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Clear Advantages (clear + advantage)
Selected AbstractsRapid-cycling bipolar disorder: effects of long-term treatmentsACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2003L. Tondo Objective: To compare responses to long-term treatment of rapid-cycling (RC) vs. non-RC bipolar disorder patients and assess relative effectiveness of specific agents in RC patients. Method: Studies identified by literature searching were analyzed for effects of RC status and treatment-type on clinical outcome (recurrence or non-improvement per exposure-time), using random-effects methods to estimate pooled rates and their 95% CI for quantitative meta-analytic modeling. Results: Data were obtained from 16 reports with 25 trial-arms involving 1856 (905 RC and 951 non-RC) patients treated with carbamazepine, lamotrigine, lithium, topiramate, or valproate, alone or with other agents over an average of 47.5 months (7347 total patient-years). Estimated RC prevalence was 15.4%. Crude rates (%/month) of recurrence (2.31/1.20) and clinical non-improvement (1.93/0.49) averaged 2.9-fold greater in RC vs. non-RC subjects. The pooled RC/non-RC risk ratio (RR) for inferior treatment-response (in 13 direct comparisons) was 1.40 (CI 1.26,1.56; P < 0.0001). Pooled crude recurrence and non-improvement rates suggested no clear advantage for any treatment, nor superiority for anticonvulsants over lithium. However, only lithium vs. carbamazepine could be directly compared (in four treatment-arms) meta-analytically in RC patients (RR = 0.93, CI 0.74,1.18, indicating no difference in effectiveness). Conclusion: As expected, RC was associated with lower effectiveness of all treatments evaluated. Direct comparisons of specific treatment alternatives for RC patients were rare, and provided no secure evidence of superiority of any treatment. Additional long-term studies comparing RC/non-RC patients randomized to specific treatments are required. [source] A comparison of habitat use and habitat-specific feeding efficiency by Eurasian ruffe (Gymnocephalus cernuus) and yellow perch (Perca flavescens)ECOLOGY OF FRESHWATER FISH, Issue 1 2006A. H. Fullerton Abstract ,, Eurasian ruffe are invading habitats in the North American Great Lakes watershed occupied by commercially important native yellow perch. We conducted laboratory experiments to evaluate potential overlap in habitat (macrophytes, mud, cobble) and food (benthic invertebrates) use. Ruffe and yellow perch both preferred macrophytes > cobble > mud in the light, but only ruffe increased their use of mud in the dark. Neither fish density nor food availability affected habitat preferences, and competition for habitat was not evident. For both species, feeding rates were marginally lower in macrophytes but did not differ between species. Our experiments suggest that if ruffe and yellow perch share a habitat (e.g., during invasion or because of predation risk), competition for space will be weak or absent. However, within a shared habitat, competition for food may occur when food is limiting because neither species has a clear advantage in its ability to consume invertebrates in any habitat. Resumen 1La especie exótica Gymnocephalus cernuus está invadiendo áreas de los Grandes Lagos de USA, ocupadas por la especie nativa Perca flavescens de manera que podrían competir por recursos de hábitat y alimenticios. La probabilidad de competición por alimento depende, en parte, de si estos peces se sobrelapan espacial y temporalmente y también de su habilidad para consumir tipos de alimento asociados a hábitats dados. Desarrollamos dos grupos de experimentos de laboratorio para cuantificar niveles de similitud en el uso de hábitat (barro, cubierta, macrófitas) y de alimento (invertebrados bénticos). El primer conjunto de experimentos examinó las preferencias de hábitat en ambas especies, la influencia de la densidad de individuos y de la presencia de alimento sobre esas preferencias y si los peces competían por el espacio del hábitat. En el segundo conjunto de experimentos cuantificamos la habilidad relativa de cada especie para consumir invertebrados bénticos (quironómidos, oligoquetos y anfípodos) en tres hábitats distintos. 2Tanto G. cernuus and P. flavescens prefirieron de macrófitas a piedras y de piedras a barro en períodos de luz. Solamente G. curnuus aumentó el uso de barro en la oscuridad. Ni la densidad de individuos ni la presencia de alimento afectó la selección de hábitat y no obtuvimos evidencia de competición por el hábitat. Para ambas especies las tasas alimenticias fueron marginalmente menores en macrófitas que en piedras o en barro y no difirieron significativamente entre especies. 3Aunque G. cernuus y P. flavescens pueden ocupar diferentes hábitats en la naturaleza, nuestros experimentos sugieren que si se vieran forzadas a ocupar el mismo hábitat (i.e., durante un proceso de invasión o debido a riesgo de predación), la competición por el espacio seria pequeña o nula. Sin embargo, en un hábitat compartido, la competición por el alimento podría ocurrir cuando el alimento esté limitado porque ninguna de las dos especies tiene una ventaja clara en su habilidad para consumir invertebrados en cualquier que sea el hábitat. [source] Issues concerning association studies for fine mapping a susceptibility gene for a complex disease,GENETIC EPIDEMIOLOGY, Issue 4 2001Norman Kaplan Abstract The usefulness of association studies for fine mapping loci with common susceptibility alleles for complex genetic diseases in outbred populations is unclear. We investigate this issue for a battery of tightly linked anonymous genetic markers spanning a candidate region centered around a disease locus, and study the joint behavior of chi-square statistics used to discover and to localize the disease locus. We used simulation methods based on a coalescent process with mutation, recombination, and genetic drift to examine the spatial distribution of markers with large noncentrality parameters in a case-control study design. Simulations with a disease allele at intermediate frequency, presumably representing an old mutation, tend to exhibit the largest noncentrality parameter values at markers near the disease locus. In contrast, simulations with a disease allele at low frequency, presumably representing a young mutation, often exhibit the largest noncentrality parameter values at markers scattered over the candidate region. In the former cases, sample sizes or marker densities sufficient to detect association are likely to lead to useful localization, whereas, in the latter case, localization of the disease locus within the candidate region is much less likely, regardless of the sample size or density of the map. The effects of increasing sample size or marker density are also investigated. Based upon a single marker analysis, we find that a simple strategy of choosing the marker with the smallest associated P value to begin a laboratory search for the disease locus performs adequately for a common disease allele. We also investigated a strategy of pooling nearby sites to form multiple allele markers. Using multiple degree of freedom chi-square tests for two or three nearby sites, we found no clear advantage of this form of pooling over a single marker analysis. Genet. Epidemiol. 20:432,457, 2001. Published by Wiley-Liss, 2001. [source] Efficacy of infliximab in pediatric Crohn's disease: A randomized multicenter open-label trial comparing scheduled to on demand maintenance therapyINFLAMMATORY BOWEL DISEASES, Issue 3 2009Frank M. Ruemmele MD Abstract Background: Infliximab (IFX) is efficacious in inducing remission in severe forms of pediatric Crohn's disease (CD). Adult studies indicate that IFX is also safe and well tolerated as maintenance therapy. The present study aimed to evaluate in a prospective manner the efficacy and safety of IFX as maintenance therapy of severe pediatric CD comparing scheduled and "on demand" treatment strategies. Methods: Forty children with CD (nonpenetrating, nonstricturing as well as penetrating forms, mean age: 13.9 ± 2.2 years) with a severe flare-up (Harvey,Bradshaw Index [HBI] ,5, erythrocyte sedimentation rate [ESR] >20 mm/h) despite well-conducted immunomodulator therapy (n = 36 azathioprine, n = 1 mercaptopurine, n = 3 methotrexate) combined with steroids were included in this randomized, multicenter, open-label study. Three IFX infusions (5 mg/kg) were administered at week (W)0/W2/W6. At W10, clinical remission (HBI <5) and steroid withdrawal were analyzed and IFX responders were randomized to maintenance therapy over 1 year: group A, scheduled every 2 months; group B, "on demand" on relapse. Results: In all, 34/40 children came into remission during IFX induction therapy (HBI: 6.7 ± 2.5 (WO) vs. 1.1 ± 1.5 (W10); P < 0.001). At the end of phase 2, 15/18 (83%) patients were in remission in group A compared to 8/13 (61%) children in group B (P < 0.01), with a mean HBI of 0.5 versus 3.2 points (group A versus B, P = 0.011). In group A, 3/13 (23.1%) children experienced a relapse compared to 11/12 (92%) children in group B. No severe adverse event occurred during this trial. Conclusions: IFX is well tolerated and safe as maintenance therapy for pediatric CD, with a clear advantage when used on a scheduled 2-month basis compared to an "on demand" basis. (Inflamm Bowel Dis 2009) [source] A numerical study of flexural buckling of foliated rock slopesINTERNATIONAL JOURNAL FOR NUMERICAL AND ANALYTICAL METHODS IN GEOMECHANICS, Issue 9 2001D. P. Adhikary Abstract The occurrence of foliated rock masses is common in mining environment. Methods employing continuum approximation in describing the deformation of such rock masses possess a clear advantage over methods where each rock layer and each inter-layer interface (joint) is explicitly modelled. In devising such a continuum model it is imperative that moment (couple) stresses and internal rotations associated with the bending of the rock layers be properly incorporated in the model formulation. Such an approach will lead to a Cosserat-type theory. In the present model, the behaviour of the intact rock layer is assumed to be linearly elastic and the joints are assumed to be elastic,perfectly plastic. Condition of slip at the interfaces are determined by a Mohr,Coulomb criterion with tension cut off at zero normal stress. The theory is valid for large deformations. The model is incorporated into the finite element program AFENA and validated against an analytical solution of elementary buckling problems of a layered medium under gravity loading. A design chart suitable for assessing the stability of slopes in foliated rock masses against flexural buckling failure has been developed. The design chart is easy to use and provides a quick estimate of critical loading factors for slopes in foliated rock masses. It is shown that the model based on Euler's buckling theory as proposed by Cavers (Rock Mechanics and Rock Engineering 1981; 14:87,104) substantially overestimates the critical heights for a vertical slope and underestimates the same for sub-vertical slopes. Copyright © 2001 John Wiley & Sons, Ltd. [source] Random error reduction in analytic hierarchies: a comparison of holistic and decompositional decision strategiesJOURNAL OF BEHAVIORAL DECISION MAKING, Issue 3 2001Osvaldo F. Morera Abstract The principle of ,divide and conquer' (DAC) suggests that complex decision problems should be decomposed into smaller, more manageable parts, and that these parts should be logically aggregated to derive an overall value for each alternative. Decompositional procedures have been contrasted with holistic evaluations that require decision makers to simultaneously consider all the relevant attributes of the alternatives under consideration (Fischer, 1977). One area where decompositional procedures have a clear advantage over holistic procedures is in the reduction of random error (Ravinder, 1992; Ravinder and Kleinmuntz, 1991; Kleinmuntz, 1990). Adopting the framework originally developed by Ravinder and colleagues, this paper details the results of a study of the random error variances associated with another popular multi-criteria decision-making technique, the Analytic Hierarchy Process (AHP); (Saaty, 1977, 1980), as well as the random error variances of a holistic version of the Analytic Hierarchy Process (Jensen, 1983). In addition, data concerning various psychometric properties (e.g. the convergent validity and temporal stability) and values of AHP inconsistency are reported for both the decompositional and holistic evaluations. The results of the study show that the Ravinder and Kleinmuntz (1991) error-propagation framework extends to the AHP and decompositional AHP judgments are more consistent than their holistic counterparts. Copyright © 2001 John Wiley & Sons, Ltd. [source] Use of oseltamivir in the treatment of canine parvoviral enteritisJOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 1 2010DACVECC, Michelle R. Savigny DVM Abstract Objective , To determine if oseltamivir with standard therapy for canine parvoviral enteritis ameliorates disease morbidity, mortality, or both; to document significant adverse effects associated with its use. Design , Prospective, randomized, blinded, placebo-controlled clinical trial. Setting , University veterinary teaching hospital. Animals , Thirty-five dogs. Interventions , Standard therapy was administered to all dogs. Treatment dogs also received oseltamivir, while control dogs received an equivalent volume of placebo. Measurements and Main Results , Dogs were monitored daily according to a clinical scoring system, physical parameters, and diagnostic evaluations. Dogs in the treatment group gained a significant percentage of weight during hospitalization (mean, +2.6%; SD, 7.1%) versus the control dogs (mean, ,4.5%; SD, 6.9%) (P=0.006). Treatment dogs did not have any significant changes in their white blood cell (WBC) count, while control dogs experienced a significant drop in their WBC counts during their initial stay. In addition, it did not appear that oseltamivir use was associated with any major adverse clinical effects. Conclusions , While a clear advantage to the use of oseltamivir was not established, a significant weight loss during hospitalization, as well as a significant decrease in WBC count were documented in the control group. No major adverse effects were identified that could be associated with oseltamivir administration. Based on these results, the true role of oseltamivir in the treatment of parvoviral enteritis remains speculative, although it is believed that further investigation is warranted. [source] Prognostic and predictive value of HER2/neu oncogene in breast cancerMICROSCOPY RESEARCH AND TECHNIQUE, Issue 2 2002Shahla Masood Abstract Assessment of HER2/neu oncogene has been used as both a prognostic and predictive marker for breast cancer. However, the choice of the best method to assess the status of HER2/neu oncogene in breast cancer tissue remains controversial. A variety of techniques are available to detect HER2/neu gene amplification and overexpression. Tissue-based detection methods by immunohistochemistry (IHC) and/or fluorescence in situ hybridization (FISH) offers a clear advantage over other approaches. FISH is a costly and relatively difficult assay and yet appears to be a better predictor of response to Herceptin® (Trastuzumab) therapy and patient outcome. IHC is less expensive and is easier to perform; however, it suffers from a high rate of false negativity and positivity as well as inter-observer variability among pathologists. Suggestions have been made to use IHC as a screening procedure followed by confirmation by FISH in selected cases. Considering the importance of an accurate assessment of HER2/neu oncogene in selecting therapy, a better alternative may be to use FISH as the primary testing for HER2/neu oncogene. Herceptin® therapy is associated with several side effects and is expensive. Thus, in the long term, it may be more cost-effective to use the FISH procedure and reduce the possibility of under-treatment or over-treatment of breast cancer patients. In addition, assessment of HER2/neu oncogene on every newly diagnosed early breast carcinoma may not be necessary. Metastatic lesions, when they occur, can be sampled by fine needle aspiration biopsy or core needle biopsy for assessment of HER2/Neu status. Microsc. Res. Tech. 59:102,108, 2002. © 2002 Wiley-Liss, Inc. [source] Practical Seakeeping Performance Measures for High Speed Displacement VesselsNAVAL ENGINEERS JOURNAL, Issue 4 2006Dr. Kadir Sariöz The seakeeping performance of high-speed displacement vessels is generally assessed, in a probabilistic manner, by using criteria-based measures of merit. Given a set of seakeeping criteria, these measures, such as the Percentage Time of Operation (PTO) and the Seakeeping Performance Index (SPI), could provide an assessment of the operability of the vessel in a specified sea area. The criteria-based measures are based upon the probability of exceeding specified ship motions in a sea environment particular to the vessel's mission. Given the operational area of the vessel, the percentage of time the vessel operates in a particular sea state can be determined by comparing the predicted motions to the motion limiting criteria. However, because the seakeeping criteria are used in a pass/fail manner, the criteria-based procedures give no credit for reducing motions that do not exceed criteria. This may result in misleading conclusions when the relative seakeeping performance of alternative design concepts is compared. It is shown that criteria-free measures, based upon a normalized summation of critical ship responses for a range of ship speeds and wave headings in a specified sea area, may produce more reliable results when the seakeeping performance of alternative designs are compared. This approach also has the clear advantage of not requiring a set of seakeeping criteria, which is subjective in nature. To demonstrate the effect of typical measures of merit on seakeeping performance assessment, six typical high-speed displacement vessel forms are considered in a comparative analysis. Both the criteria-free and criteria-based measures of merit are employed to compare the seakeeping performance of selected vessels. The results indicate that the choice of seakeeping performance measure of merit depends on the nature of seakeeping analysis and criteria-free measures offer a simple, practical, and realistic assessment in comparative seakeeeping studies. [source] The role of symplectic integrators in optimal controlOPTIMAL CONTROL APPLICATIONS AND METHODS, Issue 4 2009Monique Chyba Abstract For general optimal control problems, Pontryagin's maximum principle gives necessary optimality conditions, which are in the form of a Hamiltonian differential equation. For its numerical integration, symplectic methods are a natural choice. This article investigates to which extent the excellent performance of symplectic integrators for long-time integrations in astronomy and molecular dynamics carries over to problems in optimal control. Numerical experiments supported by a backward error analysis show that for problems in low dimension close to a critical value of the Hamiltonian, symplectic integrators have a clear advantage. This is illustrated using the Martinet case in sub-Riemannian geometry. For problems like the orbital transfer of a spacecraft or the control of a submerged rigid body, such an advantage cannot be observed. The Hamiltonian system is a boundary value problem and the time interval is in general not large enough so that symplectic integrators could benefit from their structure preservation of the flow. Copyright © 2008 John Wiley & Sons, Ltd. [source] Status of Mammography after the Digital Mammography Imaging Screening Trial: Digital versus FilmTHE BREAST JOURNAL, Issue 2 2006D. David Dershaw MD Abstract: Well-publicized results of the recent Digital Mammography Imaging Screening Trial (DMIST) have again shown that there is no clear advantage in mammographic screening of the general population with digital versus film mammography. However, several subgroups,women less than 50 years old, pre- or perimenopausal, and denser breasts,did better with digital mammography than with film. Data also suggest that women with the opposite characteristics might do better with film mammography. This article reviews the data of the four studies comparing digital and film mammographic screening. In addition, it describes the technology involved in the two types of mammographic image capture, the advantages and disadvantages of each type of imaging, and the future possibilities opened by digital technique. Because less than one-tenth of mammography units in use in the United States are digital, the availability of this technology to women undergoing screening and to physicians referring patients to screening sites is very limited. The author suggests that the quality of mammography, rather than the technique used to capture the image, is more important in selecting a mammography facility. For those who have a facility that offers both digital and film mammography, consultation on which type of imaging might be better for an individual woman would be appropriate. Because digital mammography from different manufacturers is based on differing technologies and because data comparing the advantages or disadvantages of these differing types of equipment are not available, it is impossible to recommend which type of digital mammography equipment is best for those undergoing mammography with these types of units. [source] School-based indicated prevention: a randomised trial of group therapyTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 6 2002Paul McArdle Background: One hundred and twenty-two children identified by teachers as at risk for behavioural or emotional problems were randomly allocated to drama-group therapy or to a curriculum-studies control, based in school. Methods: One hundred and seventeen completed the intervention phase of the trial, which comprised 12 hour-long sessions. Post-intervention self-reports showed significant effects associated with both interventions. Results: However, there was a clear advantage of group therapy over both a waiting list control and curriculum studies, according to teacher reports. This was true also of categorical analyses focusing on those with the most severe symptoms. Conclusions: These analyses confirmed sustained teacher-reported improvement over a year-long follow-up period. [source] The ECMWF operational implementation of four-dimensional variational assimilation.THE QUARTERLY JOURNAL OF THE ROYAL METEOROLOGICAL SOCIETY, Issue 564 2000I: Experimental results with simplified physics Abstract This paper presents results of a comparison between four-dimensional variational assimilation (4D-Var). using a 6-hour assimilation window and simplified physics during the minimization, and three-dimensional variational assimilation (3D-Var). Results have been obtained at ,operational' resolution T213L31/T63L31. (T defines the spectral triangular truncation and L the number of levels in the vertical, with the first parameters defining the resolution of the model trajectory, and the second the resolution of the inner-loop.) The sensitivity of the 4D-Var performance to different set-ups is investigated. In particular, the performance of 4D-Var in the Tropics revealed some sensitivity to the way the adiabatic nonlinear normal-mode initialization of the increments was performed. Going from four outer-loops to only one (as in 3D-Var), together with a change to the 1997 formulation of the background constraint and an initialization of only the small scales, helped to improve the 4D-Var performance. Tropical scores then became only marginally worse for 4D-Var than for 3D-Var. Twelve weeks of experimentation with the one outer-loop 4D-Var and the 1997 background formulation have been studied. The averaged scores show a small but consistent improvement in both hemispheres at all ranges. In the short range, each two- to three-week period has been found to be slightly positive throughout the troposphere. The better short-range performance of the 4D-Var system is also shown by the fits of the background fields to the data. More results are presented for the Atlantic Ocean area during FASTEX (the Fronts and Atlantic Storm-Track Experiment), during which 4D-Var is found to perform better. In individual synoptic cases corresponding to interesting Intensive Observing Periods, 4D-Var has a clear advantage over 3D-Var during rapid cyclogeneses. The very short-range forecasts used as backgrounds are much closer to the data over the Atlantic for 4D-Var than for 3D-Var. The 4D-Var analyses also display more day-to-day variability. Some structure functions are illustrated in the 4D-Var case for a height observation inserted at the beginning, in the middle or at the end of the assimilation window. The dynamical processes seem to be relevant, even with a short 6-hour assimilation period, which explains the better overall performance of the 4D-Var system. [source] Randomized phase II trial of gemcitabine and either day 1 or day 8 carboplatin for advanced non-small-cell lung cancer: Is thrombocytopenia predictable?ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, Issue 1 2009Cathy CROMBIE Abstract Aim: Two 21-day gemcitabine,carboplatin schedules were evaluated in patients with advanced non-small cell lung cancer in order to assess the effect of timing of the carboplatin dose on toxicity and efficacy. Methods: Patients were randomized to gemcitabine (1000 mg/m2 on days 1 and 8 of a 21-day cycle) and carboplatin (AUC 5, on day 1) (Carbo d1 arm) or the same gemcitabine schedule with carboplatin given on day 8 (Carbo d8 arm). Twenty patients with Stage IIIB or IV non-small-cell lung cancer were enrolled in each arm. Results: The achieved dose intensities of both gemcitabine and carboplatin were significantly higher in the Carbo d1 arm. The total rates of grade 3 or 4 hematological and non-hematological toxicities (any toxicity, any cycle) were 80% and 65%, respectively, with no significant differences between the two arms. Nine patients in the Carbo d1 arm, but only one patient in the Carbo d8 arm, required a platelet transfusion. There were 10 partial responses (four Carbo d1 arm, six Carbo d8 arm), giving an overall response rate of 25% (95% CI 13,41%). Conclusion: Administration of carboplatin on day 8 of this regimen confers no clear advantage compared with day 1 carboplatin, with similar toxicity but lower dose intensity. A formula for the prediction of thrombocytopenia is proposed. [source] Randomized phase II trial of two different schedules of docetaxel plus cisplatin as first-line therapy in advanced nonsmall cell lung cancerCANCER, Issue 4 2007Se Hoon Park MD Abstract BACKGROUND. There is increasing interest in the use of a weekly administration of docetaxel as a way of reducing its hematologic toxicity. The purpose of the current randomized study was to evaluate the toxicity and efficacy of docetaxel plus cisplatin combination on 2 schedules in patients with previously untreated, advanced nonsmall-cell lung cancer (NSCLC). METHODS. Consenting patients with advanced NSCLC were randomized to receive first-line chemotherapy with cisplatin 75 mg/m2 on Day 1, plus 3-weekly (75 mg/m2 on Day 1) or weekly (35 mg/m2 on Days 1, 8, and 15 of a 4-week cycle) docetaxel, for up to 6 cycles. RESULTS. Of 86 patients accrued, 41 patients were treated with 3-weekly and 43 with weekly docetaxel plus cisplatin. The most frequent grade 3/4 toxicity in the 3-weekly arm was neutropenia (56% of patients). In those receiving the weekly regimen, the frequent grade 3/4 toxicities were fatigue (44%) and nausea/vomiting (35%). The overall response rate was 40% with the 3-weekly and 39% with the weekly arm (P = .74). The median progression-free survival was 4.3 months in the 3-weekly arm and 3.9 months in the weekly arm (P = .08) and the median survival was 10.3 and 10.0 months, respectively (P = .76). Quality of life data showed no relevant difference between the arms. CONCLUSIONS. The weekly schedule of docetaxel plus cisplatin combination as first-line chemotherapy for advanced NSCLC, while feasible, has no clear advantage over the standard 3-weekly regimen. Cancer 2007. © 2007 American Cancer Society. [source] Haematopoietic stem cell transplantation in the treatment of severe autoimmune disease: results from phase I/II studies, prospective randomized trials and future directionsCLINICAL & EXPERIMENTAL IMMUNOLOGY, Issue 1 2005A. Tyndall Summary Around 700 patients have received an autologous haematopoietic stem cell transplant (HSCT) as treatment for a severe autoimmune disease (AD). The majority of these have been within the context of phase I/II clinical trials and following international guidelines proposed 7 years ago. In general, a positive benefit/risk ratio has led to phase III prospective randomized controlled trials in multiple sclerosis (MS), systemic sclerosis (SSc) and rheumatoid arthritis (RA) in Europe. In the US, similar trials are being planned for SSc, MS and systemic lupus erythematosus (SLE). Transplant related mortality (TRM) has fallen in all disease subgroups since the inception due to more appropriate patient selection, and so far a clear advantage of the more intense myeloablative regimens in terms of remission induction and relapse rate has not emerged. Although each AD has a different profile, over a third of patients have sustained a durable remission, often with no further need for immunosuppressive drugs. In those who relapsed, many responded to agents which pre transplant had been ineffective. The study of immune reconstitution and gene expression pre and post HSCT is being undertaken to further understand the mechanism of autoimmunity. [source] Tracing energy flow in stream food webs using stable isotopes of hydrogenFRESHWATER BIOLOGY, Issue 5 2010JACQUES C. FINLAY Summary 1. Use of the natural ratios of carbon and nitrogen stable isotopes as tracers of trophic interactions has some clear advantages over alternative methods for food web analyses, yet is limited to situations where organic materials of interest have adequate isotopic separation between potential sources. This constrains the use of natural abundance stable isotope approaches to a subset of ecosystems with biogeochemical conditions favourable to source separation. 2. Recent studies suggest that stable hydrogen isotopes (,D) could provide a robust tracer to distinguish contributions of aquatic and terrestrial production in food webs, but variation in ,D of consumers and their organic food sources are poorly known. To explore the utility of the stable hydrogen isotope approach, we examined variation in ,D in stream food webs in a forested catchment where variation in ,13C has been described previously. 3. Although algal ,D varied by taxa and, to a small degree, between sites, we found consistent and clear separation (by an average of 67,) from terrestrial carbon sources. Environmental conditions known to affect algal ,13C, such as water velocity and stream productivity did not greatly influence algal ,D, and there was no evidence of seasonal variation. In contrast, algal ,13C was strongly affected by environmental factors both within and across sites, was seasonally variable at all sites, and partially overlapped with terrestrial ,13C in all streams with catchment areas larger than 10 km2. 4. While knowledge of isotopic exchange with water and trophic fractionation of ,D for aquatic consumers is limited, consistent source separation in streams suggests that ,D may provide a complementary food web tracer to ,13C in aquatic food webs. Lack of significant seasonal or spatial variation in ,D is a distinct advantage over ,13C for applications in many aquatic ecosystems. [source] Role of exposure with response prevention in cognitive,behavioral therapy for bulimia nervosa: Three-year follow-up resultsINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 2 2003Frances A. Carter Abstract Background Previous studies have not reported the longer-term outcome of exposure-based treatments for bulimia nervosa. The current study evaluated the 3-year outcome of a randomized clinical trial that compared the additive efficacy of exposure-based versus nonexposure-based behavioral treatments (BT) with a core of cognitive,behavior therapy (CBT). Methods One hundred thirteen women participated in the original treatment trial and attended a 3-year follow-up assessment. Eating disorder diagnoses and primary, secondary, and tertiary outcome measures were assessed. The impact of treatment completion on symptomatology and the stability of treatment effects over time were evaluated. Results At the 3-year follow-up, 85% of the sample had no current diagnosis of bulimia nervosa and 69% had no current eating disorder diagnoses of any sort. Failure to complete CBT was associated with inferior outcome. No clear advantages were evident for participants who completed BT in addition to CBT. For subjects who did complete both CBT and BT, outcome was mostly stable from posttreatment to follow-up. No differential effects were found for exposure versus nonexposure-based treatments at 3-year follow-up. Discussion The results of the current study compare favorably with other treatment outcome studies for bulimia nervosa and suggest that treatment gains are maintained after 3 years. © 2003 by Wiley Periodicals, Inc. Int J Eat Disord 33: 127,135, 2003. [source] Response of pea (Pisum sativum L.) to mepiquat chloride under varying application doses and stagesJOURNAL OF AGRONOMY AND CROP SCIENCE, Issue 2 2006E. Elkoca Abstract Grown as a monoculture, peas (Pisum sativum L.) exhibit severe lodging after flowering and lodging causes yield reductions considerable. This study was conducted to investigate the effects of dose (untreated, 25, 50, 75 and 100 g a.i. ha,1) and stage (late vegetative, early blooming and early pod filling) of mepiquat chloride (MC) application on the growth, lodging control, seed yield and yield parameters of pea (Pisum sativum L.) under field conditions in Erzurum, Turkey in 2002 and 2003. Application doses of 25, 50, 75 and 100 g a.i. ha,1 significantly reduced stem height by 5.3 %, 7.2 %, 7.5 % and 6.4 % and increased stem width by 7.5 %, 12.7 %, 12.3 % and 15.7 % respectively, when compared with the untreated control, and thereby reduced the tendency of the crop to lodging. Increases of the seed yield under different application doses of MC ranged between 13.7 % and 20.1 % over the untreated control. However, in all parameters investigated, except for stem width, higher application doses of MC gave no clear advantages compared with the application dose of 25 g a.i. ha,1. Seed yield was also significantly influenced by application stage of MC and application at early blooming stage of crop, MC significantly increased seed yield by 11.4 % and 10.2 % when compared with the late vegetative and the early pod filling stages respectively. Furthermore, the interaction of application dose and stage was significant, and spraying of pea plants with 25 g a.i. ha,1 MC at early blooming stage has the most beneficial effects on the characters evaluated. [source] Retinal vascular image analysis as a potential screening tool for cerebrovascular disease: a rationale based on homology between cerebral and retinal microvasculaturesJOURNAL OF ANATOMY, Issue 4 2005Niall Patton Abstract The retinal and cerebral microvasculatures share many morphological and physiological properties. Assessment of the cerebral microvasculature requires highly specialized and expensive techniques. The potential for using non-invasive clinical assessment of the retinal microvasculature as a marker of the state of the cerebrovasculature offers clear advantages, owing to the ease with which the retinal vasculature can be directly visualized in vivo and photographed due to its essential two-dimensional nature. The use of retinal digital image analysis is becoming increasingly common, and offers new techniques to analyse different aspects of retinal vascular topography, including retinal vascular widths, geometrical attributes at vessel bifurcations and vessel tracking. Being predominantly automated and objective, these techniques offer an exciting opportunity to study the potential to identify retinal microvascular abnormalities as markers of cerebrovascular pathology. In this review, we describe the anatomical and physiological homology between the retinal and cerebral microvasculatures. We review the evidence that retinal microvascular changes occur in cerebrovascular disease and review current retinal image analysis tools that may allow us to use different aspects of the retinal microvasculature as potential markers for the state of the cerebral microvasculature. [source] Dynamic modeling, stability, and energy efficiency of a quadrupedal walking machineJOURNAL OF FIELD ROBOTICS (FORMERLY JOURNAL OF ROBOTIC SYSTEMS), Issue 11 2001Ben Sheng Lin In the past, the dynamics of walking machines was studied based on very simple or simplified leg structures. A more complete dynamic model is essential for the further development of a practical walking machine. In this paper, the dynamic model of a realistic quadrupedal walking machine is derived for simulation and real-time control purposes. The walker has four cylindrical pantograph legs, and the whole system consists of twenty-nine links. The walking gait is wave gait with at least three feet on the ground at any time. Significant efforts have been made to improve the computational efficiency of the inverse dynamics, and the required CPU time is less than 10 ms on an IBM 3090. The derived dynamic model is then applied to study two practical issues of walking: dynamic stability and mechanical efficiency of different legs and gaits. Simulation results show clear advantages of one leg type over another, and of some walking strategies in terms of adjusting velocities, strokes, and duty factors for greater efficiency. © 2001 John Wiley & Sons, Inc. [source] From marine ecology to crime analysis: Improving the detection of serial sexual offences using a taxonomic similarity measureJOURNAL OF INVESTIGATIVE PSYCHOLOGY AND OFFENDER PROFILING, Issue 1 2007Jessica Woodhams Abstract Jaccard has been the choice similarity metric in ecology and forensic psychology for comparison of sites or offences, by species or behaviour. This paper applies a more powerful hierarchical measure,taxonomic similarity (,s), recently developed in marine ecology,to the task of behaviourally linking serial crime. Forensic case linkage attempts to identify behaviourally similar offences committed by the same unknown perpetrator (called linked offences). ,s considers progressively higher-level taxa, such that two sites show some similarity even without shared species. We apply this index by analysing 55 specific offence behaviours classified hierarchically. The behaviours are taken from 16 sexual offences by seven juveniles where each offender committed two or more offences. We demonstrate that both Jaccard and ,s show linked offences to be significantly more similar than unlinked offences. With up to 20% of the specific behaviours removed in simulations, ,s is equally or more effective at distinguishing linked offences than where Jaccard uses a full data set. Moreover, ,s retains significant difference between linked and unlinked pairs, with up to 50% of the specific behaviours removed. As police decision-making often depends upon incomplete data, ,s has clear advantages and its application may extend to other crime types. Copyright © 2007 John Wiley & Sons, Ltd. [source] Learning How to Learn: A CritiqueJOURNAL OF PHILOSOPHY OF EDUCATION, Issue 3-4 2008CHRISTOPHER WINCH The claim that ,learning how to learn' is the central ability required for young people to be effective ,lifelong learners' is examined for various plausible interpretations. It is vacuous if taken to mean that we need to acquire a capacity to learn, since we necessarily have this if we are to learn anything. The claim that it is a specific ability is then looked at. Once again, if we acquire an ability to learn we do not need the ability to learn how to learn. After noting the implausibility of any such general ability, the paper goes on to examine the claim that certain specific but transferable abilities might satisfy the description ,learning how to learn'. Various candidates are considered: forming and testing hypotheses and abduction are two promising ones, but each has significant weaknesses. Numeracy and literacy are thought to be more promising, but achievements at the national level leave a lot to be desired, despite the clear advantages for learning of being able to read, write and count. If we needed to learn how to learn before we learned how to read, write and count, it is unlikely that we would get anywhere. Finally, certain non-cognitive dispositions and character traits rather than cognitive attributes are considered and, drawing on the work of Robert Dearden and others, it is suggested that the development of these aretaic (virtue-based) and personal qualities rather than cognitive ones may be most decisive for developing independent learning in a range of subject matters. [source] Treatments for Patients With Dual Diagnosis: A ReviewALCOHOLISM, Issue 4 2007Quyen Q. Tiet Background: Comorbid substance use and mental illness is prevalent and often results in serious consequences. However, little is known about the efficacy of treatments for patients with dual diagnosis. Methods: This paper reviews both the psychosocial and medication treatments for those diagnosed with a substance-related disorder and one of the following disorders: (a) depression, (b) anxiety disorder, (c) schizophrenia, (d) bipolar disorder, (e) severe mental illness, and (f) nonspecific mental illness. We made no restriction of study design to include all published studies, due to the dearth of studies on treatments of patients with dual diagnosis. Results: Fifty-nine studies were identified (36 randomized-controlled trials; RCT). Limited number of studies, especially RCTs, have been conducted within each comorbid category. This review did not find treatments that had been replicated and consistently showed clear advantages over comparison condition for both substance-related and other psychiatric outcomes. Conclusions: Although no treatment was identified as efficacious for both psychiatric disorders and substance-related disorder, this review finds: (1) existing efficacious treatments for reducing psychiatric symptoms also tend to work in dual-diagnosis patients, (2) existing efficacious treatments for reducing substance use also decrease substance use in dually diagnosed patients, and (3) the efficacy of integrated treatment is still unclear. This review provides a critique of the current state of the literature, identifies the directions for future research on treatment of dual-diagnosis individuals, and calls for urgent attention by researchers and funding agencies to conduct more and more methodologically rigorous research in this area. [source] Research prioritization based on expected value of partial perfect information: a case-study on interventions to increase uptake of breast cancer screeningJOURNAL OF THE ROYAL STATISTICAL SOCIETY: SERIES A (STATISTICS IN SOCIETY), Issue 4 2008N. J. Welton Summary., We investigate whether Bayesian decision theory, in the form of expected value of partial perfect information (EVPPI) analysis, is a realistic and practical approach to research prioritization. We develop a simple cost-effectiveness analysis of breast cancer screening as a typical case-study, motivated by data from a cluster randomized 2 × 2 factorial trial of interventions to increase uptake. An EVPPI analysis is developed which shows that, on the basis of the evidence that was available beforehand, the trial was cost effective, but that after incorporating the results of the trial it would still be cost effective to carry out research that further reduced decision uncertainty. We identify key conceptual and technical issues: the relationship between the target interventions and the previous evidence, the distinction between variation and uncertainty and methods for correlated parameters. EVPPI methods have clear advantages over current methods of research prioritization, but we suggest that some specific sensitivity analyses are required before they can be used confidently in practice. These have limitations, and there is a need to develop robust methods to optimize research portfolios. [source] One-male units and clans in a colony of hamadryas baboons (Papio hamadryas hamadryas): effect of male number and clan cohesion on feeding successAMERICAN JOURNAL OF PRIMATOLOGY, Issue 1 2006Fernando Colmenares Abstract In the multilevel societies of hamadryas baboons, adult males can be attached to single one-male units (OMUs) or to clans containing several such OMUs. This paper examines the effect of male number and rivalry between males within a clan on their ability to compete for access to a clumped food resource. The data come from a study of a multilevel colony of hamadryas baboons (Papio hamadryas hamadryas) housed at the Madrid Zoo. The colony consisted of 12 harem-holding males and 40 sexually mature females, and was organized into five single OMUs and two clans (containing three and four OMUs, respectively). The top-ranking male of one of the clans was removed and later reintroduced, so the study involved an analysis of the composition of clans and OMUs and of the males' use of the feeding area across three study periods: preseparation, separation, and reintroduction. The findings reported indicate that both males and females derived clear advantages in the context of contest competition for access to clumped food if they were members of clans, because the males and females from large clans had a feeding advantage over those from smaller clans and single OMUs. Furthermore, rivalry among males within the clan reduced their ability to compete for food against males outside their clan. This paper provides empirical evidence for one of the potential advantages that hamadryas males may enjoy if they are attached to clans, and also provides empirical support for the general hypothesis that a large number of males in a group may provide fitness-related benefits to the group members, provided they are able to cooperate with each other. Am. J. Primatol. 68:21,37, 2006. © 2006 Wiley-Liss, Inc. [source] Productivity and Preferences in a Small Open EconomyTHE MANCHESTER SCHOOL, Issue 2001Jagjit S. Chadha Following Hall (Journal of Labor Economics, Vol. 15 (1997), pp. S223,S250) it is increasingly common to incorporate preference, as well as productivity, perturbations in calibrated general equilibrium models. We assess the performance of a small open economy stochastic growth model (based on the Blanchard,Yaari framework) under alternative driving processes. Whilst both models provide familiar descriptions of the aggregate economy, we find that the model driven by productivity disturbances has clear advantages in explaining the behaviour towards foreign asset accumulation. [source] An unusual methylene aziridine refined in P21/c and the nonstandard setting P21/nACTA CRYSTALLOGRAPHICA SECTION C, Issue 12 2009George C. Feast The unusual methylene aziridine 6- tert -butyl-3-oxa-2-thia-1-azabicyclo[5.1.0]oct-6-ene 2,2-dioxide, C9H15NO3S, was found to crystallize with two molecules in the asymmetric unit. The structure was solved in both the approximately orthogonal and the oblique settings of space group No. 14, viz. P21/n and P21/c, respectively. A comparison of these results clearly displayed an increase in the correlation between coordinates in the ac plane for the oblique cell. The increase in the corresponding covariances makes a significant contribution to the standard uncertainties of derived parameters, e.g. bond lengths. Since there is yet no CIF definition for the full variance,covariance matrix, there are clear advantages to reporting the structure in the nonstandard space-group setting. [source] Lipoprotein Mutation Accelerates Substrate Permeability-Limited Toluene Dioxygenase-Catalyzed ReactionBIOTECHNOLOGY PROGRESS, Issue 3 2005Ye Ni One of the major problems in whole-cell biocatalysis is its low reaction rate. The underlying cause is the substrate permeation barrier presented by cell envelopes. The present research investigates mutation effects of the Braunapos;s lipoprotein, the most abundant outer membrane structural protein in Escherichia coli, on toluene dioxyengase (TDO)-catalyzed reaction. Dramatic enhancement of the reaction rate, an increase of up to 6-fold, was observed with the mutant for all three small, hydrophobic substrates tested (toluene, ethylbenzene, and 2-indanone). The increase was observed over a wide range of substrate concentrations (0.1,5 mM). The mutant exhibited a normal growth rate and expressed the recombinant multicomponent enzyme as well as the isogenic parent strain. Taken together, the lipoprotein mutant expressing TDO is a much better whole-cell catalyst for the oxidation reaction. The beneficial effect of the lipoprotein mutation may be general for a broad range of substrates and enzyme systems as the mutation affects the global integrity of the cell membrane. A comparison of the mutation effect with a common permeabilizing procedure, the EDTA treatment, further illustrates the clear advantages of using genetic modification in cellular membrane engineering for improved whole-cell catalysts. [source] A randomised trial of two methods of issuing prenatal test results: the ARIA (Amniocentesis Results: Investigation of Anxiety) trialBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 4 2007J Hewison Background, Many pregnant women experience anxiety while waiting for the results of diagnostic tests. Policies and practices intended to reduce this anxiety require evaluation. Objectives, To test the following two hypotheses: ,,That giving amniocentesis results out on a fixed date alters maternal anxiety during the waiting period, compared with a policy of telling parents that the result will be issued ,when available' (i.e. variable date). ,,That issuing early results from a rapid molecular test alters maternal anxiety during the waiting period, compared with not receiving any results prior to the karyotype. The effects of the two interventions on anxiety 1 month after receiving karyotype results were also examined. Design, A multicentre, randomised, controlled, open fixed sample, 2 × 2 factorial design trial, with equal randomisation. Setting, The prenatal diagnosis clinics in 12 hospitals in England offering amniocentesis as a diagnostic test for Down's syndrome. Sample, Two hundred and twenty-six women who had had an amniocentesis were randomised between June 2002 and July 2004. Eight women with abnormal results or test failure were excluded postrandomisation. Interventions, Issuing karyotype results on a prespecified fixed date, rather than issuing them as soon as they became available. Issuing karyotype results alone, or subsequent to issuing results from a rapid molecular test for the most common chromosomal abnormalities. Main outcome measures, Average anxiety during the waiting period, calculated using daily scores from the short version of the Spielberger State-Trait Anxiety Inventory (STAI). Anxiety 1 month after receiving karyotype results, measured using the short form STAI. Results, Issuing early results from a partial but rapid test reduced maternal anxiety by a clinically significant amount during the waiting period (mean daily score 12.5 versus 14.8; scale score difference ,2.36, 95% CI ,1.2, ,3.6), compared with receiving only the full karyotype results. There was no evidence that giving out karyotype results on a fixed or on a variable date altered maternal anxiety during the waiting period (mean daily score 13.2 versus 14.2; scale score difference ,1.02, 95% CI ,2.2, 0.2). One month after receiving normal karyotype results, anxiety was low in all groups, but women who had been given rapid test results tended to be more anxious than those who had not (mean single day score 9.2 versus 8.3; mean scale score difference 0.95, 95% CI ,0.03, 1.9). This small to moderate effect did not reach conventional levels of statistical significance. Conclusions, Rapid testing was a beneficial addition to karyotyping, at least in the short term. This does not necessarily imply that early results would be preferred to comprehensive ones if women had to choose between them. Because there are no clear advantages in anxiety terms of issuing karyotype results as soon as they become available, or on a fixed date, women could be given a choice between them. 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