (SiNPs) as surface texture. SiNPs are produced by the proposed metal-assisted alkaline etching method, which is an all-solution-processed method and highly simple together with cost-effective. Interestingly, compared to the conventional Si micropyramids (SiMPs)-textured solar cells, the SiNPs-textured solar cells possess lower carrier recombination and thus superior electrical performances, showing notable distinctions from other Si nanostructures-textured solar cells. Furthermore, SiNPs-textured solar cells have very little drop of quantum efficiency with increasing θ, demonstrating the quasi-omnidirectional characteristic. As an overall result, both the SiNPs-textured homojunction and heterojunction solar cells possess higher daily electric energy production with a maximum relative enhancement approaching 2.5%, when compared to their SiMPs-textured counterparts. The quasi-omnidirectional solar cell opens a new opportunity for photovoltaics to produce more electric energy with a low cost.

  18. Influence of Near-Segment Positioning in a Rotationally Asymmetric Multifocal Intraocular Lens.

    PubMed

    Song, In Seok; Yoon, Sam Young; Kim, Jae Yong; Kim, Myoung Joon; Tchah, Hungwon

    2016-04-01

    To compare visual performance and higher order aberrations (HOAs) based on the position of the near segment in eyes with rotationally asymmetric multifocal intraocular lenses (IOLs). Asymmetric multifocal IOLs (Lentis Mplus LS-313; Oculentis Optikgeräte GmbH, Wetzlar, Germany) were implanted with the near segment positioned either inferiorly, superiorly, or temporally. Uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuity, corrected distance visual acuity (CDVA), and distance-corrected intermediate (DCIVA) and near (DCNVA) visual acuity, contrast sensitivity, HOAs, and subjective symptom questionnaires were compared at 1 month postoperatively. Forty-five eyes from 45 patients were evaluated (n = 25, 9, and 11 eyes in the inferior, superior, and temporal groups, respectively). No significant differences in UDVA, UIVA, UNVA, CDVA, DCIVA, or DCNVA were found between the three groups (P > .05). The temporal group showed the best results in UDVA, CDVA, and DCNVA, but the inferior group showed the best results in DCIVA and UNVA and the superior group showed the best results in UIVA. Contrast sensitivity and the subjective symptom questionnaire also did not demonstrate any significant differences (P > .05). Total HOA and spherical aberration did not demonstrate any statistically significant differences (P > .05), but vertical coma and horizontal coma demonstrated significant differences based on near segment position (P < .001). The position of the near segment in eyes with rotationally asymmetric multifocal IOLs demonstrates no significant effect on visual performance. Copyright 2016, SLACK Incorporated.

  19. Virtual reality exposure versus prolonged exposure for PTSD: Which treatment for whom?

    PubMed

    Norr, Aaron M; Smolenski, Derek J; Katz, Andrea C; Rizzo, Albert A; Rothbaum, Barbara O; Difede, JoAnn; Koenen-Woods, Patricia; Reger, Mark A; Reger, Greg M

    2018-06-01

    The majority of studies comparing active psychological treatments for posttraumatic stress disorder (PTSD) do not find significant differences at posttreatment. This was the case in a recent trial examining prolonged exposure (PE) and virtual reality exposure (VRE) among active-duty soldiers with combat-related PTSD. Matching individual patients to specific treatments provides a potential avenue to improve significantly the public health impact of effective treatments for PTSD. A composite moderator approach was used to identify profiles of patients who would see superior PTSD symptom reduction in VRE or PE to inform future treatment matching. Active duty U.S. army soldiers (N = 108) were enrolled in a randomized clinical trial comparing VRE and PE in the treatment of PTSD stemming from deployments to Iraq or Afghanistan. Eighteen baseline variables were examined to identify treatment response heterogeneity in two patient groups: those with a superior response to PE and those with a superior response to VRE. The final composite moderator comprised four of 18 baseline variables. Results revealed that patients who were predicted to see greater PTSD symptom reduction in VRE were likely to be younger, not taking antidepressant medication, had greater PTSD hyperarousal symptoms, and were more likely to have greater than minimal suicide risk. Results suggest that treatment matching based on patient profiles could meaningfully improve treatment efficacy for combat-related PTSD. Future research can build on these results to improve our understanding of how to improve treatment matching for PTSD. © 2018 Wiley Periodicals, Inc.

  20. The effect of arm positioning on timing and enhancement of intravenous contrast media at coronary computed tomography angiography.

    PubMed

    Svensson, Anders; Cederlund, Kerstin; Aspelin, Peter; Nyman, Ulf; Brismar, Torkel B

    2016-09-01

    Adequate intravenous contrast media (CM) enhancement is crucial for evaluation of the coronary arteries. To compare the timing and enhancement of intravenous CM at coronary computed tomography angiography (CCTA) when positioning the arms in the traditional superior direction with that of positioning them in the ventral direction during the CM injection. One hundred patients were randomized into two groups. Group A (n = 50) had their arms positioned in the superior direction, resting on a head and arm support. Group B (n = 50) held their arms resting on the front panel of the computer tomography (CT) scanner. Scanning delay time was defined by test bolus technique. A total of 60 mL iodixanol, 320 mg/mL, was followed by a 50 mL saline flush at 6 mL/s. Cardiac output (CO) and heart rate (HR) were obtained before scanning. The attenuation was calculated by placing regions of interest (ROI) in ascending aorta, left atrium, and inferior vena cava. More patients in group A compared with group B (26 versus 14) showed a higher attenuation of the left atrium in comparison to the ascending aorta (P < 0.05). Body weight (BW) and CO were significantly related to the attenuation of ascending aorta (P < 0.01). By placing the arms in a ventral, instead of superior position the frequency of too early imaging at CCTA can be reduced. © The Foundation Acta Radiologica 2015.

  1. Morphological and radiological study of ossified superior transverse scapular ligament as potential risk factor of suprascapular nerve entrapment.

    PubMed

    Polguj, Michał; Sibiński, Marcin; Grzegorzewski, Andrzej; Waszczykowski, Michał; Majos, Agata; Topol, Mirosław

    2014-01-01

    The suprascapular notch is covered superiorly by the superior transverse scapular ligament. This region is the most common place of suprascapular nerve entrapment formation. The study was performed on 812 specimens: 86 dry scapulae, 104 formalin-fixed cadaveric shoulders, and 622 computer topography scans of scapulae. In the cases with completely ossified superior transverse scapular ligament, the following measurements were performed: proximal and distal width of the bony bridge, middle transverse and vertical diameter of the suprascapular foramen, and area of the suprascapular foramen. An ossified superior transverse scapular ligament was observed more often in men and in the right scapula. The mean age of the subjects with a completely ossified superior transverse scapular ligament was found to be similar than in those without ossification. The ossified band-shaped type of superior transverse scapular ligament was more common than the fan-shaped type and reduced the space below the ligament to a significantly greater degree. The ossified band-shaped type should be taken into consideration as a potential risk factor in the formation of suprascapular nerve entrapment. It could explain the comparable frequency of neuropathy in various populations throughout the world despite the significant differences between them in occurrence of ossified superior transverse scapular ligament.

  2. Survey of Nerve Fiber Layer Thickness in Anisometropic and Strabismic Amblyopia.

    PubMed

    Soltani Moghaddam, Reza; Medghalchi, Abdolreza; Alizadeh, Yousef

    2017-01-01

    . To investigate the effect of anisometropic and strabismic amblyopia on the nerve fiber layer thickness. This cross-sectional study was done on 54 amblyopic subjects, equally in both strabismic and anisometropic groups. The thickness otonerve fiber layer measured in superior, inferior, nasal, temporal quadrants and as a whole in both eyes of both groups. The means of thickness were compared in amblyopic and sound eyes. In strabismus group, the average nerve fiber layer thickness of the sound eye , in superior, inferior, nasal and temporal quadrants and as a whole were 113.23±14, 117.37±25, 68.96±6, 69.55±14 and 93.40±8 microns respectively. In amblyopic eyes of the same group, these measurements were 103.11±18, 67.74±11, and 69.59±16 and 89.59±12 microns in superior, inferior, nasal, temporal quadrants and as whole respectively. In anisometropic groups, the sound eye measurements were as 130.96±22, 129.07±29, 80.62±12, and 83.88±20 and 107.7±13 microns in superior, inferior, nasal and temporal quadrants and as a whole orderly. In amblyopic eyes of this group the mean thicknesses were 115.63±29, 133.15±25, 78.8±15, 80.2±16 and 109.17±21 microns in superior, inferior, nasal, temporal quadrants and as a whole respectively. Statistically, there were no significant differences between amblyopic and sound eyes (P>0.5). Our study did not support any significant change in a nerve fiber layer thickness of amblyopic patients; however, decreased thickness in superior and nasal quadrants of strabismic amblyopia and except inferior quadrant and as a whole. These measurements may be a clue for management and prognosis of amblyopia in old age.

  3. Memorial familiarity remains intact for pictures but not for words in patients with amnestic mild cognitive impairment.

    PubMed

    Embree, Lindsay M; Budson, Andrew E; Ally, Brandon A

    2012-07-01

    Understanding how memory breaks down in the earliest stages of Alzheimer's disease (AD) process has significant implications, both clinically and with respect to intervention development. Previous work has highlighted a robust picture superiority effect in patients with amnestic mild cognitive impairment (aMCI). However, it remains unclear as to how pictures improve memory compared to words in this patient population. In the current study, we utilized receiver operating characteristic (ROC) curves to obtain estimates of familiarity and recollection for pictures and words in patients with aMCI and healthy older controls. Analysis of accuracy shows that even when performance is matched between pictures and words in the healthy control group, patients with aMCI continue to show a significant picture superiority effect. The results of the ROC analysis showed that patients demonstrated significantly impaired recollection and familiarity for words compared controls. In contrast, patients with aMCI demonstrated impaired recollection, but intact familiarity for pictures, compared to controls. Based on previous work from our lab, we speculate that patients can utilize the rich conceptual information provided by pictures to enhance familiarity, and perceptual information may allow for post-retrieval monitoring or verification of the enhanced sense of familiarity. Alternatively, the combination of enhanced conceptual and perceptual fluency of the test item might drive a stronger or more robust sense of familiarity that can be accurately attributed to a studied item. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Memorial familiarity remains intact for pictures but not for words in patients with amnestic mild cognitive impairment

    PubMed Central

    Embree, Lindsay M.; Budson, Andrew E.; Ally, Brandon A.

    2012-01-01

    Understanding how memory breaks down in the earliest stages of the Alzheimer’s disease (AD) process has significant implications, both clinically and with respect to intervention development. Previous work has highlighted a robust picture superiority effect in patients with amnestic mild cognitive impairment (aMCI). However, it remains unclear as to how pictures improve memory compared to words in this patient population. In the current study, we utilized receiver operating characteristic (ROC) curves to obtain estimates of familiarity and recollection for pictures and words in patients with aMCI and healthy older controls. Analysis of accuracy shows that even when performance is matched between pictures and words in the healthy control group, patients with aMCI continue to show a significant picture superiority effect. The results of the ROC analysis showed that patients demonstrated significantly impaired recollection and familiarity for words compared controls. In contrast, patients with aMCI demonstrated impaired recollection, but intact familiarity for pictures, compared to controls. Based on previous work from our lab, we speculate that patients can utilize the rich conceptual information provided by pictures to enhance familiarity, and perceptual information may allow for post-retrieval monitoring or verification of the enhanced sense of familiarity. Alternatively, the combination of enhanced conceptual and perceptual fluency of the test item might drive a stronger or more robust sense of familiarity that can be accurately attributed to a studied item. PMID:22705441

  5. Premedication with Oral Alprazolam and Melatonin Combination: A Comparison with Either Alone—A Randomized Controlled Factorial Trial

    PubMed Central

    Pokharel, Krishna; Tripathi, Mukesh; Gupta, Pramod Kumar; Khatiwada, Sindhu; Subedi, Asish

    2014-01-01

    We assessed if the addition of melatonin to alprazolam has superior premedication effects compared to either drug alone. A prospective, double blind placebo controlled trial randomly assigned 80 adult patients (ASA 1&2) with a Visual Analogue Score (VAS) for anxiety ≥3 to receive a tablet containing a combination of alprazolam 0.5 mg and melatonin 3 mg, alprazolam 0.5 mg, melatonin 3 mg, or placebo orally 90 min before a standard anesthetic. Primary end points were change in anxiety and sedation score at 15, 30, and 60 min after premedication, and number of patients with loss of memory for the five pictures shown at various time points when assessed after 24 h. One-way ANOVA, Friedman repeated measures analysis of variance, Kruskal Wallis and chi square tests were used as relevant. Combination drug produced the maximum reduction in anxiety VAS (3 (1.0–4.3)) from baseline at 60 min (P < 0.05). Sedation scores at various time points and number of patients not recognizing the picture shown at 60 min after premedication were comparable between combination drug and alprazolam alone. Addition of melatonin to alprazolam had superior anxiolysis compared with either drugs alone or placebo. Adding melatonin neither worsened sedation score nor the amnesic effect of alprazolam alone. This study was registered, approved, and released from ClinicalTrials.gov. Identifier number: NCT01486615. PMID:24527443

  6. Lister vaccine strain of vaccinia virus armed with the endostatin-angiostatin fusion gene: an oncolytic virus superior to dl1520 (ONYX-015) for human head and neck cancer.

    PubMed

    Tysome, James R; Wang, Pengju; Alusi, Ghassan; Briat, Arnaud; Gangeswaran, Rathi; Wang, Jiwei; Bhakta, Vipul; Fodor, Istvan; Lemoine, Nick R; Wang, Yaohe

    2011-09-01

    Oncolytic viral therapy represents a promising strategy for the treatment of head and neck squamous cell carcinoma (HNSCC), with dl1520 (ONYX-015) the most widely used oncolytic adenovirus in clinical trials. This study aimed to determine the effectiveness of the Lister vaccine strain of vaccinia virus as well as a vaccinia virus armed with the endostatin-angiostatin fusion gene (VVhEA) as a novel therapy for HNSCC and to compare them with dl1520. The potency and replication of the Lister strain and VVhEA and the expression and function of the fusion protein were determined in human HNSCC cells in vitro and in vivo. Finally, the efficacy of VVhEA was compared with dl1520 in vivo in a human HNSCC model. The Lister vaccine strain of vaccinia virus was more effective than the adenovirus against all HNSCC cell lines tested in vitro. Although the potency of VVhEA was attenuated in vitro, the expression and function of the endostatin-angiostatin fusion protein was confirmed in HNSCC models both in vitro and in vivo. This novel vaccinia virus (VVhEA) demonstrated superior antitumor potency in vivo compared with both dl1520 and the control vaccinia virus. This study suggests that the Lister strain vaccinia virus armed with an endostatin-angiostatin fusion gene may be a potential therapeutic agent for HNSCC.

  7. Effectiveness of Adaptive Statistical Iterative Reconstruction for 64-Slice Dual-Energy Computed Tomography Pulmonary Angiography in Patients With a Reduced Iodine Load: Comparison With Standard Computed Tomography Pulmonary Angiography.

    PubMed

    Lee, Ji Won; Lee, Geewon; Lee, Nam Kyung; Moon, Jin Il; Ju, Yun Hye; Suh, Young Ju; Jeong, Yeon Joo

    2016-01-01

    The aim of the study was to assess the effectiveness of the adaptive statistical iterative reconstruction (ASIR) for dual-energy computed tomography pulmonary angiography (DE-CTPA) with a reduced iodine load. One hundred forty patients referred for chest CT were randomly divided into a DE-CTPA group with a reduced iodine load or a standard CTPA group. Quantitative and qualitative image qualities of virtual monochromatic spectral (VMS) images with filtered back projection (VMS-FBP) and those with 50% ASIR (VMS-ASIR) in the DE-CTPA group were compared. Image qualities of VMS-ASIR images in the DE-CTPA group and ASIR images in the standard CTPA group were also compared. All quantitative and qualitative indices, except attenuation value of pulmonary artery in the VMS-ASIR subgroup, were superior to those in the VMS-FBP subgroup (all P < 0.001). Noise and signal-to-noise ratio of VMS-ASIR images were superior to those of ASIR images in the standard CTPA group (P < 0.001 and P = 0.007, respectively). Regarding qualitative indices, noise was significantly lower in VMS-ASIR images of the DE-CTPA group than in ASIR images of the standard CTPA group (P = 0.001). The ASIR technique tends to improve the image quality of VMS imaging. Dual-energy computed tomography pulmonary angiography with ASIR can reduce contrast medium volume and produce images of comparable quality with those of standard CTPA.

  8. A 6-month follow-up of an RCT on behavioral and neurocognitive effects of neurofeedback in children with ADHD.

    PubMed

    Geladé, Katleen; Janssen, Tieme W P; Bink, Marleen; Twisk, Jos W R; van Mourik, Rosa; Maras, Athanasios; Oosterlaan, Jaap

    2018-05-01

    To assess the long-term effects of neurofeedback (NFB) in children with attention deficit hyperactivity disorder (ADHD), we compared behavioral and neurocognitive outcomes at a 6-month naturalistic follow-up of a randomized controlled trial on NFB, methylphenidate (MPH), and physical activity (PA). Ninety-two children with a DSM-IV-TR ADHD diagnosis, aged 7-13, receiving NFB (n = 33), MPH (n = 28), or PA (n = 31), were re-assessed 6-months after the interventions. NFB comprised theta/beta training on the vertex (cortical zero). PA comprised moderate to vigorous intensity exercises. Outcome measures included parent and teacher behavioral reports, and neurocognitive measures (auditory oddball, stop-signal, and visual spatial working memory tasks). At follow-up, longitudinal hierarchical multilevel model analyses revealed no significant group differences for parent reports and neurocognitive measures (p = .058-.997), except for improved inhibition in MPH compared to NFB (p = .040) and faster response speed in NFB compared to PA (p = .012) during the stop-signal task. These effects, however, disappeared after controlling for medication use at follow-up. Interestingly, teacher reports showed less inattention and hyperactivity/impulsivity at follow-up for NFB than PA (p = .004-.010), even after controlling for medication use (p = .013-.036). Our findings indicate that the superior results previously found for parent reports and neurocognitive outcome measures obtained with MPH compared to NFB and PA post intervention became smaller or non-significant at follow-up. Teacher reports suggested superior effects of NFB over PA; however, some children had different teachers at follow-up. Therefore, this finding should be interpreted with caution. Clinical trial registration Train your brain and exercise your heart? Advancing the treatment for Attention Deficit Hyperactivity Disorder (ADHD), Ref. no. NCT01363544, https://clinicaltrials.gov/show/NCT01363544 .

  9. Biomechanical Comparison of Superior Versus Anterior Plate Position for Fixation of Distal Clavicular Fractures: A New Model.

    PubMed

    Wilkerson, James; Paryavi, Ebrahim; Kim, Hyunchul; Murthi, Anand; Pensy, Raymond A

    2017-01-01

    Although most clavicular fractures are amenable to nonoperative management, metadiaphyseal fractures are considerably more complex, with rates of suboptimal healing as high as 75% when treated nonoperatively. The poor results are ascribed to the deforming forces on the distal clavicle from the surrounding muscles and the weight of the arm. It recently has been noted that some operative fixations of these fractures are also failing when a standard superiorly placed plate is used. We hypothesized that anterior plating, when compared with superior plating, improves the strength and durability of the construct by redirecting the axis of the major deforming force across rather than in line with the screws of the construct. Six pairs of fresh-frozen human cadaveric clavicles with the scapula attached by the coracoclavicular ligaments were osteotomized just medial to the ligaments and plated with a standard 3.5-mm limited-contact dynamic compression plate. Specimens were potted and mounted on a materials testing system machine, preserving the anatomic relationship of the clavicle and scapula. They were then loaded through the coracoclavicular ligaments to mimic the weight of the arm pulling inferiorly. Each specimen was loaded with 375 N at 1 Hz for 2000 cycles. Sequential loading was then applied at 25-N intervals until failure. Statistical analysis was performed using a Wilcoxon signed-rank test. The superiorly plated specimens failed after fewer cycles and with lower force than the anteriorly plated specimens. The median number of cycles to failure was 2082 for anterior plated specimens and 50 for superiorly plated (P = 0.028). The median load to failure was 587.5 N in the anterior group and 375 N in the superior group (P = 0.035). The median stiffness was 46.13 N/mm for anterior and 40.45 N/mm for superior (P = 0.375) plates. Anteriorly plated distal third clavicular fractures have superior strength and durability compared with fractures plated superiorly when using a physician-contoured, 3.5-mm, limited-contact, dynamic compression plate in this cadaver model.

  10. Strategic Management: An Evaluation of the Use of Three Learning Methods.

    ERIC Educational Resources Information Center

    Jennings, David

    2002-01-01

    A study of 46 management students compared three methods for learning strategic management: cases, simulation, and action learning through consulting projects. Simulation was superior to action learning on all outcomes and equal or superior to cases on two. Simulation gave students a central role in management and greater control of the learning…

  11. ROSGREN STREAM TYPES AS A TOOL FOR PREDICTING BEDLOAD AND SUSPENDED SEDIMENT EXPORT IN LOW-ORDER LAKE SUPERIOR WATERSHEDS

    EPA Science Inventory

    Bedload samples were collected from 48 second and third order Lake Superior tributaries during snowmelt in 1998 and 1999. Suspended sediment samples were collected over a three-year period during baseflow, rain events, and snowmelt. This work was part of a comparative watershed...

  12. Why Is Visual Search Superior in Autism Spectrum Disorder?

    ERIC Educational Resources Information Center

    Joseph, Robert M.; Keehn, Brandon; Connolly, Christine; Wolfe, Jeremy M.; Horowitz, Todd S.

    2009-01-01

    This study investigated the possibility that enhanced memory for rejected distractor locations underlies the superior visual search skills exhibited by individuals with autism spectrum disorder (ASD). We compared the performance of 21 children with ASD and 21 age- and IQ-matched typically developing (TD) children in a standard static search task…

  13. Comparing Behavior Modification Approaches to Habit Decrement--Smoking

    ERIC Educational Resources Information Center

    Wagner, M. K.; Bragg, R. A.

    1970-01-01

    Five methods for control of smoking were tested on 54 Ss using systematic desensitization (SD), covert sensitization (CS), a combination of SD and CS (SD-CS), relaxation, and counseling. The SD-CS treatment was superior at all points during the treatment, though not significantly superior to all other treatments at all time points. Reprints from…

  14. REGIONAL, WATERSHED, AND SITE-SPECIFIC ENVIRONMENTAL INFLUENCES ON FISH ASSEMBLAGE STRUCTURE AND FUNCTION IN WESTERN LAKE SUPERIOR TRIBUTARIES

    EPA Science Inventory

    The relative importance of regional, watershed, and in-stream environmental factors on stream fish assemblage structure and function was investigated as part of a comparative watershed project in the western Lake Superior basin. We selected 48 second and third order watersheds fr...

  15. The diagnostic utility of 3D-ESI rotating and moving dipole methodology in the pre-surgical evaluation of MRI-negative childhood epilepsy due to focal cortical dysplasia.

    PubMed

    Russo, Angelo; Lallas, Matt; Jayakar, Prasanna; Miller, Ian; Hyslop, Ann; Dunoyer, Catalina; Resnick, Trevor; Duchowny, Michael

    2016-09-01

    This study investigates whether a combined rotating dipole (RD) and moving dipole (MD) solution enhances three-dimensional electroencephalography (EEG) source imaging (3D-ESI) localization in magnetic resonance imaging (MRI)-negative pediatric patients with focal cortical dysplasia (FCD). We retrospectively selected 14 MRI-negative patients with FCD from a cohort of 60 pediatric patients previously used to evaluate the diagnostic utility of 3D-ESI in epilepsy surgery. Patients were younger than 18 years at time of surgery and had at least 1 year of outcome data. RD and MD models were constructed for each interictal spike or sharp wave, and it was determined whether each inverse algorithm localized within the surgical resection cavity (SRC). We also compared the 3D-ESI findings and surgical outcome with positron emission tomography (PET) and ictal single photon emission computed tomography (iSPECT). RD analyses revealed a high concordance with the SRC (78.6%), particularly for temporal lobe resection (100.0%), and showed superior localization compared to PET and iSPECT, with the highest correlation in FCD type I and temporal lobe resection. Furthermore, the RD method was superior to iSPECT in FCD type II cases and to PET in extratemporal resections. RD and MD results were comparable, but in 18.2% of patients with FCD type I with localizing RDs, the MD solution was only partially within the SRC; in all of these patients 3D-ESI also correlated with superior surgical outcome compared to PET and iSPECT, especially when RD and MD solutions were analyzed together. 3D-ESI in MRI-negative cases showed superior localization compared to iSPECT or PET, especially in FCD type I and temporal lobe epilepsy, and correlated with superior surgical outcome compared to iSPECT and PET at 1 year and 2 years postoperatively, especially when RD and MD solutions were analyzed together. These findings suggest that 3D-ESI based on a combined RD-MD solution improves surgical accuracy in MRI-negative patients with FCD. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

  16. Minimizing the Maximum Expected Sample Size in Two-Stage Phase II Clinical Trials with Continuous Outcomes

    PubMed Central

    Wason, James M. S.; Mander, Adrian P.

    2012-01-01

    Two-stage designs are commonly used for Phase II trials. Optimal two-stage designs have the lowest expected sample size for a specific treatment effect, for example, the null value, but can perform poorly if the true treatment effect differs. Here we introduce a design for continuous treatment responses that minimizes the maximum expected sample size across all possible treatment effects. The proposed design performs well for a wider range of treatment effects and so is useful for Phase II trials. We compare the design to a previously used optimal design and show it has superior expected sample size properties. PMID:22651118

  17. Abnormal frontoparietal synaptic gain mediating the P300 in patients with psychotic disorder and their unaffected relatives.

    PubMed

    Díez, Álvaro; Ranlund, Siri; Pinotsis, Dimitris; Calafato, Stella; Shaikh, Madiha; Hall, Mei-Hua; Walshe, Muriel; Nevado, Ángel; Friston, Karl J; Adams, Rick A; Bramon, Elvira

    2017-06-01

    The "dysconnection hypothesis" of psychosis suggests that a disruption of functional integration underlies cognitive deficits and clinical symptoms. Impairments in the P300 potential are well documented in psychosis. Intrinsic (self-)connectivity in a frontoparietal cortical hierarchy during a P300 experiment was investigated. Dynamic Causal Modeling was used to estimate how evoked activity results from the dynamics of coupled neural populations and how neural coupling changes with the experimental factors. Twenty-four patients with psychotic disorder, twenty-four unaffected relatives, and twenty-five controls underwent EEG recordings during an auditory oddball paradigm. Sixteen frontoparietal network models (including primary auditory, superior parietal, and superior frontal sources) were analyzed and an optimal model of neural coupling, explaining diagnosis and genetic risk effects, as well as their interactions with task condition were identified. The winning model included changes in connectivity at all three hierarchical levels. Patients showed decreased self-inhibition-that is, increased cortical excitability-in left superior frontal gyrus across task conditions, compared with unaffected participants. Relatives had similar increases in excitability in left superior frontal and right superior parietal sources, and a reversal of the normal synaptic gain changes in response to targets relative to standard tones. It was confirmed that both subjects with psychotic disorder and their relatives show a context-independent loss of synaptic gain control at the highest hierarchy levels. The relatives also showed abnormal gain modulation responses to task-relevant stimuli. These may be caused by NMDA-receptor and/or GABAergic pathologies that change the excitability of superficial pyramidal cells and may be a potential biological marker for psychosis. Hum Brain Mapp 38:3262-3276, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  18. Manual treatment effects to the upper cervical apophysial joints before, during, and after endotracheal anesthesia: a placebo-controlled comparison.

    PubMed

    Buchmann, Johannes; Wende, Klaus; Kundt, Guenther; Haessler, Frank

    2005-04-01

    In this preliminary, placebo-controlled clinical trial, two different manual treatments were compared, spinal manipulation and postisometric relaxation, for dysfunctional motion segments of the upper cervical spinal column. The influence of the muscular portion on the joint-play restriction of a motion segment can be ignored in anesthesia, and the manual evaluation of this joint-play restriction must be focused on nonmuscular structures. By retesting in anesthesia, it is possible to examine whether mobilization and manipulation affect exclusively the muscular structures or also affect the other parts of the motion segment. Conclusions can be drawn about the superiority of one or both treatments and about the structural basis of the restricted joint play and its palpation. A total of 26 inpatients at the surgical or orthopedic department of the University of Rostock were examined manually at four testing times: before and after manual treatment, in anesthesia, and within 24 hrs of completing anesthesia. They were randomized into three groups: postisometric relaxation (mobilization), spinal manipulation (thrust technique), and placebo. A highly significant effect for both treatments was found posttherapeutically (P < 0.01) but not for placebo. In anesthesia, the treatment effect of spinal manipulation was further significant (P < 0.01) when compared with placebo. For postisometric relaxation, however, it was not (P = 0.160). A significant difference between spinal manipulation and postisometric relaxation was not found in anesthesia (P = 0.137). The treatment effect postnarcotically was further significant when compared with placebo only for spinal manipulation (P = 0.011). Both treatments are superior to placebo. Postisometric relaxation seems to affect mainly the muscular parts of the treated segments and less so the other parts, such as the joint capsule or the segmental affiliated ligaments and fascia. Spinal manipulation seems to influence all other segmental parts more effectively, and the treatment effect persists longer. A joint-play restriction cannot be an exclusively muscular tension phenomenon. Segmental motion dysfunctions show a high variability in their spontaneous course.

  19. Systematic Review of Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome

    PubMed Central

    Qin, Zongshi; Wu, Jiani; Zhou, Jing; Liu, Zhishun

    2016-01-01

    Abstract Acupuncture is a promising therapy for relieving symptoms in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), which affects >15% of adult men worldwide. The aim of the study was to assess the effects and safety of the use of acupuncture for CP/CPPS. MEDLINE, EMBASE, CENTRAL, Web of Science, CBM, CNKI, Wang-Fang Database, JCRM, and CiNii were searched from their inception through 30 November 2015. Grey literature databases and websites were also searched. No language limits were applied. Only randomized controlled trials (RCTs) with CP/CPPS treated by acupuncture were included. Two reviewers extracted data and assessed the risk of bias of RCTs using the Cochrane Risk of Bias Tools, respectively. Seven trials were included, involving 471 participants. The result of meta-analysis indicated that compared with sham acupuncture (MD: −6.09 [95%CI: −8.12 to −5.68]) and medicine (Levofloxacinand, Ibuprofen, and Tamsulosin) (MD: −4.57 [95%CI: −7.58 to −1.56]), acupuncture was more effective at decreasing the total NIH-CPSI score. Real acupuncture was superior to sham acupuncture in improving symptoms (pain, voiding) and quality of life (Qof) domain subscores. Compared to sham acupuncture and medicine, acupuncture appears to be more effective at improving the global assessment. Two trials found that there is no significant difference between acupuncture and sham acupuncture in decreasing the IPSS score. Acupuncture failed to show more favorable effects in improving both symptoms and the Qof domain compared with medicine. Overall, current evidence supports acupuncture as an effective treatment for CP/CPPS-induced symptoms, particularly in relieving pain. Based on the meta-analysis, acupuncture is superior to sham acupuncture in improving symptoms and Qof. Acupuncture might be similar to medicine (Levofloxacinand, Ibuprofen, and Tamsulosin) in its long-term effects, but evidence was limited due to high ROB among included trials as well as potential heterogeneity. Acupuncture is associated with rare and slightly adverse events. Protocol registration PROSPERO CRD42015027522. PMID:26986148

  20. Cost-effectiveness of artemisinin-naphthoquine versus artemether-lumefantrine for the treatment of uncomplicated malaria in Papua New Guinean children.

    PubMed

    Moore, Brioni R; Davis, Wendy A; Clarke, Philip M; Robinson, Leanne J; Laman, Moses; Davis, Timothy M E

    2017-10-30

    A recent randomized trial showed that artemisinin-naphthoquine (AN) was non-inferior to artemether-lumefantrine (AL) for falciparum malaria and superior for vivax malaria in young Papua New Guinean children. The aim of this study was to compare the cost-effectiveness of these two regimens. An incremental cost-effectiveness analysis was performed using data from 231 children with Plasmodium falciparum and/or Plasmodium vivax infections in an open-label, randomized, parallel-group trial. Recruited children were randomized 1:1 to receive once daily AN for 3 days with water or twice daily AL for 3 days given with fat. World Health Organisation (WHO) definitions were used to determine clinical/parasitological outcomes. The cost of transport between the home and clinic, plus direct health-care costs, served as a basis for determining each regimen's incremental cost per incremental treatment success relative to AL by Day 42 and its cost per life year saved. In the usual care setting, AN was more effective for the treatment of uncomplicated malaria in children aged 0.5-5.9 years. AL and AN were equally efficacious for the treatment of falciparum malaria, however AN had increased anti-malarial treatment costs per patient of $10.46, compared with AL. AN was the most effective regimen for treatment of vivax malaria, but had increased treatment costs of $14.83 per treatment success compared with AL. Whilst AN has superior overall efficacy for the treatment of uncomplicated malaria in PNG children, AL was the less costly regimen. An indicative extrapolation estimated the cost per life year saved by using AN instead of AL to treat uncomplicated malaria to be $12,165 for girls and $12,469 for boys (discounted), which means AN may not be cost-effective and affordable for PNG at current cost. However, AN may become acceptable should it become WHO prequalified and/or should donated/subsidized drug supply become available.

  1. What is the superior surgical strategy for bi-level cervical spondylosis-anterior cervical disc replacement or anterior cervical decompression and fusion?: A meta-analysis from 11 studies.

    PubMed

    Zhao, He; Duan, Li-Jun; Gao, Yu-Shan; Yang, Yong-Dong; Tang, Xiang-Sheng; Zhao, Ding-Yan; Xiong, Yang; Hu, Zhen-Guo; Li, Chuan-Hong; Yu, Xing

    2018-03-01

    Nowadays, anterior cervical artificial disc replacement (ACDR) has achieved favorable outcomes in treatment for patients with single-level cervical spondylosis. However, It is still controversial that whether or not it will become a potent therapeutic alternation in treating 2 contiguous levels cervical spondylosis compared with anterior cervical decompression and fusion (ACDF). Therefore, we conducted a systematic review and meta-analysis to compare the efficacy and safety of ACDR and ACDF in patients with 2 contiguous levels cervical spondylosis. According to the computer-based online search, PubMed, Embase, Web of Science, and Cochrane Library for articles published before July 1, 2017 were searched. The following outcome measures were extracted: neck disability index (NDI), visual analog scale (VAS) neck, VAS arm, Short Form (SF)-12 mental component summary (MCS), SF-12 physical component summary (PCS), overall clinical success (OCS), patient satisfaction (PS), device-related adverse event (DRAE), subsequent surgical intervention (SSI), neurological deterioration (ND), and adjacent segment degeneration (ASD). Methodological quality was evaluated independently by 2 reviewers using the Furlan for randomized controlled trial (RCT) and MINORS scale for clinical controlled trials (CCT). The chi-squared test and Higgin I test were used to evaluate the heterogeneity. A P < .10 for the chi-squared test or I values exceeding 50% indicated substantial heterogeneity and a random-effect model was applied; otherwise, a fixed-effect model was used. All quantitative data were analyzed by the Review Manager 5.2 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). Nine RCTs and 2 CCT studies containing 2715 patients were included for this meta-analysis. The pooled analysis indicated that the ACDR group is superior to ACDF in NDI, VAS neck, PCS score, OCS, PS, DRAE, ASD, and SSI. However, the pooled results indicate that there was no significant difference in the ND, VAS arm and in MCS score. The present meta-analysis suggests that for bi-level cervical spondylosis, ACDR appears to provide superior clinical effectiveness and safety effects than ACDF. In the future, more high-quality RCTs are warranted to enhance this conclusion.

  2. Flat-panel-detector chest radiography: effect of tube voltage on image quality.

    PubMed

    Uffmann, Martin; Neitzel, Ulrich; Prokop, Mathias; Kabalan, Nahla; Weber, Michael; Herold, Christian J; Schaefer-Prokop, Cornelia

    2005-05-01

    To compare the visibility of anatomic structures in direct-detector chest radiographs acquired with different tube voltages at equal effective doses to the patient. The study protocol was approved by the institutional internal review board, and written informed consent was obtained from all patients. Posteroanterior chest radiographs of 48 consecutively selected patients were obtained at 90, 121, and 150 kVp by using a flat-panel-detector unit that was based on cesium iodide technology and automated exposure control. Monte Carlo simulations were used to verify that the effective dose for all kilovoltage settings was equal. Five radiologists subjectively and independently rated the delineation of anatomic structures on hard-copy images by using a five-point scale. They also ranked image quality in a blinded side-by-side comparison. Average ranking scores were compared by using one-way analysis of variance with repeated measures. Data were analyzed for the entire patient group and for two patient subgroups that were formed according to body mass index (BMI). The visibility scores of most anatomic structures were significantly superior with the 90-kVp images (mean score, 3.11), followed by the 121-kVp (mean score, 2.95) and 150-kVp images (mean score, 2.80). Differences did not reach significance (P > .05) only for the delineation of the peripheral vessels, the heart contours, and the carina. This was also true for the subgroup of patients (n = 24) with a BMI greater than and the subgroup of patients (n = 24) with a BMI less than the mean BMI (26.9 kg/m(2)). At side-by-side comparison, the readers rated 90-kVp images as having superior image quality in the majority of image triplets; the percentage of 90-kVp images rated as "first choice" ranged from 60% (29 of 48 patients) to 90% (43 of 48 patients), with a median of 88% (42 of 48 patients), among the readers. Delineation of most anatomic structures and overall image quality were ranked superior in digital radiographs acquired with lower kilovoltage at a constant effective patient dose. (c) RSNA, 2005.

  3. [Opioids in chronic noncancer pain-are opioids superior to nonopioid analgesics? A systematic review and meta-analysis of efficacy, tolerability and safety in randomized head-to-head comparisons of opioids versus nonopioid analgesics of at least four week's duration].

    PubMed

    Welsch, P; Sommer, C; Schiltenwolf, M; Häuser, W

    2015-02-01

    Some leading German pain medicine experts postulate that there is a type of chronic non-cancer pain (CNCP) with an opioid requirement. We tested whether opioids are superior to nonopioid analgesics in the management of CNCP in studies of at least 4 week's duration. We screened MEDLINE, Scopus and the Cochrane Central Register of Controlled Trials (CENTRAL) up until October 2013, as well as the reference sections of original studies and systematic reviews of randomised controlled trials (RCTs) of opioids in CNCP. We included double-blind RTCs comparing opioids to nonopioid analgesics of at least 4 week's duration. Relative risks differences (RD) of categorical data and standardized mean differences (SMD) of continuous variables were calculated using a random effects model. We included 10 RCTs with 3046 participants. Median study duration was 6 weeks (range 4-12 weeks). Five studies compared tramadol with nonsteroidal anti-inflammatory drugs (NSAIDs) in osteoarthritis pain and one trial compared tramadol to flupirtine in low back pain. Morphine was compared to antidepressants (two studies), an anticonvulsant (one study) and an antiarrhythmic (one study) in different neuropathic pain syndromes. There was no significant difference between opioids and nonopioid analgesics in pain reduction (SMD 0.03 [95 % confidence interval, CI - 0.18, 0.24]; p = 0.76). Nonopioid analgesics were superior to opioids in improving physical function (SMD 0.17 [95 % CI 0.02, 0.32]; p = 0.03). Patients dropped out due to adverse events more frequently with opioids than with nonopioid analgesics (RD 0.09 [95 % CI 0.06, 0.13]; p < 0.0001). There was no significant difference between opioids and nonopioid analgesics in terms of serious adverse events or dropout rates due to lack of efficacy. Nonopioid analgesics are superior to opioids in terms of improvement of physical function and tolerability in short-term (4-12 weeks) therapy of neuropathic, low back and osteoarthritis pain. Our results do not support the concept of an"opioid-requiring" CNCP. The English full-text version of this article is freely available at SpringerLink (under "Supplemental").

  4. Comparative safety and effectiveness of serotonin receptor antagonists in patients undergoing chemotherapy: a systematic review and network meta-analysis.

    PubMed

    Tricco, Andrea C; Blondal, Erik; Veroniki, Areti Angeliki; Soobiah, Charlene; Vafaei, Afshin; Ivory, John; Strifler, Lisa; Cardoso, Roberta; Reynen, Emily; Nincic, Vera; Ashoor, Huda; Ho, Joanne; Ng, Carmen; Johnson, Christy; Lillie, Erin; Antony, Jesmin; Roberts, Derek J; Hemmelgarn, Brenda R; Straus, Sharon E

    2016-12-23

    Although serotonin (5-HT 3 ) receptor antagonists are effective in reducing nausea and vomiting, they may be associated with increased cardiac risk. Our objective was to examine the comparative safety and effectiveness of 5-HT 3 receptor antagonists (e.g., dolasetron, granisetron, ondansetron, palonosetron, tropisetron) alone or combined with steroids for patients undergoing chemotherapy. We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials from inception until December 2015 for studies comparing 5-HT 3 receptor antagonists with each other or placebo in chemotherapy patients. The search results were screened, data were abstracted, and risk of bias was appraised by pairs of reviewers, independently. Random-effects meta-analyses and network meta-analyses (NMAs) were conducted. After screening 9226 citations and 970 full-text articles, we included 299 studies (n = 58,412 patients). None of the included studies reported harms for active treatment versus placebo. For NMAs on the risk of arrhythmia (primary outcome; three randomized controlled trials [RCTs], 627 adults) and mortality (secondary outcome; eight RCTs, 4823 adults), no statistically significant differences were observed between agents. A NMA on the risk of QTc prolongation showed a significantly greater risk for dolasetron + dexamethasone versus ondansetron + dexamethasone (four RCTs, 3358 children and adults, odds ratio 2.94, 95% confidence interval 2.13-4.17). For NMAs on the number of patients without nausea (44 RCTs, 11,664 adults, 12 treatments), number of patients without vomiting (63 RCTs, 15,460 adults, 12 treatments), and number of patients without chemotherapy-induced nausea or vomiting (27 RCTs, 10,924 adults, nine treatments), all agents were significantly superior to placebo. For a NMA on severe vomiting (10 RCTs, 917 adults), all treatments decreased the risk, but only ondansetron and ramosetron were significantly superior to placebo. According to a rank-heat plot with the surface under the cumulative ranking curve results, palonosetron + steroid was ranked the safest and most effective agent overall. Most 5-HT 3 receptor antagonists were relatively safe when compared with each other, yet none of the studies compared active treatment with placebo for harms. However, dolasetron + dexamethasone may prolong the QTc compared to ondansetron + dexamethasone. All agents were effective for reducing risk of nausea, vomiting, and chemotherapy-induced nausea or vomiting. This study was registered at PROSPERO: ( CRD42013003564 ).

  5. Superior anti-suicidal effects of electroconvulsive therapy in unipolar disorder and bipolar depression.

    PubMed

    Liang, Chih-Sung; Chung, Chi-Hsiang; Ho, Pei-Shen; Tsai, Chia-Kuang; Chien, Wu-Chien

    2017-12-11

    Electroconvulsive therapy (ECT) has long been believed to reduce suicidal tendencies in patients with affective disorders; however, ECT recipients, who constitute the most severely ill and suicidal patients, are not eligible to participate in head-to-head randomized controlled trials. Large-scale studies are required to investigate the anti-suicidal effects of ECT vs psychopharmacotherapy. A nationwide retrospective cohort study design was used. Data were obtained from the Taiwan National Health Insurance Research Database. Inpatients with unipolar disorder or bipolar disorder who received ECT (n = 487) were observed from 1 January 2000 to 31 December 2013 for suicide events. The non-ECT control cohort consisted of inpatients with psychopharmacotherapy randomly matched (ratio, 1:4) by age, sex, and diagnosis. After potential confounds had been accounted for, the adjusted hazard ratio (HR) was 0.803, indicating that ECT recipients showed a 19.7% lower risk of suicide than control individuals. The stratum-specific adjusted HR was 0.79 in patients with unipolar disorder (P = .041) and 0.923 in patients with bipolar disorder (P = .254). Upon further stratification of the patients with bipolar disorder by their affective states, the adjusted HR was 0.805 (P = .046) for bipolar depression, 1.048 for bipolar mania (P = .538), and 0.976 for mixed bipolar state (P = .126). Compared with psychopharmacotherapy, ECT exerted superior anti-suicidal effects in patients with unipolar disorder and bipolar depression; however, there was a lack of superior anti-suicidal effects of ECT in the treatment of patients with bipolar mania and mixed state. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Over-activation in bilateral superior temporal gyrus correlated with subsequent forgetting effect of Chinese words.

    PubMed

    Chen, Tzu-Ching; Kuo, Wen-Jui; Chiang, Ming-Chang; Tseng, Yi-Jhan; Lin, Yung-Yang

    2013-08-01

    We evaluated the subsequent memory and forgotten effects for Chinese using event-related fMRI. Sixteen normal subjects were recruited and performing incidental memory tasks where semantic decision was required during memory encoding. Consistent with previous studies, our results showed bilateral frontal regions as the main locus for the subsequent memory effect. However, contrast between miss and hit responses revealed larger activation in bilateral superior temporal gyrus. We proposed that larger activation in the superior temporal gyrus may reflect alteration of self-monitoring process which resulted in unsuccessful memory encoding for the miss items. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Dry-grind processing using amylase corn and superior yeast to reduce the exogenous enzyme requirements in bioethanol production.

    PubMed

    Kumar, Deepak; Singh, Vijay

    2016-01-01

    Conventional corn dry-grind ethanol production process requires exogenous alpha and glucoamylases enzymes to breakdown starch into glucose, which is fermented to ethanol by yeast. This study evaluates the potential use of new genetically engineered corn and yeast, which can eliminate or minimize the use of these external enzymes, improve the economics and process efficiencies, and simplify the process. An approach of in situ ethanol removal during fermentation was also investigated for its potential to improve the efficiency of high-solid fermentation, which can significantly reduce the downstream ethanol and co-product recovery cost. The fermentation of amylase corn (producing endogenous α-amylase) using conventional yeast and no addition of exogenous α-amylase resulted in ethanol concentration of 4.1 % higher compared to control treatment (conventional corn using exogenous α-amylase). Conventional corn processed with exogenous α-amylase and superior yeast (producing glucoamylase or GA) with no exogenous glucoamylase addition resulted in ethanol concentration similar to control treatment (conventional yeast with exogenous glucoamylase addition). Combination of amylase corn and superior yeast required only 25 % of recommended glucoamylase dose to complete fermentation and achieve ethanol concentration and yield similar to control treatment (conventional corn with exogenous α-amylase, conventional yeast with exogenous glucoamylase). Use of superior yeast with 50 % GA addition resulted in similar increases in yield for conventional or amylase corn of approximately 7 % compared to that of control treatment. Combination of amylase corn, superior yeast, and in situ ethanol removal resulted in a process that allowed complete fermentation of 40 % slurry solids with only 50 % of exogenous GA enzyme requirements and 64.6 % higher ethanol yield compared to that of conventional process. Use of amylase corn and superior yeast in the dry-grind processing industry can reduce the total external enzyme usage by more than 80 %, and combining their use with in situ removal of ethanol during fermentation allows efficient high-solid fermentation.

  8. Yoga practice is associated with superior motor imagery performance.

    PubMed

    Hartnoll, Susannah H; Punt, T David

    2017-11-01

    Yoga is an activity that aims to integrate physical, mental and spiritual elements and is an increasingly popular approach to enhancing physical fitness. The integration of imagery within yoga practice is considered an important component and may be critical in contributing to the benefits of yoga that have been reported. In this study, we tested whether individuals who practice yoga demonstrate superior performance on an objective measure of implicit motor imagery. Thirty-six participants (18 yoga, 18 non-yoga) matched for age, sex and handedness, undertook the hand laterality recognition task; an objective measure of implicit motor imagery performance. Accuracy and response times were gathered and analysed to determine any group differences as well as any differences relating to the typical hallmarks of imagery (i.e. dominance and awkwardness effects) on the task. Response Times (RTs) in the yoga group were significantly faster than controls (p < 0.05) and there was also a trend towards greater accuracy for the Yoga group (p = 0.073). Dominance effects (faster responses to images corresponding with the dominant limb) and Awkwardness effects (faster responses to images corresponding with natural compared with awkward postures) were evident across groups, supporting the participants' use of motor imagery in undertaking the task. Additionally, a Group × Awkwardness interaction (p < 0.05) revealed that the enhanced imagery performance for the yoga group was most pronounced for awkward postures. This is the first study to show that yoga practice is associated with superior motor imagery performance; an association that may be important in explaining the established rehabilitative value of yoga for chronic pain.

  9. Yoga practice is associated with superior motor imagery performance.

    PubMed

    Hartnoll, Susannah H; Punt, T David

    2017-08-02

    Yoga is an activity that aims to integrate physical, mental and spiritual elements and is an increasingly popular approach to enhancing physical fitness. The integration of imagery within yoga practice is considered an important component and may be critical in contributing to the benefits of yoga that have been reported. In this study, we tested whether individuals who practice yoga demonstrate superior performance on an objective measure of implicit motor imagery. Thirty-six participants (18 yoga, 18 nonyoga) matched for age, sex and handedness, undertook the hand laterality recognition task; an objective measure of implicit motor imagery performance. Accuracy and response times were gathered and analysed to determine any group differences as well as any differences relating to the typical hallmarks of imagery (i.e. dominance and awkwardness effects) on the task. Response Times (RTs) in the yoga group were significantly faster than controls (p < 0.05) and there was also a trend towards greater accuracy for the Yoga group (p = 0.073). Dominance effects (faster responses to images corresponding with the dominant limb) and Awkwardness effects (faster responses to images corresponding with natural compared with awkward postures) were evident across groups, supporting the participants' use of motor imagery in undertaking the task. Additionally, a Group × Awkwardness interaction (p < 0.05) revealed that the enhanced imagery performance for the yoga group was most pronounced for awkward postures. This is the first study to show that yoga practice is associated with superior motor imagery performance; an association that may be important in explaining the established rehabilitative value of yoga for chronic pain.

  10. The effects of moon illumination, moon angle, cloud cover, and sky glow on night vision goggle flight performance

    NASA Astrophysics Data System (ADS)

    Loro, Stephen Lee

    This study was designed to examine moon illumination, moon angle, cloud cover, sky glow, and Night Vision Goggle (NVG) flight performance to determine possible effects. The research was a causal-comparative design. The sample consisted of 194 Fort Rucker Initial Entry Rotary Wing NVG flight students being observed by 69 NVG Instructor Pilots. The students participated in NVG flight training from September 1992 through January 1993. Data were collected using a questionnaire. Observations were analyzed using a Kruskal-Wallis one-way analysis of variance and a Wilcox matched pairs signed-ranks test for difference. Correlations were analyzed using Pearson's r. The analyses results indicated that performance at high moon illumination levels is superior to zero moon illumination, and in most task maneuvers, superior to >0%--50% moon illumination. No differences were found in performance at moon illumination levels above 50%. Moon angle had no effect on night vision goggle flight performance. Cloud cover and sky glow have selective effects on different maneuvers. For most task maneuvers, cloud cover does not affect performance. Overcast cloud cover had a significant effect on seven of the 14 task maneuvers. Sky glow did not affect eight out of 14 task maneuvers at any level of sky glow.

  11. Update on ibuprofen for rheumatoid arthritis.

    PubMed

    Ward, J R

    1984-07-13

    In doses of 1,200 mg/day or more, ibuprofen is as effective as aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of rheumatoid arthritis. The tolerability and safety of ibuprofen are superior to those of aspirin and compare favorably with those of other NSAIDs. Although additional controlled trials are indicated to determine optimal dose, ibuprofen's excellent therapeutic index establishes it as a useful drug in the treatment of rheumatoid arthritis.

  12. Streamlining ICAT development through off-the shelf hypermedia systems

    NASA Technical Reports Server (NTRS)

    Orey, Michael; Trent, Ann; Young, James; Sanders, Michael

    1993-01-01

    This project examined the efficacy of building intelligent computer assisted training using an off-the-shelf hypermedia package. In addition, we compared this package to an architecture that had been developed in a previous contract which was based in the C programming language. One person developed a tutor in LinkWay (an off-the-shelf hypermedia system) and another developed the same tutor using the ALM C-based architecture. Development times, ease of use, learner preferences, learner options, and learning effectiveness were compared. In all cases, the off-the-shelf package was shown to be superior to the C-based system.

  13. LDR vs. HDR brachytherapy for localized prostate cancer: the view from radiobiological models.

    PubMed

    King, Christopher R

    2002-01-01

    Permanent LDR brachytherapy and temporary HDR brachytherapy are competitive techniques for clinically localized prostate radiotherapy. Although a randomized trial will likely never be conducted comparing these two forms of brachytherapy, a comparative radiobiological modeling analysis proves useful in understanding some of their intrinsic differences, several of which could be exploited to improve outcomes. Radiobiological models based upon the linear quadratic equations are presented for fractionated external beam, fractionated (192)Ir HDR brachytherapy, and (125)I and (103)Pd LDR brachytherapy. These models incorporate the dose heterogeneities present in brachytherapy based upon patient-derived dose volume histograms (DVH) as well as tumor doubling times and repair kinetics. Radiobiological parameters are normalized to correspond to three accepted clinical risk factors based upon T-stage, PSA, and Gleason score to compare models with clinical series. Tumor control probabilities (TCP) for LDR and HDR brachytherapy (as monotherapy or combined with external beam) are compared with clinical bNED survival rates. Predictions are made for dose escalation with HDR brachytherapy regimens. Model predictions for dose escalation with external beam agree with clinical data and validate the models and their underlying assumptions. Both LDR and HDR brachytherapy achieve superior tumor control when compared with external beam at conventional doses (<70 Gy), but similar to results from dose escalation series. LDR brachytherapy as boost achieves superior tumor control than when used as monotherapy. Stage for stage, both LDR and current HDR regimens achieve similar tumor control rates, in agreement with current clinical data. HDR monotherapy with large-dose fraction sizes might achieve superior tumor control compared with LDR, especially if prostate cancer possesses a high sensitivity to dose fractionation (i.e., if the alpha/beta ratio is low). Radiobiological models support the current clinical evidence for equivalent outcomes in localized prostate cancer with either LDR or HDR brachytherapy using current dose regimens. However, HDR brachytherapy dose escalation regimens might be able to achieve higher biologically effective doses of irradiation in comparison to LDR, and hence improved outcomes. This advantage over LDR would be amplified should prostate cancer possess a high sensitivity to dose fractionation (i.e., a low alpha/beta ratio) as the current evidence suggests.

  14. Impact of remuneration and organizational factors on completing preventive manoeuvres in primary care practices

    PubMed Central

    Dahrouge, Simone; Hogg, William E.; Russell, Grant; Tuna, Meltem; Geneau, Robert; Muldoon, Laura K.; Kristjansson, Elizabeth; Fletcher, John

    2012-01-01

    Background: Several jurisdictions attempting to reform primary care have focused on changes in physician remuneration. The goals of this study were to compare the delivery of preventive services by practices in four primary care funding models and to identify organizational factors associated with superior preventive care. Methods: In a cross-sectional study, we included 137 primary care practices in the province of Ontario (35 fee-for-service practices, 35 with salaried physicians [community health centres], 35 practices in the new capitation model [family health networks] and 32 practices in the established capitation model [health services organizations]). We surveyed 288 family physicians. We reviewed 4108 randomly selected patient charts and assigned prevention scores based on the proportion of eligible preventive manoeuvres delivered for each patient. Results: A total of 3284 patients were eligible for at least one of six preventive manoeuvres. After adjusting for patient profile and contextual factors, we found that, compared with prevention scores in practices in the new capitation model, scores were significantly lower in fee-for-service practices (β estimate for effect on prevention score = −6.3, 95% confidence interval [CI] −11.9 to −0.6) and practices in the established capitation model (β = −9.1, 95% CI −14.9 to −3.3) but not for those with salaried remuneration (β = −0.8, 95% CI −6.5 to 4.8). After accounting for physician characteristics and organizational structure, the type of funding model was no longer a statistically significant factor. Compared with reference practices, those with at least one female family physician (β = 8.0, 95% CI 4.2 to 11.8), a panel size of fewer than 1600 patients per full-time equivalent family physician (β = 6.8, 95% CI 3.1 to 10.6) and an electronic reminder system (β = 4.6, 95% CI 0.4 to 8.7) had superior prevention scores. The effect of these three factors was largely but not always consistent across the funding models; it was largely consistent across the preventive manoeuvres. Interpretation: No funding model was clearly associated with superior preventive care. Factors related to physician characteristics and practice structure were stronger predictors of performance. Practices with one or more female physicians, a smaller patient load and an electronic reminder system had superior prevention scores. Our findings raise questions about reform initiatives aimed at increasing patient numbers, but they support the adoption of information technology. PMID:22143227

  15. [Effect of electroacupuncture of different acupoints on the excitability of detrusor muscle and the expression of BDNF and TrkB in the spinal cord of rats with urinary retention due to spinal cord injury].

    PubMed

    Wang, Jun-hua; Chen, Bang-guo; Yin, Jing; Wang, Gang; Zou, Wei-Geng; Luo, Xiao-juan

    2009-12-01

    To observe the effect of electroacupuncture (EA) of different acupoints on the expression of brain-derived neurotrophic factor (BDNF) and tropomyosine receptor kinase B (TrkB) in the spinal cord and the excitability of detrusor muscle of the uninary bladder in rats with urinary retention owing to spinal cord injury (SCI). A total of 100 female SD rats were randomly divided into normal, sham-operation (sham), model, EA-Guanyuan (CV 4), and EA-Shuidao (ST 28) groups, with 20 cases in each. SCI induced urinary retention model was established by using weight dropping method. EA (1 mA, 2 Hz/15 Hz) was applied to "Guanyuan" (CV 4) and "Shuidao" (ST 28) respectively for 20 min, once a day for 10 days. The excitability (tone, contraction frequency) of the detrusor muscle of the bladder was detected in vitro by using electrophysiological method, and the expression of BDNF and TrkB in spinal cord was determined by immunohistochemistry staining. In comparison with normal control and sham groups, the tension and the contraction frequency of detrusor muscle in model group lowered significantly (P<0.05), while compared with model group, both the tension and contraction frequency of detrusor muscle increased pronouncedly in EA-CV 4 and EA-ST 28 groups (P<0.05), and the effect of EA-CV 4 was apparently superior to that of EA-ST 28 (P<0.05). In comparison with normal and sham groups, the BDNF and TrkB immunoreaction positive cells in the spinal cord were significantly more in model group (P<0.05). Compared with model group, those of EA-CV 4 and EA-ST 28 groups were obviously further increased (P<0.05), and the effect of EA-CV 4 group was markedly superior to that of EA-ST 28 group (P<0.05). EA of CV 4 and ST 28 can raise the excitability of the smooth muscle of the uninary bladder in rats with SCI-induced urinary retention, which may be related to its effects in upregulating the expression of BDNF and TrkB in the spinal cord. The effects of EA of CV 4 were evidently superior to those of EA of ST 28.

  16. Comparison of the immunogenicity and safety of the conventional subunit, MF59-adjuvanted, and intradermal influenza vaccines in the elderly.

    PubMed

    Seo, Yu Bin; Choi, Won Suk; Lee, Jacob; Song, Joon Young; Cheong, Hee Jin; Kim, Woo Joo

    2014-07-01

    The influenza vaccination is known as the most effective method for preventing influenza infection and its complications in the elderly. Conventional subunit (Agrippal S1; Novartis), MF59-adjuvanted (Fluad; Novartis), and intradermal (IDflu15; Sanofi Pasteur) influenza vaccines are widely used throughout South Korea. However, few comparative studies evaluating the safety and immunogenicity of these vaccines are available. Prior to the beginning of the 2011-2012 influenza season, 335 healthy elderly volunteers randomly received one of three seasonal trivalent influenza vaccines, the conventional subunit, MF59-adjuvanted, or intradermal influenza vaccine. Serum hemagglutination-inhibiting antibody levels were measured at the time of vaccination and at 1 and 6 months after vaccination. Adverse events were recorded prospectively. A total of 113 conventional subunit, 111 MF59-adjuvanted, and 111 intradermal influenza vaccine volunteers were followed up during a 6-month postvaccination period. One month after vaccination, all three vaccines satisfied Committee for Medical Products for Human Use (CHMP) immunogenicity criteria for the A/H1N1 and A/H3N2 strains but not for the B strain. Compared with the subunit vaccine, the intradermal vaccine exhibited noninferiority, while the MF59-adjuvanted vaccine exhibited superiority. Furthermore, the MF59-adjuvanted vaccine was more immunogenic against the A/H3N2 strain than was the subunit vaccine up to 6 months postvaccination. The most common local and systemic reactions to the conventional subunit, MF59-adjuvanted, and intradermal influenza vaccines were pain at the injection site (7.1%, 10.8%, and 6.3%, respectively) and generalized myalgia (0.9%, 8.1%, and 5.4%, respectively). Local and systemic reactions were similar among the three vaccine groups. MF59-adjuvanted vaccine exhibited superior immunogenicity compared with a conventional subunit vaccine and had a comparable safety profile. For older adults, the MF59-adjuvanted vaccine is preferable for providing superior immunogenicity. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  17. The neural bases of the multiplication problem-size effect across countries

    PubMed Central

    Prado, Jérôme; Lu, Jiayan; Liu, Li; Dong, Qi; Zhou, Xinlin; Booth, James R.

    2013-01-01

    Multiplication problems involving large numbers (e.g., 9 × 8) are more difficult to solve than problems involving small numbers (e.g., 2 × 3). Behavioral research indicates that this problem-size effect might be due to different factors across countries and educational systems. However, there is no neuroimaging evidence supporting this hypothesis. Here, we compared the neural correlates of the multiplication problem-size effect in adults educated in China and the United States. We found a greater neural problem-size effect in Chinese than American participants in bilateral superior temporal regions associated with phonological processing. However, we found a greater neural problem-size effect in American than Chinese participants in right intra-parietal sulcus (IPS) associated with calculation procedures. Therefore, while the multiplication problem-size effect might be a verbal retrieval effect in Chinese as compared to American participants, it may instead stem from the use of calculation procedures in American as compared to Chinese participants. Our results indicate that differences in educational practices might affect the neural bases of symbolic arithmetic. PMID:23717274

  18. Effect of hypoxia on the retina and superior colliculus of neonatal pigs

    PubMed Central

    Ruzafa, Noelia; Rey-Santano, Carmen; Mielgo, Victoria; Pereiro, Xandra; Vecino, Elena

    2017-01-01

    Purpose To evaluate the effect of hypoxia on the neonatal pig retina and brain, we analysed the retinal ganglion cells (RGCs) and neurons in the superior colliculus, as well as the response of astrocytes in both these central nervous system (CNS) structures. Methods Newborn pigs were exposed to 120 minutes of hypoxia, induced by decreasing the inspiratory oxygen fraction (FiO2: 10–15%), followed by a reoxygenation period of 240 minutes (FiO2: 21–35%). RGCs were quantified using Brn3a, a specific nuclear marker for these cells, and apoptosis was assessed through the appearance of active caspase-3. A morphometric analysis of the cytoskeleton of astrocytes (identified with GFAP) was performed in both the retina and superior colliculus. Results Hypoxia produced no significant change in the RGCs, although, it did induce a 37.63% increase in the number of active caspase-3 positive cells in the superior colliculus. This increase was particularly evident in the superficial layers of the superior colliculus, where 56.93% of the cells were positive for active caspase-3. In addition, hypoxia induced changes in the morphology of the astrocytes in the superior colliculus but not in the retina. Conclusions Hypoxia in the neonatal pig does not affect the retina but it does affect more central structures in the brain, increasing the number of apoptotic cells in the superior colliculus and inducing changes in astrocyte morphology. This distinct sensibility to hypoxia may pave the way to design specific approaches to combat the effects of hypoxia in specific areas of the CNS. PMID:28407001

  19. Femoroacetabular Impingement Is Associated With Sports-Related Posterior Hip Instability in Adolescents: A Matched-Cohort Study.

    PubMed

    Mayer, Stephanie W; Abdo, João Caetano Munhoz; Hill, Mary K; Kestel, Lauryn A; Pan, Zhaoxing; Novais, Eduardo N

    2016-09-01

    Femoroacetabular impingement (FAI) deformity has been associated with posterior hip instability in adult athletes. To determine if FAI deformity is associated with posterior hip instability in adolescents, the femoral head-neck junction or acetabular structure in a cohort of adolescent patients who sustained a low-energy, sports-related posterior hip dislocation was compared with that in a group of healthy age- and sex-matched controls with no history of hip injury or pain. Cross-sectional study; Level of evidence, 3. We identified 12 male patients (mean age, 13.9 years; range, 12-16 years) who sustained a sports-related posterior hip dislocation and underwent a computed tomography (CT) scan after closed reduction. For each patient, 3 age- and sex-matched healthy controls were identified. Femoral head-neck type was assessed by measurement of the alpha angle on the radially oriented CT images at the 12-, 1-, 2-, and 3-o'clock positions. Age, body mass index (BMI), alpha angle at each position, acetabular version, Tönnis angle, and lateral center-edge angle (LCEA) on the involved hip in the dislocation group were compared with those of the matched controls using a mixed-effects model. A logistic regression analysis using a generalized estimating equation was used to compare the percentage of subjects with cam-type FAI deformity (alpha angle >55°) in each group. The dislocation and control groups were similar in age distribution and BMI (P > .05). The mean alpha angles were statistically significantly higher in the dislocation group compared with the control group at the superior (46.3° ± 1.1° vs 42.7° ± 0.6°; P = .0213), superior-anterior (55.5° ± 1.9° vs 46.0° ± 1.3°; P = .0005), and anterior-superior (54.9° ± 1.5° vs 48.9° ± 1.0°; P = .0045) regions. Cam deformity was present in a larger proportion of patients in the dislocation group than in the control group (P < .0035). An alpha angle greater than 55° was present in 16.7% of the dislocation group and 0% of the control group at the 12-o'clock position (P = .1213), 41.7% versus 0% at the 1-o'clock position (P = .0034), 58% versus 6% at the 2-o'clock position (P = .0004), and 25% versus 2.8% at the 3-o'clock position (P = .0929). Acetabular anteversion was lower in the dislocation group (9.6° ± 1.4°) compared with the control group (15.1° ± 0.8°) (P = .0068). Mean acetabular LCEA was within a normal range in both groups. A significantly higher mean alpha angle from the superior to the anterior-superior regions of the femoral head-neck junction and lower acetabular version were found in adolescents who sustained low-energy, sports-related posterior hip dislocations. © 2016 The Author(s).

  20. Multilayered Electromagnetic Interference Shielding Structures for Suppressing Magnetic Field Coupling

    NASA Astrophysics Data System (ADS)

    Watanabe, Atom O.; Raj, Pulugurtha Markondeya; Wong, Denny; Mullapudi, Ravi; Tummala, Rao

    2018-05-01

    Control of electromagnetic interference (EMI) represents a major challenge for emerging consumer electronics, the Internet of Things, automotive electronics, and wireless communication systems. This paper discusses innovative EMI shielding materials and structures that offer higher shielding effectiveness compared with copper. To create high shielding effectiveness in the frequency range of 1 MHz to 100 MHz, multilayered shielding topologies with electrically conductive and nanomagnetic materials were modeled, designed, fabricated, and characterized. In addition, suppression of out-of-plane and in-plane magnetic-field coupling noise with these structures is compared with that of traditional single-layer copper or nickel-iron films. Compared with single-layered copper shields, multilayered structures consisting of copper, nickel-iron, and titanium showed a 3.9 times increase in shielding effectiveness in suppressing out-of-plane or vertically coupled noise and 1.3 times increase in lateral coupling. The superiority of multilayered thin-film shields over conventional shielding enables greater design flexibility, higher shielding effectiveness, and further miniaturization of emerging radiofrequency (RF) and power modules.

  1. Comparative effectiveness of light emitting diodes (LEDs) and Lasers in near infrared photoimmunotherapy

    PubMed Central

    Sato, Kazuhide; Watanabe, Rira; Hanaoka, Hirofumi; Nakajima, Takahito; Choyke, Peter L.; Kobayashi, Hisataka

    2016-01-01

    Near infrared photoimmunotherapy (NIR-PIT) is a new cancer treatment that combines the specificity of antibodies for targeting tumors with the toxicity induced by photosensitizers after exposure to near infrared (NIR) light. Herein we compare two NIR-light sources; light emitting diodes (LEDs) and Lasers, for their effectiveness in NIR-PIT. A photosensitizer, IRDye-700DX, conjugated to panitumumab (pan-IR700), was incubated with EGFR-expressing A431 and MDA-MB-468-luc cells. NIR-light was provided by LEDs or Lasers at the same light dose. Laser-light produced more cytotoxicity and greater reductions in IR700-fluorescence intensity than LED-light. Laser-light also produced more cytotoxicity in vivo in both cell lines. Assessment of super-enhanced permeability and retention (SUPR) effects were stronger with Laser than LED. These results suggest that Laser-light produced significantly more cytotoxic effects compared to LEDs. Although LED is less expensive, Laser-light produces superior results in NIR-PIT. PMID:26885688

  2. Comparative effectiveness of light emitting diodes (LEDs) and Lasers in near infrared photoimmunotherapy.

    PubMed

    Sato, Kazuhide; Watanabe, Rira; Hanaoka, Hirofumi; Nakajima, Takahito; Choyke, Peter L; Kobayashi, Hisataka

    2016-03-22

    Near infrared photoimmunotherapy (NIR-PIT) is a new cancer treatment that combines the specificity of antibodies for targeting tumors with the toxicity induced by photosensitizers after exposure to near infrared (NIR) light. Herein we compare two NIR-light sources; light emitting diodes (LEDs) and Lasers, for their effectiveness in NIR-PIT. A photosensitizer, IRDye-700DX, conjugated to panitumumab (pan-IR700), was incubated with EGFR-expressing A431 and MDA-MB-468-luc cells. NIR-light was provided by LEDs or Lasers at the same light dose. Laser-light produced more cytotoxicity and greater reductions in IR700-fluorescence intensity than LED-light. Laser-light also produced more cytotoxicity in vivo in both cell lines. Assessment of super-enhanced permeability and retention (SUPR) effects were stronger with Laser than LED. These results suggest that Laser-light produced significantly more cytotoxic effects compared to LEDs. Although LED is less expensive, Laser-light produces superior results in NIR-PIT.

  3. The effects of therapeutic climbing in patients with chronic low back pain: a randomized controlled study.

    PubMed

    Engbert, Kai; Weber, Michaela

    2011-05-15

    A randomized controlled study investigated the effects of therapeutic climbing in patients with chronic low back pain. Before and after 4 weeks of training, physical and mental well-being were measured by two questionnaires (36-Item Short Form Health Survey [SF-36]; Hannover Functional Ability Questionnaire for measuring back pain-related disability [FFbH-R]). Therapeutic climbing has been suggested to increase muscular strength and perceived physical and mental well-being. This study focused on the psychological effects of therapeutic climbing and compared it with standard exercise therapy. Therapeutic climbing has become increasingly popular in rehabilitation and its effects on muscular strengthening have been shown. Therapeutic climbing has also been suggested to yield psychological effects such as changes in attentional focus from pain to physical capabilities. To date, no controlled clinical trial has investigated these psychological effects and it is unclear whether therapeutic climbing is comparable or superior to other forms of exercise. Twenty-eight patients with chronic low back pain conducted either a therapeutic climbing or a standard exercise regime. Each program took 4 weeks, including four guided training sessions per week. Before and after the program, patients answered two questionnaires assessing their physical and mental well-being. For the Hannover Functional Ability Questionnaire for measuring back pain-related disability, there was no difference before versus after or between the treatments. For the SF-36, both treatments showed significant improvements in 3/8 subscales of the SF-36. In 2/8 subscales, only the participants of the therapeutic climbing improved and in 1/8 subscales the converse was true. Comparing both groups, significantly larger improvements were found after therapeutic climbing in two subscales of the SF-36: physical functioning and general health perception. The benefits of therapeutic climbing were comparable with those of a standard exercise regime. In two subscales of the SF-36, the benefits of therapeutic climbing exceeded those of standard exercise therapy, primarily in perceived health and physical functioning of the patients. This finding demonstrates that therapeutic climbing is equivalent and partly superior to standard exercise therapy for patients with chronic low back pain.

  4. Interactions of cognitive and auditory abilities in congenitally blind individuals.

    PubMed

    Rokem, Ariel; Ahissar, Merav

    2009-02-01

    Congenitally blind individuals have been found to show superior performance in perceptual and memory tasks. In the present study, we asked whether superior stimulus encoding could account for performance in memory tasks. We characterized the performance of a group of congenitally blind individuals on a series of auditory, memory and executive cognitive tasks and compared their performance to that of sighted controls matched for age, education and musical training. As expected, we found superior verbal spans among congenitally blind individuals. Moreover, we found superior speech perception, measured by resilience to noise, and superior auditory frequency discrimination. However, when memory span was measured under conditions of equivalent speech perception, by adjusting the signal to noise ratio for each individual to the same level of perceptual difficulty (80% correct), the advantage in memory span was completely eliminated. Moreover, blind individuals did not possess any advantage in cognitive executive functions, such as manipulation of items in memory and math abilities. We propose that the short-term memory advantage of blind individuals results from better stimulus encoding, rather than from superiority at subsequent processing stages.

  5. Superior voice recognition in a patient with acquired prosopagnosia and object agnosia.

    PubMed

    Hoover, Adria E N; Démonet, Jean-François; Steeves, Jennifer K E

    2010-11-01

    Anecdotally, it has been reported that individuals with acquired prosopagnosia compensate for their inability to recognize faces by using other person identity cues such as hair, gait or the voice. Are they therefore superior at the use of non-face cues, specifically voices, to person identity? Here, we empirically measure person and object identity recognition in a patient with acquired prosopagnosia and object agnosia. We quantify person identity (face and voice) and object identity (car and horn) recognition for visual, auditory, and bimodal (visual and auditory) stimuli. The patient is unable to recognize faces or cars, consistent with his prosopagnosia and object agnosia, respectively. He is perfectly able to recognize people's voices and car horns and bimodal stimuli. These data show a reverse shift in the typical weighting of visual over auditory information for audiovisual stimuli in a compromised visual recognition system. Moreover, the patient shows selectively superior voice recognition compared to the controls revealing that two different stimulus domains, persons and objects, may not be equally affected by sensory adaptation effects. This also implies that person and object identity recognition are processed in separate pathways. These data demonstrate that an individual with acquired prosopagnosia and object agnosia can compensate for the visual impairment and become quite skilled at using spared aspects of sensory processing. In the case of acquired prosopagnosia it is advantageous to develop a superior use of voices for person identity recognition in everyday life. Copyright © 2010 Elsevier Ltd. All rights reserved.

  6. Slowed Search in the Context of Unimpaired Grouping in Autism: Evidence from Multiple Conjunction Search.

    PubMed

    Keehn, Brandon; Joseph, Robert M

    2016-03-01

    In multiple conjunction search, the target is not known in advance but is defined only with respect to the distractors in a given search array, thus reducing the contributions of bottom-up and top-down attentional and perceptual processes during search. This study investigated whether the superior visual search skills typically demonstrated by individuals with autism spectrum disorder (ASD) would be evident in multiple conjunction search. Thirty-two children with ASD and 32 age- and nonverbal IQ-matched typically developing (TD) children were administered a multiple conjunction search task. Contrary to findings from the large majority of studies on visual search in ASD, response times of individuals with ASD were significantly slower than those of their TD peers. Evidence of slowed performance in ASD suggests that the mechanisms responsible for superior ASD performance in other visual search paradigms are not available in multiple conjunction search. Although the ASD group failed to exhibit superior performance, they showed efficient search and intertrial priming levels similar to the TD group. Efficient search indicates that ASD participants were able to group distractors into distinct subsets. In summary, while demonstrating grouping and priming effects comparable to those exhibited by their TD peers, children with ASD were slowed in their performance on a multiple conjunction search task, suggesting that their usual superior performance in visual search tasks is specifically dependent on top-down and/or bottom-up attentional and perceptual processes. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

  7. ERP correlates of recognition memory in Autism Spectrum Disorder.

    PubMed

    Massand, Esha; Bowler, Dermot M; Mottron, Laurent; Hosein, Anthony; Jemel, Boutheina

    2013-09-01

    Recognition memory in autism spectrum disorder (ASD) tends to be undiminished compared to that of typically developing (TD) individuals (Bowler et al. 2007), but it is still unknown whether memory in ASD relies on qualitatively similar or different neurophysiology. We sought to explore the neural activity underlying recognition by employing the old/new word repetition event-related potential effect. Behavioural recognition performance was comparable across both groups, and demonstrated superior recognition for low frequency over high frequency words. However, the ASD group showed a parietal rather than anterior onset (300-500 ms), and diminished right frontal old/new effects (800-1500 ms) relative to TD individuals. This study shows that undiminished recognition performance results from a pattern of differing functional neurophysiology in ASD.

  8. Superior performance of a paraaortic counterpulsation device compared to the intraaortic balloon pump.

    PubMed

    Terrovitis, John V; Charitos, Christos E; Tsolakis, Elias J; Dolou, Paraskevi; Pierrakos, Charalampos N; Siafakas, Kostas X; Nanas, John N

    2003-12-01

    The purpose of this study was to compare the hemodynamic effectiveness of a 30-ml stroke volume paraaortic counterpulsation device (PACD), presenting the advantages of ease of implantation and driving by a standard intraaortic balloon pump (IABP) console (Datascope 96, Datascope Corp., Montvale, NJ, USA) to that of a 40-ml IABP, in the setting of experimental heart failure. In an acute heart failure model, the IABP was placed in the descending aorta and the PACD in the ascending aorta of eight pigs. Both devices were driven by the same system, and hemodynamic measurements were obtained with and without mechanical assistance. The two pumps significantly reduced the systolic and end-diastolic aortic pressures, but the PACD reduced the latter more effectively (42.6 +/- 18.1% vs 11.0 +/- 9.9%, p = 0.0001). Both pumps provided significant aortic diastolic augmentation, but the counterpulsation wave of the PACD was significantly greater (augmentation of 44.8 +/- 22.2% vs 37.6 +/- 15.6%, p = 0.031). Both lowered the end-diastolic left ventricular pressure with a trend toward PACD superiority (24.2 +/- 13.7% vs 19.7 +/- 13.5%, p = 0.064). It is concluded that the PACD, even with smaller stroke volume, is more effective than the IABP. The simplicity of its implantation, together with the ability of the standard IABP consoles to control its function, make it a promising device for mechanical assistance of the failing heart.

  9. Improved techniques for fluid diversion in oil recovery. Final report

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

    Seright, R.

    This three-year project had two technical objectives. The first objective was to compare the effectiveness of gels in fluid diversion (water shutoff) with those of other types of processes. Several different types of fluid-diversion processes were compared, including those using gels, foams, emulsions, particulates, and microorganisms. The ultimate goals of these comparisons were to (1) establish which of these processes are most effective in a given application and (2) determine whether aspects of one process can be combined with those of other processes to improve performance. Analyses and experiments were performed to verify which materials are the most effective inmore » entering and blocking high-permeability zones. The second objective of the project was to identify the mechanisms by which materials (particularly gels) selectively reduce permeability to water more than to oil. A capacity to reduce water permeability much more than oil or gas permeability is critical to the success of gel treatments in production wells if zones cannot be isolated during gel placement. Topics covered in this report include (1) determination of gel properties in fractures, (2) investigation of schemes to optimize gel placement in fractured systems, (3) an investigation of why some polymers and gels can reduce water permeability more than oil permeability, (4) consideration of whether microorganisms and particulates can exhibit placement properties that are superior to those of gels, and (5) examination of when foams may show placement properties that are superior to those of gels.« less

  10. Enhanced iron removal from liver parenchymal cells in experimental iron overload: liposome encapsulation of HBED and phenobarbital administration

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

    Rahman, Y.E.; Cerny, E.A.; Lau, E.H.

    1983-07-01

    The effectiveness of N,N'-bis(2-hydroxybenzyl)-ethylene-diamine-N,N'-diacetic acid (HBED) in removing radioiron introduced into the parenchymal cells of mouse liver as /sup 59/Fe-ferritin has been investigated. The effectiveness of HBED, an iron chelator of low water solubility, has also been compared with that of desferrioxamine (DF), an iron chelator of high water solubility and currently in clinical use for treatment of transfusional iron overload. Using the /sup 59/Fe excretion as the measure of effectiveness of chelation therapy and a standardized single chelator dose of 25 mg/kg, they have found that: (1) a saline suspension of HBED, prepared by sonication and given intraperitoneally tomore » mice, promotes a small but significant increase in excretion of radioiron compared to the untreated controls, whereas DF, in its free form, is ineffective; (2) HBED encapsulated in lipid bilayers of liposomes and given intravenously is superior to nonencapsulated HBED; (3) DF encapsulated in small unilamellar liposomes is ineffective in removing iron given in the form of ferritin; (4) administration of phenobarbital in drinking water, at a concentration of 1 g/liter, induces a 30%-55% increase of iron excretion from untreated control mice and also from mice given HBED either in liposome-encapsulated or nonencapsulated form. HBED is superior to DF for removal of storage iron from liver parenchymal cells and liposomes are useful carriers for iron chelators of low water solubility.« less

  11. [Dengzhan Xixin injection as an adjuvant treatment for angina pectoris: a systematic review and Meta-analysis of randomized controlled trials].

    PubMed

    Wang, Feng-jiao; Xie, Yan-ming; Liao, Xing; Jia, Min

    2015-08-01

    The paper is to systematically evaluate the efficacy and safety of Deng Zhan Xi Xin injection ( DZXXI) as an adjuvant treatment for patients with angina pectoris. The Cochrane Library, Medline, EMbase, CBM, CNKI, VIP, and Wan fang Data base were searched. Randomized controlled trials (RCTs) of DZXXI combined with western medicine routine treatment versus western medicine routine treatment alone for angina pectoris patients were all included. All trials were assessed according to the Cochrane Reviewer' s Handbook 5.1 for Systematic Reviews of Intervention and Meta analyses were performed by RevMan 5. 2 Software. A total of 30RCTs (3 086 patients including 1 572 patients of treatment group and 1 514 patients of control group) were included. Meta-analysis of treatment group compared with control group showed superior effect over reducing cardiovascular events ( OR = 0.33; 95% CI: [0.16, 0.67], P = 0.002, improving effective rate of DZXXI as adjuvant treatment for angina pectoris patients (OR = 3.97; 95% CI: [3.15, 5.02]; P < 0.000 010 and electrocardiogram curative effect (OR = 2.21; 95% CI; [1.83, 2.68]; P < 0.000 010. Funnel figure seemed that there was publication bias. The current limited evidence showed that when compared with the control group, treatment group was superior in improving patients with angina pectoris. But based on the limitations of the study, rigorous design with long follow up clinical trials are necessary for further evidence.

  12. Sleep Duration and Subsequent Cortical Thinning in Cognitively Normal Older Adults.

    PubMed

    Spira, Adam P; Gonzalez, Christopher E; Venkatraman, Vijay K; Wu, Mark N; Pacheco, Jennifer; Simonsick, Eleanor M; Ferrucci, Luigi; Resnick, Susan M

    2016-05-01

    To determine the association between self-reported sleep duration and cortical thinning among older adults. We studied 122 cognitively normal participants in the Baltimore Longitudinal Study of Aging with a mean age = 66.6 y (range, 51-84) at baseline sleep assessment and 69.5 y (range, 56-86) at initial magnetic resonance imaging (MRI) scan. Participants reported average sleep duration and completed a mean of 7.6 1.5-T MRI scans (range, 3-11), with mean follow-up from initial scan of 8.0 y (range, 2.0-11.8). In analyses adjusted for age, sex, education, race, and interval between sleep assessment and initial MRI scan, participants reporting > 7 h sleep at baseline had thinner cortex in the inferior occipital gyrus and sulcus of the left hemisphere at initial MRI scan than those reporting 7 h (cluster P < 0.05). In adjusted longitudinal analyses, compared to those reporting 7 h of sleep, participants reporting < 7 h exhibited higher rates of subsequent thinning in the superior temporal sulcus and gyrus, inferior and middle frontal gyrus, and superior frontal sulcus of the left hemisphere, and in the superior frontal gyrus of the right hemisphere; those reporting > 7 h of sleep had higher rates of thinning in the superior frontal and middle frontal gyrus of the left hemisphere (cluster P < 0.05 for all). In sensitivity analyses, adjustment for apolipoprotein E (APOE) e4 genotype reduced or eliminated some effects but revealed others. When reports of < 7 h of sleep were compared to reports of 7 or 8 h combined, there were no significant associations with cortical thinning. Among cognitively normal older adults, sleep durations of < 7 h and > 7 h may increase the rate of subsequent frontotemporal gray matter atrophy. Additional studies, including those that use objective sleep measures and investigate mechanisms linking sleep duration to gray matter loss, are needed. © 2016 Associated Professional Sleep Societies, LLC.

  13. Value of Egy-Score in diagnosis of significant, advanced hepatic fibrosis and cirrhosis compared to aspartate aminotransferase-to-platelet ratio index, FIB-4 and Forns' index in chronic hepatitis C virus.

    PubMed

    Alboraie, Mohamed; Khairy, Marwa; Elsharkawy, Marwa; Asem, Noha; Elsharkawy, Aisha; Esmat, Gamal

    2015-05-01

    Serum markers and developed scores are of rising importance in non-invasive diagnosis of hepatic fibrosis. Aspartate aminotransferase-to-platelet ratio index (APRI), FIB-4 and Forns' index are validated scores used for diagnosis of liver fibrosis. The Egy-Score is a newly developed score for detection of hepatic fibrosis with promising results. We aimed to assess the accuracy of the Egy-Score in the diagnosis of significant fibrosis, advanced fibrosis and cirrhosis compared to APRI, FIB-4 and Forns' in chronic hepatitis C virus (HCV) patients. A retrospective study including 100 chronic hepatitis C naïve Egyptian patients was performed. Patients were classified according to stages of fibrosis into three groups: significant fibrosis (≥ F2), advanced fibrosis (≥ F3) and cirrhosis (F4). Egy-Score, APRI, FIB-4 and Forns' index were calculated. Regression analysis and receiver-operator curves were plotted to assess the sensitivity, specificity and predictive values for the significant scores with the best cut-off for diagnosis. An Egy-Score of 3.28 or more was superior to APRI, FIB-4 and Forns' index for detecting advanced fibrosis with a sensitivity of 91% and specificity of 78%. An Egy-Score of 3.67 or more was superior to APRI, FIB-4 and Forns' index for detecting cirrhosis with a sensitivity of 82% and specificity of 87%. Forns' index was superior to Egy-Score, FIB-4 and APRI for detecting significant fibrosis. The Egy-Score is a promising, accurate, easily calculated, cost-effective score in the prediction of hepatic fibrosis in chronic HCV patients with superiority over APRI, FIB-4 and Forns' index in advanced hepatic fibrosis and cirrhosis. © 2014 The Japan Society of Hepatology.

  14. Microphotochemistry: 4,4'-Dimethoxybenzophenone mediated photodecarboxylation reactions involving phthalimides

    PubMed Central

    Shvydkiv, Oksana; Nolan, Kieran

    2011-01-01

    Summary A series of 4,4'-dimethoxybenzophenone mediated intra- and intermolecular photodecarboxylation reactions involving phthalimides have been examined under microflow conditions. Conversion rates, isolated yields and chemoselectivities were compared to analogous reactions in a batch photoreactor. In all cases investigated, the microreactions gave superior results thus proving the superiority of microphotochemistry over conventional technologies. PMID:21915208

  15. Predator Arithmetic

    ERIC Educational Resources Information Center

    Shutler, Paul M. E.; Fong, Ng Swee

    2010-01-01

    Modern Hindu-Arabic numeration is the end result of a long period of evolution, and is clearly superior to any system that has gone before, but is it optimal? We compare it to a hypothetical base 5 system, which we dub Predator arithmetic, and judge which of the two systems is superior from a mathematics education point of view. We find that…

  16. Sex Effects on Smoking Cue Perception in Non-Smokers, Smokers, and Ex-Smokers: A Pilot Study.

    PubMed

    Zanchi, Davide; Brody, Arthur; Borgwardt, Stefan; Haller, Sven

    2016-01-01

    Recent neuroimaging research suggests sex-related brain differences in smoking addiction. In the present pilot study, we assessed gender-related differences in brain activation in response to cigarette-related video cues, investigating non-smokers, smokers, and ex-smokers. First, we compared 29 females (28.6 ± 5.3) vs. 23 males (31.5 ± 6.4), regardless of current smoking status to assess global gender-related effects. Second, we performed a post hoc analysis of non-smokers (9 females and 8 males), smokers (10 females and 8 males), and ex-smokers (10 females and 7 males). Participants performed a block-design functional magnetic resonance imaging paradigm contrasting smoking with control cue video exposures. Data analyses included task-related general linear model, voxel-based morphometry of gray matter (GM), and tract-based spatial statistics of white matter (WM). First, the global effect regardless of current smoking status revealed higher activation in the bilateral superior frontal gyrus and anterior cingulate cortex (ACC) for females compared to males. Second, the analysis according to current smoking status demonstrated higher activation in female vs. male smokers vs. non-smokers in the superior frontal gyrus, anterior and posterior cingulate cortex, and precuneus, and higher activation in female vs. male ex-smokers vs. non-smokers in the right precentral gyrus, in the right insula and ACC. No structural differences were found in GM or WM. The current study identifies gender-related brain functional differences in smokers and ex-smokers compared to non-smokers. The current work can be considered as a starting point for future investigations into gender differences in brain responses to cigarette-related cues.

  17. Effect of LI4 and BL32 acupressure on labor pain and delivery outcome in the first stage of labor in primiparous women: A randomized controlled trial.

    PubMed

    Ozgoli, Giti; Sedigh Mobarakabadi, Sedigheh; Heshmat, Reza; Alavi Majd, Hamid; Sheikhan, Zohreh

    2016-12-01

    This study examines and compares the effect of LI4 and BL32 acupressure with each other and control group on labor pain and delivery outcomes. In this randomized controlled trial, 105 primiparous women in active phase of first-stage of labor were equally assigned to two experimental groups [acupressure on LI4 (n=35) or BL32 (n=35)] and a control group (n=35). The experimental groups received routine labor care and acupressure in LI4 or BL32 points in three cervical dilatations (4-5, 6-7, and 8-10cm). The control group only received routine labor care. Pain was assessed by numerical rating scale in three cervical dilatations, before and after intervention. Type of delivery (cesarean, vaginal or operative delivery) and neonatal Apgar score were considered as delivery outcomes, these data collected by a check list. Data were analyzed using Repeated Measurement, ANOVA, Chi-Square, Kruskal-Wallis, and Mann-Whitney tests. Pain reduction was significantly greater in LI4 and BL32 groups compared with control in all periods of study. Also, acupressure on BL32 point was superior to LI4 point in pain relief in the first and second but not third intervention. No statistically significant difference was observed in terms of delivery outcomes. Acupressure on BL32 and LI4 points are effective in reducing labor pain compared to control group with a slight superiority for BL32 points. Acupressure on these points could apply for relief pain in labor as an inexpensive and easy to administered method. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. What is the effect on comorbid personality disorder of brief panic-focused psychotherapy in patients with panic disorder?

    PubMed

    Keefe, John R; Milrod, Barbara L; Gallop, Robert; Barber, Jacques P; Chambless, Dianne L

    2018-03-01

    No studies of psychotherapies for panic disorder (PD) have examined effects on comorbid personality disorders (PersD), yet half such patients have a PersD. In a randomized trial for PD with and without agoraphobia comparing Cognitive-Behavioral Therapy (CBT) and Panic-Focused Psychodynamic Psychotherapy (PFPP), PersD was assessed pre-to-post treatment with the Structured Clinical Interview for the Diagnosis of Axis-II Disorders (SCID-II). For patients completing therapy (n = 118, 54 with PersD), covariance between panic and SCID-II criteria improvements was analyzed. SCID-II diagnostic remission and recovery were evaluated. Comparative efficacy of PFPP versus CBT for improving PersD was analyzed both for the average patient, and as a function of PersD severity. 37 and 17% of PersD patients experienced diagnostic PersD remission and recovery, respectively. Larger reductions in PersD were related to more panic improvement, with a modest effect size (r = 0.28). Although there was no difference between treatments in their ability to improve PersD for the average patient (d = 0.01), patients meeting more PersD criteria did better in PFPP compared to CBT (P = .007), with PFPP being significantly superior at 11 criteria and above (d = 0.66; 3 more criteria lost). PersD presenting in the context of primary PD rarely resolves during psychotherapies focused on PD, and change in PersD only moderately tracks panic improvements, indicating non-overlap of the constructs. Patients receiving panic-focused psychotherapies may require additional treatment for their PersD. PFPP may be superior at improving severe PersD, but replication of this finding is required. © 2017 Wiley Periodicals, Inc.

  19. The effect of a new lifetime-cardiovascular-risk display on patients' motivation to participate in shared decision-making.

    PubMed

    Jegan, Nikita Roman A; Kürwitz, Sarah Anna; Kramer, Lena Kathrin; Heinzel-Gutenbrunner, Monika; Adarkwah, Charles Christian; Popert, Uwe; Donner-Banzhoff, Norbert

    2018-06-09

    This study investigated the effects of three different risk displays used in a cardiovascular risk calculator on patients' motivation for shared decision-making (SDM). We compared a newly developed time-to-event (TTE) display with two established absolute risk displays (i.e. emoticons and bar charts). The accessibility, that is, how understandable, helpful, and trustworthy patients found each display, was also investigated. We analysed a sample of 353 patients recruited in general practices. After giving consent, patients were introduced to one of three fictional vignettes with low, medium or high cardiovascular risk. All three risk displays were shown in a randomized order. Patients were asked to rate each display with regard to motivation for SDM and accessibility. Two-factorial repeated measures analyses of variance were conducted to compare the displays and investigate possible interactions with age. Regarding motivation for SDM, the TTE elicited the highest motivation, followed by the emoticons and bar chart (p < .001). The displays had no differential influence on the age groups (p = .445). While the TTE was generally rated more accessible than the emoticons and bar chart (p < .001), the emoticons were only superior to the bar chart in the younger subsample. However, this was only to a small effect (interaction between display and age, p < .01, η 2  = 0.018). Using fictional case vignettes, the novel TTE display was superior regarding motivation for SDM and accessibility when compared to established displays using emoticons and a bar chart. If future research can replicate these results in real-life consultations, the TTE display will be a valuable addition to current risk calculators and decision aids by improving patients' participation.

  20. Hyaluronic acid for the treatment of osteoarthritis in all joints except the knee: what is the current evidence?

    PubMed

    Colen, Sascha; Haverkamp, Daniel; Mulier, Michiel; van den Bekerom, Michel P J

    2012-04-01

    The use of intra-articular hyaluronic acid (HA) is a well known treatment in patients with knee osteoarthritis (OA). In other joints, less evidence is available about the efficacy of treatment with intra-articular HA. HA is also used intra-articularly in the metatarsophalangeal-1 joint, the ankle, the hip, the sacroiliac joint, the facet joints, the carpometacarpal-1 joint, the shoulder and the temporo-mandibular joint. In this systematic review we include all prospective studies about the effects of intra-articular HA in the above-mentioned joints. Its use in the knee joint, however, will be discussed in a separate article in this journal. A systematic review was conducted using databases including MEDLINE, Cochrane Database of Systematic Reviews, Cochrane Clinical Trial Register, and EMBASE. After performing a solid systematic review using a rigid methodology and trying to pool the outcomes of different studies, we noticed that, compared with baseline, there is statistical evidence for a positive effect of intra-articular HA. However, there is limited evidence HA is superior to placebo and no evidence that intra-articular HA is better than corticosteroids or other conservative therapies. Our recommendation for future research is that one should focus on adequately powered randomized trials comparing HA treatment with other types of intra-articular or conservative treatment. We think it is useless to further perform and publish (large) non-comparative prospective studies about the use of HA in the treatment of problems caused by OA. It is well perceived that HA exerts positive effects in the treatment of OA, but up to now there is no (strong) evidence available that HA is superior to other treatments of OA such as corticosteroids, physiotherapy or other conservative measures.

  1. A comparative review of escitalopram, paroxetine, and sertraline: are they all alike?

    PubMed Central

    Reines, Elin H.; Montgomery, Stuart A.

    2014-01-01

    It is known that newer antidepressants, such as the selective serotonin reuptake inhibitors (SSRIs), provide advantages in tolerability over antidepressants such as the tricyclics. However, even within the SSRI class, differences in efficacy or tolerability exist between the individual drugs. Among the three most widely prescribed SSRIs are paroxetine, sertraline, and escitalopram. Escitalopram is commonly referred to as an SSRI, but also has well-documented allosteric properties, and thus can be further classed as an allosteric serotonin reuptake inhibitor. All three antidepressants are efficacious compared with placebo, but there is evidence that escitalopram is more effective than a range of other antidepressants. There are no direct data to regard either paroxetine or sertraline as a superior antidepressant. Escitalopram is superior compared with paroxetine, which has a less favorable tolerability profile. Paroxetine is associated with cholinergic muscarinic antagonism and potent inhibition of CYP2D6, and sertraline has moderate drug interaction issues in comparison with escitalopram. Overall, as an allosteric serotonin reuptake inhibitor that is somewhat different from classical SSRIs, escitalopram is the first choice judged by combined efficacy and tolerability, and nonclinical data have offered possible mechanisms through which escitalopram could be more efficacious, based on its interaction with orthosteric and allosteric binding sites at the serotonin transporter. PMID:24424469

  2. A comparative review of escitalopram, paroxetine, and sertraline: Are they all alike?

    PubMed

    Sanchez, Connie; Reines, Elin H; Montgomery, Stuart A

    2014-07-01

    It is known that newer antidepressants, such as the selective serotonin reuptake inhibitors (SSRIs), provide advantages in tolerability over antidepressants such as the tricyclics. However, even within the SSRI class, differences in efficacy or tolerability exist between the individual drugs. Among the three most widely prescribed SSRIs are paroxetine, sertraline, and escitalopram. Escitalopram is commonly referred to as an SSRI, but also has well-documented allosteric properties, and thus can be further classed as an allosteric serotonin reuptake inhibitor. All three antidepressants are efficacious compared with placebo, but there is evidence that escitalopram is more effective than a range of other antidepressants. There are no direct data to regard either paroxetine or sertraline as a superior antidepressant. Escitalopram is superior compared with paroxetine, which has a less favorable tolerability profile. Paroxetine is associated with cholinergic muscarinic antagonism and potent inhibition of CYP2D6, and sertraline has moderate drug interaction issues in comparison with escitalopram. Overall, as an allosteric serotonin reuptake inhibitor that is somewhat different from classical SSRIs, escitalopram is the first choice judged by combined efficacy and tolerability, and nonclinical data have offered possible mechanisms through which escitalopram could be more efficacious, based on its interaction with orthosteric and allosteric binding sites at the serotonin transporter.

  3. Thin-layer preparations of dithiothreitol-treated bronchial washing specimens.

    PubMed

    Koivurinne, Kirsti I; Shield, Paul W

    2003-01-01

    To evaluate the combined effect of dithiothreitol (DTT) treatment and ThinPrep (TP) (Cytyc Corp, Boxborough, Massachusetts, U.S.A.) processing on bronchial washing specimens. A total of 431 bronchial washing specimens were initially treated with 0.05% DTT in a 30% methanol solution. After centrifugation, 1 TP slide and 2-4 conventional cytospin or smear preparations (CPs) were prepared. The reports of both preparations were compared in all cases. All 48 abnormal cases and 52 consecutive negative cases were also compared for cellular composition, distribution of the cells, ease of interpretation and overall preparation quality. Screening time was recorded for 20 of the cases. The diagnostic accuracy of one TP slide appeared comparable to that of 2-4 CPs. The TP slide was assessed to be equal or superior in overall quality to CP in 85% of 100 cases of paired specimens. The cleaner background and smaller cellular area of TP slides significantly reduced the screening time. Mucolysis and specimen homogenization were not always optimal, occasionally resulting in uneven subsampling and poorly cellular TPs. However, in general, TP slides were considered superior to CPs in overall quality. Improvement in specimen quality and reduced screening time have to be balanced against the high cost of consumables with the TP technique.

  4. Microbial communities in liquid and fiber fractions of food waste digestates are differentially resistant to inhibition by ammonia.

    PubMed

    Peng, Wei; Lü, Fan; Shao, Liming; He, Pinjing

    2015-04-01

    The effect of different concentrations of ammonia (1.0-7.0 g/L) during mesophilic anaerobic digestion with fiber or liquid digestate as inoculum was examined. Evolution of microbial community within fiber and liquid digestates was quantitatively assessed by the intact lipid analysis methods and qualitatively by DNA fingerprint methods in order to determine their resistance to ammonia inhibition. The results showed that an increased level of total ammonia nitrogen prolonged the lag phase of fiber digestates while reduced the metabolic rate of liquid digestates. Fiber digestates had 19.6-50.9-fold higher concentrations of phospholipid fatty acids (PLFA) compared to liquid digestates, whereas concentrations of phospholipid ether lipids (PLEL) in the fiber digestates were only 2.91-17.6-fold higher compared to liquid digestates. Although the cell concentration in liquid fraction was far lower than that in the fiber one, the ammonia-resistant ability and the methanization efficiency of the liquid digestate was superior to the fiber digestate. The bacterial profiles were affected more by the type of digestate inoculum compared to the concentration of ammonia. Principal component analysis indicated that the lipids technique was superior to the DNA technique for bacterial quantification but detected less archaeal diversity.

  5. Reverse total shoulder glenoid baseplate stability with superior glenoid bone loss.

    PubMed

    Martin, Elise J; Duquin, Thomas R; Ehrensberger, Mark T

    2017-10-01

    Superior wear of the glenoid bone is common in patients with rotator cuff arthropathy. This can become a treatment challenge for patients who require shoulder arthroplasty. In reverse shoulder arthroplasty (RSA), glenoid bone loss may affect the stability of baseplate fixation. The primary purpose of this biomechanical laboratory study was to assess the initial fixation stability of RSA glenosphere baseplates in the presence of variable amounts of superior glenoid bone loss. High-density solid rigid polyurethane foam (30 pounds/cubic foot) was machined to model the glenoid with variable superior defects that provided different levels of support (100%, 90%, 75%, and 50%) for the glenosphere baseplate. The samples were cyclically loaded (0-750 N at 1 Hz for 5000 cycles) at a 60° glenohumeral angle. The micromotion and migration of the baseplate were calculated from displacement data captured during the loading tests with an array of 3 linear variable differential transformers mounted around the baseplate. Micromotion was significantly greater in samples with 50% defects compared with those with smaller defects. Migration was significantly greater after testing for all defect sizes. Initial fixation of RSA glenosphere baseplates was significantly reduced in models with 50% bone loss on the superior edge compared with models with less bone loss in this high-density bone foam model. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  6. Drilling through lateral transmuscular portal lowers the risk of suprascapular nerve injury during arthroscopic SLAP repair.

    PubMed

    Kocaoglu, Baris; Ulku, Tekin Kerem; Sayilir, Safiye; Ozbaydar, Mehmet Ugur; Bayramoglu, Alp; Karahan, Mustafa

    2017-10-01

    The aim of our study was to evaluate the risk of medial glenoid perforation and possible injury to suprascapular nerve during arthroscopic SLAP repair using lateral transmuscular portal. Ten cadaveric shoulder girdles were isolated and drilled at superior glenoid rim from both anterior-superior portal (1 o'clock) and lateral transmuscular portal (12 o'clock) for SLAP repairs. Drill hole depth was determined by the manufacturer's drill stop (20 mm), and any subsequent drill perforations through the medial bony surface of the glenoid were directly confirmed by dissection. The bone tunnel depth and subsequent distance to the suprascapular nerve, scapular height and width, were compared for investigated locations. Four perforations out of ten (40 %) occurred through anterior-superior portal with one associated nerve injury. One perforation out of ten (10 %) occurred through lateral transmuscular portal without any nerve injury. The mean depth was calculated as 17.6 mm (SD 3) for anterior-superior portal and 26.5 mm (SD 3.6) for lateral transmuscular portal (P < 0.001). It is anatomically possible that suprascapular nerve could sustain iatrogenic injury during labral anchor placement during SLAP repair. However, lateral transmuscular portal at 12 o'clock drill entry location has lower risk of suprascapular nerve injury compared with anterior-superior portal at 1 o'clock drill entry location.

  7. Enhanced tactile encoding and memory recognition in congenital blindness.

    PubMed

    D'Angiulli, Amedeo; Waraich, Paul

    2002-06-01

    Several behavioural studies have shown that early-blind persons possess superior tactile skills. Since neurophysiological data show that early-blind persons recruit visual as well as somatosensory cortex to carry out tactile processing (cross-modal plasticity), blind persons' sharper tactile skills may be related to cortical re-organisation resulting from loss of vision early in their life. To examine the nature of blind individuals' tactile superiority and its implications for cross-modal plasticity, we compared the tactile performance of congenitally totally blind, low-vision and sighted children on raised-line picture identification test and re-test, assessing effects of task familiarity, exploratory strategy and memory recognition. What distinguished the blind from the other children was higher memory recognition and higher tactile encoding associated with efficient exploration. These results suggest that enhanced perceptual encoding and recognition memory may be two cognitive correlates of cross-modal plasticity in congenital blindness.

  8. Teflon/SiO₂ Bilayer Passivation for Improving the Electrical Reliability of Oxide TFTs Fabricated Using a New Two-Photomask Self-Alignment Process.

    PubMed

    Fan, Ching-Lin; Shang, Ming-Chi; Li, Bo-Jyun; Lin, Yu-Zuo; Wang, Shea-Jue; Lee, Win-Der; Hung, Bohr-Ran

    2015-04-13

    This study proposes a two-photomask process for fabricating amorphous indium-gallium-zinc oxide (a-IGZO) thin-film transistors (TFTs) that exhibit a self-aligned structure. The fabricated TFTs, which lack etching-stop (ES) layers, have undamaged a-IGZO active layers that facilitate superior performance. In addition, we demonstrate a bilayer passivation method that uses a polytetrafluoroethylene (Teflon) and SiO₂ combination layer for improving the electrical reliability of the fabricated TFTs. Teflon was deposited as a buffer layer through thermal evaporation. The Teflon layer exhibited favorable compatibility with the underlying IGZO channel layer and effectively protected the a-IGZO TFTs from plasma damage during SiO₂ deposition, resulting in a negligible initial performance drop in the a-IGZO TFTs. Compared with passivation-free a-IGZO TFTs, passivated TFTs exhibited superior stability even after 168 h of aging under ambient air at 95% relative humidity.

  9. MALDI-MS analysis and imaging of small molecule metabolites with 1,5-diaminonaphthalene (DAN).

    PubMed

    Korte, Andrew R; Lee, Young Jin

    2014-08-01

    1,5-Diaminonaphthalene (DAN) has previously been reported as an effective matrix for matrix-assisted laser desorption ionization-mass spectrometry of phospholipids. In the current work, we investigate the use of DAN as a matrix for small metabolite analysis in negative ion mode. DAN was found to provide superior ionization to the compared matrices for MW < ~400 Da; however, 9-aminoacridine (9-AA) was found to be superior for a uridine diphosphate standard (MW 566 Da). DAN was also found to provide a more representative profile of a natural phospholipid mixture than 9-AA. Finally, DAN and 9-AA were applied for imaging of metabolites directly from corn leaf sections. Published 2014. This article is a U.S. Government work and is in the public domain in the USA. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

  10. Electric Field-aided Selective Activation for Indium-Gallium-Zinc-Oxide Thin Film Transistors.

    PubMed

    Lee, Heesoo; Chang, Ki Soo; Tak, Young Jun; Jung, Tae Soo; Park, Jeong Woo; Kim, Won-Gi; Chung, Jusung; Jeong, Chan Bae; Kim, Hyun Jae

    2016-10-11

    A new technique is proposed for the activation of low temperature amorphous InGaZnO thin film transistor (a-IGZO TFT) backplanes through application of a bias voltage and annealing at 130 °C simultaneously. In this 'electrical activation', the effects of annealing under bias are selectively focused in the channel region. Therefore, electrical activation can be an effective method for lower backplane processing temperatures from 280 °C to 130 °C. Devices fabricated with this method exhibit equivalent electrical properties to those of conventionally-fabricated samples. These results are analyzed electrically and thermodynamically using infrared microthermography. Various bias voltages are applied to the gate, source, and drain electrodes while samples are annealed at 130 °C for 1 hour. Without conventional high temperature annealing or electrical activation, current-voltage curves do not show transfer characteristics. However, electrically activated a-IGZO TFTs show superior electrical characteristics, comparable to the reference TFTs annealed at 280 °C for 1 hour. This effect is a result of the lower activation energy, and efficient transfer of electrical and thermal energy to a-IGZO TFTs. With this approach, superior low-temperature a-IGZO TFTs are fabricated successfully.

  11. A prospective clinical pilot-trial comparing the effect of an optimized mixed diet versus a flexible low-glycemic index diet on nutrient intake and HbA(1c) levels in children with type 1 diabetes.

    PubMed

    Marquard, Jan; Stahl, Anna; Lerch, Christian; Wolters, Mareen; Grotzke-Leweling, Maike; Mayatepek, Ertan; Meissner, Thomas

    2011-01-01

    Low-glycemic index (GI) diet vs. high-GI diet improves glycemic control, but it is not clear whether a low-GI diet is superior to an optimized mixed diet (OMD). This was a 12-week parallel-group pilot-trial including 17 children with type 1 diabetes. A separate dietary education into the allocated diet (OMD vs. low-GI) was performed. Nutrition was recorded by means of a three-day dietary record. The primary objective was to determine the macro- and micronutrient composition of the different diets, the secondary objective was to determine the short-term effect on HbA(1c) levels. In the low-GI group carbohydrate intake decreased, fat intake increased by trend. In the OMD group fat and energy intake decreased. No changes of HbA(1c) levels between the groups were observed. OMD could have positive effects in overweight and obese diabetic children, since a reduction in fat and energy intake can be achieved. The findings of this pilot-trial suggest that OMD could be superior to a low-GI diet.

  12. Oral lysine clonixinate in the acute treatment of migraine: a double-blind placebo-controlled study.

    PubMed

    Krymchantowski, A V; Barbosa, J S; Cheim, C; Alves, L A

    2001-03-01

    Several oral nonsteroidal anti-inflammatory drugs (NSAIDs) are effective to treat migraine attacks. Lysine clonixinate (LC) is a NSAID derived from nicotinic acid that has proven to be effective in various pain syndromes such as renal colic and muscular pain. The aim of this double-blind, placebo-controlled study was to evaluate the efficacy of oral LC compared to placebo in the acute treatment of migraine. Sixty four patients with the diagnosis of migraine, according to the IHS criteria, were studied prospectively. Patients received LC or placebo once the headache reached moderate or severe intensity for 6 consecutive attacks. With regard to the moderate attacks, LC was superior than placebo after 1, 2 and 4 hours. The consumption of other rescue medications after 4 hours was significantly higher in the placebo group. With regard to the severe attacks, there was no difference between the active drug group and the placebo group concerning headache intensity and consumption of other rescue medications. We conclude that the NSAID lysine clonixinate is effective in treating moderately severe migraine attacks. It is not superior than placebo in treating severe migraine attacks.

  13. The effects of oat β-glucan incorporation on the quality, structure, consumer acceptance and glycaemic response of steamed bread.

    PubMed

    Wang, Lei; Ye, Fayin; Feng, Liyuan; Wei, Fubin; Zhao, Guohua

    2017-12-01

    The objective of this study was to evaluate the effects of the incorporation of oat β-glucan (OβG) on the sensory and nutritional quality of steamed bread. Wheat flour was substituted with OβG at levels varying from 0 g/100 g to 5 g/100 g. The results showed that the products containing 1 g/100 g and 3 g/100 g OβG produced a comparable overall consumer acceptance while a significantly lower score was given to the product with 5 g/100 g. Nutritionally, the presence of OβG impeded in vitro starch hydrolysis by amylolytic enzymes. More importantly, the addition of OβG up to 5 g/100 g did bring about a lower in vitro predicted glycaemic index to steamed bread, but it generated insignificant effects on the in vivo glycaemic response. The current work first demonstrated the feasibility of fabricating OβG-enriched steamed bread and its nutritional superiority compared to the corresponding normal product. Modern methods of food elaboration and processing frequently reduce the content of dietary fiber (DF). Despite the well-known health benefits of DF consumption, average intake levels still fall far below recommended ones. Oat β-glucan (OβG) is a kind of indigestible polysaccharide with diverse bioactivity. This article evaluated the effects of OβG incorporation on quality, structure, consumer acceptance, and glycaemic response of steamed bread. The addition of less than 3 g/100 g of OβG had negligible effects on the consumer acceptance of steamed bread. The enrichment at 5 g/100 g indeed deteriorated the consumer acceptance. Moreover, OβG highly lowered the glycaemic response of steamed bread. The current work first demonstrated the feasibility of fabricating OβG-enriched steamed bread and its nutritional superiority compared to the corresponding normal product. OβG enriched steamed bread may offer an alternative to improve DF intake of residents. © 2017 Wiley Periodicals, Inc.

  14. Gender Differences in Food Choice: Effects of Superior Temporal Sulcus Stimulation.

    PubMed

    Manippa, Valerio; Padulo, Caterina; van der Laan, Laura N; Brancucci, Alfredo

    2017-01-01

    The easy availability of food has caused a shift from eating for survival to hedonic eating. Women, compared to men, have shown to respond differently to food cues in the environment on a behavioral and a neural level, in particular to energy rich (compared to low energy) foods. It has been demonstrated that the right posterior superior temporal sulcus (STS) is the only region exhibiting greater activation for high vs. low calorie food choices. In order to test for a possible causal role of STS in food choice, we applied high frequency transcranial random noise stimulation (tRNS) on STS assuming a different response pattern between males and females. Our participants (18 females, 17 males) performed a forced choice task between food pairs matched for individual liking but differed in calorie, during the left STS, right STS stimulation and sham condition. Male participants showed a general preference for low calorie (LC) foods compared to females. In addition, we observed in males, but not in females, an increase of high calorie (HC) food choice during right STS tRNS compared to sham condition and left STS tRNS. Finally, we found an increase of missed choices during right STS stimulation compared to sham condition and left STS stimulation. In conclusion, thanks to tRNS evidence, we both confirm the involvement and suggest a causal role of right posterior STS in feeding behavior. Moreover, we suggest that gender differences exist in STS mechanisms underlying food choice.

  15. Comparing multiple competing interventions in the absence of randomized trials using clinical risk-benefit analysis

    PubMed Central

    2012-01-01

    Background To demonstrate the use of risk-benefit analysis for comparing multiple competing interventions in the absence of randomized trials, we applied this approach to the evaluation of five anticoagulants to prevent thrombosis in patients undergoing orthopedic surgery. Methods Using a cost-effectiveness approach from a clinical perspective (i.e. risk benefit analysis) we compared thromboprophylaxis with warfarin, low molecular weight heparin, unfractionated heparin, fondaparinux or ximelagatran in patients undergoing major orthopedic surgery, with sub-analyses according to surgery type. Proportions and variances of events defining risk (major bleeding) and benefit (thrombosis averted) were obtained through a meta-analysis and used to define beta distributions. Monte Carlo simulations were conducted and used to calculate incremental risks, benefits, and risk-benefit ratios. Finally, net clinical benefit was calculated for all replications across a range of risk-benefit acceptability thresholds, with a reference range obtained by estimating the case fatality rate - ratio of thrombosis to bleeding. Results The analysis showed that compared to placebo ximelagatran was superior to other options but final results were influenced by type of surgery, since ximelagatran was superior in total knee replacement but not in total hip replacement. Conclusions Using simulation and economic techniques we demonstrate a method that allows comparing multiple competing interventions in the absence of randomized trials with multiple arms by determining the option with the best risk-benefit profile. It can be helpful in clinical decision making since it incorporates risk, benefit, and personal risk acceptance. PMID:22233221

  16. Gender Differences in Food Choice: Effects of Superior Temporal Sulcus Stimulation

    PubMed Central

    Manippa, Valerio; Padulo, Caterina; van der Laan, Laura N.; Brancucci, Alfredo

    2017-01-01

    The easy availability of food has caused a shift from eating for survival to hedonic eating. Women, compared to men, have shown to respond differently to food cues in the environment on a behavioral and a neural level, in particular to energy rich (compared to low energy) foods. It has been demonstrated that the right posterior superior temporal sulcus (STS) is the only region exhibiting greater activation for high vs. low calorie food choices. In order to test for a possible causal role of STS in food choice, we applied high frequency transcranial random noise stimulation (tRNS) on STS assuming a different response pattern between males and females. Our participants (18 females, 17 males) performed a forced choice task between food pairs matched for individual liking but differed in calorie, during the left STS, right STS stimulation and sham condition. Male participants showed a general preference for low calorie (LC) foods compared to females. In addition, we observed in males, but not in females, an increase of high calorie (HC) food choice during right STS tRNS compared to sham condition and left STS tRNS. Finally, we found an increase of missed choices during right STS stimulation compared to sham condition and left STS stimulation. In conclusion, thanks to tRNS evidence, we both confirm the involvement and suggest a causal role of right posterior STS in feeding behavior. Moreover, we suggest that gender differences exist in STS mechanisms underlying food choice. PMID:29270120

  17. Effects of Group Psychotherapy, Individual Counseling, Methylphenidate, and Placebo in the Treatment of Adult Attention-Deficit/Hyperactivity Disorder: A Randomized Clinical Trial.

    PubMed

    Philipsen, Alexandra; Jans, Thomas; Graf, Erika; Matthies, Swantje; Borel, Patricia; Colla, Michael; Gentschow, Laura; Langner, Daina; Jacob, Christian; Groß-Lesch, Silke; Sobanski, Esther; Alm, Barbara; Schumacher-Stien, Martina; Roesler, Michael; Retz, Wolfgang; Retz-Junginger, Petra; Kis, Bernhard; Abdel-Hamid, Mona; Heinrich, Viola; Huss, Michael; Kornmann, Catherine; Bürger, Arne; Perlov, Evgeniy; Ihorst, Gabriele; Schlander, Michael; Berger, Mathias; Tebartz van Elst, Ludger

    2015-12-01

    Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with high prevalence in adulthood. There is a recognized need to assess the efficacy of psychotherapy in adult ADHD. To evaluate the efficacy of cognitive behavioral group psychotherapy (GPT) compared with individual clinical management (CM) and that of methylphenidate hydrochloride compared with placebo. Prospective, multicenter, randomized clinical trial of 18- to 58-year-old outpatients with ADHD from 7 German study centers. Patients were recruited between January 2007 and August 2010, treatment was finalized in August 2011, and final follow-up assessments occurred in March 2013. Sessions of GPT and CM were held weekly for the first 12 weeks and monthly thereafter (9 months). Patients received either methylphenidate or placebo for 1 year. The primary outcome was the change in the ADHD Index of the Conners Adult ADHD Rating Scale from baseline to the end of the 3-month intensive treatment (blinded observer ratings). Secondary outcomes included ADHD ratings after 1 year, blinded observer ratings using the Clinical Global Impression Scale, and self-ratings of depression. Among 1480 prescreened patients, 518 were assessed for eligibility, 433 were centrally randomized, and 419 were analyzed as randomized. After 3 months, the ADHD Index all-group baseline mean of 20.6 improved to adjusted means of 17.6 for GPT and 16.5 for CM, with no significant difference between groups. Methylphenidate (adjusted mean, 16.2) was superior to placebo (adjusted mean, 17.9) (difference, -1.7; 97.5% CI, -3.0 to -0.4; P = .003). After 1 year, treatment effects remained essentially stable. Descriptive analyses showed that methylphenidate was superior to placebo in patients assigned to GPT (difference, -1.7; 95% CI, -3.2 to -0.1; P = .04) or CM (difference, -1.7; 95% CI, -3.3 to -0.2; P = .03). Regarding depression, no significant differences were found. In contrast, GPT was superior to CM for all visits in the Clinical Global Impression global assessment of effectiveness. Highly structured group intervention did not outperform individual CM with regard to the primary outcome. Psychological interventions resulted in better outcomes during a 1-year period when combined with methylphenidate as compared with placebo. isrctn.org Identifier: ISRCTN54096201.

  18. Cost-Effectiveness of Fecal Microbiota Transplantation in the Treatment of Recurrent Clostridium Difficile Infection: A Literature Review

    PubMed Central

    Arbel, Leor T; McNally, Keegan

    2017-01-01

    Clostridium difficile (C. difficile) is a common cause of antibiotic-­associated diarrhea (AAD), being responsible for 15­-25% of all AAD cases. The purpose of this literature review is to determine the cost-effectiveness of fecal microbiota transplantation (FMT) and how it compares in this regard to the standard treatments of choice for recurrent C. difficile infection (CDI). The review of the literature along with the evaluation of three comparative cost effective analyses yielded findings consistent with the view that FMT is the most cost-effective option in treating recurrent CDI. There are some (but considerably less) data indicating that FMT may be a cost effective strategy in treating initial CDI, as well. The superior cost-effectiveness of FMT as compared to the preferred standards of treatment for recurrent CDI suggest FMT use should become more integrated in routine clinical practice. Increased utilization of FMTs would allow for better control of this increasingly problematic disease as well as lower costs associated with its management. PMID:29067223

  19. Effectiveness of Psychotherapy in Personality Disorders Not Otherwise Specified: A Comparison of Different Treatment Modalities.

    PubMed

    Horn, Eva K; Bartak, Anna; Meerman, Anke M M A; Rossum, Bert V; Ziegler, Uli M; Thunnissen, Moniek; Soons, Mirjam; Andrea, Helene; Hamers, Elisabeth F M; Emmelkamp, Paul M G; Stijnen, Theo; Busschbach, Jan J V; Verheul, Roel

    2015-01-01

    Although personality disorder not otherwise specified (PDNOS) is highly prevalent and associated with a high burden of disease, only a few treatment studies in this patient group exist. This study is the first to investigate the effectiveness of different modalities of psychotherapy in patients with PDNOS, i.e., short-term (up to 6 months) and long-term (more than 6 months) outpatient, day hospital, and inpatient psychotherapy. A total of 205 patients with PDNOS were assigned to one of six treatment modalities. Effectiveness was assessed over 60 months after baseline. The primary outcome measure was symptom severity, and the secondary outcome measures included psychosocial functioning and quality of life. The study design was quasi-experimental, and the multiple propensity score was used to control for initial differences between treatment groups. All treatment modalities showed positive outcomes, especially in terms of improvements of symptom severity and social role functioning. At 12-month follow-up, after adjustment for initial differences between the treatment groups, short-term outpatient psychotherapy and short-term inpatient psychotherapy showed most improvement and generally outperformed the other modalities concerning symptom severity. At 60 months after baseline, effectiveness remained but observed differences between modalities mostly diminished. Patients with PDNOS benefit from psychotherapy both at short-term and long-term follow-up. Short-term outpatient psychotherapy and short-term inpatient psychotherapy seem to be superior to the other treatment modalities at 12-month follow-up. At 60-month follow-up, treatments showed mostly comparable effectiveness. The effectiveness of different modalities of psychotherapy in patients with PDNOS (i.e., short-term vs long-term; outpatient versus day hospital versus inpatient psychotherapy) has not yet been compared. Different modalities of psychotherapy are effective for patients with PDNOS, and positive effects remain after 5 years. In patients with PDNOS short-term (less than 6 months) outpatient psychotherapy and short-term inpatient psychotherapy seem to be superior to the four other treatment modalities at 12-month follow-up. At 60-month follow-up, treatments showed mostly comparable effectiveness. Copyright © 2014 John Wiley & Sons, Ltd.

  20. Oral delivery of plant-derived HIV-1 p24 antigen in low doses shows a superior priming effect in mice compared to high doses.

    PubMed

    Lindh, Ingrid; Bråve, Andreas; Hallengärd, David; Hadad, Ronza; Kalbina, Irina; Strid, Åke; Andersson, Sören

    2014-04-25

    During early infection with human immunodeficiency virus type 1 (HIV-1), there is a rapid depletion of CD4(+) T-cells in the gut-associated lymphoid tissue (GALT) in the gastrointestinal tract. Therefore, immediate protection at these surfaces is of high priority for the development of an HIV-1 vaccine. Thus, transgenic plants expressing HIV-1 antigens, which are exposed to immune competent cells in the GALT during oral administration, can be interesting as potential vaccine candidates. In the present study, we used two HIV-1 p24 antigen-expressing transgenic plant systems, Arabidopsis thaliana and Daucus carota, in oral immunization experiments. Both transgenic plant systems showed a priming effect in mice and induced humoral immune responses, which could be detected as anti-p24-specific IgG in sera after an intramuscular p24 protein boost. Dose-dependent antigen analyses using transgenic A. thaliana indicated that low p24 antigen doses were superior to high p24 antigen doses. Copyright © 2014. Published by Elsevier Ltd.

  1. Effects of aging on neuromagnetic mismatch responses to pitch changes.

    PubMed

    Cheng, Chia-Hsiung; Baillet, Sylvain; Hsiao, Fu-Jung; Lin, Yung-Yang

    2013-06-07

    Although aging-related alterations in the auditory sensory memory and involuntary change discrimination have been widely studied, it remains controversial whether the mismatch negativity (MMN) or its magnetic counterpart (MMNm) is modulated by physiological aging. This study aimed to examine the effects of aging on mismatch activity to pitch deviants by using a whole-head magnetoencephalography (MEG) together with distributed source modeling analysis. The neuromagnetic responses to oddball paradigms consisting of standards (1000 Hz, p=0.85) and deviants (1100 Hz, p=0.15) were recorded in healthy young (n=20) and aged (n=18) male adults. We used minimum norm estimate of source reconstruction to characterize the spatiotemporal neural dynamics of MMNm responses. Distributed activations to MMNm were identified in the bilateral fronto-temporo-parietal areas. Compared to younger participants, the elderly exhibited a significant reduction of cortical activation in bilateral superior temporal guri, superior temporal sulci, inferior fontal gyri, orbitofrontal cortices and right inferior parietal lobules. In conclusion, our results suggest an aging-related decline in auditory sensory memory and automatic change detection as indexed by MMNm. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  2. Bullets versus burgers: is it threat or relevance that captures attention?

    PubMed

    de Oca, Beatrice M; Black, Alison A

    2013-01-01

    Previous studies have found that potentially dangerous stimuli are better at capturing attention than neutral stimuli, a finding sometimes called the threat superiority effect. However, non-threatening stimuli also capture attention in many studies of visual attention. In Experiment 1, the relevance superiority effect was tested with a visual search task comparing detection times for threatening stimuli (guns), pleasant but motivationally relevant stimuli (food), and neutral stimuli (flowers and chairs). Gun targets were detected more rapidly than both types of neutral targets, whereas food targets were detected more quickly than the neutral chair targets only. Guns were detected more rapidly than food. In Experiment 2, threatening targets (guns and snakes), pleasant but motivationally relevant targets (money and food), and neutral targets (trees and couches) were all presented with the same neutral distractors (cactus and pots) in order to control for the valence of the distractor stimulus across the three categories of target stimuli. Threatening and pleasant target categories facilitated attention relative to neutral targets. The results support the view that both threatening and pleasant pictures can be detected more rapidly than neutral targets.

  3. Performance improvements from imagery: evidence that internal visual imagery is superior to external visual imagery for slalom performance

    PubMed Central

    Callow, Nichola; Roberts, Ross; Hardy, Lew; Jiang, Dan; Edwards, Martin Gareth

    2013-01-01

    We report three experiments investigating the hypothesis that use of internal visual imagery (IVI) would be superior to external visual imagery (EVI) for the performance of different slalom-based motor tasks. In Experiment 1, three groups of participants (IVI, EVI, and a control group) performed a driving-simulation slalom task. The IVI group achieved significantly quicker lap times than EVI and the control group. In Experiment 2, participants performed a downhill running slalom task under both IVI and EVI conditions. Performance was again quickest in the IVI compared to EVI condition, with no differences in accuracy. Experiment 3 used the same group design as Experiment 1, but with participants performing a downhill ski-slalom task. Results revealed the IVI group to be significantly more accurate than the control group, with no significant differences in time taken to complete the task. These results support the beneficial effects of IVI for slalom-based tasks, and significantly advances our knowledge related to the differential effects of visual imagery perspectives on motor performance. PMID:24155710

  4. Creatine salts provide neuroprotection even after partial impairment of the creatine transporter.

    PubMed

    Adriano, E; Garbati, P; Salis, A; Damonte, G; Millo, E; Balestrino, M

    2017-01-06

    Creatine, a compound that is critical for energy metabolism of nervous cells, crosses the blood-brain barrier (BBB) and the neuronal plasma membrane with difficulty, and only using its specific transporter. In the hereditary condition where the creatine transporter is defective (creatine transporter deficiency) there is no creatine in the brain, and administration of creatine is useless lacking the transporter. The disease is severe and incurable. Creatine-derived molecules that could cross BBB and plasma membrane independently of the transporter might be useful to cure this condition. Moreover, such molecules could be useful also in stroke and other brain ischemic conditions. In this paper, we investigated three creatine salts, creatine ascorbate, creatine gluconate and creatine glucose. Of these, creatine glucose was ineffective after transporter block with guanidine acetic acid (GPA) administration. Creatine ascorbate was not superior to creatine in increasing tissue creatine and phosphocreatine content after transporter impairment, however even after such impairment it delayed synaptic failure during anoxia. Finally, creatine gluconate was superior to creatine in increasing tissue content of creatine after transporter block and slowed down PS disappearance during anoxia, an effect that creatine did not have. These findings suggest that coupling creatine to molecules having a specific transporter may be a useful strategy in creatine transporter deficiency. In particular, creatine ascorbate has effects comparable to those of creatine in normal conditions, while being superior to it under conditions of missing or impaired creatine transporter. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Cognitively normal individuals with AD parents may be at risk for developing aging-related cortical thinning patterns characteristic of AD.

    PubMed

    Reiter, Katherine; Alpert, Kathryn I; Cobia, Derin J; Kwasny, Mary J; Morris, John C; Csernansky, John C; Wang, Lei

    2012-07-02

    Children of Alzheimer's disease (AD) patients are at heightened risk of developing AD due to genetic influences, including the apolipoprotein E4 (ApoE4) allele. In this study, we assessed the earliest cortical changes associated with AD in 71 cognitively healthy, adult children of AD patients (AD offspring) as compared with 69 with no family history of AD (non-AD offspring). Cortical thickness measures were obtained using FreeSurfer from 1.5T magnetic resonance (MR) scans. ApoE genotyping was obtained. Primary analyses examined family history and ApoeE4 effects on cortical thickness. Secondary analyses examined age effects within groups. All comparisons were adjusted using False Discovery Rate at a significance threshold of p<0.05. There were no statistically significant differences between family history and ApoE4 groups. Within AD offspring, increasing age was related to reduced cortical thickness (atrophy) over large areas of the precuneus, superior frontal and superior temporal gyri, starting at around age 60. Further, these patterns existed within female and maternal AD offspring, but were absent in male and paternal AD offspring. Within non-AD offspring, negative correlations existed over small regions of the superior temporal, insula and lingual cortices. These results suggest that as AD offspring age, cortical atrophy is more prominent, particularly if the parent with AD is mother or if the AD offspring is female. Copyright © 2012 Elsevier Inc. All rights reserved.

  6. COGNITIVELY NORMAL INDIVIDUALS WITH AD PARENTS MAY BE AT RISK FOR DEVELOPING AGING-RELATED CORTICAL THINNING PATTERNS CHARACTERISTIC OF AD

    PubMed Central

    Reiter, Katherine; Alpert, Kathryn I.; Cobia, Derin J.; Kwasny, Mary J.; Morris, John C.; Csernansky, John C.; Wang, Lei

    2012-01-01

    Children of Alzheimer's Disease (AD) patients are at heightened risk of developing AD due to genetic influences, including the apolipoprotein E4 (ApoE4) allele. In this study, we assessed the earliest cortical changes associated with AD in 71 cognitively healthy, adult children of AD patients (AD offspring) as compared with 69 with no family history of AD (non-AD offspring). Cortical thickness measures were obtained using FreeSurfer from 1.5T magnetic resonance (MR) scans. ApoE genotyping was obtained. Primary analyses examined family history and ApoeE4 effects on cortical thickness. Secondary analyses examined age effects within groups. All comparisons were adjusted using False Discovery Rate at a significance threshold of p < 0.05. There were no statistically significant differences between family history and ApoE4 groups. Within AD offspring, increasing age was related to reduced cortical thickness (atrophy) over large areas of the precuneus, superior frontal and superior temporal gyri, starting at around age 60. Further, these patterns existed within female and maternal AD offspring, but were absent in male and paternal AD offspring. Within non-AD offspring, negative correlations existed over small regions of the superior temporal, insula and lingual cortices. These results suggest that as AD offspring age, cortical atrophy is more prominent, particularly if the parent with AD is mother or if the AD offspring is female. PMID:22503937

  7. Highly active carbon supported ternary PdSnPtx (x=0.1-0.7) catalysts for ethanol electro-oxidation in alkaline and acid media.

    PubMed

    Wang, Xiaoguang; Zhu, Fuchun; He, Yongwei; Wang, Mei; Zhang, Zhonghua; Ma, Zizai; Li, Ruixue

    2016-04-15

    A series of trimetallic PdSnPtx (x=0.1-0.7)/C catalysts with varied Pt content have been synthesized by co-reduction method using NaBH4 as a reducing agent. These catalysts were characterized using X-ray diffraction (XRD), transmission electron microscopy (TEM), high resolution transmission electron microscopy (HRTEM), energy dispersive X-ray spectroscopy (EDX), X-ray photoelectron spectroscopy (XPS), cyclic voltammetry (CV) and chronoamperometry (CA). The electrochemical results show that, after adding a minor amount of Pt dopant, the resultant PdSnPtx/C demonstrated more superior catalytic performance toward ethanol oxidation as compared with that of mono-/bi-metallic Pd/C or PdSn/C in alkaline solution and the PdSnPt0.2/C with optimal molar ratio reached the best. In acid solution, the PdSnPt0.2/C also depicted a superior catalytic activity relative to the commercial Pt/C catalyst. The possible enhanced synergistic effect between Pd, Sn/Sn(O) and Pt in an alloyed state should be responsible for the as-revealed superior ethanol electro-oxidation performance based upon the beneficial electronic effect and bi-functional mechanism. It implies the trimetallic PdSnPt0.2/C with a low Pt content has a promising prospect as anodic electrocatalyst in fields of alkali- and acid-type direct ethanol fuel cells. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. A novel study design for antibiotic trials in acute exacerbations of COPD: MAESTRAL methodology

    PubMed Central

    Wilson, Robert; Anzueto, Antonio; Miravitlles, Marc; Arvis, Pierre; Faragó, Geneviève; Haverstock, Daniel; Trajanovic, Mila; Sethi, Sanjay

    2011-01-01

    Antibiotics, along with oral corticosteroids, are standard treatments for acute exacerbations of chronic obstructive pulmonary disease (AECOPD). The ultimate aims of treatment are to minimize the impact of the current exacerbation, and by ensuring complete resolution, reduce the risk of relapse. In the absence of superiority studies of antibiotics in AECOPD, evidence of the relative efficacy of different drugs is lacking, and so it is difficult for physicians to select the most effective antibiotic. This paper describes the protocol and rationale for MAESTRAL (moxifloxacin in AECBs [acute exacerbation of chronic bronchitis] trial; www.clinicaltrials.gov: NCT00656747), one of the first antibiotic comparator trials designed to show superiority of one antibiotic over another in AECOPD. It is a prospective, multinational, multicenter, randomized, double-blind controlled study of moxifloxacin (400 mg PO [ per os] once daily for 5 days) vs amoxicillin/clavulanic acid (875/125 mg PO twice daily for 7 days) in outpatients with COPD and chronic bronchitis suffering from an exacerbation. MAESTRAL uses an innovative primary endpoint of clinical failure: the requirement for additional or alternate treatment for the exacerbation at 8 weeks after the end of antibiotic therapy, powered for superiority. Patients enrolled are those at high-risk of treatment failure, and all are experiencing an Anthonisen type I exacerbation. Patients are stratified according to oral corticosteroid use to control their effect across antibiotic treatment arms. Secondary endpoints include quality of life, symptom assessments and health care resource use. PMID:21760724

  9. Preparation and in vitro/in vivo evaluation of metformin hydrochloride rectal dosage forms for treatment of patients with type II diabetes.

    PubMed

    Zaghloul, Abdel-Azim; Lila, Ahmad; Abd-Allah, Fathy; Nada, Aly

    2017-06-01

    Metformin hydrochloride (MtHCL) is an oral antidiabetic drug and has many other therapeutic benefits. It has poor bioavailability, narrow absorption window and extensive liver metabolism. Moreover, children and elders face difficulty to swallow the commercial oral tablets. Preparation, in vitro/in vivo evaluation of MtHCL suppositories for rectal administration to solve some of these problems. Suppository fatty bases (Witepsol ® , Suppocire ® and Massa ® ; different grades) and PEG bases 1000, 4000 and 6000 (different ratios), were used to prepare rectal suppository formulations each containing 500 mg drug. These were characterized for manufacturing defects, and pharmacotechnical performance and formulations showing superior results were subjected to bioavailability testing in human volunteers compared with the commercial oral tablet (Ref) applying LC-MS/MS developed analytical technique. The preparation method produced suppositories with satisfactory characteristics and free of manufacturing defects. The fatty bases were superior compared with PEG bases regarding the physical characteristics. Three formulations were chosen for bioavailability testing and the results showed comparable bioavailability compared to the Ref. The fatty bases showed superior characteristics compared with the PEG bases. MtHCL formulated in selected fatty bases could be a potential alternative to the commercial oral tablets particularly for pediatric and geriatric patients.

  10. Comparing extracorporeal cardiopulmonary resuscitation with conventional cardiopulmonary resuscitation: A meta-analysis.

    PubMed

    Kim, Su Jin; Kim, Hyun Jung; Lee, Hee Young; Ahn, Hyeong Sik; Lee, Sung Woo

    2016-06-01

    The objective was to determine whether extracorporeal cardiopulmonary resuscitation (ECPR), when compared with conventional cardiopulmonary resuscitation (CCPR), improves outcomes in adult patients, and to determine appropriate conditions that can predict good survival outcome in ECPR patients through a meta-analysis. We searched the relevant literature of comparative studies between ECPR and CCPR in adults, from the MEDLINE, EMBASE, and Cochrane databases. The baseline information and outcome data (survival, good neurologic outcome at discharge, at 3-6 months, and at 1 year after arrest) were extracted. Beneficial effect of ECPR on outcome was analyzed according to time interval, location of arrest (out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA)), and pre-defined population inclusion criteria (witnessed arrest, initial shockable rhythm, cardiac etiology of arrest and CPR duration) by using Review Manager 5.3. Cochran's Q test and I(2) were calculated. 10 of 1583 publications were included. Although survival to discharge did not show clear superiority in OHCA, ECPR showed statistically improved survival and good neurologic outcome as compared to CCPR, especially at 3-6 months after arrest. In the subgroup of patients with pre-defined inclusion criteria, the pooled meta-analysis found similar results in studies with pre-defined criteria. Survival and good neurologic outcome tended to be superior in the ECPR group at 3-6 months after arrest. The effect of ECPR on survival to discharge in OHCA was not clearly shown. As ECPR showed better outcomes than CCPR in studies with pre-defined criteria, strict indications criteria should be considered when implementation of ECPR. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Therapeutic superiority and safety of combined hydroxyurea with recombinant human erythropoietin over hydroxyurea in young β-thalassemia intermedia patients.

    PubMed

    Elalfy, Mohsen S; Adly, Amira A M; Ismail, Eman A; Elhenawy, Yasmine I; Elghamry, Islam R

    2013-12-01

    To assess the efficacy and safety of combined hydroxyurea (HU) and recombinant human erythropoietin (rHuEPO) in β-thalassemia intermedia (TI) patients compared with single HU therapy. An interventional prospective randomized study registered in the ClinicalTrials.gov (NCT01624038) was performed on 80 TI patients (≤ 18 yr) divided into group A (40 patients received combined HU and rHuEPO) and group B (40 patients received single HU therapy). Baseline serum EPO levels were measured, and both groups were followed up for a mean period of 1 yr with regular assessment of transfusion requirements, blood pressure, ferritin, liver and renal functions, hemoglobin, and HbF. Quality of life (QoL) was assessed at the start and end of the study. Transfusion frequency and index were significantly decreased, while QoL was increased in group A compared with group B where 85% of patients showed improvement on combined therapy compared with 50% of patients on HU. Hemoglobin and HbF were significantly increased in both TI groups; however, this was more evident in group A than in group B. Also, 37.5% of patients in group A became transfusion-independent compared with 15% in group B. EPO levels were negatively related to increments of hemoglobin and HbF. Splenectomized patients and those with initial HbF% >40% had the best response to combined therapy. No serious adverse events necessitating discontinuation of therapy in both groups. HU was effective in management of TI; however, combination with rHuEPO gave a superior therapeutic effect resulting in the best clinical and hematological responses without adverse events. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Environmental fatigue in aluminum-lithium alloys

    NASA Technical Reports Server (NTRS)

    Piascik, Robert S.

    1992-01-01

    Aluminum-lithium alloys exhibit similar environmental fatigue crack growth characteristics compared to conventional 2000 series alloys and are more resistant to environmental fatigue compared to 7000 series alloys. The superior fatigue crack growth behavior of Al-Li alloys 2090, 2091, 8090, and 8091 is due to crack closure caused by tortuous crack path morphology and crack surface corrosion products. At high R and reduced closure, chemical environment effects are pronounced resulting in accelerated near threshold da/dN. The beneficial effects of crack closure are minimized for small cracks resulting in rapid growth rates. Limited data suggest that the 'chemically small crack' effect, observed in other alloy system, is not pronounced in Al-Li alloys. Modeling of environmental fatigue in Al-Li-Cu alloys related accelerated fatigue crack growth in moist air and salt water to hydrogen embrittlement.

  13. The Effectiveness of Cognitive Behavioral Therapy versus Psychoeducation in the Management of Depression among Patients Undergoing Haemodialysis.

    PubMed

    Al Saraireh, Faris A; Aloush, Sami M; Al Azzam, Manar; Al Bashtawy, Mohammed

    2018-01-25

    The aim of this randomized controlled trial was to compare the effectiveness of psychoeducation versus cognitive behavioral therapy (CBT) in the management of depression among renal dialysis patients. A sample of 130 dialysis patients participated in the study and they were assigned at random to one of two therapies: psychoeducation (N = 65) or CBT (N = 65). Hamilton depression rating scale was completed by the participants in both groups prior to the therapies and after completion. Both therapies were effective in the management of depression, although psychoeducation was superior. Psychoeducation is recommended over CBT in the management of depression among renal dialysis patients.

  14. Atheroprotective potentials of curcuminoids against ginger extract in hypercholesterolaemic rabbits.

    PubMed

    Elseweidy, M M; Younis, N N; Elswefy, S E; Abdallah, F R; El-Dahmy, S I; Elnagar, G; Kassem, H M

    2015-01-01

    The anti-atherogenic potentials of total ginger (Zingiber officinale) extract (TGE) or curcuminoids extracted from turmeric (Curcuma longa), members of family Zingiberaceae, were compared in hypercholesterolaemia. Rabbits were fed either normal or atherogenic diet. The rabbits on atherogenic diet received treatments with TGE or curcumenoids and placebo concurrently for 6 weeks (n = 6). The anti-atherogenic effects of curcuminoids and ginger are mediated via multiple mechanisms. This effect was correlated with their ability to lower cholesteryl ester transfer protein activity. Ginger extract exerted preferential effects on plasma lipids, reverse cholesterol transport, cholesterol synthesis and inflammatory status. Curcuminoids, however, showed superior antioxidant activity.

  15. Effectiveness of spoilers on the GA(W)-1 airfoil with a high performance Fowler flap

    NASA Technical Reports Server (NTRS)

    Wentz, W. H., Jr.

    1975-01-01

    Two-dimensional wind-tunnel tests were conducted to determine effectiveness of spoilers applied to the GA(W)-1 airfoil. Tests of several spoiler configurations show adequate control effectiveness with flap nested. It is found that providing a vent path allowing lower surface air to escape to the upper surface as the spoiler opens alleviates control reversal and hysteresis tendencies. Spoiler cross-sectional shape variations generally have a modest influence on control characteristics. A series of comparative tests of vortex generators applied to the (GA-W)-1 airfoil show that triangular planform vortex generators are superior to square planform vortex generators of the same span.

  16. Activity of terbinafine in experimental fungal infections of laboratory animals.

    PubMed Central

    Petranyi, G; Meingassner, J G; Mieth, H

    1987-01-01

    The allylamine derivative terbinafine is the first antifungal agent with primary fungicidal properties against dermatophytes which acts systemically after oral application as well as locally after topical application. Comparative oral studies carried out with griseofulvin and ketoconazole in model infections such as guinea pig trichophytosis and microsporosis revealed terbinafine to be superior to the reference compounds both clinically and mycologically. An excellent antimycotic activity of terbinafine was also demonstrable after topical treatment of guinea pig dermatophytoses caused by Trichophyton mentagrophytes or Microsporum canis. Results of comparative chemotherapeutic studies carried out with econazole and tolnaftate demonstrated superior efficacy of terbinafine in the treatment of both trichophytosis and microsporosis. Skin infections of guinea pigs caused by Candida albicans and vaginal candidiasis in rats proved to be responsive to a topical application of terbinafine also. However, the reference compounds, clotrimazole and miconazole, exhibited activity superior to that of terbinafine in both models. PMID:3435103

  17. Interoceptive awareness in experienced meditators.

    PubMed

    Khalsa, Sahib S; Rudrauf, David; Damasio, Antonio R; Davidson, Richard J; Lutz, Antoine; Tranel, Daniel

    2008-07-01

    Attention to internal body sensations is practiced in most meditation traditions. Many traditions state that this practice results in increased awareness of internal body sensations, but scientific studies evaluating this claim are lacking. We predicted that experienced meditators would display performance superior to that of nonmeditators on heartbeat detection, a standard noninvasive measure of resting interoceptive awareness. We compared two groups of meditators (Tibetan Buddhist and Kundalini) to an age- and body mass index-matched group of nonmeditators. Contrary to our prediction, we found no evidence that meditators were superior to nonmeditators in the heartbeat detection task, across several sessions and respiratory modulation conditions. Compared to nonmeditators, however, meditators consistently rated their interoceptive performance as superior and the difficulty of the task as easier. These results provide evidence against the notion that practicing attention to internal body sensations, a core feature of meditation, enhances the ability to sense the heartbeat at rest.

  18. Interoceptive awareness in experienced meditators

    PubMed Central

    KHALSA, SAHIB S.; RUDRAUF, DAVID; DAMASIO, ANTONIO R.; DAVIDSON, RICHARD J.; LUTZ, ANTOINE; TRANEL, DANIEL

    2009-01-01

    Attention to internal body sensations is practiced inmost meditation traditions. Many traditions state that this practice results in increased awareness of internal body sensations, but scientific studies evaluating this claim are lacking. We predicted that experienced meditators would display performance superior to that of nonmeditators on heartbeat detection, a standard noninvasive measure of resting interoceptive awareness. We compared two groups of meditators (Tibetan Buddhist and Kundalini) to an age- and body mass index-matched group of nonmeditators. Contrary to our prediction, we found no evidence that meditators were superior to nonmeditators in the heartbeat detection task, across several sessions and respiratory modulation conditions. Compared to nonmeditators, however, meditators consistently rated their interoceptive performance as superior and the difficulty of the task as easier. These results provide evidence against the notion that practicing attention to internal body sensations, a core feature of meditation, enhances the ability to sense the heartbeat at rest. PMID:18503485

  19. Do Adults with Mental Retardation Show Pictorial Superiority Effects in Recall and Recognition?

    ERIC Educational Resources Information Center

    Cherry, Katie E.; Applegate, Heather; Reese, Celinda M.

    2002-01-01

    A study examined memory for pictures and words in 16 adults with mental retardation and 24 controls. Pictorial superiority effects occurred in free recall and recognition for both intelligence-level groups. Correlational analyses indicated working memory span was primarily related to recall performance, irrespective of stimulus format. (Contains…

  20. The Contribution of Executive Functions to Naming Digits, Objects, and Words

    ERIC Educational Resources Information Center

    Altani, Angeliki; Protopapas, Athanassios; Georgiou, George K.

    2017-01-01

    Although it is established that reading fluency is more strongly related to serial naming of symbols than to naming of isolated items ("serial superiority effect"), the reason for the difference remains unclear. The purpose of this study was to examine the role of executive functions in explaining the serial superiority effect. One…

  1. Tacit Knowledge Flows and Institutional Theory: Accelerating Acculturation

    DTIC Science & Technology

    2010-01-01

    sustainable competitive advantage , but different kinds of knowledge affect competitive advantage differently. This applies especially to the...such qualitative fieldwork and informs theory and practice alike. 1. Introduction Knowledge is key to sustainable competitive advantage ...4,8,19]. Knowledge enables effective action; effective action drives superior performance; and superior performance supports competitive advantage

  2. Enhanced Antiproliferative Effect of Carboplatin in Cervical Cancer Cells Utilizing Folate-Grafted Polymeric Nanoparticles

    NASA Astrophysics Data System (ADS)

    Ji, Jing; Zuo, Ping; Wang, Yue-Ling

    2015-11-01

    Carboplatin (CRB) possesses superior anticancer effect in cervical cancer cells with lower incidence of side effects compared to that of cisplatin. However, CRB suffers from severe side effects due to undesirable tissue distributions which contribute to the low therapeutic efficacy. Here, we report a unique folic acid-conjugated chitosan-coated poly( d- l-lactideco-glycolide) (PLGA) nanoparticles (FPCC) prepared for the selective delivery of carboplatin to the cervical cancer cells. The particles were nanosized and spherical shaped with size less than <200 nm. The presence of protective chitosan layer controlled the overall release rate of CRB from chitosan-coated PLGA nanoparticles (PCC) and FPCC. FPCC displayed a higher cellular uptake capacity in HeLa cells than compared to non-targeted nanoparticles. Selective uptake of FPCC was due to an interaction of folic acid (FA) with the folate receptors alpha (FRs-α) which is overexpressed on the HeLa and promoted active targeting. These results indicated that FPCC had a specific affinity for the cancerous, HeLa cells owing to ligand-receptor (FA-FR-α) recognition. Consistently, FPCC showed superior cytotoxic effect than any other formulations. The IC50 (concentration of the drug required to kill 50 % of the cells) value of FPCC was 0.65 μg/ml while it was 1.08, 1.56, and 2.35 μg/ml for PCC, PLGA NP, and free CRB, respectively. Consistent with the cytotoxicity assay, FPCC induced higher fraction of early as well as late apoptosis cells. Especially, FPCC induced nearly 45 % of early apoptosis cells and more than 35 % in late apoptosis. Therefore, we propose that folate-conjugated nanoparticles might have potential applications in cervical cancer therapy.

  3. [Alemtuzumab for relapsing-remitting multiple sclerosis. Results of two randomized controlled phase III studies].

    PubMed

    Klotz, L; Meuth, S G; Kieseier, B; Wiendl, H

    2013-08-01

    In November 2012 the results of 2 clinical phase III trials were published which addressed the effects of alemtuzumab in patients with relapsing-remitting multiple sclerosis (MS). In the CARE-MS-I study patients with early untreated MS (EDSS ≤ 3.0, disease duration < 5 years) were included, whereas CARE-MS-II investigated the effects of alemtuzumab in patients with persisting disease activity under standard disease-modifying treatment (EDSS ≤ 5.0, disease duration < 10 years). These groups were compared to patients under treatment with frequently applied interferon β 1a (3 times  44 µg subcutaneous). Both studies clearly demonstrated a superiority of alemtuzumab compared to interferon in terms of reduction of relapse rate as well as the number of new or enlarging T2 lesions and gadolinium-enhancing lesions. Moreover, the CARE-MS-II study showed a significant delay in disease progression by alemtuzumab. The portfolio and the frequency of relevant side effects, such as infusion-related reactions, development of secondary autoimmunity or infections were within the expected range. Taken together these studies confirm the high anti-inflammatory efficacy of alemtuzumab and hence provide the first evidence of superiority of a monotherapy in direct comparison to standard disease-modifying treatment in two phase III trials in relapsing-remitting MS. These data in the context of the mode of action of alemtuzumab provide evidence for the relevance of immune cells, especially T cells, in the pathophysiology of MS. Experience with long-term effects of alemtuzumab, e.g. from the phase II extension trial as well as the side effect profile argue in favor of a sustained reprogramming of the immune system as a consequence of immune cell depletion by alemtuzumab.

  4. Sublimation measurements and analysis of high temperature thermoelectric materials and devices

    NASA Technical Reports Server (NTRS)

    Shields, V.; Noon, L.

    1983-01-01

    High temperature thermoelectric device sublimation effects are compared for rare earth sulfides, selenides, and state-of-the-art Si-Ge alloys. Although rare earth calcogenides can potentially exhibit superior sublimation characteristics, the state-of-the-art Si-Ge alloy with silicon nitride sublimation-inhibitive coating has been tested to 1000 C. Attention is given to the ceramic electrolyte cells, forming within electrical and thermal insulation, which affect leakage conductance measurements in Si-Ge thermoelectric generators.

  5. Empiricism or rationalism: how should we measure proteinuria?

    PubMed

    Methven, Shona; MacGregor, Mark S

    2013-07-01

    Proteinuria is the cardinal sign of renal disease, therefore accurate identification of clinically significant proteinuria is essential to the diagnosis and management of kidney disease. Spot samples are now widely used, namely protein: creatinine ratio (uPCR) and albumin: creatinine ratio (uACR). In this article we review the evidence comparing uPCR and uACR including clinical, laboratory and financial arguments. uPCR has a superior performance to uACR to predict 24-hour total proteinuria, the measurement on which the evidence for interventions in chronic kidney disease is based. Furthermore a retrospective study comparing uPCR and uACR as predictors of renal outcome found comparable performance to predict all-cause mortality, commencement of renal replacement therapy and doubling of serum creatinine. Only uPCR takes account of non-albumin proteinuria which has been shown to have prognostic significance. uACR was been thought to be superior at low levels (where there is less 'noise' from physiological urinary proteins), but uPCR has recently been shown to perform well at levels equivalent to <0.5 g/day (and even within the reference range) as a predictor of outcomes. uACR is measured using an immunoassay that may be technically superior, but is not without shortcomings (such as antigen excess) and is 2-10 times more expensive than uPCR. The theories explaining the superiority of albumin are appealing. However, the available comparative data do not seem to support the theory. We cannot explain the disparity, but in science, if the data do not fit the existing theory, then maybe it's time for a new theory.

  6. Spherical α-MnO₂ Supported on N-KB as Efficient Electrocatalyst for Oxygen Reduction in Al-Air Battery.

    PubMed

    Chen, Kui; Wang, Mei; Li, Guangli; He, Quanguo; Liu, Jun; Li, Fuzhi

    2018-04-13

    Traditional noble metal platinum (Pt) is regarded as a bifunctional oxygen catalyst due to its highly catalytic efficiency, but its commercial availability and application is often restricted by high cost. Herein, a cheap and effective catalyst mixed with α-MnO₂ and nitrogen-doped Ketjenblack (N-KB) (denoted as MnO₂-SM150-0.5) is examined as a potential electrocatalyst in oxygen reduction reactions (ORR) and oxygen evolution reactions (OER). This α-MnO₂ is prepared by redox reaction between K₂S₂O₈ and MnSO₄ in acid conditions with a facile hydrothermal process (named the SM method). As a result, MnO₂-SM150-0.5 exhibits a good catalytic performance for ORR in alkaline solution, and this result is comparable to a Pt/C catalyst. Moreover, this catalyst also shows superior durability and methanol tolerance compared with a Pt/C catalyst. It also displays a discharge voltage (~1.28 V) at a discharge density of 50 mA cm -2 in homemade Al-air batteries that is higher than commercial 20% Pt/C (~1.19 V). The superior electrocatalytic performance of MnO₂-SM150-0.5 could be attributed to its higher Mn 3+ /Mn 4+ ratio and the synergistic effect between MnO₂ and the nitrogen-doped KB. This study provides a novel strategy for the preparation of an MnO₂-based composite electrocatalyst.

  7. Neural mechanisms of savant calendar calculating in autism: an MEG-study of few single cases.

    PubMed

    Dubischar-Krivec, Anna Milena; Bölte, Sven; Braun, Christoph; Poustka, Fritz; Birbaumer, Niels; Neumann, Nicola

    2014-10-01

    This study contrasted the neurological correlates of calendar calculating (CC) between those individuals with autism spectrum disorder (ASD) and typically developing individuals. CC is the ability to correctly and quickly state the day of the week of a given date. Using magnetoencephalography (MEG), we presented 126 calendar tasks with dates of the present, past, and future. Event-related magnetic fields (ERF) of 3000ms duration and brain activation patterns were compared in three savant calendar calculators with ASD (ASDCC) and three typically developing calendar calculators (TYPCC). ASDCC outperformed TYPCC in correct responses, but not in answering speed. Comparing amplitudes of their ERFs, there was a main effect of group between 1000 and 3000ms, but no further effects of hemisphere or sensor location. We conducted CLARA source analysis across the entire CC period in each individual. Both ASDCC and TYPCC exhibited activation maxima in prefrontal areas including the insulae and the left superior temporal gyrus. This is in accordance with verbal fact retrieval and working memory as well as monitoring and coordination processes. In ASDCC, additional activation sites at the right superior occipital gyrus, the right precuneus, and the right putamen point to visual-spatial strategies and are in line with the preference of autistic individuals for engaging posterior regions relatively more strongly in various reasoning and problem solving tasks. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Collagen concentration on the facial skin of postmenopausal women after topical treatment with estradiol and genistein: a randomized double-blind controlled trial.

    PubMed

    Silva, Lidia Aragão; Ferraz Carbonel, Adriana Aparecida; de Moraes, Andréa Regina Barbosa; Simões, Ricardo S; Sasso, Gisela Rodrigues da Silva; Goes, Lívia; Nunes, Winnie; Simões, Manuel Jesus; Patriarca, Marisa Teresinha

    2017-11-01

    The objective of this study is to compare the effects of topical estrogen and genistein (a soy isoflavone) on the facial skin collagen of postmenopausal women not undergoing systemic hormonal therapy. This is a prospective, double blind, randomized, controlled clinical trial. Volunteer women (N = 30) 45-55 year old from the Endocrine Gynecology sector of the Gynecology Department of the Federal University of São Paulo (UNIFESP). The Ethical Committee of the Federal University of São Paulo approved the study (report no. 386/2004; registration on ClinicalTrials.gov NCT01553773), were assigned to topical treatment with either estrogen or genistein for 24 weeks. We quantified and compared facial collagen concentration before and after each treatment by performing pre-auricular skin biopsies. Our data showed an increase in the amount of both type I and type III facial collagen by the end of both treatments. However, the outcomes of the estrogen GI (ER) group were superior to the genistein GII (GEN) group, with statistical significance p < 000.1 Conclusion: Treatment with topical estrogen is superior to genistein, but both have positive impacts on facial skin collagen. Nevertheless, it is still unclear whether prolonged use of genistein and other topical phytoestrogens could produce systemic effects and further research is needed to clarify this question.

  9. More than Just Another Face in the Crowd: Evidence for an "Angry Superiority Effect" in Children with and without Autism

    ERIC Educational Resources Information Center

    Rosset, Delphine; Santos, Andreia; Da Fonseca, David; Rondan, Cecilie; Poinso, Francois; Deruelle, Christine

    2011-01-01

    The angry superiority effect refers to more efficient way individuals detect angry relative to happy faces in a crowd. Given their socio-emotional deficits, children with autism spectrum disorders (ASD) may be impervious to this effect. Thirty children with ASD and 30 matched-typically developing children were presented with a visual search task,…

  10. The drawing effect: Evidence for reliable and robust memory benefits in free recall.

    PubMed

    Wammes, Jeffrey D; Meade, Melissa E; Fernandes, Myra A

    2016-01-01

    In 7 free-recall experiments, the benefit of creating drawings of to-be-remembered information relative to writing was examined as a mnemonic strategy. In Experiments 1 and 2, participants were presented with a list of words and were asked to either draw or write out each. Drawn words were better recalled than written. Experiments 3-5 showed that the memory boost provided by drawing could not be explained by elaborative encoding (deep level of processing, LoP), visual imagery, or picture superiority, respectively. In Experiment 6, we explored potential limitations of the drawing effect, by reducing encoding time and increasing list length. Drawing, relative to writing, still benefited memory despite these constraints. In Experiment 7, the drawing effect was significant even when encoding trial types were compared in pure lists between participants, inconsistent with a distinctiveness account. Together these experiments indicate that drawing enhances memory relative to writing, across settings, instructions, and alternate encoding strategies, both within- and between-participants, and that a deep LoP, visual imagery, or picture superiority, alone or collectively, are not sufficient to explain the observed effect. We propose that drawing improves memory by encouraging a seamless integration of semantic, visual, and motor aspects of a memory trace.

  11. Link prediction measures considering different neighbors’ effects and application in social networks

    NASA Astrophysics Data System (ADS)

    Luo, Peng; Wu, Chong; Li, Yongli

    Link prediction measures have been attracted particular attention in the field of mathematical physics. In this paper, we consider the different effects of neighbors in link prediction and focus on four different situations: only consider the individual’s own effects; consider the effects of individual, neighbors and neighbors’ neighbors; consider the effects of individual, neighbors, neighbors’ neighbors, neighbors’ neighbors’ neighbors and neighbors’ neighbors’ neighbors’ neighbors; consider the whole network participants’ effects. Then, according to the four situations, we present our link prediction models which also take the effects of social characteristics into consideration. An artificial network is adopted to illustrate the parameter estimation based on logistic regression. Furthermore, we compare our methods with the some other link prediction methods (LPMs) to examine the validity of our proposed model in online social networks. The results show the superior of our proposed link prediction methods compared with others. In the application part, our models are applied to study the social network evolution and used to recommend friends and cooperators in social networks.

  12. The picture superiority effect: support for the distinctiveness model.

    PubMed

    Mintzer, M Z; Snodgrass, J G

    1999-01-01

    The form change paradigm was used to explore the basis for the picture superiority effect. Recognition memory for studied pictures and words was tested in their study form or the alternate form. Form change cost was defined as the difference between recognition performance for same and different form items. Based on the results of Experiment 1 and previous studies, it was difficult to determine the relative cost for studied pictures and words due to a reversal of the mirror effect. We hypothesized that the reversed mirror effect results from subjects' basing their recognition decisions on their assumptions about the study form. Experiments 2 and 3 confirmed this hypothesis and generated a method for evaluating the relative cost for pictures and words despite the reversed mirror effect. More cost was observed for pictures than words, supporting the distinctiveness model of the picture superiority effect.

  13. Research related to improved computer aided design software package. [comparative efficiency of finite, boundary, and hybrid element methods in elastostatics

    NASA Technical Reports Server (NTRS)

    Walston, W. H., Jr.

    1986-01-01

    The comparative computational efficiencies of the finite element (FEM), boundary element (BEM), and hybrid boundary element-finite element (HVFEM) analysis techniques are evaluated for representative bounded domain interior and unbounded domain exterior problems in elastostatics. Computational efficiency is carefully defined in this study as the computer time required to attain a specified level of solution accuracy. The study found the FEM superior to the BEM for the interior problem, while the reverse was true for the exterior problem. The hybrid analysis technique was found to be comparable or superior to both the FEM and BEM for both the interior and exterior problems.

  14. Do Children with Visual Impairments Demonstrate Superior Short-term Memory, Memory Strategies, and Metamemory?

    ERIC Educational Resources Information Center

    Wyver, Shirley R.; Markham, Roslyn

    1998-01-01

    This study compared the memory processes underpinning the performance of 19 children with visual impairments and 19 sighted children on the Digit Span subtest of the Wechsler Intelligence Scales. No support was found for claims of the superior performance of children with visual impairments on the subtest nor of a greater awareness of memory…

  15. To Flip or Not to Flip? Analysis of a Flipped Classroom Pedagogy in a General Biology Course

    ERIC Educational Resources Information Center

    Heyborne, William H.; Perrett, Jamis J.

    2016-01-01

    In an attempt to better understand the flipped technique and evaluate its purported superiority in terms of student learning gains, the authors conducted an experiment comparing a flipped classroom to a traditional lecture classroom. Although the outcomes were mixed, regarding the superiority of either pedagogical approach, there does seem to be a…

  16. Identifying Attention Deficit Hyperactive Disorder with the WISC-R and the Stroop Color and Word Test.

    ERIC Educational Resources Information Center

    Lufi, Dubi; And Others

    1990-01-01

    Compared 29 children with Attention Deficit Hyperactive Disorder (ADHD), 21 emotionally disturbed (ED) children, and control (CO) group of 20 nonproblem children using 12 subtests of Wechsler Intelligence Scale for Children-Revised and Stroop Color and Word Test. Results showed CO group superior to ADHD and ED groups and ED group superior to ADHD…

  17. Effect of Low-Fat vs. Other Diet Interventions on Long-Term Weight Change in Adults: A Systematic Review and Meta-Analysis

    PubMed Central

    Tobias, Deirdre K.; Chen, Mu; Manson, JoAnn E.; Ludwig, David S.; Willett, Walter; Hu, Frank B.

    2015-01-01

    Background The effectiveness of low-fat diets for long-term weight loss has been debated for decades, with dozens of randomized trials (RCTs) and recent reviews giving mixed results. Methods We conducted a random effects meta-analysis of RCTs to estimate the long-term effect of low-fat vs. higher fat dietary interventions on weight loss. Our search included RCTs conducted in adult populations reporting weight change outcomes at ≥1 year, comparing low-fat with higher fat interventions, published through July 2014. The primary outcome measure was mean difference in weight change between interventions. Findings Fifty-three studies met inclusion criteria representing 68,128 participants. In the setting of weight loss trials, low-carbohydrate interventions led to significantly greater weight loss than low-fat interventions (n comparisons=18; weighted mean difference [WMD]=1.15 kg, 95% CI=0.52 to 1.79; I2=10%). Low-fat did not lead to differences in weight change compared with other moderate fat weight loss interventions (n=19; WMD=0.36, 95% CI=-0.66 to 1.37; I2=82%), and were superior only when compared with “usual diet” (n=8; WMD=-5.41, 95% CI=-7.29 to −3.54; I2=68%). Similarly, non-weight loss trials and weight maintenance trials, for which there were no low-carbohydrate comparisons, had similar effects for low-fat vs moderate fat interventions, and were superior compared with “usual diet”. Weight loss trials achieving a greater difference in fat intake at follow-up significantly favored the higher fat dietary interventions, as indicated by difference of ≥5% of calories from fat (n=18; WMD=1.04, 95% CI=0.06 to 2.03; I2=78%) or by difference in change serum triglycerides of ≥5 mg/dL (n=17; WMD=1.38, 95% CI=0.50 to 2.25; I2=62%). Interpretation These findings suggest that the long-term effect of low-fat diets on body weight depends on the intensity of intervention in the comparison group. When compared to dietary interventions of similar intensity, evidence from RCTs does not support low-fat diets over other dietary interventions. PMID:26527511

  18. Escitalopram: superior to citalopram or a chiral chimera?

    PubMed

    Svensson, Staffan; Mansfield, Peter R

    2004-01-01

    Escitalopram is the active isomer of the antidepressant citalopram. In theory single-isomer drugs may be superior but few have been found to have clinically significant advantages. The manufacturer claims that escitalopram has more efficacy and a faster onset of effect than citalopram. The purpose of this study was to assess how far these claims are justified. Relevant trial reports were requested from H. Lundbeck A/S and the Swedish drug regulatory authority. The trials consisted of a pooled analysis of 1,321 patients from one unpublished, one partly published and one published eight-week trial, as well as a 24-week trial with 357 patients published as a poster. The studies compared escitalopram with placebo and/or citalopram in outpatients aged or=18 years who met specified criteria for depression. The trials' quality was assessed with Moncrieff et al.'s quality assessment instrument and the results compared with the claims from the advertisements. The advertising claims are not justified because they are based on secondary outcomes, non-intention-to-treat analyses and arbitrarily defined subgroups. The subgroup results are inconsistent. Methodological flaws in the trials could account for the differences found. Even if the differences claimed were real they appear too small to justify higher prices. On the evidence available to us the manufacturer's claims of superiority for escitalopram over citalopram are unwarranted. The Swedish and Danish drug regulatory authorities reached similar conclusions. This highlights the need for wider dissemination of national authorities' statements to other countries affected by the European Union's mutual recognition procedure. Copyright 2004 S. Karger AG, Basel

  19. Necessary conditions for superior thermoelectric power of Si/Au artificial superlattice thin-film

    NASA Astrophysics Data System (ADS)

    Okamoto, Yoichi; Watanabe, Shin; Miyazaki, Hisashi; Morimoto, Jun

    2018-03-01

    The Si-Ge-Au ternary artificial superlattice thin-films showed superior thermoelectric power with low reproducibility. Superior thermoelectric power was only generated, when nanocrystals existed. Therefore, the origin of superior thermoelectric power was considered to be the quantum size effect of nanocrystals. However, even with the presence of nanocrystals, superior thermoelectric power was often not generated. In order to investigate the generation conditions of superior thermoelectric power in more detail, the samples were simplified to Si-Au binary artificial superlattice samples. Furthermore, annealings were carried out under conditions where nanocrystals were likely to be formed. From the results of Raman scattering spectroscopy and X-ray diffraction (XRD) analysis, the diameter of nanocrystals and the spacing between nanocrystals were calculated with an isotropic three-dimensional mosaic model. It was found that superior thermoelectric power was generated only when the diameter of nanocrystals was 11 nm or less and the spacing between nanocrystals was 3 nm or less.

  20. Locally advanced squamous cell carcinoma of the head and neck: A systematic review and Bayesian network meta-analysis of the currently available treatment options.

    PubMed

    Iocca, Oreste; Farcomeni, Alessio; Di Rocco, Arianna; Di Maio, Pasquale; Golusinski, Paweł; Pardiñas López, Simón; Savo, Alfredo; Pellini, Raul; Spriano, Giuseppe

    2018-05-01

    There are still many unresolved questions in the management of locally advanced Head and Neck Cancer (HNC). Many chemotherapeutic drugs and radiotherapy fractionation schemes are available and not all have been evaluated in head-to-head clinical trials. This systematic review and Bayesian network meta-analysis aims to compare the available treatment strategies and chemotherapeutic options for locally advanced HNC. We performed a search on bibliography databases, trials registries and meetings proceedings for published and unpublished randomized trials from January 1st 2000 to December 1st 2017. Trials had to compare systemic interventions and radiotherapy (RT) approaches for locally advanced, non-metastatic HNC. Trials recruiting patients whose surgery was the first treatment option, sample size less than 20 per arm or that did not use randomization for treatment allocation were excluded from the analysis. Summary estimates on Overall survival (OS), Progression-free survival (PFS) and toxicity outcomes (grade 3-4 mucositis and neutropenia) were extracted from the included studies on a predefined database sheet. Bias was assessed through the Chocrane risk of bias assessment tool. We performed a set of pair-wise meta-analyses using a random effect model. We also performed a random effect network meta-analysis under a Bayesian framework. From the 57 included trials, including 15,723 patients, was possible to conduct analysis on 26 treatments for OS, 22 treatments for PFS and 10 treatments for toxicity. In terms of OS Concurrent chemoradiotherapy (CCRT) with cisplatin (HR 0.70, 95% CrI [credible interval] 0.62-0.78) and cetuximab on top of CCRT (HR 0.7, 95% CrI 0.5-0.97) are clearly superior to conventional RT alone. Induction chemotherapy (IC) with cisplatin and fluorouracil (HR 0.74, 95% CrI 0.52-0.95), IC with docetaxel, cisplatin, fluorouracil (HR 0.55, 95% CrI 0.54-0.89) and IC with paclitaxel, cisplatin, fluorouracil (HR 0.55, 95% CrI 0.34-0.89) before CCRT are all superior to conventional RT. CCRT with cisplatin is also superior to altered fractionation RT (HR 0.74, 95% CrI 0.64-0.84). Altered fractionation RT is not superior to conventional RT (HR 0.95, 95% CrI 0.85-1.06). Regarding PFS, CCRT with cisplatin (HR 0.72, 95% CrI 0.63-0.83), cisplatin and fluorouracil (HR 0.67, 95% CrI 0.5-0.88), carboplatin (HR 0.63, 95% CrI 0.46-0.87), carboplatin and fluorouracil (HR 0.75, 95% CrI 0.56-1), IC with cisplatin and fluorouracil (HR 0.59, 95% CrI 0.45-0.78), IC with docetaxel, cisplatin and fluorouracil (HR 0.53, 95% CrI 0.41-0.68) and IC with paclitaxel, cisplatin and fluorouracil (HR 0.59, 95% CrI 0.35-0.99) are superior to conventional RT and altered fractionation RT. IC with docetaxel, cisplatin and fluorouracil shows a significant superiority against CCRT with cisplatin (HR 0.73 95% CrI 0.58-0.92). Altered fractionation RT is not superior to conventional RT (HR 0.91, 95% CrI 0.81-1.02). Altered fractionation increases the risk of developing grade 3-4 mucositis compared to conventional RT (OR 3.74 95% 1.64-8.67) INTERPRETATION: CCRT with cisplatin remains the gold standard of treatment. Taxane based IC regimens may have a impact on locally advanced disease. Altered fractionation RT is inferior to CCRT and also does not seem to be meaningfully better than conventionally fractionated RT alone. Its role in locally advanced disease should be reevaluated. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. Behavioral and ERP evidence of word and pseudoword superiority effects in 7- and 11-year-olds

    PubMed Central

    Coch, Donna; Mitra, Priya; George, Elyse

    2012-01-01

    In groups of 7-year-olds and 11-year-olds, event-related potentials (ERPs) were recorded to briefly presented, masked letter strings that included real word (DARK/PARK), pronounceable pseudoword (DARL/PARL), unpronounceable nonword (RDKA/RPKA), and letter-in-xs (DXXX, PXXX) stimuli in a variant of the Reicher-Wheeler paradigm. Behaviorally, participants decided which of two letters occurred at a given position in each string (here, forced-choice alternatives D and P). Both groups showed evidence of behavioral word (more accurate choices for letters in words than in baseline nonwords or letter-in-xs) and pseudoword (more accurate choices for letters in pseudowords than in baseline nonwords or letter-in-xs) superiority effects. Electrophysiologically, 11-year-olds evidenced superiority effects on P150 and N400 peak amplitude, while 7-year-olds showed effects only on N400 amplitude. These findings suggest that the mechanisms underlying the observed behavioral superiority effects may be lexical in younger children but both sublexical and lexical in older children. These results are consistent with a lengthy developmental time course for automatic sublexical orthographic specialization, extending beyond the age of 11. PMID:23036274

  2. Effect of intratympanic dexamethasone, memantine and piracetam on cellular apoptosis due to cisplatin ototoxicity.

    PubMed

    Topdag, M; Iseri, M; Gelenli, E; Yardimoglu, M; Yazir, Y; Ulubil, S A; Topdag, D O; Ustundag, E

    2012-11-01

    This study aimed to contribute to the literature on the prevention and treatment of ototoxicity due to various drugs and chemicals. This study compared the histological effects of intratympanic dexamethasone, memantine and piracetam on cellular apoptosis due to cisplatin ototoxicity, in 36 rats. Dexamethasone and memantine had significant effects on the stria vascularis, organ of Corti and spiral ganglion (p < 0.05). Although piracetam decreased the apoptosis rate, this effect was not statistically significant (p > 0.05). Dexamethasone and memantine were found superior to piracetam in reducing apoptosis due to cisplatin ototoxicity. Further studies of this subject are needed, incorporating electron microscopy and auditory brainstem response testing.

  3. Cat-eye effect target recognition with single-pixel detectors

    NASA Astrophysics Data System (ADS)

    Jian, Weijian; Li, Li; Zhang, Xiaoyue

    2015-12-01

    A prototype of cat-eye effect target recognition with single-pixel detectors is proposed. Based on the framework of compressive sensing, it is possible to recognize cat-eye effect targets by projecting a series of known random patterns and measuring the backscattered light with three single-pixel detectors in different locations. The prototype only requires simpler, less expensive detectors and extends well beyond the visible spectrum. The simulations are accomplished to evaluate the feasibility of the proposed prototype. We compared our results to that obtained from conventional cat-eye effect target recognition methods using area array sensor. The experimental results show that this method is feasible and superior to the conventional method in dynamic and complicated backgrounds.

  4. Anthropogenic climate change has altered primary productivity in Lake Superior

    PubMed Central

    O'Beirne, M. D.; Werne, J. P.; Hecky, R. E.; Johnson, T. C.; Katsev, S.; Reavie, E. D.

    2017-01-01

    Anthropogenic climate change has the potential to alter many facets of Earth's freshwater resources, especially lacustrine ecosystems. The effects of anthropogenic changes in Lake Superior, which is Earth's largest freshwater lake by area, are not well documented (spatially or temporally) and predicted future states in response to climate change vary. Here we show that Lake Superior experienced a slow, steady increase in production throughout the Holocene using (paleo)productivity proxies in lacustrine sediments to reconstruct past changes in primary production. Furthermore, data from the last century indicate a rapid increase in primary production, which we attribute to increasing surface water temperatures and longer seasonal stratification related to longer ice-free periods in Lake Superior due to anthropogenic climate warming. These observations demonstrate that anthropogenic effects have become a prominent influence on one of Earth's largest, most pristine lacustrine ecosystems. PMID:28598413

  5. Anthropogenic climate change has altered primary productivity in Lake Superior.

    PubMed

    O'Beirne, M D; Werne, J P; Hecky, R E; Johnson, T C; Katsev, S; Reavie, E D

    2017-06-09

    Anthropogenic climate change has the potential to alter many facets of Earth's freshwater resources, especially lacustrine ecosystems. The effects of anthropogenic changes in Lake Superior, which is Earth's largest freshwater lake by area, are not well documented (spatially or temporally) and predicted future states in response to climate change vary. Here we show that Lake Superior experienced a slow, steady increase in production throughout the Holocene using (paleo)productivity proxies in lacustrine sediments to reconstruct past changes in primary production. Furthermore, data from the last century indicate a rapid increase in primary production, which we attribute to increasing surface water temperatures and longer seasonal stratification related to longer ice-free periods in Lake Superior due to anthropogenic climate warming. These observations demonstrate that anthropogenic effects have become a prominent influence on one of Earth's largest, most pristine lacustrine ecosystems.

  6. Characteristics of superior orbital subperiosteal abscesses in children.

    PubMed

    Quintanilla-Dieck, Lourdes; Chinnadurai, Sivakumar; Goudy, Steven L; Virgin, Frank W

    2017-03-01

    Superior pediatric orbital subperiosteal abscesses (SPAs) are less common than medial ones, and clinical features specific to patients with superior SPAs have not been well defined. Clinical characteristics between patients with superior and medial SPAs are compared to determine whether superior location is a risk factor for surgical intervention. Retrospective cohort study. The target population consisted of patients diagnosed with an SPA and seen by the pediatric otolaryngology service at a tertiary children's hospital between January 2010 and October 2014. Imaging characteristics including proptosis, hypoglobus, intraorbital air, and abscess volume as well as treatment interventions were reviewed. Forty patients between 5 and 17 years of age treated for an orbital SPA were identified. Thirteen patients were identified as having superior SPAs; 27 had medial SPAs. The average ages in the two groups were 10.92 and 9.26 years, respectively. The odds ratio for surgical treatment per each increasing year of age was 1.5 (P = .004). The proportion of patients requiring surgery was significantly different between the groups (12/13 superior vs. 13/27 medial, P = .01). The predominant organism group cultured in surgical patients was Streptococcus anginosus (8/24, 29.17%). Superior SPA patients had significantly more proptosis, hypoglobus, and abscess volume on computed tomography scan. Patients with superior SPAs may present with more advanced disease, leading to a higher rate of characteristics such as proptosis, hypoglobus, and intraorbital air, factors that would predispose to surgical drainage. We found that abscess volume was the most predictive of surgery. 4 Laryngoscope, 127:735-740, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  7. The Extracellular Matrix of the Lateral Pharyngeal Wall in Obstructive Sleep Apnea

    PubMed Central

    Dantas, Danielle Andrade da Silva; Mauad, Thais; Silva, Luiz F. F.; Lorenzi-Filho, Geraldo; Formigoni, Gilberto G. S.; Cahali, Michel B.

    2012-01-01

    Study Objectives: To compare the components of the extracellular matrix in the lateral pharyngeal muscular wall in patients with and without obstructive sleep apnea (OSA). This may help to explain the origin of the increased collapsibility of the pharynx in patients with OSA. Design: Specimens from the superior pharyngeal constrictor muscle, obtained during pharyngeal surgeries, were evaluated using histochemical and immunohistochemical analyses to determine the fractional area of collagen types I and III, elastic fibers, versican, fibronectin, and matrix metalloproteinases 1 and 2 in the endomysium. Setting: Academic tertiary center. Patiens: A total of 51 nonobese adult patients, divided into 38 patients with OSA and 13 nonsnoring control subjects without OSA. Interventions: Postintervention study performed on tissues from patients after elective surgery. Measurements and Results: Pharyngeal muscles of patients with OSA had significantly more collagen type I than pharyngeal muscles in control subjects. Collagen type I was correlated positively and independently with age. The other tested components of the extracellular matrix did not differ significantly between groups. In a logistic regression, an additive effect of both the increase of collagen type I and the increase in age with the presence of OSA was observed (odds ratio (OR), 2.06; 95% confidence interval (CI), 1.17-3.63), when compared with the effect of increased age alone (OR, 1.11; 95% CI, 1.03-1.20). Conclusion: Collagen type I in the superior pharyngeal constrictor muscle was more prevalent in patients with OSA and also increased with age. It was hypothesized that this increase could delay contractile-relaxant responses in the superior pharyngeal constrictor muscle at the expiratory-inspiratory phase transition, thus increasing pharyngeal collapsibility. Citation: Dantas DAS; Mauad T; Silva LFF; Lorenzi-Filho G; Formigoni GGS; Cahali MB. The extracellular matrix of the lateral pharyngeal wall in obstructive sleep apnea. SLEEP 2012;35(4):483-490. PMID:22467986

  8. Articulatory movements modulate auditory responses to speech

    PubMed Central

    Agnew, Z.K.; McGettigan, C.; Banks, B.; Scott, S.K.

    2013-01-01

    Production of actions is highly dependent on concurrent sensory information. In speech production, for example, movement of the articulators is guided by both auditory and somatosensory input. It has been demonstrated in non-human primates that self-produced vocalizations and those of others are differentially processed in the temporal cortex. The aim of the current study was to investigate how auditory and motor responses differ for self-produced and externally produced speech. Using functional neuroimaging, subjects were asked to produce sentences aloud, to silently mouth while listening to a different speaker producing the same sentence, to passively listen to sentences being read aloud, or to read sentences silently. We show that that separate regions of the superior temporal cortex display distinct response profiles to speaking aloud, mouthing while listening, and passive listening. Responses in anterior superior temporal cortices in both hemispheres are greater for passive listening compared with both mouthing while listening, and speaking aloud. This is the first demonstration that articulation, whether or not it has auditory consequences, modulates responses of the dorsolateral temporal cortex. In contrast posterior regions of the superior temporal cortex are recruited during both articulation conditions. In dorsal regions of the posterior superior temporal gyrus, responses to mouthing and reading aloud were equivalent, and in more ventral posterior superior temporal sulcus, responses were greater for reading aloud compared with mouthing while listening. These data demonstrate an anterior–posterior division of superior temporal regions where anterior fields are suppressed during motor output, potentially for the purpose of enhanced detection of the speech of others. We suggest posterior fields are engaged in auditory processing for the guidance of articulation by auditory information. PMID:22982103

  9. Long-term outcome after percutaneous closure of persistent left superior caval vein draining into the left atrium: a contrast-enhanced CT study.

    PubMed

    Marini, Davide; Castagno, Matteo; Millesimo, Michele; Ferroni, Francesca; Ferraro, Gaetana; Pace Napoleone, Carlo; Agnoletti, Gabriella

    2017-10-01

    Data regarding long-term outcome after percutaneous closure of left superior caval vein draining into the left atrium are lacking. The aim of the present study was to report the long-term follow-up by using contrast-enhanced CT. In all, three patients underwent percutaneous closure of left superior caval vein draining into the left atrium between 2005 and 2015. All of them were evaluated clinically and underwent contrast-enhanced CT. In one patient, the Amplatzer® Septal Occluder was used. In two patients, the Amplatzer® Vascular Plug type-1 was preferred: the device size/LSVC diameter ratio was 1.7 in the child and 1.2 in the adult. There were no early-onset or long-term onset complications. CT was performed 1, 2, and 10 years after the procedure, respectively. Complete occlusion of the vessel was documented in all. After 10 years since the procedure, CT revealed a persistent trivial residual shunt through the accessory hemiazygos vein in one patient, in whom the device was implanted above its drainage into the left superior caval vein. When an Amplatzer® Vascular Plug type-1 is oversized compared with the venous vessel diameter, it immediately assumes a dog-bone shape that disappears early to regain its shape memory and nominal size. Percutaneous occlusion of left superior caval vein draining into the left atrium has excellent early and long-term outcomes. The optimal implantation of the device is below the drainage of the accessory hemiazygos vein, when present. The device might be oversized compared with the left superior caval vein diameter according to the age of the patient.

  10. Structural and Diffusion Property Alterations in Unaffected Siblings of Patients with Obsessive-Compulsive Disorder

    PubMed Central

    Shi, Changzheng; Miao, Guodong; Yang, Qiong; Gao, Wei; Wolff, Jason J.; Chan, Raymond C. K.; Shen, Dinggang

    2014-01-01

    Disrupted white matter integrity and abnormal cortical thickness are widely reported in the pathophysiology of obsessive-compulsive disorder (OCD). However, the relationship between alterations in white matter connectivity and cortical thickness in OCD is unclear. In addition, the heritability of this relationship is poorly understood. To investigate the relationship of white matter microstructure with cortical thickness, we measure fractional anisotropy (FA) of white matter in 30 OCD patients, 19 unaffected siblings and 30 matched healthy controls. Then, we take those regions of significantly altered FA in OCD patients compared with healthy controls to perform fiber tracking. Next, we calculate the fiber quantity in the same tracts. Lastly, we compare cortical thickness in the target regions of those tracts. Patients with OCD exhibited decreased FA in cingulum, arcuate fibers near the superior parietal lobule, inferior longitudinal fasciculus near the right superior temporal gyrus and uncinate fasciculus. Siblings showed reduced FA in arcuate fibers near the superior parietal lobule and anterior limb of internal capsule. Significant reductions in both fiber quantities and cortical thickness in OCD patients and their unaffected siblings were also observed in the projected brain areas when using the arcuate fibers near the left superior parietal lobule as the starting points. Reduced FA in the left superior parietal lobule was observed not only in patients with OCD but also in their unaffected siblings. Originated from the superior parietal lobule, the number of fibers was also found to be decreased and the corresponding cortical regions were thinner relative to controls. The linkage between disrupted white matter integrity and the abnormal cortical thickness may be a vulnerability marker for OCD. PMID:24489665

  11. Effects of practice and experience on the arcuate fasciculus: comparing singers, instrumentalists, and non-musicians.

    PubMed

    Halwani, Gus F; Loui, Psyche; Rüber, Theodor; Schlaug, Gottfried

    2011-01-01

    Structure and function of the human brain are affected by training in both linguistic and musical domains. Individuals with intensive vocal musical training provide a useful model for investigating neural adaptations of learning in the vocal-motor domain and can be compared with learning in a more general musical domain. Here we confirm general differences in macrostructure (tract volume) and microstructure (fractional anisotropy, FA) of the arcuate fasciculus (AF), a prominent white-matter tract connecting temporal and frontal brain regions, between singers, instrumentalists, and non-musicians. Both groups of musicians differed from non-musicians in having larger tract volume and higher FA values of the right and left AF. The AF was then subdivided in a dorsal (superior) branch connecting the superior temporal gyrus and the inferior frontal gyrus (STG ↔ IFG), and ventral (inferior) branch connecting the middle temporal gyrus and the inferior frontal gyrus (MTG ↔ IFG). Relative to instrumental musicians, singers had a larger tract volume but lower FA values in the left dorsal AF (STG ↔ IFG), and a similar trend in the left ventral AF (MTG ↔ IFG). This between-group comparison controls for the general effects of musical training, although FA was still higher in singers compared to non-musicians. Both musician groups had higher tract volumes in the right dorsal and ventral tracts compared to non-musicians, but did not show a significant difference between each other. Furthermore, in the singers' group, FA in the left dorsal branch of the AF was inversely correlated with the number of years of participants' vocal training. Our findings suggest that long-term vocal-motor training might lead to an increase in volume and microstructural complexity of specific white-matter tracts connecting regions that are fundamental to sound perception, production, and its feedforward and feedback control which can be differentiated from a more general musician effect.

  12. Endovascular Therapy is Effective and Safe for Patients with Severe Ischemic Stroke: Pooled Analysis of IMS III and MR CLEAN Data

    PubMed Central

    Broderick, Joseph P.; Berkhemer, Olvert A.; Palesch, Yuko Y.; Dippel, Diederik W.J.; Foster, Lydia D.; Roos, Yvo B.W.E.M.; van der Lugt, Aad; Tomsick, Thomas A.; Majoie, Charles B.L.M.; van Zwam, Wim H.; Demchuk, Andrew M.; van Oostenbrugge, Robert J.; Khatri, Pooja; Lingsma, Hester F.; Hill, Michael D.; Roozenbeek, Bob; Jauch, Edward C.; Jovin, Tudor G.; Yan, Bernard; von Kummer, Rüdiger; Molina, Carlos A.; Goyal, Mayank; Schonewille, Wouter J.; Mazighi, Mikael; Engelter, Stefan T.; Anderson, Craig S.; Spilker, Judith; Carrozzella, Janice; Ryckborst, Karla J.; Janis, L. Scott; Simpson, Kit

    2015-01-01

    Background and Purpose We assessed the effect of endovascular treatment in acute ischemic stroke patients with severe neurological deficit (NIHSS ≥20) following a pre-specified analysis plan. Methods The pooled analysis of the IMS III and MR CLEAN trial included participants with an NIHSS ≥20 prior to intravenous (IV) t-PA treatment (IMS III) or randomization (MR CLEAN) who were treated with IV t-PA ≤ 3 hours of stroke onset. Our hypothesis was that participants with severe stroke randomized to endovascular therapy following IV t-PA would have improved 90-day outcome (distribution of modified Rankin scale [mRS] scores), as compared to those who received IV t-PA alone. Results Among 342 participants in the pooled analysis (194 from IMS III, 148 from MR CLEAN), an ordinal logistic regression model showed that the endovascular group had superior 90-day outcome compared to the IV t-PA group (adjusted odds ratio [aOR] 1.78; 95% confidence interval [CI] 1.20-2.66). In the logistic regression model of the dichotomous outcome (mRS 0-2, or ‘functional independence’), the endovascular group had superior outcomes (aOR 1.97; 95% CI 1.09-3.56). Functional independence (mRS ≤2) at 90 days was 25% in the endovascular group as compared to 14% in the IV t-PA group. Conclusions Endovascular therapy following IV t-PA within 3 hours of symptom onset improves functional outcome at 90 days after severe ischemic stroke. PMID:26486865

  13. Comparison between analgesic effects of buprenorphine, carprofen, and buprenorphine with carprofen for canine ovariohysterectomy.

    PubMed

    Shih, Andre C; Robertson, Sheilah; Isaza, Natalie; Pablo, Luisito; Davies, Wendy

    2008-01-01

    To compare the analgesic effects of buprenorphine, carprofen, and their combination in dogs undergoing ovariohysterectomy. Prospective, randomized blinded clinical study. 60 dogs. Treatments were buprenorphine 0.02 mg kg(-1), intramuscularly (IM) (group B); carprofen 4 mg kg(-1), subcutaneously (SC) (group C); or a combination of both (group CB). Anesthesia was induced with propofol and maintained with isoflurane. A Dynamic Interactive Visual Analog Scale (DIVAS, 0-100 mm) and the Glasgow Composite Pain Scale (GCMPS, 0-24) were used to evaluate comfort and sedation at baseline, 2, 4, 6, and 24 hours after extubation. Rescue analgesia was provided with buprenorphine (0.02 mg kg(-1)). Wound swelling measurements (WM) and a visual inflammation score (VIS) of the incision were made after surgery and 2, 4, 6, and 24 hours later. p < 0.05 was considered significant. Group C required more propofol (5.0 +/- 1.4 mg kg(-1)) compared with B (3.3 +/- 1.1 mg kg(-1)) and CB (3.2 +/- 0.7 mg kg(-1)); respectively, p = 0.0002 and 0.0001. Rescue analgesia was required in nine dogs. B had a higher GCMPS and DIVAS III score at 6 hours (2.6 +/- 2.5) and (23 +/- 22.5 mm) compared with C (1.0 +/- 1.3, 6 +/- 7.3 mm) and CB (1.5 +/- 1.4, 8 +/- 10.7 mm); respectively, p = 0.02 and 0.006. Group C had a lower sedation score at 2 hours (43 +/- 23.6 mm) compared with B (68 +/- 32.1 mm) and BC (69 +/- 22.1 mm); respectively, p = 0.03 and 0.004. Group B had a higher WM score at 2 hours (3 +/- 0.8 mm) compared with C (2 +/- 0.6 mm) p = 0.01 and at 6 hours (3 +/- 1 mm) compared with C (2 +/- 0.8 mm) and CB (2 +/- 0.8 mm); respectively, p = 0.01 and 0.008. VIS was not different between groups. All treatments provided satisfactory analgesia for the first 6 hours and at 24 hours. C and CB pain score and WS were superior to B at 6 hours. No superior analgesic effect was noted when the drugs were combined.

  14. Pain Management After Outpatient Anterior Cruciate Ligament Reconstruction: A Systematic Review of Randomized Controlled Trials.

    PubMed

    Secrist, Eric S; Freedman, Kevin B; Ciccotti, Michael G; Mazur, Donald W; Hammoud, Sommer

    2016-09-01

    Effective pain management after anterior cruciate ligament (ACL) reconstruction improves patient satisfaction and function. To collect and evaluate the available evidence from randomized controlled trials (RCTs) on pain control after ACL reconstruction. Systematic review. A systematic literature review was performed using PubMed, Medline, Google Scholar, UpToDate, Cochrane Reviews, CINAHL, and Scopus following PRISMA guidelines (July 2014). Only RCTs comparing a method of postoperative pain control to another method or placebo were included. A total of 77 RCTs met inclusion criteria: 14 on regional nerve blocks, 21 on intra-articular injections, 4 on intramuscular/intravenous injections, 12 on multimodal regimens, 6 on oral medications, 10 on cryotherapy/compression, 6 on mobilization, and 5 on intraoperative techniques. Single-injection femoral nerve blocks provided superior analgesia to placebo for up to 24 hours postoperatively; however, this also resulted in a quadriceps motor deficit. Indwelling femoral catheters utilized for 2 days postoperatively provided superior analgesia to a single-injection femoral nerve block. Local anesthetic injections at the surgical wound site or intra-articularly provided equivalent analgesia to regional nerve blocks. Continuous-infusion catheters of a local anesthetic provided adequate pain relief but have been shown to cause chondrolysis. Cryotherapy improved analgesia compared to no cryotherapy in 4 trials, while in 4 trials, ice water and water at room temperature provided equivalent analgesic effects. Early weightbearing decreased pain compared to delayed weightbearing. Oral gabapentin given preoperatively and oral zolpidem given for the first week postoperatively each decreased opioid consumption as compared to placebo. Ibuprofen reduced pain compared to acetaminophen. Oral ketorolac reduced pain compared to hydrocodone-acetaminophen. Regional nerve blocks and intra-articular injections are both effective forms of analgesia. Cryotherapy-compression appears to be beneficial, provided that intra-articular temperatures are sufficiently decreased. Early mobilization reduces pain symptoms. Gabapentin, zolpidem, ketorolac, and ibuprofen decrease opioid consumption. Despite the vast amount of high-quality evidence on this topic, further research is needed to determine the optimal multimodal approach that can maximize recovery while minimizing pain and opioid consumption. These results provide the best available evidence from RCTs on pain control regimens after ACL reconstruction. © 2015 The Author(s).

  15. Immediate Effects of Proprioceptive Neuromuscular Facilitation Stretching Programs Compared With Passive Stretching Programs for Hamstring Flexibility: A Critically Appraised Topic.

    PubMed

    Hill, Kristian J; Robinson, Kendall P; Cuchna, Jennifer W; Hoch, Matthew C

    2017-11-01

    Clinical Scenario: Increasing hamstring flexibility through clinical stretching interventions may be an effective means to prevent hamstring injuries. However the most effective method to increase hamstring flexibility has yet to be determined. For a healthy individual, are proprioceptive neuromuscular facilitation (PNF) stretching programs more effective in immediately improving hamstring flexibility when compared with static stretching programs? Summary of Key Findings: A thorough literature search returned 195 possible studies; 5 studies met the inclusion criteria and were included. Current evidence supports the use of PNF stretching or static stretching programs for increasing hamstring flexibility. However, neither program demonstrated superior effectiveness when examining immediate increases in hamstring flexibility. Clinical Bottom Line: There were consistent findings from multiple low-quality studies that indicate there is no difference in the immediate improvements in hamstring flexibility when comparing PNF stretching programs to static stretching programs in physically active adults. Strength of Recommendation: Grade B evidence exists that PNF and static stretching programs equally increase hamstring flexibility immediately following the stretching program.

  16. Comparing Text-based and Graphic User Interfaces for Novice and Expert Users

    PubMed Central

    Chen, Jung-Wei; Zhang, Jiajie

    2007-01-01

    Graphic User Interface (GUI) is commonly considered to be superior to Text-based User Interface (TUI). This study compares GUI and TUI in an electronic dental record system. Several usability analysis techniques compared the relative effectiveness of a GUI and a TUI. Expert users and novice users were evaluated in time required and steps needed to complete the task. A within-subject design was used to evaluate if the experience with either interface will affect task performance. The results show that the GUI interface was not better than the TUI for expert users. GUI interface was better for novice users. For novice users there was a learning transfer effect from TUI to GUI. This means a user interface is user-friendly or not depending on the mapping between the user interface and tasks. GUI by itself may or may not be better than TUI. PMID:18693811

  17. Comparing Text-based and Graphic User Interfaces for novice and expert users.

    PubMed

    Chen, Jung-Wei; Zhang, Jiajie

    2007-10-11

    Graphic User Interface (GUI) is commonly considered to be superior to Text-based User Interface (TUI). This study compares GUI and TUI in an electronic dental record system. Several usability analysis techniques compared the relative effectiveness of a GUI and a TUI. Expert users and novice users were evaluated in time required and steps needed to complete the task. A within-subject design was used to evaluate if the experience with either interface will affect task performance. The results show that the GUI interface was not better than the TUI for expert users. GUI interface was better for novice users. For novice users there was a learning transfer effect from TUI to GUI. This means a user interface is user-friendly or not depending on the mapping between the user interface and tasks. GUI by itself may or may not be better than TUI.

  18. Pain Modulation in Waking and Hypnosis in Women: Event-Related Potentials and Sources of Cortical Activity

    PubMed Central

    De Pascalis, Vilfredo; Varriale, Vincenzo; Cacace, Immacolata

    2015-01-01

    Using a strict subject selection procedure, we tested in High and Low Hypnotizable subjects (HHs and LHs) whether treatments of hypoalgesia and hyperalgesia, as compared to a relaxation-control, differentially affected subjective pain ratings and somatosensory event-related potentials (SERPs) during painful electric stimulation. Treatments were administered in waking and hypnosis conditions. LHs showed little differentiation in pain and distress ratings between hypoalgesia and hyperalgesia treatments, whereas HHs showed a greater spread in the instructed direction. HHs had larger prefrontal N140 and P200 waves of the SERPs during hypnotic hyperalgesia as compared to relaxation-control treatment. Importantly, HHs showed significant smaller frontocentral N140 and frontotemporal P200 waves during hypnotic hypoalgesia. LHs did not show significant differences for these SERP waves among treatments in both waking and hypnosis conditions. Source localization (sLORETA) method revealed significant activations of the bilateral primary somatosensory (BA3), middle frontal gyrus (BA6) and anterior cingulate cortices (BA24). Activity of these contralateral regions significantly correlated with subjective numerical pain scores for control treatment in waking condition. Moreover, multivariate regression analyses distinguished the contralateral BA3 as the only region reflecting a stable pattern of pain coding changes across all treatments in waking and hypnosis conditions. More direct testing showed that hypnosis reduced the strength of the association of pain modulation and brain activity changes at BA3. sLORETA in HHs revealed, for the N140 wave, that during hypnotic hyperalgesia, there was an increased activity within medial, supramarginal and superior frontal gyri, and cingulated gyrus (BA32), while for the P200 wave, activity was increased in the superior (BA22), middle (BA37), inferior temporal (BA19) gyri and superior parietal lobule (BA7). Hypnotic hypoalgesia in HHs, for N140 wave, showed reduced activity within medial and superior frontal gyri (BA9,8), paraippocampal gyrus (BA34), and postcentral gyrus (BA1), while for the P200, activity was reduced within middle and superior frontal gyri (BA9 and BA10), anterior cingulate (BA33), cuneus (BA19) and sub-lobar insula (BA13). These findings demonstrate that hypnotic suggestions can exert a top-down modulatory effect on attention/preconscious brain processes involved in pain perception. PMID:26030417

  19. Evaluation of retinal nerve fiber layer thickness in vernal keratoconjunctivitis patients under long-term topical corticosteroid therapy.

    PubMed

    Cingu, Abdullah Kursat; Cinar, Yasin; Turkcu, Fatih Mehmet; Sahinoglu-Keskek, Nedime; Sahin, Alparslan; Sahin, Muhammed; Yuksel, Harun; Caca, Ihsan

    2014-09-01

    The aim of this study was to evaluate the retinal nerve fiber layer (RNFL) thickness in vernal keratoconjunctivitis (VKC) patients who were under long-term topical corticosteroid therapy. Thirty-six eyes of 36 VKC patients with clear cornea and normal videokeratography and 40 eyes of 40 age- and gender-matched normal children were included in the study. Clinical and demographic characteristics of the patients were noted and detailed ophthalmological examination was performed. Visual acuity (VA), spherical equivalent (SE), axial length (AL) and RNFL thickness measurements were compared between the groups. To correct ocular magnification effect on RNFL, we used Littmann's formula. All VKC patients had history of topical corticosteroid use and the mean duration of the topical corticosteroid use was 23.8 ± 9.09 months. There was no significant difference between the groups in terms of intraocular pressure (IOP). VKC group had significantly worse VA, greater SE and AL and thinner mean global, superior and inferior RNFL thickness. There were significant negative correlations between the duration of topical corticosteroid use and the mean global, superior and temporal RNFL thickness in VKC group. After correction of magnification effect, VKC group still had thinner mean global, superior and inferior RNFL thickness, and significant difference between the groups in inferior RNFL thickness did not disappear. Significant RNFL thickness difference between the groups suggests a possible effect of long-term corticosteroid use in VKC patients. Because visual field (VF) analysis in pediatric patients is difficult to perform and IOP may be illusive, RNFL thickness measurements in addition to routine examinations in VKC patients may help clinicians in their practice.

  20. Cardiac pacing for severe childhood neurally mediated syncope with reflex anoxic seizures

    PubMed Central

    McLeod, K; Wilson, N; Hewitt, J; Norrie, J; Stephenson, J

    1999-01-01

    OBJECTIVE—To determine whether permanent cardiac pacing could prevent syncope and seizures in children with frequent severe neurally mediated syncope, and if so whether dual chamber pacing was superior to single chamber ventricular pacing.
METHODS—Dual chamber pacemakers were implanted into 12 children (eight male, four female) aged 2-14 years (median 2.8 years) with frequent episodes of reflex anoxic seizures and a recorded prolonged asystole during an attack. The pacemaker was programmed to sensing only (ODO), single chamber ventricular pacing with hysteresis (VVI), and dual chamber pacing with rate drop response (DDD) for four month periods, with each patient allocated to one of the six possible sequences of these modes, according to chronological order of pacemaker implantation. The parent and patient were blinded to the pacemaker mode and asked to record all episodes of syncope or presyncope ("near miss" events). The doctor analysing the results was blinded to the patient and pacemaker mode.
RESULTS—One patient was withdrawn from the study after the pacemaker was removed because of infection. In the remaining children, both dual chamber and single chamber pacing significantly reduced the number of syncopal episodes compared with sensing only (p = 0.0078 for both). VVI was as effective as DDD for preventing syncope, but DDD was superior to VVI in reducing near miss events (p = 0.016).
CONCLUSIONS—Permanent pacing is an effective treatment for children with severe neurally mediated syncope and reflex anoxic seizures. VVI is as effective as DDD in preventing syncope and seizures, but DDD is superior in preventing overall symptoms.


Keywords: syncope; reflex anoxic seizures; pacing; paediatric cardiology PMID:10573501

  1. Enlarged right superior temporal gyrus in children and adolescents with autism.

    PubMed

    Jou, Roger J; Minshew, Nancy J; Keshavan, Matcheri S; Vitale, Matthew P; Hardan, Antonio Y

    2010-11-11

    The superior temporal gyrus has been implicated in language processing and social perception. Therefore, anatomical abnormalities of this structure may underlie some of the deficits observed in autism, a severe neurodevelopmental disorder characterized by impairments in social interaction and communication. In this study, volumes of the left and right superior temporal gyri were measured using magnetic resonance imaging obtained from 18 boys with high-functioning autism (mean age=13.5±3.4years; full-scale IQ=103.6±13.4) and 19 healthy controls (mean age=13.7±3.0years; full-scale IQ=103.9±10.5), group-matched on age, gender, and handedness. When compared to the control group, right superior temporal gyral volumes was significantly increased in the autism group after controlling for age and total brain volume. There was no significant difference in the volume of the left superior temporal gyrus. Post-hoc analysis revealed a significant increase of the right posterior superior temporal gyral volume in the autism group, before and after controlling for age and total brain volume. Examination of the symmetry index for the superior temporal gyral volumes did not yield statistically significant between-group differences. Findings from this preliminary investigation suggest the existence of volumetric alterations in the right superior temporal gyrus in children and adolescents with autism, providing support for a neuroanatomical basis of the social perceptual deficits characterizing this severe neurodevelopmental disorder. Copyright © 2010 Elsevier B.V. All rights reserved.

  2. Enlarged Right Superior Temporal Gyrus in Children and Adolescents with Autism

    PubMed Central

    Jou, Roger J.; Minshew, Nancy J.; Keshavan, Matcheri S.; Vitale, Matthew P.; Hardan, Antonio Y.

    2010-01-01

    The superior temporal gyrus has been implicated in language processing and social perception. Therefore, anatomical abnormalities of this structure may underlie some of the deficits observed in autism, a severe neurodevelopmental disorder characterized by impairments in social interaction and communication. In this study, volumes of the left and right superior temporal gyri were measured using magnetic resonance imaging obtained from 18 boys with high-functioning autism (mean age = 13.5 ±3.4 years; full-scale IQ = 103.6 ±13.4) and 19 healthy controls (mean age = 13.7 ±3.0 years; full-scale IQ = 103.9 ±10.5), group-matched on age, gender, and handedness. When compared to the control group, right superior temporal gyral volumes were significantly increased in the autism group after controlling for age and total brain volume. There was no significant difference in the volume of the left superior temporal gyrus. Post-hoc analysis revealed a significant increase of the right posterior superior temporal gyral volume in the autism group, before and after controlling for age and total brain volume. Examination of the symmetry index for the superior temporal gyral volumes did not yield statistically significant between-group differences. Findings from this preliminary investigation suggest the existence of volumetric alterations in the right superior temporal gyrus in children and adolescents with autism, providing support for a neuroanatomical basis of the social perceptual deficits characterizing this severe neurodevelopmental disorder. PMID:20833154

  3. The apparent size of three-dimensional objects and their silhouettes: a solid-superiority effect.

    PubMed

    Walker, J T; Walker, M J

    1988-01-01

    A solid object looks larger than its outline or silhouette under many viewing conditions. This solid-superiority effect may result from the assimilation or confusion of visual contours within the projection of a three-dimensional object on the picture plane. An aspect of the Müller-Lyer illusion may also play a role.

  4. A Label Superiority Effect in Children's Categorization of Facial Expressions.

    ERIC Educational Resources Information Center

    Russell, James A.; Widen, Sherri C.

    2002-01-01

    Three studies investigated whether children, ages 2-7, recognized facial expressions by category. Study 1 focused on emotion categories of happiness and anger; Study 2, on sex differences, with sadness added. Study 3 was on 2- and 3-year-olds. All three studies showed a Label Superiority Effect, in which emotion labels resulted in more accurate…

  5. Recognition Memory and Source Memory in Autism Spectrum Disorder: A Study of the Intention Superiority and Enactment Effects

    ERIC Educational Resources Information Center

    Grainger, Catherine; Williams, David M.; Lind, Sophie E.

    2017-01-01

    It is well established that neurotypical individuals generally show better memory for actions they have performed than actions they have observed others perform or merely read about, a so-called "enactment effect." Strikingly, research has also shown that neurotypical individuals demonstrate superior memory for actions they…

  6. Ti-6Al-4V Additively Manufactured by Selective Laser Melting with Superior Mechanical Properties

    NASA Astrophysics Data System (ADS)

    Xu, W.; Sun, S.; Elambasseril, J.; Liu, Q.; Brandt, M.; Qian, M.

    2015-03-01

    The Achilles' heel of additively manufactured Ti-6Al-4V by selective laser melting (SLM) is its inferior mechanical properties compared with its wrought (forged) counterparts. Acicular α' martensite resulted from rapid cooling by SLM is primarily responsible for high strength but inadequate tensile ductility achieved in the as-fabricated state. This study presents a solution to eliminating the adverse effect of the nonequilibrium α' martensite. This is achieved by enabling in situ martensite decomposition into a novel ultrafine (200-300 nm) lamellar ( α + β) microstructure via the selection of an array of processing variables including the layer thickness, energy density, and focal offset distance. The resulting tensile elongation reached 11.4% while the yield strength was kept above 1100 MPa. These properties compare favorably with those of mill-annealed Ti-6Al-4V consisting of globular α and β. The fatigue life of SLM-fabricated Ti-6Al-4V with an ultrafine lamellar ( α + β) structure has approached that of the mill-annealed counterparts and is much superior to that of SLM-fabricated Ti-6Al-4V with α' martensite.

  7. Effect of core strength and endurance training on performance in college students: randomized pilot study.

    PubMed

    Schilling, Jim F; Murphy, Jeff C; Bonney, John R; Thich, Jacob L

    2013-07-01

    Core training continues to be emphasized with the proposed intent of improving athletic performance. The purpose of this investigation was to discover if core isometric endurance exercises were superior to core isotonic strengthening exercises and if either influenced specific endurance, strength, and performance measures. Ten untrained students were randomly assigned to core isometric endurance (n = 5) and core isotonic strength training (n = 5). Each performed three exercises, two times per week for six weeks. A repeated measures ANOVA was used to compare the measurements for the dependent variables and significance by bonferroni post-hoc testing. The training protocols were compared using a 2 × 3 mixed model ANOVA. Improvement in trunk flexor and extensor endurance (p < 0.05) along with squat and bench press strength (p < 0.05) occurred with the strength group. Improvement in trunk flexor and right lateral endurance (p < 0.05) along with strength in the squat (p < 0.05) were found with the endurance group. Neither training protocol claimed superiority and both were ineffective in improving performance. Published by Elsevier Ltd.

  8. Performance of Infinitely Wide Parabolic and Inclined Slider Bearings Lubricated with Couple Stress or Magnetic Fluids

    NASA Astrophysics Data System (ADS)

    Oladeinde, Mobolaji Humphrey; Akpobi, John Ajokpaoghene

    2011-10-01

    The hydrodynamic and magnetohydrodynamic (MHD) lubrication problem of infinitely wide inclined and parabolic slider bearings is solved numerically using the finite element method. The bearing configurations are discretized into three-node isoparametric quadratic elements. Stiffness integrals obtained from the weak form of the governing equations are solved using Gauss quadrature to obtain a finite number of stiffness matrices. The global system of equations obtained from enforcing nodal continuity of pressure for the bearings are solved using the Gauss-Seidel iterative scheme with a convergence criterion of 10-10. Numerical computations reveal that, when compared for similar profile and couple stress parameters, greater pressure builds up in a parabolic slider compared to an inclined slider, indicating a greater wedge effect in the parabolic slider. The parabolic slider bearing is also shown to develop a greater load capacity when lubricated with magnetic fluids. The superior performance of parabolic slider bearing is more pronounced at greater Hartmann numbers for identical bearing structural parameters. It is also shown that when load carrying capacity is the yardstick for comparison, the parabolic slider bearings are superior to the inclined bearings when lubricated with couple stress or magnetic lubricants.

  9. Lo que Piensan los Estudiantes y Profesores Sobre la Calidad de la Educacion Superior. Estudio Comparativo en 5 Instituciones de Educacion Superior--dos publicas y tres privadas--en Guadalajara, Jalisco, Mexico (What Students and Faculties Think about the Quality of Higher Education. Comparative Study of 5 Higher Education Institutions--Two Public and Three Private--in Guadalajara, Jalisco, Mexico).

    ERIC Educational Resources Information Center

    Yanez, Maria Lorena Hernandez

    This study, written in Spanish, compared attitudes of students (N=302) and faculty (N=28) at five institutions of higher education (two public and three private) in Guadalajara, Jalisco, Mexico. The study explored first, whether respondents believed there are significant quality differences between private and public universities and, second, what…

  10. [Difference in action sites between mecamylamine and hexamethonium on nicotinic receptors of sympathetic neurons].

    PubMed

    Liu, Wei; Zheng, Jian-Quan; Liu, Zhen-Wei; Li, Li-Jun; Wan, Qin; Liu, Chuan-Gui

    2002-12-25

    To compare the difference in action sites between mecamylamine (MEC) and hexamethonium (HEX) on nicotinic receptors of sympathetic neurons, we investigated the effects of MEC and HEX on the nicotine-induced currents in cultured superior cervical ganglion neurons by whole-cell patch clamp technique. The IC(50) of MEC and HEX for antagonizing the effect of 0.08 mmol/L nicotine was 0.0012 and 0.0095 mmol/L, respectively. Both MEC and HEX accelerated the desensitization of nicotinic receptors. Furthermore, by comparing their effects at holding potentials 30, 70 and 110 mV, it was indicated that their suppressing effect on the nicotine-induced currents was voltage-dependent. However, different from that of HEX, the inhibitory effect of MEC increased with administering the mixture of MEC and nicotine at intervals of 3 min, indicating a use-dependent effect of MEC. It is concluded that the action site of MEC on nicotinic receptors of sympathetic neurons is different from that of HEX.

  11. Which rivastigmine formula is better for heart in elderly patients with Alzheimer's disease: oral or patch?

    PubMed

    Isik, Ahmet Turan; Soysal, Pinar; Yay, Adnan

    2014-12-01

    Rivastigmine is commonly used for the treatment of Alzheimer's disease (AD). All cholinesterase inhibitors, including rivastigmine, may cause cardiac side effects. The aim of this study is to compare the electrocardiographic (ECG) and hypotensive effects of formulations of rivastigmine. Eighty-five newly diagnosed patients with AD who were treated with rivastigmine were retrospectively evaluated. The ECG records were reviewed at baseline and at administration of either 12 mg of oral rivastigmine or 10 cm(2) transdermal rivastigmine. When compared with the baseline, there were no changes in any of the ECG parameters in all of the patients (P > .05). Moreover, when compared with the mean change from baseline for each treatment group, there were no changes, except heart rate (P = .035). It was demonstrated that rivastigmine formulations were not associated with increased arrhythmogenic or hypotensive effects in elderly patients with AD and was not superior to each other. © The Author(s) 2014.

  12. Thermodynamic properties of gases dissolved in electrolyte solutions.

    NASA Technical Reports Server (NTRS)

    Tiepel, E. W.; Gubbins, K. E.

    1973-01-01

    A method based on perturbation theory for mixtures is applied to the prediction of thermodynamic properties of gases dissolved in electrolyte solutions. The theory is compared with experimental data for the dependence of the solute activity coefficient on concentration, temperature, and pressure; calculations are included for partial molal enthalpy and volume of the dissolved gas. The theory is also compared with previous theories for salt effects and found to be superior. The calculations are best for salting-out systems. The qualitative feature of salting-in is predicted by the theory, but quantitative predictions are not satisfactory for such systems; this is attributed to approximations made in evaluating the perturbation terms.

  13. N, P-codoped Mesoporous Carbon Supported PtCox Nanoparticles and Their Superior Electrochemical toward Methanol Oxidation

    NASA Astrophysics Data System (ADS)

    Cui, Hangjun; Li, Yueming; Liu, Shimin

    2018-03-01

    In this report, a novel strategy by using the N, P co-doped mesoporous carbon structure as catalyst support to enhance the electrochemical catalytic activity of Pt-based catalysts is proposed. The as-synthesized PtCox@N, P-doped mesoporous carbon nanocomposties have been studied as an anode catalyst toward methanol oxidation, exhibiting greatly improved electrochemical activity and stability compared with Pt@mesoporous carbon. The synergistic effects of N, P dual-doping and porous carbon structure help to achieve better electron transport at the electrode surface, which eventually leads to greatly enhanced catalytic activity compared to the pristine Pt/mesoporous carbon.…

  14. Multilayer compressive seal for sealing in high temperature devices

    DOEpatents

    Chou, Yeong-Shyung [Richland, WA; Stevenson, Jeffry W [Richland, WA

    2007-08-21

    A mica based compressive seal has been developed exhibiting superior thermal cycle stability when compared to other compressive seals known in the art. The seal is composed of compliant glass or metal interlayers and a sealing (gasket) member layer composed of mica that is infiltrated with a glass forming material, which effectively reduces leaks within the seal. The compressive seal shows approximately a 100-fold reduction in leak rates compared with previously developed hybrid seals after from 10 to about 40 thermal cycles under a compressive stress of from 50 psi to 100 psi at temperatures in the range from 600.degree. C. to about 850.degree. C.

  15. Biological Applications and Effects of Optical Masers.

    DTIC Science & Technology

    1983-08-01

    exposures began. By March 1983 after 316 daily exposures, there were large lesions in the superior and temporal macula and the exposure regime was stopped...epithelium (RPE) depigmentation in the superior macula . Now funduscopic examination of 11 the exposed eye disclosed a large lesion in the superior...paramacula where an edematous area had been observed previously and another large lesion in the temporal macula . There were numerous small depigmented

  16. Autologous Transplantation for Newly Diagnosed Multiple Myeloma in the Era of Novel Agent Induction: A Systematic Review and Meta-analysis.

    PubMed

    Dhakal, Binod; Szabo, Aniko; Chhabra, Saurabh; Hamadani, Mehdi; D'Souza, Anita; Usmani, Saad Z; Sieracki, Rita; Gyawali, Bishal; Jackson, Jeffrey L; Asimakopoulos, Fotis; Hari, Parameswaran N

    2018-03-01

    The role of high-dose therapy with melphalan followed by autologous stem cell transplant (HDT/ASCT) in patients with multiple myeloma continues to be debated in the context of novel agent induction. To perform a systematic review, conventional meta-analysis, and network meta-analysis of all phase 3 randomized clinical trials (RCTs) evaluating the role of HDT/ASCT. We performed a systematic literature search of Cochrane Central, MEDLINE, and Scopus from January 2000 through April 2017 and relevant annual meeting abstracts from January 2014 to December 2016. The following search terms were used: "myeloma" combined with "autologous," "transplant," "myeloablative," or "stem cell." Phase 3 RCTs comparing HDT/ASCT with standard-dose therapy (SDT) using novel agents were assessed. Studies comparing single HDT/ASCT with bortezomib, lenalidomide, and dexamethasone consolidation and tandem transplantation were included for network meta-analysis. For the random effects meta-analysis, we used hazard ratios (HRs) and corresponding 95% CIs. The primary outcome was progression-free survival (PFS). Overall survival (OS), complete response, and treatment-related mortality were secondary outcomes. A total of 4 RCTs (2421 patients) for conventional meta-analysis and 5 RCTs (3171 patients) for network meta-analysis were selected. The combined odds for complete response were 1.27 (95% CI, 0.97-1.65; P = .07) with HDT/ASCT when compared with SDT. The combined HR for PFS was 0.55 (95% CI, 0.41-0.74; P < .001) and 0.76 for OS (95% CI, 0.42-1.36; P = .20) in favor of HDT. Meta-regression showed that longer follow-up was associated with superior PFS (HR/mo, 0.98; 95% CI, 0.96-0.99; P = .03) and OS (HR/mo, 0.90; 95% CI, 0.84-0.96; P = .002). For PFS, tandem HDT/ASCT had the most favorable HR (0.49; 95% CI, 0.37-0.65) followed by single HDT/ASCT with bortezomib, lenalidomide, and dexamethasone (HR, 0.53; 95% CI, 0.37-0.76) and single HDT/ASCT alone (HR, 0.68; 95% CI, 0.53-0.87) compared with SDT. For OS, none of the HDT/ASCT-based approaches had a significant effect on survival. Treatment-related mortality with HDT/ASCT was minimal (<1%). The results of the conventional meta-analysis and network meta-analysis of all the phase 3 RCTs showed that HDT/ASCT was associated with superior PFS with minimal toxic effects compared with SDT. Both tandem HDT/ASCT and single HDT/ASCT with bortezomib, lenalidomide, and dexamethasone were superior to single HDT/ASCT alone and SDT for PFS, but OS was similar across the 4 approaches. Longer follow-up may better delineate any OS benefit; however, is likely to be affected by effective postrelapse therapy.

  17. Judgments of duration, figure-ground contrast, and size for words and nonwords.

    PubMed

    Reber, Rolf; Zimmermann, Thomas D; Wurtz, Pascal

    2004-10-01

    Does the word-superiority effect on letter discrimination result in a word-superiority effect on duration judgments? We examined this question in five experiments. In the first four experiments, we have demonstrated that (1) words shown for 32-80 msec were judged as presented longer than non-words shown for the same duration; (2) this word-superiority effect persists if the stimuli are shown for an objective duration of up to 250 msec; and (3) these effects can be extended to judgments of figure-ground contrast and letter size. These findings extend existing data on effects of processing fluency on perceptual judgments. In Experiment 5, we found that duration judgments were higher for words than for pronounceable nonwords, and duration judgments were higher for pronounceable non-words than for nonpronounceable nonwords. We discuss the implications of this finding for the discrepancy-attribution hypothesis.

  18. Alteration of glycine receptor immunoreactivity in the auditory brainstem of mice following three months of exposure to radiofrequency radiation at SAR 4.0 W/kg.

    PubMed

    Maskey, Dhiraj; Kim, Hyung Gun; Suh, Myung-Whan; Roh, Gu Seob; Kim, Myeung Ju

    2014-08-01

    The increasing use of mobile communication has triggered an interest in its possible effects on the regulation of neurotransmitter signals. Due to the close proximity of mobile phones to hearing-related brain regions during usage, its use may lead to a decrease in the ability to segregate sounds, leading to serious auditory dysfunction caused by the prolonged exposure to radiofrequency (RF) radiation. The interplay among auditory processing, excitation and inhibitory molecule interactions plays a major role in auditory function. In particular, inhibitory molecules, such a glycine, are predominantly localized in the auditory brainstem. However, the effects of exposure to RF radiation on auditory function have not been reported to date. Thus, the aim of the present study was to investigate the effects of exposure to RF radiation on glycine receptor (GlyR) immunoreactivity (IR) in the auditory brainstem region at 835 MHz with a specific absorption rate of 4.0 W/kg for three months using free-floating immunohistochemistry. Compared with the sham control (SC) group, a significant loss of staining intensity of neuropils and cells in the different subdivisions of the auditory brainstem regions was observed in the mice exposed to RF radiation (E4 group). A decrease in the number of GlyR immunoreactive cells was also noted in the cochlear nuclear complex [anteroventral cochlear nucleus (AVCN), 31.09%; dorsal cochlear nucleus (DCN), 14.08%; posteroventral cochlear nucleus (PVCN), 32.79%] and the superior olivary complex (SOC) [lateral superior olivary nucleus (LSO), 36.85%; superior paraolivary nucleus (SPN), 24.33%, medial superior olivary nucleus (MSO), 23.23%; medial nucleus of the trapezoid body (MNTB), 10.15%] of the mice in the E4 group. Auditory brainstem response (ABR) analysis also revealed a significant threshold elevation of in the exposed (E4) group, which may be associated with auditory dysfunction. The present study suggests that the auditory brainstem region is susceptible to chronic exposure to RF radiation, which may affect the function of the central auditory system.

  19. Comparison of commercial analytical techniques for measuring chlorine dioxide in urban desalinated drinking water.

    PubMed

    Ammar, T A; Abid, K Y; El-Bindary, A A; El-Sonbati, A Z

    2015-12-01

    Most drinking water industries are closely examining options to maintain a certain level of disinfectant residual through the entire distribution system. Chlorine dioxide is one of the promising disinfectants that is usually used as a secondary disinfectant, whereas the selection of the proper monitoring analytical technique to ensure disinfection and regulatory compliance has been debated within the industry. This research endeavored to objectively compare the performance of commercially available analytical techniques used for chlorine dioxide measurements (namely, chronoamperometry, DPD (N,N-diethyl-p-phenylenediamine), Lissamine Green B (LGB WET) and amperometric titration), to determine the superior technique. The commonly available commercial analytical techniques were evaluated over a wide range of chlorine dioxide concentrations. In reference to pre-defined criteria, the superior analytical technique was determined. To discern the effectiveness of such superior technique, various factors, such as sample temperature, high ionic strength, and other interferences that might influence the performance were examined. Among the four techniques, chronoamperometry technique indicates a significant level of accuracy and precision. Furthermore, the various influencing factors studied did not diminish the technique's performance where it was fairly adequate in all matrices. This study is a step towards proper disinfection monitoring and it confidently assists engineers with chlorine dioxide disinfection system planning and management.

  20. Rational geometrical engineering of palladium sulfide multi-arm nanostructures as a superior bi-functional electrocatalyst.

    PubMed

    Nandan, R; Nanda, K K

    2017-08-31

    Geometrical tunability offers sharp edges and an open-armed structure accompanied with a high electrochemical active surface area to ensure the efficient and effective utilization of materials by exposing the electrochemical active sites for facile accessibility of reactant species. Herein, we report a one-step, single-pot, surfactant-free, electroless, and economic route to synthesize palladium sulfide nanostructures with different geometries at mild temperatures and their catalytic properties towards the oxygen reduction reaction (ORR) and methanol electro-oxidation (MOR). For ORR, the positive on-set, half wave potentials, smaller Tafel slope, high electrochemical active surface area, large roughness factor, and better cyclic stability of the proposed nanostructures as compared to those of the commercial state-of-the-art Pt-C/PdS catalysts suggest their superiority in an alkaline medium. In addition, high mass activity (J f ∼ 715 mA mg -1 ), in comparison with that of the commercial state-of-the-art Pt-C/PdS catalysts (J f ∼ 138/41 mA mg -1 , respectively), and high J f /J b (1.52) along with the superior operational stability of the multi-arm palladium sulfide nanostructures towards MOR advocates the bi-functional behavior of the catalyst and its potential as a promising Pt-free anode/cathode electrocatalyst in fuel cells.

  1. Photointerpretation of Skylab photography

    NASA Technical Reports Server (NTRS)

    Mcmurtry, G. J.; Petersen, G. W. (Principal Investigator); Weeden, H. W.; Kleeman, C.; Daelhausen, S.; Hesler, G.

    1975-01-01

    The author has identified the following significant results. In terms of film grain texture and object definition, the S190B color positive film is distinctly superior to the S190A films, when both are compared in the 9 x 9 inch format. Within the six S190A films, the panchromatic black and white films are superior to the infrared black and white, and the color positive film is superior to the color infrared. Minimum relief differences on the order of 500 to 100 feet could be detected by stereoscopic study, however, it is not possible to determine to what extent vegetation and cultural practices assist in such delineations. Water and wind gaps through major ridges were easily seen. Streams of third order and larger were clearly visible and easy to trace; second order streams were not identified with consistency. Differences in color, tone, and textural patterns rarely supplied clues for differentiating soils or bedrock. The separation of naturally forested areas from areas of cultivation and pasture was effective and a valuable clue to the underlying geology. Suburban and industrial developments were clearly differentiated from urban areas and surrounding agricultural fields. Soil associations could be identified on a regional basis, but no sharp boundary could be drawn separating soil associations.

  2. Feeling safe in the plane: neural mechanisms underlying superior action control in airplane pilot trainees--a combined EEG/MRS study.

    PubMed

    Yildiz, Ali; Quetscher, Clara; Dharmadhikari, Shalmali; Chmielewski, Witold; Glaubitz, Benjamin; Schmidt-Wilcke, Tobias; Edden, Richard; Dydak, Ulrike; Beste, Christian

    2014-10-01

    In day-to-day life, we need to apply strategies to cascade different actions for efficient unfolding of behavior. While deficits in action cascading are examined extensively, almost nothing is known about the neuronal mechanisms mediating superior performance above the normal level. To examine this question, we investigate action control in airplane pilot trainees. We use a stop-change paradigm that is able to estimate the efficiency of action cascading on the basis of mathematical constraints. Behavioral and EEG data is analyzed along these constraints and integrated with neurochemical data obtained using Magnetic Resonance Spectroscopy (MRS) from the striatal gamma-aminobutyric acid (GABA) -ergic system. We show that high performance in action cascading, as exemplified in airplane pilot trainees, can be driven by intensified attentional processes, circumventing response selection processes. The results indicate that the efficiency of action cascading and hence the speed of responding as well as attentional gating functions are modulated by striatal GABA and Glutamate + Glutamine concentrations. In superior performance in action cascading similar increases in the concentrations of GABA and Glutamate + Glutamine lead to stronger neurophysiological and behavioral effects as compared to subjects with normal performance in action cascading. Copyright © 2014 Wiley Periodicals, Inc.

  3. Is attention to detail a similarly strong candidate endophenotype for anorexia nervosa and bulimia nervosa?

    PubMed

    Roberts, Marion E; Tchanturia, Kate; Treasure, Janet L

    2013-08-01

    To investigate whether attention to detail is a similarly strong candidate endophenotype of anorexia (AN) and bulimia nervosa (BN), and to explore the incidence and clinical correlates of attention to detail. A total of 266 women (including AN, BN, recovered AN, unaffected sisters of AN/BN & control women) undertook a thorough clinical assessment and were administered two neuropsychological measures of attention to detail (Group Embedded Figure Test; Rey-Osterrieth Complex Figure). Superior attention to detail was found across all AN groups including recovered AN and unaffected AN sisters. Those with BN and their unaffected sisters showed a profile more consistent with poor global integration. The combined effect of superior attention to detail and poor global integration ("weak coherence") was present in 42.3% of active cases and corresponded with a more severe illness, elevated obsessive-compulsive symptoms, and a higher likelihood of comorbid clinical anxiety and self-harm. Attention to detail is a stronger candidate endophenotype of AN compared to BN, where poor global integration may be more relevant. The unique contribution of both aspects of weak coherence (superior attention to detail/poor global integration) requires further exploration and understanding in both eating disorders. Integrating cognitive remediation of these traits into treatment for the subset of patients it is relevant for may improve outcome.

  4. Whole-brain haemodynamic after-effects of 1-Hz magnetic stimulation of the posterior superior temporal cortex during action observation.

    PubMed

    Arfeller, Carola; Schwarzbach, Jens; Ubaldi, Silvia; Ferrari, Paolo; Barchiesi, Guido; Cattaneo, Luigi

    2013-04-01

    The posterior superior temporal sulcus (pSTS) is active when observing biological motion. We investigated the functional connections of the pSTS node within the action observation network by measuring the after-effect of focal repetitive transcranial magnetic stimulation (rTMS) with whole-brain functional magnetic resonance imaging (fMRI). Participants received 1-Hz rTMS over the pSTS region for 10 min and underwent fMRI immediately after. While scanned, they were shown short video clips of a hand grasping an object (grasp clips) or moving next to it (control clips). rTMS-fMRI was repeated for four consecutive blocks. In two blocks we stimulated the left pSTS region and in the other two the right pSTS region. For each side TMS was applied with an effective intensity (95 % of motor threshold) or with ineffective intensity (50 % of motor threshold). Brain regions showing interactive effects of (clip type) × (TMS intensity) were identified in the lateral temporo-occipital cortex, in the anterior intraparietal region and in the ventral premotor cortex. Remote effects of rTMS were mostly limited to the stimulated hemisphere and consisted in an increase of blood oxygen level-dependent responses to grasp clips compared to control clips. We show that the pSTS occupies a pivotal relay position during observation of goal-directed actions.

  5. Cost-Effectiveness of Reverse Total Shoulder Arthroplasty Versus Arthroscopic Rotator Cuff Repair for Symptomatic Large and Massive Rotator Cuff Tears.

    PubMed

    Makhni, Eric C; Swart, Eric; Steinhaus, Michael E; Mather, Richard C; Levine, William N; Bach, Bernard R; Romeo, Anthony A; Verma, Nikhil N

    2016-09-01

    To compare the cost-effectiveness within the United States health care system of arthroscopic rotator cuff repair versus reverse total shoulder arthroplasty in patients with symptomatic large and massive rotator cuff tears without cuff-tear arthropathy. An expected-value decision analysis was constructed comparing the costs and outcomes of patients undergoing arthroscopic rotator cuff repair and reverse total shoulder arthroplasty for large and massive rotator cuff tears (and excluding cases of cuff-tear arthropathy). Comprehensive literature search provided input data to extrapolate costs and health utility states for these outcomes. The primary outcome assessed was that of incremental cost-effectiveness ratio (ICER) of reverse total shoulder arthroplasty versus rotator cuff repair. For the base case, both arthroscopic rotator cuff repair and reverse total shoulder were superior to nonoperative care, with an ICER of $15,500/quality-adjusted life year (QALY) and $37,400/QALY, respectively. Arthroscopic rotator cuff repair was dominant over primary reverse total shoulder arthroplasty, with lower costs and slightly improved clinical outcomes. Arthroscopic rotator cuff repair was the preferred strategy as long as the lifetime progression rate from retear to end-stage cuff-tear arthropathy was less than 89%. However, when the model was modified to account for worse outcomes when reverse shoulder arthroplasty was performed after a failed attempted rotator cuff repair, primary reverse total shoulder had superior outcomes with an ICER of $90,000/QALY. Arthroscopic rotator cuff repair-despite high rates of tendon retearing-for patients with large and massive rotator cuff tears may be a more cost-effective initial treatment strategy when compared with primary reverse total shoulder arthroplasty and when assuming no detrimental impact of previous surgery on outcomes after arthroplasty. Clinical judgment should still be prioritized when formulating treatment plans for these patients. LEVEL OF EVIDENCE: Level II, economic decision analysis. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  6. Brain anomalies in children exposed prenatally to a common organophosphate pesticide

    PubMed Central

    Rauh, Virginia A.; Perera, Frederica P.; Horton, Megan K.; Whyatt, Robin M.; Bansal, Ravi; Hao, Xuejun; Liu, Jun; Barr, Dana Boyd; Slotkin, Theodore A.; Peterson, Bradley S.

    2012-01-01

    Prenatal exposure to chlorpyrifos (CPF), an organophosphate insecticide, is associated with neurobehavioral deficits in humans and animal models. We investigated associations between CPF exposure and brain morphology using magnetic resonance imaging in 40 children, 5.9–11.2 y, selected from a nonclinical, representative community-based cohort. Twenty high-exposure children (upper tertile of CPF concentrations in umbilical cord blood) were compared with 20 low-exposure children on cortical surface features; all participants had minimal prenatal exposure to environmental tobacco smoke and polycyclic aromatic hydrocarbons. High CPF exposure was associated with enlargement of superior temporal, posterior middle temporal, and inferior postcentral gyri bilaterally, and enlarged superior frontal gyrus, gyrus rectus, cuneus, and precuneus along the mesial wall of the right hemisphere. Group differences were derived from exposure effects on underlying white matter. A significant exposure × IQ interaction was derived from CPF disruption of normal IQ associations with surface measures in low-exposure children. In preliminary analyses, high-exposure children did not show expected sex differences in the right inferior parietal lobule and superior marginal gyrus, and displayed reversal of sex differences in the right mesial superior frontal gyrus, consistent with disruption by CPF of normal behavioral sexual dimorphisms reported in animal models. High-exposure children also showed frontal and parietal cortical thinning, and an inverse dose–response relationship between CPF and cortical thickness. This study reports significant associations of prenatal exposure to a widely used environmental neurotoxicant, at standard use levels, with structural changes in the developing human brain. PMID:22547821

  7. Drop-off Detection with the Long Cane: Effects of Different Cane Techniques on Performance

    PubMed Central

    Kim, Dae Shik; Emerson, Robert Wall; Curtis, Amy

    2010-01-01

    This study compared the drop-off detection performance with the two-point touch and constant contact cane techniques using a repeated-measures design with a convenience sample of 15 cane users with visual impairments. The constant contact technique was superior to the two-point touch technique in the drop-off detection rate and the 50% detection threshold. The findings may help an orientation and mobility instructor select an appropriate technique for a particular client or training situation. PMID:21209791

  8. [Application and comparison of NDT-Bobath and Vojta methods in treatment of selected pathologies of the nervous system in children].

    PubMed

    Jóźwiak, Sergiusz; Podogrodzki, Jacek

    2010-01-01

    The paper compares effectiveness of NDT-Bobath and Vojta methods in the treatment of selected dysfunctions of the nervous system in children. It evaluates applicability of both methods in prenatal and perinatal injury of the central nervous system, myelomeningocele, Down syndrome and spasticity. The existing literature is supplemented by own clinical experience of the authors. The paper forms the opinion on the constant debates on the superiority of one method over another.

  9. Heat Stress Is More Damaging to Superior Spikelets than Inferiors of Rice (Oryza sativa L.) due to Their Different Organ Temperatures

    PubMed Central

    Fu, Guanfu; Feng, Baohua; Zhang, Caixia; Yang, Yongjie; Yang, Xueqin; Chen, Tingting; Zhao, Xia; Zhang, Xiufu; Jin, Qianyu; Tao, Longxing

    2016-01-01

    In general, the fertility and kernel weight of inferior spikelets of rice (Oryza Sativa L.) are obviously lower than those of superior spikelets, especially under abiotic stress. However, different responses to heat stress are seemed to show between the superior and inferior spikelet, and this response is scarcely documented that the intrinsic factors remain elusive. In order to reveal the mechanism underlying, two rice plants with different heat tolerance were subjected to heat stress of 40°C at anthesis. The results indicated that a greater decrease in fertility and kernel weight was observed in superior spikelets compared to inferior spikelets. This decrease was primarily ascribed to their different organ temperatures, in which the temperature of the superior spikelets was significantly higher than that of inferior spikelets. We inferred the differences in canopy temperature, light intensity and panicle types, were the primary reasons for the temperature difference between superior and inferior spikelets. Under heat stress, the fertility and kernel weight of superior and inferior spikelets decreased as the panicle numbers per plant were reduced, which was accompanied by significantly increasing the canopy temperatures. Thus, it was suggested that the rice plant with characteristic features of an upright growth habit and loose panicles might be more susceptible to heat stress resulting from their higher canopy and spikelets temperatures. PMID:27877180

  10. Efficacy of atomoxetine versus midodrine for the treatment of orthostatic hypotension in autonomic failure.

    PubMed

    Ramirez, Claudia E; Okamoto, Luis E; Arnold, Amy C; Gamboa, Alfredo; Diedrich, André; Choi, Leena; Raj, Satish R; Robertson, David; Biaggioni, Italo; Shibao, Cyndya A

    2014-12-01

    The clinical presentation of autonomic failure is orthostatic hypotension. Severely affected patients require pharmacological treatment to prevent presyncopal symptoms or frank syncope. We previously reported in a proof of concept study that pediatric doses of the norepinephrine transporter blockade, atomoxetine, increases blood pressure in autonomic failure patients with residual sympathetic activity compared with placebo. Given that the sympathetic nervous system is maximally activated in the upright position, we hypothesized that atomoxetine would be superior to midodrine, a direct vasoconstrictor, in improving upright blood pressure and orthostatic hypotension-related symptoms. To test this hypothesis, we compared the effect of acute atomoxetine versus midodrine on upright systolic blood pressure and orthostatic symptom scores in 65 patients with severe autonomic failure. There were no differences in seated systolic blood pressure (means difference=0.3 mm Hg; 95% confidence [CI], -7.3 to 7.9; P=0.94). In contrast, atomoxetine produced a greater pressor response in upright systolic blood pressure (means difference=7.5 mm Hg; 95% CI, 0.6 to 15; P=0.03) compared with midodrine. Furthermore, atomoxetine (means difference=0.4; 95% CI, 0.1 to 0.8; P=0.02), but not midodrine (means difference=0.5; 95% CI, -0.1 to 1.0; P=0.08), improved orthostatic hypotension-related symptoms as compared with placebo. The results of our study suggest that atomoxetine could be a superior therapeutic option than midodrine for the treatment of orthostatic hypotension in autonomic failure. © 2014 American Heart Association, Inc.

  11. Comparison of human umbilical cord blood-derived mesenchymal stem cells with healthy fibroblasts on wound-healing activity of diabetic fibroblasts.

    PubMed

    Jung, Jae-A; Yoon, Young-Don; Lee, Hyup-Woo; Kang, So-Ra; Han, Seung-Kyu

    2018-02-01

    Various types of skin substitutes composed of fibroblasts and/or keratinocytes have been used for the treatment of diabetic ulcers. However, the effects have generally not been very dramatic. Recently, human umbilical cord blood-derived mesenchymal stromal cells (hUCB-MSCs) have been commercialised for cartilage repair as a first cell therapy product using allogeneic stem cells. In a previous pilot study, we reported that hUCB-MSCs have a superior wound-healing capability compared with fibroblasts. The present study was designed to compare the treatment effect of hUCB-MSCs with that of fibroblasts on the diabetic wound healing in vitro. Diabetic fibroblasts were cocultured with healthy fibroblasts or hUCB-MSCs. Five groups were evaluated: group I, diabetic fibroblasts without coculture; groups II and III, diabetic fibroblasts cocultured with healthy fibroblasts or hUCB-MSCs; and groups IV and V, no cell cocultured with healthy fibroblasts or hUCB-MSCs. After a 3-day incubation, cell proliferation, collagen synthesis levels and glycosaminoglycan levels, which are the major contributing factors in wound healing, were measured. As a result, a hUCB-MSC-treated group showed higher cell proliferation, collagen synthesis and glycosaminoglycan level than a fibroblast-treated group. In particular, there were significant statistical differences in collagen synthesis and glycosaminoglycan levels (P = 0·029 and P = 0·019, respectively). In conclusion, these results demonstrate that hUCB-MSCs may have a superior effect to fibroblasts in stimulating diabetic wound healing. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  12. Inner speech impairments in autism.

    PubMed

    Whitehouse, Andrew J O; Maybery, Murray T; Durkin, Kevin

    2006-08-01

    Three experiments investigated the role of inner speech deficit in cognitive performances of children with autism. Experiment 1 compared children with autism with ability-matched controls on a verbal recall task presenting pictures and words. Experiment 2 used pictures for which the typical names were either single syllable or multisyllable. Two encoding conditions manipulated the use of verbal encoding. Experiment 3 employed a task-switching paradigm for which performance has been shown to be contingent upon inner speech. In Experiment 1, children with autism demonstrated a lower picture-superiority effect compared to controls. In Experiment 2, the children with autism showed a lower word-length effect when pictures were presented alone, but a more substantial word-length effect in a condition requiring overt labelling. In Experiment 3, articulatory suppression affected the task-switching performance of the control participants only. Individuals with autism have limitations in their use of inner speech.

  13. The effects of sleep on episodic memory in older and younger adults.

    PubMed

    Aly, Mariam; Moscovitch, Morris

    2010-04-01

    Evidence on sleep-dependent benefits for episodic memory remains elusive. Furthermore we know little about age-related changes on the effects of sleep on episodic memory. The study we report is the first to compare the effects of sleep on episodic memories in younger and older adults. Memories of stories and personal events were assessed following a retention interval that included sleep and following an equal duration of wakefulness. Both older and younger adults have superior memory following sleep compared to following wakefulness for both types of material. Amount of forgetting of personal events was less during wakefulness in older adults than in younger adults, possibly due to spontaneous rehearsal. Amount of time spent sleeping correlated highly with sleep benefit in older adults, suggesting that quantity of total sleep, and/or time spent in some stages of sleep, are important contributors to age-related differences in memory consolidation or protection from interference during sleep.

  14. Numerical simulation of offset-drain amorphous oxide-based thin-film transistors

    NASA Astrophysics Data System (ADS)

    Jeong, Jaewook

    2016-11-01

    In this study, we analyzed the electrical characteristics of amorphous indium-gallium-zinc-oxide (a-IGZO) thin-film transistors (TFTs) with an offset-drain structure by technology computer aided design (TCAD) simulation. When operating in a linear region, an enhancement-type TFT shows poor field-effect mobility because most conduction electrons are trapped in acceptor-like defects in an offset region when the offset length (L off) exceeds 0.5 µm, whereas a depletion-type TFT shows superior field-effect mobility owing to the high free electron density in the offset region compared with the trapped electron density. When operating in the saturation region, both types of TFTs show good field-effect mobility comparable to that of a reference TFT with a large gate overlap. The underlying physics of the depletion and enhancement types of offset-drain TFTs are systematically analyzed.

  15. Effectiveness of Traditional Chinese Acupuncture versus Sham Acupuncture: a Systematic Review

    PubMed Central

    Carlos, Luís; da Cruz, Lóris Aparecida Prado; Leopoldo, Vanessa Cristina; de Campos, Fabrício Ribeiro; de Almeida, Ana Maria; Silveira, Renata Cristina de Campos Pereira

    2016-01-01

    ABSTRACT Objective: to identify and synthesize the evidence from randomized clinical trials that tested the effectiveness of traditional Chinese acupuncture in relation to sham acupuncture for the treatment of hot flashes in menopausal women with breast cancer. Method: systematic review guided by the recommendations of the Cochrane Collaboration. Citations were searched in the following databases: MEDLINE via PubMed, Web of Science, CENTRAL, CINAHL, and LILACS. A combination of the following keywords was used: breast neoplasm, acupuncture, acupuncture therapy, acupuncture points, placebos, sham treatment, hot flashes, hot flushes, menopause, climacteric, and vasomotor symptoms. Results: a total of 272 studies were identified, five of which were selected and analyzed. Slight superiority of traditional acupuncture compared with sham acupuncture was observed; however, there were no strong statistical associations. Conclusions: the evidence gathered was not sufficient to affirm the effectiveness of traditional acupuncture compared with sham acupuncture. PMID:27533271

  16. ACPA and JWH-133 modulate the vascular tone of superior mesenteric arteries through cannabinoid receptors, BKCa channels, and nitric oxide dependent mechanisms.

    PubMed

    López-Dyck, Evelyn; Andrade-Urzúa, Felipa; Elizalde, Alejandro; Ferrer-Villada, Tania; Dagnino-Acosta, Adan; Huerta, Miguel; Osuna-Calleros, Zyanya; Rangel-Sandoval, Cinthia; Sánchez-Pastor, Enrique

    2017-12-01

    Some cannabinoids, a family of compounds derived from Cannabis sativa (marijuana), have previously shown vasodilator effects in several studies, a feature that makes them suitable for the generation of a potential treatment for hypertension. The mechanism underlying this vasodilator effect in arteries is still controversial. In this report, we explored how the synthetic cannabinoids ACPA (CB 1 -selective agonist) and JWH-133 (CB 2 -selective agonist) regulate the vascular tone of rat superior mesenteric arteries. To screen the expression of CB 1 (Cannabinoid receptor 1) and CB 2 (Cannabinoid receptor 2) receptors in arterial rings or isolated smooth muscle cells obtained from the artery, immunocytochemistry, immunohistochemistry, and confocal microscopy were performed. In addition, the effects on vascular tone induced by the two cannabinoids were tested in isometric tension experiments in rings obtained from superior mesenteric arteries. The participation of voltage and calcium-activated potassium channel of big conductance (BK Ca ) and the role of nitric oxide (NO) release on the vascular effects induced by ACPA and JWH-133 were tested. CB 1 and CB 2 receptors were highly expressed in the rat superior mesenteric artery, in both smooth muscle and endothelium. The vasodilation effect shown by ACPA was endothelium-dependent through a mechanism involving CB 1 receptors, BK Ca channel activation, and NO release; meanwhile, the vasodilator effect of JWH-133 was induced by the activation of CB 2 receptors located in smooth muscle and by a CB 2 receptor-independent mechanism inducing NO release. CB 1 and CB 2 receptor activation in superior mesenteric artery causes vasorelaxation by mechanisms involving BK Ca channels and NO release. Copyright © 2017 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  17. The Picture Superiority Effect in Recognition Memory: A Developmental Study Using the Response Signal Procedure

    ERIC Educational Resources Information Center

    Defeyter, Margaret Anne; Russo, Riccardo; McPartlin, Pamela Louise

    2009-01-01

    Items studied as pictures are better remembered than items studied as words even when test items are presented as words. The present study examined the development of this picture superiority effect in recognition memory. Four groups ranging in age from 7 to 20 years participated. They studied words and pictures, with test stimuli always presented…

  18. Levels of processing and picture memory: the physical superiority effect.

    PubMed

    Intraub, H; Nicklos, S

    1985-04-01

    Six experiments studied the effect of physical orienting questions (e.g., "Is this angular?") and semantic orienting questions (e.g., "Is this edible?") on memory for unrelated pictures at stimulus durations ranging from 125-2,000 ms. Results ran contrary to the semantic superiority "rule of thumb," which is based primarily on verbal memory experiments. Physical questions were associated with better free recall and cued recall of a diverse set of visual scenes (Experiments 1, 2, and 4). This occurred both when general and highly specific semantic questions were used (Experiments 1 and 2). Similar results were obtained when more simplistic visual stimuli--photographs of single objects--were used (Experiments 5 and 6). As in the case of the semantic superiority effect with words, the physical superiority effect for pictures was eliminated or reversed when the same physical questions were repeated throughout the session (Experiments 4 and 6). Conflicts with results of previous levels of processing experiments with words and nonverbal stimuli (e.g., faces) are explained in terms of the sensory-semantic model (Nelson, Reed, & McEvoy, 1977). Implications for picture memory research and the levels of processing viewpoint are discussed.

  19. Donor selection for natural killer cell receptor genes leads to superior survival after unrelated transplantation for acute myelogenous leukemia.

    PubMed

    Cooley, Sarah; Weisdorf, Daniel J; Guethlein, Lisbeth A; Klein, John P; Wang, Tao; Le, Chap T; Marsh, Steven G E; Geraghty, Daniel; Spellman, Stephen; Haagenson, Michael D; Ladner, Martha; Trachtenberg, Elizabeth; Parham, Peter; Miller, Jeffrey S

    2010-10-07

    Killer-cell immunoglobulin-like receptor (KIR) genes form a diverse, immunogenetic system. Group A and B KIR haplotypes have distinctive centromeric (Cen) and telomeric (Tel) gene-content motifs. Aiming to develop a donor selection strategy to improve transplant outcome, we compared the contribution of these motifs to the clinical benefit conferred by B haplotype donors. We KIR genotyped donors from 1409 unrelated transplants for acute myelogenous leukemia (AML; n = 1086) and acute lymphoblastic leukemia (ALL; n = 323). Donor KIR genotype influenced transplantation outcome for AML but not ALL. Compared with A haplotype motifs, centromeric and telomeric B motifs both contributed to relapse protection and improved survival, but Cen-B homozygosity had the strongest independent effect. With Cen-B/B homozygous donors the cumulative incidence of relapse was 15.4% compared with 36.5% for Cen-A/A donors (relative risk of relapse 0.34; 95% confidence interval 0.2-0.57; P < .001). Overall, significantly reduced relapse was achieved with donors having 2 or more B gene-content motifs (relative risk 0.64; 95% confidence interval 0.48-0.86; P = .003) for both HLA-matched and mismatched transplants. KIR genotyping of several best HLA-matched potential unrelated donors should substantially increase the frequency of transplants by using grafts with favorable KIR gene content. Adopting this practice could result in superior disease-free survival for patients with AML.

  20. Single versus double-row repair of the rotator cuff: does double-row repair with improved anatomical and biomechanical characteristics lead to better clinical outcome?

    PubMed

    Pauly, Stephan; Gerhardt, Christian; Chen, Jianhai; Scheibel, Markus

    2010-12-01

    Several techniques for arthroscopic repair of rotator cuff defects have been introduced over the past years. Besides established techniques such as single-row repairs, new techniques such as double-row reconstructions have gained increasing interest. The present article therefore provides an overview of the currently available literature on both repair techniques with respect to several anatomical, biomechanical, clinical and structural endpoints. Systematic literature review of biomechanical, clinical and radiographic studies investigating or comparing single- and double-row techniques. These results were evaluated and compared to provide an overview on benefits and drawbacks of the respective repair type. Reconstructions of the tendon-to-bone unit for full-thickness tears in either single- or double-row technique differ with respect to several endpoints. Double-row repair techniques provide more anatomical reconstructions of the footprint and superior initial biomechanical characteristics when compared to single-row repair. With regard to clinical results, no significant differences were found while radiological data suggest a better structural tendon integrity following double-row fixation. Presently published clinical studies cannot emphasize a clearly superior technique at this time. Available biomechanical studies are in favour of double-row repair. Radiographic studies suggest a beneficial effect of double-row reconstruction on structural integrity of the reattached tendon or reduced recurrent defect rates, respectively.

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