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Substantial Benefit (substantial + benefit)
Selected AbstractsLong-term efficacy of botulinum toxin A in treatment of various movement disorders over a 10-year periodMOVEMENT DISORDERS, Issue 6 2002G-Y.R. Hsiung MD Abstract Although botulinum toxin A (BTX) has been licensed in Canada for treatment of various movement disorders since 1990, few clinical studies regarding its long-term efficacy and side effects have been reported. We conducted a retrospective analysis of 235 patients who received BTX from our movement disorders clinic over a 10-year period (January 1990 to December 1999). A total of 2,616 treatment cycles (multiple injections) were administered to 235 patients with cervical dystonia (CD), hemifacial spasm (HS), blepharospasm (BP), and other movement disorders. Substantial benefit at 5 years was seen in most patients (90% in BP, 88% in HS, 63% in CD, 100% in jaw closing and lower limb dystonia, and 56% in writer's cramp). Benefit was maintained for up to 10 years in CD, HS, and BP data, with a 75.8% benefit reported. Twenty-eight percent of patients discontinued treatment during the follow-up period due to a variety of reasons. Of these, 9.1% of patients developed primary resistance, and 7.5% of patients secondary resistance. Adverse effects, mostly minor, developed in 27% of patients at any one time, occurring over 4.5% of treatment cycles. These were most frequently reported in blepharospasm (22 of 36 patients in 40 cycles), followed by hemifacial spasm (21 of 70 patients in 46 cycles), and cervical dystonia (17 of 106 in 28 cycles). Only 1.3% of patients discontinued therapy due intolerable adverse effects. The results show that BTX is a safe and effective treatment of various types of movement disorders, and most side effects are well tolerated. Discontinuation for any reason was also low after 5 years. Efficacy was maintained after long periods of treatment with high degree of patient satisfaction. © 2002 Movement Disorder Society [source] Alcohol use trajectories among adults in an urban area after a disaster: evidence from a population-based cohort studyADDICTION, Issue 8 2008Magdalena Cerda ABSTRACT Alcohol use increased in the New York City (NYC) metropolitan area in the first months after the 11 September 2001 terrorist attacks. Aims To investigate alcohol use trajectories in the NYC metropolitan area in the 3 years after 11 September and examine the relative contributions of acute exposure to the attacks and ongoing stressors to these trajectories. Design We used a population-based cohort of adults recruited through a random-digit-dial telephone survey in 2002; participants completed three follow-up interviews over 30 months. Setting The NYC metropolitan area. Participants A total of 2752 non-institutionalized adult residents of NYC. Measurements We used growth mixture models to assess trajectories in levels of total alcohol consumption and bingeing in the past 30 days, and predictors of these trajectories. Findings We identified five trajectories of alcohol consumption levels and three bingeing trajectories. Predictors of higher levels of use over time included ongoing stressors, traumatic events and lower income. Ongoing exposure to stressors and low income also play a central role in bingeing trajectories. Conclusions While point-in-time mass traumatic events may matter in the short term, their contribution subsides over time. Accumulated stressors and traumatic events, in contrast, lead to higher levels of consumption among respondents already vulnerable to high alcohol use. Interventions to mitigate post-disaster stressors may have substantial benefit in reducing alcohol abuse in the medium- to long term. [source] Repeat intrathecal triamcinolone acetonide application is beneficial in progressive MS patientsEUROPEAN JOURNAL OF NEUROLOGY, Issue 1 2006V. Hoffmann Available immunomodulatory and conventional steroid treatment regimens provide a limited symptomatic benefit for patients with progressive multiple sclerosis (MS). We performed an open trial on the short-term efficacy of repeated intrathecal application of the sustained release steroid triamcinolone acetonide (TCA) in 27 progressive MS patients. Six TCA administrations, performed every third day, reduced the Expanded Disability Status Scale (EDSS) score [initial: 5.4 ± 1.3, 3,7.5 (mean ± SD, range); end: 4.9 ± 1.1; 2.5,6.5; P < 0.001] and significantly increased the walking distance and speed in particular after the fourth TCA injection. Concomitantly serially determined cerebrospinal fluid (CSF) markers of cell injury, neuron-specific enolase, total , -protein, S-100, and , -amyloid did not significantly change within the interval of TCA treatment. No serious side effects appeared. We conclude that repeat intrathecal injection of 40 mg TCA provides a substantial benefit in progressive MS patients with predominant spinal symptoms and does not alter CSF markers of neuronal cell injury. [source] Sampling variability of liver fibrosis in chronic hepatitis CHEPATOLOGY, Issue 6 2003Pierre Bedossa M.D. Fibrosis is a common endpoint of clinical trials in chronic hepatitis C, and liver biopsy remains the gold standard for fibrosis evaluation. However, variability in the distribution of fibrosis within the liver is a potential limitation. Our aim was to assess the heterogeneity of liver fibrosis and its influence on the accuracy of assessment of fibrosis with liver biopsy. Surgical samples of livers from patients with chronic hepatitis C were studied. Measurement of fibrosis was performed on the whole section by using both image analysis and METAVIR score (reference value). From the digitized image of the whole section, virtual biopsy specimens of increasing length were produced. Fibrosis was assessed independently on each individual virtual biopsy specimen. Results were compared with the reference value according to the length of the biopsy specimen. By using image analysis, the coefficient of variation of fibrosis measurement with 15-mm long biopsy specimens was 55%; and for biopsy specimens of 25-mm length it was 45%. By using the METAVIR scoring system, 65% of biopsies 15 mm in length were categorized correctly according to the reference value. This increased to 75% for a 25-mm liver biopsy specimen without any substantial benefit for longer biopsy specimens. Sampling variability of fibrosis is a significant limitation in the assessment of fibrosis with liver biopsy. In conclusion, this study suggests that a length of at least 25 mm is necessary to evaluate fibrosis accurately with a semiquantitative score. Sampling variability becomes a major limitation when using more accurate methods such as automated image analysis. [source] An eddy current integral formulation on parallel computer systemsINTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN ENGINEERING, Issue 9 2005Raffaele Fresa Abstract In this paper, we show how an eddy current volume integral formulation can be used to analyse complex 3D conducting structures, achieving a substantial benefit from the use of a parallel computer system. To this purpose, the different steps of the numerical algorithms in view of their parallelization are outlined to enlighten the merits and the limitations of the proposed approach. Numerical examples are developed in a parallel environment to show the effectiveness of the method. Copyright © 2004 John Wiley & Sons, Ltd. [source] Natural gas internal combustion engine hybrid passenger vehicleINTERNATIONAL JOURNAL OF ENERGY RESEARCH, Issue 7 2008S. Wright Abstract The implementation of hybrid electric vehicles powered with alternative fuels is critical in reducing national dependence on imported crude oil, addressing the detrimental environmental impact of increasing petroleum usage worldwide, and sustaining the national economy. The question is not whether changes should be made, but instead centers on identifying pathways that will lead to the greatest environmental and economic benefits. To avoid misuse of limited infrastructure investment, the objective of this research is to consider a broad range of relevant factors to determine desirable power plant,fuel combinations for hybrid electric vehicles. In the long term, fuel cells may dominate this application, but at least in the short term, proton exchange membrane fuel cells (PEMFCs) will not likely offer immediate substantial benefit over internal combustion (IC) engines. Environmentally friendly operation of the PEMFC results partly due to low-temperature operation but primarily due to the requirement of a clean fuel, hydrogen. In addition, the differential benefits from power plant choice can be overshadowed by the advantages obtained from hybrid electric vehicle technology and alternative fuels. Consequently, the fuel flexibility of IC engines provides an advantage over the relatively fuel inflexible PEMFC. The methane/hythane IC engine hybrid option, as developed and presented here, is a promising pathway that avoids the barriers encountered with conventional non-hybrid natural gas vehicles, namely range, power and fueling infrastructure difficulties. Dynamometer testing of the natural gas hybrid prototype on the certification FTP-72 duty cycle revealed very low emissions and mileage greater than 33 miles per gallon gasoline equivalent. This hybrid option utilizes a domestic, cost-effective fuel with renewable sources. With multi-fuel capability (methane, hythane and gasoline) it is also designed for use within the emerging hydrogen market. This hybrid option offers reliability and cost-effective technology with immediate wide spread market availability. Copyright © 2007 John Wiley & Sons, Ltd. [source] Bilateral internal globus pallidus stimulation for the treatment of spasmodic torticollis,MOVEMENT DISORDERS, Issue 3 2001Simon Parkin MRCP Abstract Three patients with spasmodic torticollis (ST) obtained substantial benefit from bilateral globus pallidus internus (GPi) stimulation. Progressive improvement in ST occurred over several months but residual cervical dystonia remained. These results corroborate those obtained by Krauss et al. on three patients with ST. © 2001 Movement Disorder Society. [source] TARGETED ADVERTISING: THE ROLE OF SUBSCRIBER CHARACTERISTICS IN MEDIA MARKETS,THE JOURNAL OF INDUSTRIAL ECONOMICS, Issue 1 2009AMBARISH CHANDRA This paper seeks to establish the importance of targeted advertising in media markets. Using zip-code level circulation for U.S. newspapers, I show that newspapers facing more competition have lower circulation prices but higher advertising prices than similar newspapers facing little or no competition. I explain this by showing that newspapers in more competitive markets are better able to segment readers according to their location and demographics. This leads to greater homogeneity in the characteristics of subscribers and raises advertisers' willingness to pay for such readers. The results imply a substantial benefit to advertisers and media firms from targeted advertising. [source] Reproductive hierarchies in the African allodapine bee Allodapula dichroa (Apidae: Xylocopinae) and ancestral forms of socialityBIOLOGICAL JOURNAL OF THE LINNEAN SOCIETY, Issue 3 2009SIMON M. TIERNEY The social organization of allodapine bees has been described in detail for most genera, although there remains a notable gap for one major lineage, the genus Allodapula. Here, we provide the first detailed study of social organization in Allodapula dichroa. Colony sizes are small and the frequency of cooperative nesting is low compared with other allodapine taxa, but there is very clear evidence for reproductive differentiation among adult nestmates. Reproductively dominant females tend to be larger than their nestmates and have much higher levels of wing wear, suggesting that they perform most foraging activities. Multi-female colonies have: (1) lower rates of complete brood absence, suggesting a substantial benefit to cooperative nesting; and (2) larger numbers of brood, suggesting that the presence of a second adult female leads to a greater reproductive output. These data suggest a major phylogenetic split in the form of social organization within the allodapines. In the genus Macrogalea (sister clade to all other allodapines), body size does not preclude young females from laying eggs, and there appears to be, at most, weak reproductive queues. However, in most other allodapines, reproductive hierarchies are prominent and younger and/or smaller females queue for reproductive opportunities, adopt permanently subordinate roles, or disperse. Interestingly, the most common forms of reproductive hierarchies in allodapines do not involve subordinates undertaking foraging roles before reproduction, but instead involve the delaying of both reproduction and foraging. This has implications for the understanding of suggested developmental ground plans in the early stages of social evolution. © 2009 The Linnean Society of London, Biological Journal of the Linnean Society, 2009, 97, 520,530. [source] Optimal Spending Functions for Asymmetric Group Sequential DesignsBIOMETRICAL JOURNAL, Issue 3 2007Keaven M. Anderson Abstract We present optimized group sequential designs where testing of a single parameter , is of interest. We require specification of a loss function and of a prior distribution for ,. For the examples presented, we pre-specify Type I and II error rates and minimize the expected sample size over the prior distribution for ,. Minimizing the square of sample size rather than the sample size is found to produce designs with slightly less aggressive interim stopping rules and smaller maximum sample sizes with essentially identical expected sample size. We compare optimal designs using Hwang-Shih-DeCani and Kim-DeMets spending functions to fully optimized designs not restricted by a spending function family. In the examples selected, we also examine when there might be substantial benefit gained by adding an interim analysis. Finally, we provide specific optimal asymmetric spending function designs that should be generally useful and simply applied when a design with minimal expected sample size is desired. (© 2007 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] Effects of a sustained heroin shortage in three Australian StatesADDICTION, Issue 7 2005Louisa Degenhardt ABSTRACT Background In early 2001 in Australia there was a sudden and dramatic decrease in heroin availability that occurred throughout the country that was evidenced by marked increases in heroin price and decreases in its purity. Aim This study examines the impact of this change in heroin supply on the following indicators of heroin use: fatal and non-fatal drug overdoses; treatment seeking for heroin dependence; injecting drug use; drug-specific offences; and general property offences. The study was conducted using data from three Australian States [New South Wales (NSW), Victoria (VIC) and South Australia (SA)]. Methods Data were obtained on fatal and non-fatal overdoses from hospital emergency departments (EDs), ambulance services and coronial systems; treatment entries for heroin dependence compiled by State health departments; numbers of needles and syringes distributed to drug users; and data on arrests for heroin-related incidents and property-related crime incidents compiled by State Police Services. Time-series analyses were conducted where possible to examine changes before and after the onset of the heroin shortage. These were supplemented with information drawn from studies involving interviews with injecting drug users. Results After the reduction in heroin supply, fatal and non-fatal heroin overdoses decreased by between 40% and 85%. Despite some evidence of increased cocaine, methamphetamine and benzodiazepine use and reports of increases in harms related to their use, there were no increases recorded in the number of either non-fatal overdoses or deaths related to these drugs. There was a sustained decline in injecting drug use in NSW and VIC, as indicated by a substantial drop in the number of needles and syringes distributed (to 1999 levels in Victoria). There was a short-lived increase in property crime in NSW followed by a sustained reduction in such offences. SA and VIC did not show any marked change in the categories of property crime examined in the study. Conclusions Substantial reductions in heroin availability have not occurred often, but in this Australian case a reduction had an aggregate positive impact in that it was associated with: reduced fatal and non-fatal heroin overdoses; reduced the apparent extent of injecting drug use in VIC and NSW; and may have contributed to reduced crime in NSW. All these changes provide substantial benefits to the community and some to heroin users. Documented shifts to other forms of drug use did not appear sufficient to produce increases in deaths, non-fatal overdoses or treatment seeking related to those drugs. [source] Florida Scrub-Jays (Aphelocoma coerulescens) are Sentinels More When Well-Fed (Even with no Kin Nearby)ETHOLOGY, Issue 11 2003Peter A. Bednekoff Sentinels occupy high, exposed positions while other group members forage nearby. If sentinel behavior involves a foraging,predation risk trade-off, animals should be sentinels more when fed supplemental food. When individual Florida scrub-jays (Aphelocoma coerulescens) were fed fragments of peanuts, during the following 30 min they shifted 30% of their time from foraging to sentinel behavior. In a follow-up experiment, we fed either one or two members in each group. As before, the jays reduced their foraging and spent much more time as sentinels when given supplemental food. In each treatment, pairs were sentinels simultaneously considerably less often than expected by chance. The dramatic shift from foraging to sentinel behavior suggests that for Florida scrub-jays sentinel behavior brings substantial benefits for no greater cost than that of lost opportunities to forage. Because the results held for simple mated pairs of scrub-jays, we argue that kin selection and social prestige are not necessary to explain sentinel behavior. [source] Review of the functional surgical treatment of dystoniaEUROPEAN JOURNAL OF NEUROLOGY, Issue 5 2001Paul Krack A review of functional surgery for dystonia is presented. Recently renewed interest in stereotaxy for dystonia has followed the resurgence of pallidotomy and the introduction of deep brain stimulation (DBS) in Parkinson's disease (PD) in the early 1990s. However, even since the 1950s, small series of patients treated with ablative surgery have been carefully studied, providing useful information, notably regarding the tolerability of surgery. In the setting of dystonia, thalamotomy was first performed with substantial benefits, but some authors outlined the great variability in outcome, and the high incidence of operative side-effects. In the ,modern' era of functional surgery for movement disorders, the globus pallidus internus (GPi) has emerged to be currently the best target for dystonia, based on small series of patients published in the last few years. Both bilateral posteroventral pallidotomy (PVP) and bilateral pallidal stimulation, performed by several teams, have benefited a variety of patients with severe dystonia, the most dramatic improvements being seen in primary dystonia with a mutation in the DYT1 gene. Whereas patients with secondary dystonia have often shown a lesser degree of improvement, some publications have nevertheless reported major benefit. There is today a strong need for carefully controlled studies comparing secondary and primary dystonia, DYT1 and non-DYT1 dystonia, ablative surgery and DBS, with additional assessment of neuropsychological changes, especially in children treated with bilateral pallidal procedures. [source] Is Bt Cotton a Pro-Poor Technology?JOURNAL OF AGRARIAN CHANGE, Issue 4 2010A Review, Critique of the Empirical Record Policy makers, journalists and other commentators have hailed genetically modified (GM) crops as a ,pro-poor' success in the developing world. Their confidence appears to be justified by the encouraging conclusions reached by academic studies on the performance and impacts of GM crops, which seem to provide convincing evidence of substantial benefits for smallholders in developing countries. However, a detailed, critical examination of studies on transgenic, insect-resistant cotton in China, India and South Africa demonstrates that the technology's impacts have been evaluated and represented in selective and misleading ways. The performance and impacts of GM crops have in fact been highly variable, socio-economically differentiated and contingent on a range of agronomic, socio-economic and institutional factors. The shortcomings of the GM crop-impacts literature have done a disservice to public and policy debates about GM crops in international development and impeded the development of sound, evidence-based policy. [source] Retail oligopoly power, dairy compact, and Boston milk pricesAGRIBUSINESS : AN INTERNATIONAL JOURNAL, Issue 4 2005Benaissa Chidmi This paper assesses the impacts of the Northeast Dairy Compact (NEDC) and retail oligopoly power on fluid milk prices in Boston. Empirical results reveal that price increases due to oligopoly power outweighed those caused by the NEDC by nearly seven times. In fact, markups are estimated at approximately 25% of the retail milk price, translating into approximately a little less than $0.75/gallon. We also estimated that only around two-thirds of the raw milk price changes were passed forward to consumers. This helps explain why consumer prices have come down only little after elimination of the NEDC. In fact, the new milk income-loss contract program, which basically provides partial price subsidies to farmers, has contributed to low raw milk prices that have generated substantial benefits to milk processors and retailers, modest benefits to farmers and consumers, all at the expense of taxpayers. [JEL classification: L66, L11, L13]. © 2005 Wiley Periodicals, Inc. Agribusiness 21: 477,491, 2005. [source] A New Paradigm for the Teaching of Business Law and Legal Environment ClassesJOURNAL OF LEGAL STUDIES EDUCATION, Issue 1 2006Marc Lampe There is a need to develop curriculum and materials on law-related topics better designed for business students planning a career in business. Except incidentally, business school legal faculty are not teaching future lawyers or paralegals. The world of the business practitioner is very different from that of the lawyer. For most business people the law and lawyers are a necessary nuisance. Furthermore, the legal world is changing. For example, methods of alternative dispute resolution (ADR) have become mainstream. Opportunities for "self-help law" have proliferated. These trends, and other opportunities considered in this article, offer substantial benefits to the business community. To meet the needs of today's business person, college business law and legal environment courses must stress economical, intelligent prevention of legal problems and resolution of conflict. This article is about empowering future business managers by utilizing their class time to educate them to more directly meet these goals. Topical coverage and pedagogical approaches for implementing a new paradigm in a business school introductory law course are detailed. Faculty members should not allow fear of change to deter a needed overhauling of the curriculum, as such procrastination could harm the profession's future standing. [source] Non-target impacts of poison baiting for predator control in AustraliaMAMMAL REVIEW, Issue 3 2007A. S. GLEN ABSTRACT 1Mammalian predators are controlled by poison baiting in many parts of the world, often to alleviate their impacts on agriculture or the environment. Although predator control can have substantial benefits, the poisons used may also be potentially harmful to other wildlife. 2Impacts on non-target species must be minimized, but can be difficult to predict or quantify. Species and individuals vary in their sensitivity to toxins and their propensity to consume poison baits, while populations vary in their resilience. Wildlife populations can accrue benefits from predator control, which outweigh the occasional deaths of non-target animals. We review recent advances in Australia, providing a framework for assessing non-target effects of poisoning operations and for developing techniques to minimize such effects. We also emphasize that weak or circumstantial evidence of non-target effects can be misleading. 3Weak evidence that poison baiting presents a potential risk to non-target species comes from measuring the sensitivity of species to the toxin in the laboratory. More convincing evidence may be obtained by quantifying susceptibility in the field. This requires detailed information on the propensity of animals to locate and consume poison baits, as well as the likelihood of mortality if baits are consumed. Still stronger evidence may be obtained if predator baiting causes non-target mortality in the field (with toxin detected by post-mortem examination). Conclusive proof of a negative impact on populations of non-target species can be obtained only if any observed non-target mortality is followed by sustained reductions in population density. 4Such proof is difficult to obtain and the possibility of a population-level impact cannot be reliably confirmed or dismissed without rigorous trials. In the absence of conclusive evidence, wildlife managers should adopt a precautionary approach which seeks to minimize potential risk to non-target individuals, while clarifying population-level effects through continued research. [source] Competing with channel partners: Supply chain conflict when retailers introduce store brandsNAVAL RESEARCH LOGISTICS: AN INTERNATIONAL JOURNAL, Issue 5 2010Hans Sebastian Heese Abstract Private-label products are of increasing importance in many retail categories. While national-brand products are designed by the manufacturer and sold by the retailer, the positioning of store-brand products is under the complete control of the retailer. We consider a scenario where products differ on a performance quality dimension and we analyze how retailer,manufacturer interactions in product positioning are affected by the introduction of a private-label product. Specifically, we consider a national-brand manufacturer who determines the quality of its product as well the product's wholesale price charged to the retailer. Given the national-brand quality and wholesale price, the retailer then decides the quality level of its store brand and sets the retail prices for both products. We find that a manufacturer can derive substantial benefits from considering a retailer's store-brand introduction when determining the national brand's quality and wholesale price. If the retailer has a significant cost disadvantage in producing high-quality products, the manufacturer does not need to adjust the quality of the national-brand product, but he should offer a wholesale price discount to ensure its distribution through the retailer. If the retailer is competitive in providing products of high-quality, the manufacturer should reduce this wholesale price discount and increase the national-brand quality to mitigate competition. Interestingly, we find the retailer has incentive to announce a store-brand introduction to induce the manufacturer's consideration of these plans in determining the national-brand product quality and wholesale price. © 2010 Wiley Periodicals, Inc. Naval Research Logistics, 2010 [source] Water fluoridation in the Blue Mountains reduces risk of tooth decayAUSTRALIAN DENTAL JOURNAL, Issue 4 2009RW Evans Abstract Background:, In April 1992, the fluoride concentration in the Blue Mountains water supply was adjusted to 1 mg/L. Baseline dmft/DMFT has been determined in children attending schools in the region and in the adjacent reference region of Hawkesbury, fluoridated since 1968. The aim of this study was to evaluate the effect of the water fluoridation programme in the Blue Mountains. Methods:, In 2003, children attending the same schools were sampled. Residential history data were obtained by questionnaire and caries experience was assessed according to WHO guidelines. The analysis was restricted to lifelong resident children aged 5,11 years. Results:, The baseline and follow-up dmft scores for Blue Mountains children aged 5,8 years were 2.36 and 0.67, respectively. The age-adjusted decrease in odds of experiencing one or more dmft due to fluoridation was 0.26 (CI95 0.19, 0.37). The corresponding DMFT scores for Blue Mountains children aged 8,11 were 0.76 and 0.21 and the corresponding decrease in odds of experiencing one or more DMFT due to fluoridation was 0.25 (CI95 0.16, 0.40). Conclusions:, Tooth decay reduction observed in the Blue Mountains corresponds to high rates reported elsewhere and demonstrates the substantial benefits of water fluoridation. [source] | ||||||||||||||||||||||