Reduction

Distribution by Scientific Domains
Distribution within Medical Sciences

Kinds of Reduction

  • absolute reduction
  • absolute risk reduction
  • acetylene reduction
  • activity reduction
  • acute reduction
  • additional reduction
  • age-related reduction
  • anxiety reduction
  • apparent reduction
  • area reduction
  • artifact reduction
  • asymmetric borane reduction
  • asymmetric reduction
  • average reduction
  • bacterial reduction
  • bias reduction
  • biomimetic reduction
  • blood pressure reduction
  • body weight reduction
  • borane reduction
  • borohydride reduction
  • bp reduction
  • brood reduction
  • c reduction
  • carbonyl reduction
  • carbothermal reduction
  • cardiovascular risk reduction
  • catalytic reduction
  • cfu reduction
  • chemical reduction
  • chemoselective reduction
  • clear reduction
  • closed reduction
  • co2 reduction
  • complete reduction
  • concomitant reduction
  • concurrent reduction
  • consequent reduction
  • considerable reduction
  • consistent reduction
  • corresponding reduction
  • cost reduction
  • crime reduction
  • cytochrome c reduction
  • data reduction
  • density reduction
  • diameter reduction
  • diastereoselective reduction
  • dimension reduction
  • dimensional reduction
  • dimensionality reduction
  • direct reduction
  • disaster risk reduction
  • dose reduction
  • dose-dependent reduction
  • drag reduction
  • dramatic reduction
  • drastic reduction
  • early reduction
  • efficiency reduction
  • efficient reduction
  • electrocatalytic reduction
  • electrochemical reduction
  • emission reduction
  • enantioselective reduction
  • enzymatic reduction
  • error reduction
  • expected reduction
  • experimental reduction
  • facile reduction
  • fat reduction
  • fecundity reduction
  • first reduction
  • flow reduction
  • fold reduction
  • force reduction
  • fourfold reduction
  • fracture reduction
  • fracture risk reduction
  • future reduction
  • general reduction
  • gradual reduction
  • great reduction
  • greater reduction
  • greatest reduction
  • growth reduction
  • hair reduction
  • harm reduction
  • hba1c reduction
  • heart rate reduction
  • height reduction
  • highly significant reduction
  • hydrogen reduction
  • immediate reduction
  • important reduction
  • impressive reduction
  • induced reduction
  • initial reduction
  • insignificant reduction
  • iron reduction
  • ketone reduction
  • large reduction
  • larger reduction
  • largest reduction
  • ldl-c reduction
  • length reduction
  • limb reduction
  • little reduction
  • load reduction
  • loading reduction
  • local reduction
  • log reduction
  • long-term reduction
  • loss reduction
  • m-protein reduction
  • major reduction
  • marginal reduction
  • marked reduction
  • mass reduction
  • matter reduction
  • maximal reduction
  • maximum reduction
  • mean reduction
  • median reduction
  • metabolic reduction
  • microbial reduction
  • mild reduction
  • minimal reduction
  • minor reduction
  • model order reduction
  • model reduction
  • moderate reduction
  • modest reduction
  • mortality reduction
  • mtt reduction
  • multifactor dimensionality reduction
  • myocardial reduction
  • nadph-dependent reduction
  • net reduction
  • nitrate reduction
  • nitrite reduction
  • no reduction
  • noise reduction
  • non-significant reduction
  • nonsignificant reduction
  • noticeable reduction
  • novel reduction
  • observed reduction
  • one-electron reduction
  • open reduction
  • order reduction
  • oxygen reduction
  • pain reduction
  • partial reduction
  • particle size reduction
  • pd reduction
  • percent reduction
  • percentage reduction
  • perchlorate reduction
  • persistent reduction
  • photocatalytic reduction
  • pocket reduction
  • population reduction
  • possible reduction
  • postoperative reduction
  • potential reduction
  • poverty reduction
  • ppd reduction
  • preferential reduction
  • preload reduction
  • pressure reduction
  • price reduction
  • profound reduction
  • progressive reduction
  • prolonged reduction
  • pronounced reduction
  • proportional reduction
  • protein reduction
  • rapid reduction
  • rate reduction
  • recent reduction
  • regioselective reduction
  • relative reduction
  • relative risk reduction
  • remarkable reduction
  • reversible reduction
  • risk factor reduction
  • risk reduction
  • rural poverty reduction
  • score reduction
  • seizure reduction
  • selective catalytic reduction
  • selective reduction
  • severe reduction
  • sharp reduction
  • short-term reduction
  • significant dose-dependent reduction
  • significant reduction
  • significant yield reduction
  • similar reduction
  • simultaneous reduction
  • situ chemical reduction
  • situ reduction
  • size reduction
  • slight reduction
  • slow reduction
  • small reduction
  • smoking reduction
  • specific reduction
  • spontaneous reduction
  • stereoselective reduction
  • stereospecific reduction
  • stress reduction
  • strong reduction
  • subsequent reduction
  • substantial reduction
  • sulphate reduction
  • surgical reduction
  • sustained reduction
  • symptom reduction
  • tariff reduction
  • tax reduction
  • temperature reduction
  • temperature-programmed reduction
  • temporary reduction
  • threefold reduction
  • tick size reduction
  • time reduction
  • transient reduction
  • two-electron reduction
  • variance reduction
  • vibration reduction
  • viscosity reduction
  • volume reduction
  • volumetric reduction
  • waste reduction
  • weight reduction
  • workforce reduction
  • wrinkle reduction
  • yield reduction

  • Terms modified by Reduction

  • reduction activity
  • reduction approach
  • reduction behavior
  • reduction condition
  • reduction defect
  • reduction effect
  • reduction efficiency
  • reduction factor
  • reduction group
  • reduction in pain
  • reduction intervention
  • reduction kinetics
  • reduction measure
  • reduction mechanism
  • reduction method
  • reduction methods
  • reduction peak
  • reduction potential
  • reduction problem
  • reduction procedure
  • reduction process
  • reduction product
  • reduction products
  • reduction program
  • reduction programme
  • reduction rate
  • reduction ratio
  • reduction reaction
  • reduction route
  • reduction scheme
  • reduction sequence
  • reduction step
  • reduction strategy
  • reduction strategy paper
  • reduction surgery
  • reduction system
  • reduction technique
  • reduction techniques
  • reduction test
  • reduction therapy
  • reduction time
  • reduction treatment
  • reduction wave

  • Selected Abstracts


    ChemInform Abstract: Atom-Efficient Synthesis of 2,6-Diazacyclophane Compounds Through Alcoholysis/Reduction of 3-Nitroarylmethylene-2,5-piperazinediones.

    CHEMINFORM, Issue 38 2008
    Juan Francisco Gonzalez
    Abstract ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract of an article which was published elsewhere, please select a "Full Text" option. The original article is trackable via the "References" option. [source]


    Role of Iron(III) and Aluminum Hydroxides in Concentration/reduction of Au(III) Complexes

    RESOURCE GEOLOGY, Issue 3 2002
    Akiko UCHIDA
    Abstract: The adsorption of gold on iron(III) and aluminum hydroxides from solutions containing Au(III) complexes has been studied as a function of pH and chloride concentration at 30C. Iron(III) hydroxide was more effective in adsorbing gold from solution than aluminum hydroxide. However, both hydroxides controlled the behavior of Au(III) complex with very similar manner. The most effective gold adsorption occurred in aqueous solution with near neutral pH and low Cl concentration. In this solution condition, Au(III) complexes were mainly dissolved as AuCl2(OH)2 - and AuCl(OH)3 - , and the surface charge for both hydroxides was positive. In addition, the adsorbed Au(III) complexes were spontaneously reduced to elemental gold in spite of the absence of a specific reducing agent. The results of this study suggest that adsorption and spontaneous reduction of gold complexes on the surface of hydrous metal oxides with positive charge play an important role in gold precipitation in subsurface environment. [source]


    Amperometric Ion Sensing Using Polypyrrole Membranes

    ELECTROANALYSIS, Issue 5-6 2003
    Agata Michalska
    Abstract Oxidation/reduction of conducting polymers, coupled with ion exchange between the polymer and electrolyte solution can be utilized for amperometric ion sensing. Electrochemically deposited "model" polypyrrole membranes doped by chloride (PPyCl) and hexacyanoferrate (PPyFeCN) anions were studied from the point of view of their advantages and limits for amperometric determination of electroinactive anions and cations, respectively. Monotonous dependences of the current on electrolyte concentration were obtained for short reading times after potential step application (in the range of ms). The experimental conditions were optimized to obtain linear dependences: log (current) vs. log (KCl concentration) within the range 10,6,1,M. The advantages of the amperometric method over the potentiometric one are highlighted: much lower effect of redox and pH interferences, wider concentration range, elimination of long conditioning procedure. [source]


    HARM REDUCTION IN THE UNITED STATES AT A MOMENT OF CHANGE: MOVING INNOVATION FROM GRASSROOTS TO MAINSTREAM?

    ADDICTION, Issue 9 2009
    JEAN-PAUL C. GRUND
    No abstract is available for this article. [source]


    [Commentary] THE POTENTIAL ROLE OF SNUS IN TOBACCO HARM REDUCTION

    ADDICTION, Issue 9 2009
    CORAL GARTNER
    No abstract is available for this article. [source]


    HARM REDUCTION IS A GOOD LABEL FOR A CRITERION ALL DRUG PROGRAMS SHOULD MEET

    ADDICTION, Issue 3 2009
    ROBERT J. MACCOUN
    No abstract is available for this article. [source]


    HARM REDUCTION,AN ETHICAL IMPERATIVE

    ADDICTION, Issue 3 2009
    INGRID VAN BEEK
    No abstract is available for this article. [source]


    HARM REDUCTION IS NOW THE MAINSTREAM GLOBAL DRUG POLICY

    ADDICTION, Issue 3 2009
    ALEX WODAK
    No abstract is available for this article. [source]


    EVOLUTIONARY REDUCTION IN TESTES SIZE AND COMPETITIVE FERTILIZATION SUCCESS IN RESPONSE TO THE EXPERIMENTAL REMOVAL OF SEXUAL SELECTION IN DUNG BEETLES

    EVOLUTION, Issue 10 2008
    Leigh W. Simmons
    Sexual selection is thought to favor the evolution of secondary sexual traits in males that contribute to mating success. In species where females mate with more than one male, sexual selection also continues after copulation in the form of sperm competition and cryptic female choice. Theory suggests that sperm competition should favor traits such as testes size and sperm production that increase a male's competitive fertilization success. Studies of experimental evolution offer a powerful approach for assessing evolutionary responses to variation in sexual selection pressures. Here we removed sexual selection by enforcing monogamy on replicate lines of a naturally polygamous horned beetle, Onthophagus taurus, and monitoring male investment in their testes for 21 generations. Testes size decreased in monogamous lines relative to lines in which sexual selection was allowed to continue. Differences in testes size were dependent on selection history and not breeding regime. Males from polygamous lines also had a competitive fertilization advantage when in sperm competition with males from monogamous lines. Females from polygamous lines produced sons in better condition, and those from monogamous lines increased their sons condition by mating polygamously. Rather than being costly for females, multiple mating appears to provide females with direct and/or indirect benefits. Neither body size nor horn size diverged between our monogamous and polygamous lines. Our data show that sperm competition does drive the evolution of testes size in onthophagine beetles, and provide general support for sperm competition theory. [source]


    STRESS REDUCTION IN A GEAR TOOTH USING PHOTOELASTICITY AND FINITE ELEMENT ANALYSIS

    EXPERIMENTAL TECHNIQUES, Issue 5 2001
    A. Ahlqvist
    No abstract is available for this article. [source]


    FASTER, EASIER FINITE ELEMENT MODEL REDUCTION

    EXPERIMENTAL TECHNIQUES, Issue 5 2000
    T.A. Deiters
    First page of article [source]


    EFFECT OF ANTICAKING AGENT ADDITION AND HEADSPACE REDUCTION IN THE POWDERED-DRINK MIX SENSORY STABILITY

    JOURNAL OF FOOD QUALITY, Issue 3 2006
    INAR A. CASTRO
    ABSTRACT The objective of the present study was to assess the effect of the addition of 0.2% anticaking agent "silicon dioxide" (S) and of 70.0% reduction of the headspace in the package (H) both individually and combined (SH), on the sensory and physicochemical characteristics of a powdered-drink mix over a shelf-life period of 120 days. The "difference from control" test was applied to 10 trained panelists in order to assess the four treatments at 30-day intervals throughout the experimental period, according to visual aspect of the powdered mix and drink flavor. The results demonstrated that a reduction of 70% of the headspace was the most effective treatment for product sensory stability. Water activity (Aw) was a more sensitive parameter than moisture content and ascorbic acid degradation. Although Aw has shown a significant difference over time, the sensory properties still seemed to be a better shelf-life indicator for powdered mixes. Based on the sensory alterations of the aspect of the powder, a reduction of headspace and the limiting of shelf life to between 60 and 90 days could be recommended for powdered-drink mixes packaged in polypropylene containers. [source]


    REDUCTION IN MICROBIAL GROWTH AND IMPROVEMENT OF STORAGE QUALITY IN FRESH-CUT PINEAPPLE AFTER METHYL JASMONATE TREATMENT

    JOURNAL OF FOOD QUALITY, Issue 1 2005
    MAGALY MARTÍNEZ-FERRER
    ABSTRACT Maintaining the quality of a fresh-cut fruit or vegetable product is a major concern and a priority in the development and in the production of fresh-cut produce products of the industry. The industry has been searching for alternative methods to protect fresh-cut produce from decay and to prolong shelf life. The objective of this research is to enhance the quality and the shelf life of fresh-cut pineapple by exposure to methyl jasmonate (MJ). The exposure of the diced pineapple to a MJ emulsion at a concentration of 10,4 M for 5 min in a sealed container decreased microbiological growth by 3 logs after 12 days of storage at 7C, compared with the control pineapple. Methyl jasmonate as vapor or as dip did not affect the firmness or the color of the fruit. Methyl jasmonate may be a practical treatment to ensure the safety and the quality of fresh-cut pineapple and other fruits and vegetables. [source]


    COMBINED EFFECT OF OSMOTIC PRESSURE AND SONICATION ON THE REDUCTION OF SALMONELLA SPP.

    JOURNAL OF FOOD SAFETY, Issue 4 2008
    IN CONCENTRATED ORANGE JUICE
    ABSTRACT The effect of osmotic pressure alone or combined with the application of sonication on the reduction of Salmonella spp. in concentrated orange juice was evaluated. Frozen concentrated orange juice (12.6 MPa, pH = 3.2), a neutral sugar solution (9.2 MPa, pH = 6.6) and an acid sugar solution (8.8 MPa, pH = 3.2) were inoculated with Salmonella spp. (6,7 log cfu/mL). Reductions were measured after different storage times with or without previous sonication treatment of 1 h (42 KHz,330W). No significant osmotic shock was observed. Reductions appeared to increase over storage time in high osmotic environments. Reductions were also significantly higher for sonicated samples when compared with nonsonicated samples. The highest reduction (7.21 log cfu/mL) was found for concentrated orange juice sonicated during 60 min and stored for 168 h. Combination of sonication and osmotic evaporation (osmosonication) represents a promising new technology that could be designed to athermally produce safe, concentrated fruit juices. PRACTICAL APPLICATIONS The results derived from this research indicate that combining sonication with osmotic pressure during storage of concentrated orange juice provides a way of achieving a >5-log reduction of Salmonella spp. A new promising technology that we call "osmosonication" could be developed, using sonication and osmotic evaporation combined, to athermally process fruit juices. Besides the nutritional and sensory benefits already known to be provided by athermal processes, final products would also be safe for the consumer. [source]


    REDUCTION OF PATULIN IN APPLE JUICE CONCENTRATES DURING STORAGE

    JOURNAL OF FOOD SAFETY, Issue 1 2005
    NURAY KOCA
    ABSTRACT In this study, the reduction of patulin content in apple juice concentrates during 6 months of storage at 22 and 30C was investigated. Results demonstrated that reduction in patulin content was dependent on the storage temperature and time. Patulin reductions after 1 month of storage at 22 and 30C were in the ranges of 45,64% and 66,86%, respectively. Levels of patulin were below detectable limits after 4 months of storage at 22 and 30C. [source]


    INITIAL LEVELS OF DIFFERENTIATION AND REDUCTION IN PSYCHOLOGICAL SYMPTOMS FOR CLIENTS IN MARRIAGE AND FAMILY THERAPY

    JOURNAL OF MARITAL AND FAMILY THERAPY, Issue 1 2005
    Suzanne Bartle-Haring
    Using Bowen Family Systems Theory as a theoretical underpinning, in this study, we investigated the hypothesis that clients with higher levels of differentiation would improve more quickly in therapy than clients with lower levels of differentiation. Hierarchical Linear Modeling was used to analyze the data over nine sessions of therapy in a sample from an on-campus training clinic. The results suggest that there was variation in the initial levels of psychological symptoms and that differentiation was a significant predictor of this variance. The results also suggest that although psychological symptoms decreased over the nine sessions of therapy, there was very little variance in this change. These results are discussed in relation to Bowen Theory. The difficulties of doing this type of research and the lessons learned from this project are also discussed. [source]


    BACTERIA-INDUCED MOTILITY REDUCTION IN LINGULODINIUM POLYEDRUM (DINOPHYCEAE),

    JOURNAL OF PHYCOLOGY, Issue 4 2008
    Xavier Mayali
    Biotic factors that affect phytoplankton physiology and behavior are not well characterized but probably play a crucial role in regulating their population dynamics in nature. We document evidence that some marine bacteria can decrease the swimming speed of motile phytoplankton through the release of putative protease(s). Using the dinoflagellate Lingulodinium polyedrum (F. Stein) J. D. Dodge as a model system, we showed that the motility-reducing components of bacterial-algal cocultures were mostly heat labile, were of high molecular weight (>50 kDa), and could be partially neutralized by incubations with protease inhibitors. We further showed that additions of the purified protease pronase E decreased dinoflagellate swimming speed in a concentration-dependent manner. We propose that motility can be used as a marker for dinoflagellate stress or general unhealthy status due to proteolytic bacteria, among other factors. [source]


    ASYMPTOTIC METHODS: APPLICATION TO REDUCTION OF MODELS

    NATURAL RESOURCE MODELING, Issue 3 2000
    LEONID V. KALACHEV
    ABSTRACT. A survey of results on reduction of models related to problems of natural resource modeling using the boundary function method is presented. Detailed reduction procedures as well as conditions under which the reductions are at all possible are discussed. Particular asymptotic techniques are illustrated by simple examples taken from chemical kinetics, and a realistic example from atmospheric chemistry modeling. [source]


    PAIN REDUCTION WITH OPIOID ELIMINATION

    PAIN MEDICINE, Issue 2 2002
    Article first published online: 4 JUL 200
    Edward Covington, MD, Cleveland Clinic Foundation; Margaret Kotz, DO, Cleveland Clinic Foundation The last decade has seen a reversal of the historical belief that chronic opioid therapy (COT) was inadvisable in nonmalignant palm. Numerous studies demonstrate sustained pain reduction with chronic opioid therapy; however, there are clinical reports and animal models that suggest chronic opioids may at times exacerbate pain. Clearly, many patients without apparent structural deficit have persistent pain and dysfunction despite high dose opioid therapy. Thus, while opioids have been shown to be safe in long term use, the question of efficacy remains. Predictors of success in COT are not fully established. Studies of intrathecal opioids suggest that high levels of patient satisfaction and retrospective reports of benefit may occur despite minimal change in pain level and function. This raises the question of whether at times the purported benefits of long-term opioid therapy may be illusory. Consecutive admissions to a chronic pain rehabilitation program (n = 228) were studied. This program represents a biased population in that many referrals have dysfunction that is discordant with pathology, inordinate suffering and dysphoria, poorly explained pain, or substance use problems. Of 228, 56 were taking , 100 mg p.o. morphine equivalents/d on admission (mean 456 mg/d). Data are available on 46 of these receiving ,high dose' opioids. Patients participated in a rehabilitation program that included reconditioning, cognitive behavioral psychotherapy, adjuvant medications, and elimination of opioids and benzodiazepines. 43 (93%) experienced a reduction in pain with opioid elimination (from 7.2 to 4.0/10). Three experienced an increase in pain. Depression and functional impairment also improved. Cases will be presented of patients who believed they were benefiting from chronic opioid therapy, but improved after opioid elimination. They commonly described "getting myself back" after elimination of opioids. Physiological considerations and treatment implications will be described. [source]


    REDUCTION WITHOUT REDUCTIONISM: A DEFENCE OF NAGEL ON CONNECTABILITY

    THE PHILOSOPHICAL QUARTERLY, Issue 234 2009
    Colin Klein
    Unlike the overall framework of Ernest Nagel's work on reduction, his theory of intertheoretic connection still has life in it. It handles aptly cases where reduction requires complex representation of a target domain. Abandoning his formulation as too liberal was a mistake. Arguments that it is too liberal at best touch only Nagel's deductivist theory of explanation, not his condition of connectability. Taking this condition seriously gives a powerful view of reduction, but one which requires us to index explanatory power to sciences as they are formulated at particular times. While we may thereby reduce more than philosophers have supposed, we must abandon hope (as Nagel did) of saying anything useful about reductionism. [source]


    REDUCTIONS OF ESCHERICHIA COLI, COLIFORMS, AEROBIC PLATE COUNTS AND CAMPYLOBACTER JEJUNI BY A SMALL-SCALE, HIGH-PRESSURE SYSTEM DEVISED TO CLEAN A MINIATURIZED POULTRY GIBLETS TRANSPORT SYSTEM

    JOURNAL OF FOOD SAFETY, Issue 4 2009
    OMAR A. OYARZABAL
    ABSTRACT The efficacy of using direct high-pressure hot water (60C, 140F) and a quaternary ammonium compound to clean the inside of stainless steel pipe used to transport chicken giblets was evaluated. The giblets were collected from a commercial processing plant and were inoculated with Campylobacter jejuni. The cleaning system was effective in reducing the numbers of inoculated C. jejuni and naturally occurring mesotrophic bacteria (aerobic plate counts) on the inside surface of the stainless steel pipe used to transport the giblets. However, the decreases in naturally occurring Escherichia coli and coliforms were not significant. These results suggest that additional improvements are needed to better disinfect the piping system used to transport giblets to reduce the potential for cross-contamination with C. jejuni and E. coli. The devised cleaning system could be optimized to reduce the use of chemical agents, the cleaning time and the cost of cleaning pipes in poultry processing facilities. PRACTICAL APPLICATIONS These experiments suggest that the traditional use of hot water and quaternary ammonium compounds to clean the inside of the piping system used to transport chicken giblets may not be sufficient to reduce the contamination with Campylobacter jejuni and mesotrophic bacteria (aerobic plate count). Poultry processors should be aware of the limitations of cleaning closed piping systems and develop and test high-pressure systems to thoroughly clean the pipes used to transport giblets after processing to avoid potential sources of cross-contamination with C. jejuni and mesotrophic bacteria. [source]


    REDUCTIONS IN OXYGEN CONSUMPTION DURING DIVES AND ESTIMATED SUBMERGENCE LIMITATIONS OF STELLER SEA LIONS (EUMETOPIAS JUBATUS)

    MARINE MAMMAL SCIENCE, Issue 2 2007
    Gordon D. Hastie
    Abstract Accurate estimates of diving metabolic rate are central to assessing the energy needs of marine mammals. To circumvent some of the limitations inherent with conducting energy studies in both the wild and captivity, we measured diving oxygen consumption of two trained Steller sea lions (Eumetopias jubatus) in the open ocean. The animals dived to predetermined depths (5,30 m) for controlled periods of time (50,200 s). Rates of oxygen consumption were measured using open-circuit respirometry before and after each dive. Mean resting rates of oxygen consumption prior to the dives were 1.34 (±0.18) and 1.95 (±0.19) liter/min for individual sea lions. Mean rates of oxygen consumption during the dives were 0.71 (±0.24) and 1.10 (±0.39) liter/min, respectively. Overall, rates of oxygen consumption during dives were significantly lower (45% and 41%) than the corresponding rates measured before dives. These results provide the first estimates of diving oxygen consumption rate for Steller sea lions and show that this species can exhibit a marked decrease in oxygen consumption relative to surface rates while submerged. This has important consequences in the evaluation of physiological limitations associated with diving such as dive duration and subsequent interpretations of diving behavior in the wild. [source]


    ELECTIVE TWIN REDUCTIONS: EVIDENCE AND ETHICS

    BIOETHICS, Issue 6 2010
    LEAH MCCLIMANS
    ABSTRACT Twelve years ago the British media got wind of a London gynecologist who performed an elective reduction on a twin pregnancy reducing it to a singleton. Perhaps not surprisingly, opinion on the moral status of twin reductions was divided. But in the last few years new evidence regarding the medical risks of twin pregnancies has emerged, suggesting that twin reductions are relevantly similar to the reductions performed on high-end multi-fetal pregnancies. This evidence has appeared to resolve the moral debate. In this paper I look at the role of clinical evidence in medical ethics. In particular I examine the role of clinical evidence in determining what counts as a significant harm or risk. First, I challenge the extent to which these empirical claims are descriptive, suggesting instead that the evidence is to some degree normative in character. Second, I question whether such empirical claims should count as evidence for what are essentially difficult ethical decisions , a role they appear to play in the case of elective reductions. I will argue that they should not, primarily because the value-laden nature of this evidence conceals much of what is ethically at stake. It is important to recognize that empirical evidence cannot be a substitute for ethical deliberation. [source]


    Latest news and product developments

    PRESCRIBER, Issue 8 2007
    Article first published online: 23 JUL 200
    Lamotrigine for partial, valproate for generalised A large UK trial has shown that lamotrigine is the most effective choice in the treatment of partial epilepsy (Lancet 2007;369: 1000-15). The SANAD trial, commissioned by the National Institute for Health Research's Health Technology Assessment programme, randomised 1721 patients (for whom carbamazepine monotherapy would have been the treatment of choice) to treatment with carbamazepine, gabapentin, lamotrigine, oxcarbazepine (Trileptal) or topiramate (Topamax). Lamotrigine was associated with a longer time to treatment failure, though time to 12-month remission favoured carbamazepine. Over four years' follow-up, lamotrigine was numerically but not significantly superior. The authors concluded lamotrigine is clinically superior to carbamazepine for partial epilepsy A second arm of the trial, yet to be published, evaluated the treatment of generalised epilepsy and found valproate to be clinically most effective, though topiramate was cost effective for some patients. Chronic pain common in nursing homes Most residents in nursing homes say they have long- term pain but only one in seven say a health professional has ever discussed its treatment with them, according to a report by the Patients' Association (www.patients-association.org.uk). Pain in Older People ,A Hidden Problem was a qualitative study of 77 older residents in care homes in England. Most were frail and suffered long-term illness. The study found that 85 per cent of residents said they were often troubled by aches or pains and these lasted over a year in 74 per cent. Most described their pain as moderate (33 per cent) or severe (38 per cent) but 8 per cent said it was excruciating. Many reported limitations on mobility and social activities despite a high level of stoicism. All but one were taking medication to relive pain; one-third experienced adverse effects but 78 per cent believed drugs offered the most effective treatment. One-quarter said a doctor or nurse had discussed how to stop their pain worsening, and 15 per cent said they had discussed how to treat their pain. Visits from GPs appeared to be uncommon. Atherothrombotic events despite treatment Between one in five and one in seven of high-risk patients experience atherothrombotic events despite evidence-based treatment, the REACH study has shown (J Am Med Assoc 2007;297:1197-1206). REACH (REduction of Atherothrombosis for Continued Health) is an international observational study involving 68 236 patients with atherothrombotic disease or at least three risk factors. Most were taking conventional evidence-based medication. After one year, the incidence of the combined endpoint of cardiovascular death, myocardial infarction, stroke or hospitalisation for atherothrombotic events was approximately 15 per cent for patients with coronary artery disease or cardiovascular disease, and 21 per cent in patients with peripheral artery disease and established coronary disease. Event rates increased with the number of vascular beds affected, rising to 26 per cent in patients with three symptomatic arterial disease locations. Extended CD prescribing by nurses and pharmacists The Medicines and Healthcare products Regulatory Agency (MHRA) is consulting on expanding the prescribing of controlled drugs (CDs) by nonmedical prescribers. Currently, nurse independent prescribers can prescribe 12 CDs, including diamorphine and morphine, but pharmacist independent prescribers may not prescribe any CDs. The proposal is to allow both professions to prescribe any CDs within their competence, with the exception of cocaine, diamorphine or dipipanone for the management of addiction. The closing date for consultation is 15 June. Consultation is also underway on expanding the range of CDs nurses and pharmacists can prescribe under a patient group direction (PGD), and their use for pain relief. The closing date for consultation is 20 April. Intrinsa: transdermal testosterone for women A transdermal formulation of testosterone has been introduced for the treatment of low sexual desire associated with distress in women who have experienced an early menopause following hysterectomy involving a bilateral oophorectomy and are receiving concomitant oestrogen therapy. Manufacturer Procter & Gamble says that Intrinsa, a twice-weekly patch, delivers testosterone 300µg every 24 hours, achieving premenopausal serum testosterone levels. Clinical trials showed that Intrinsa reduced distress in 65-68 per cent and increased satisfying sexual activity in 51-74 per cent of women. A month's treatment (eight patches) costs Ł28.00. Fish oil for secondary ,not primary ,prevention of CHD Supplementing statin therapy with eicosapentaenoic acid (EPA) reduces the risk of major coronary events in patients with coronary heart disease (CHD) ,but not in patients with no history of CHD Lancet 2007;369:1090-8). The five-year study in 18 645 patients with total cholesterol levels of 6.5mmol per litre or greater found that the incidence of sudden cardiac death, fatal and nonfatal myocardial infarction in CHD patients treated with EPA plus a statin was 8.7 per cent compared with 10.7 per cent with a statin alone (relative risk reduction 19 per cent). A similar relative risk reduction in patients with no CHD was not statistically significant. There was no difference in mortality between the groups but EPA did reduce unstable angina and nonfatal coronary events. Department pilots information prescriptions The Department of Health has announced 20 sites to pilot information prescriptions prior to a nationwide roll-out in 2008. The prescriptions will guide people with long-term conditions such as diabetes and cancer to sources of support and information about their condition. The Department hopes the project will increase patients' understanding of their discussions with health professionals, empower them to locate the information they need, and provide long-term support. NPSA guidelines for safer prescribing The National Patient Safety Agency (www.npsa.nhs.uk) has published five guidelines to improve medication safety in the NHS. Targeting ,high-risk issues', the guidance covers anticoagulant prescribing, liquid medicines for oral or enteral administration, injectable medicines, epidural injections and infusions, and paediatric intravenous infusions. The implementation of each guide is supported by additional tools and resources. Better adherence not matched to outcomes A systematic review has found that interventions can increase adherence to prescribed medication but there is no evidence that clinical outcomes also improve (Arch Intern Med 2007;167:540-9). The review of 37 trials identified 20 reporting increased adherence. The most effective interventions were behavioural changes to reduce dose demands and those involving monitoring and feedback. Improvements in clinical outcomes were variable and did not correspond to changes in adherence. Antidepressant plus mood stabiliser no better US investigators have found that combining a mood stabiliser with an antidepressant is no more effective than a mood stabiliser alone in preventing mood changes (N Engl J Med 2007; published online 28 March, doi.10.1056/NEJMoa064135). The study found durable recovery occurred in 23.5 per cent of patients treated with a mood stabiliser and adjunctive antidepressant therapy for six months compared with 27.3 per cent of those taking a mood stabiliser plus placebo. [source]


    Discovering Maximal Generalized Decision Rules Through Horizontal and Vertical Data Reduction

    COMPUTATIONAL INTELLIGENCE, Issue 4 2001
    Xiaohua Hu
    We present a method to learn maximal generalized decision rules from databases by integrating discretization, generalization and rough set feature selection. Our method reduces the data horizontally and vertically. In the first phase, discretization and generalization are integrated and the numeric attributes are discretized into a few intervals. The primitive values of symbolic attributes are replaced by high level concepts and some obvious superfluous or irrelevant symbolic attributes are also eliminated. Horizontal reduction is accomplished by merging identical tuples after the substitution of an attribute value by its higher level value in a pre-defined concept hierarchy for symbolic attributes, or the discretization of continuous (or numeric) attributes. This phase greatly decreases the number of tuples in the database. In the second phase, a novel context-sensitive feature merit measure is used to rank the features, a subset of relevant attributes is chosen based on rough set theory and the merit values of the features. A reduced table is obtained by removing those attributes which are not in the relevant attributes subset and the data set is further reduced vertically without destroying the interdependence relationships between classes and the attributes. Then rough set-based value reduction is further performed on the reduced table and all redundant condition values are dropped. Finally, tuples in the reduced table are transformed into a set of maximal generalized decision rules. The experimental results on UCI data sets and a real market database demonstrate that our method can dramatically reduce the feature space and improve learning accuracy. [source]


    Reduction of cerebral hyperperfusion by aminophylline: an example of pharmacological restoration of normal vascular homeostasis?

    ACTA PAEDIATRICA, Issue 8 2000
    HC Lou
    No abstract is available for this article. [source]


    Object combining: a new aggressive optimization for object intensive programs

    CONCURRENCY AND COMPUTATION: PRACTICE & EXPERIENCE, Issue 5-6 2005
    Ronald Veldema
    Abstract Object combining tries to put objects together that have roughly the same life times in order to reduce strain on the memory manager and to reduce the number of pointer indirections during a program's execution. Object combining works by appending the fields of one object to another, allowing allocation and freeing of multiple objects with a single heap (de)allocation. Unlike object inlining, which will only optimize objects where one has a (unique) pointer to another, our optimization also works if there is no such relation. Object inlining also directly replaces the pointer by the inlined object's fields. Object combining leaves the pointer in place to allow more combining. Elimination of the pointer accesses is implemented in a separate compiler optimization pass. Unlike previous object inlining systems, reference field overwrites are allowed and handled, resulting in much more aggressive optimization. Our object combining heuristics also allow unrelated objects to be combined, for example, those allocated inside a loop; recursive data structures (linked lists, trees) can be allocated several at a time and objects that are always used together can be combined. As Java explicitly permits code to be loaded at runtime and allows the new code to contribute to a running computation, we do not require a closed-world assumption to enable these optimizations (but it will increase performance). The main focus of object combining in this paper is on reducing object (de)allocation overhead, by reducing both garbage collection work and the number of object allocations. Reduction of memory management overhead causes execution time to be reduced by up to 35%. Indirection removal further reduces execution time by up to 6%. Copyright © 2005 John Wiley & Sons, Ltd. [source]


    Motility-induced but not vasoactive intestinal peptide-induced increase in luminal alkalinization in rat duodenum is dependent on luminal Cl,

    ACTA PHYSIOLOGICA, Issue 2 2010
    L. Pihl
    Abstract Aim:, To investigate whether the motility- and the vasoactive intestinal peptide (VIP)-induced increase in luminal alkalinization in the duodenum is dependent on luminal Cl,. Methods:, Experiments were performed in anaesthetized rats in vivo. The proximal duodenum was perfused luminally with an isotonic solution, containing zero or low Cl, and the effects on luminal alkalinization, motility, fluid flux and epithelial permeability were determined. Parecoxib, a COX-2 inhibitor, was used to induce duodenal contractions. Results:, Control rats lacked duodenal wall contractions while parecoxib-treated ones exhibited contractions throughout the experiment. Most animals had a net fluid absorption during the perfusion with isotonic NaCl. Luminal alkalinization was about 100% higher in parecoxib-treated rats than in controls. Cl, -free solutions did not affect epithelial permeability or motility but decreased luminal alkalinization by ,50% and decreased net fluid absorption in both control and parecoxib-treated animals. Reduction in luminal Cl, decreased alkalinization in a concentration-dependent manner. The parecoxib-induced increase in alkalinization was markedly reduced in the absence of luminal Cl,. VIP increased luminal alkalinization and induced fluid secretion. The lack of luminal Cl, did not affect the VIP-induced increase in alkalinization but reduced fluid secretion. Conclusions:, The parecoxib-induced increase in luminal alkalinization is highly dependent on luminal Cl, and it is proposed that COX-2 inhibition, via induction of duodenal motility, enhances HCO3, efflux through stimulation of apical Cl,/HCO3, exchange in duodenal epithelial cells. Although the VIP-induced stimulation of fluid secretion is partly dependent on luminal Cl,, the VIP-induced increase in luminal alkalinization is not. [source]


    Molecular characterization of the effects of Y-27632

    CYTOSKELETON, Issue 2 2007
    Hassina Darenfed
    Abstract Many key cellular functions, such as cell motility and cellular differentiation are mediated by Rho-associated protein kinases (ROCKs). Numerous studies have been conducted to examine the ROCK signal transduction pathways involved in these motile and contractile events with the aid of pharmacological inhibitors such as Y-27632. However the molecular mechanism of action of Y-27632 has not been fully defined. To assess the relative contribution of these Rho effectors to the effects of Y-27632, we compared the cytoskeletal phenotype, wound healing and neurite outgrowth in cells treated with Y-27632 or subjected to knockdown with ROCK-I, ROCK-II or PRK-2- specific siRNAs. Reduction of ROCK-I enhances the formation of thin actin-rich membrane extensions, a phenotype that closely resembles the effect of Y-27632. Knockdown of ROCK II or PRK-2, leads to the formation of disc-like extenstions and thick actin bundles, respectively. The effect of ROCK-I knockdown also mimicked the effect of Y-27632 on wound closer rates. ROCK-I knockdown and Y-27632 enhanced wound closure rates, while ROCK-II and PRK-2 were not appreciably different from control cells. In neurite outgrowth assays, knockdown of ROCK-I, ROCK-II or PRK-2 enhances neurite lengths, however no individual knockdown stimulated neurite outgrowth as robustly as Y-27632. We conclude that several kinases contribute to the global effect of Y-27632 on cellular responses. Cell Motil. Cytoskeleton 2006. © 2006 Wiley-Liss, Inc. [source]


    Reduction in the Incidence of Squamous Cell Carcinoma in Solid Organ Transplant Recipients Treated with Cyclic Photodynamic Therapy

    DERMATOLOGIC SURGERY, Issue 5 2010
    ANDREA WILLEY MD
    BACKGROUND AND OBJECTIVES Squamous cell carcinomas (SCCs) produce significant morbidity in solid organ transplant recipients (SOTRs), particularly in patients who develop multiple tumors. Topical photodynamic therapy (PDT) has been shown to decrease the number of keratotic lesions in SOTRs, but the duration of the beneficial effect is limited. The aim of this study was to evaluate the potential benefit of cyclic PDT in the prevention of new SCCs in SOTRs. METHODS Twelve high-risk SOTRs received cyclic PDT treatments at 4- to 8-week intervals for 2 years. The development of new SCCs (invasive and in situ) performed 12 and 24 months after the start of cyclic PDT were compared with the number of SCCs developed during the year before initiation of cyclic PDT. RESULTS The median reduction in the 12- and 24-month post-treatment counts from the 1-month pretreatment counts was 79.0% (73.3,81.8%) and 95.0% (87.5,100.0%), respectively. Treatments were well tolerated. CONCLUSION Cyclic PDT with 5-aminolevulinic acid may reduce the incidence of SCC in SOTRs. Additional studies with larger numbers of patients and optimized protocols are necessary to further explore the potential benefits of cyclic PDT in the prevention of skin cancer in this high-risk patient population. Dr. Lee is member of the Medical Advisory Board of Dusa Pharmaceuticals, Inc. [source]