Home About us Contact
|
Home About us Contact | ||
|
|
||
Full
Kinds of Full Terms modified by Full Selected AbstractsPerformance and scalability of MPI on PC clustersCONCURRENCY AND COMPUTATION: PRACTICE & EXPERIENCE, Issue 1 2004Glenn R. Luecke Abstract The purpose of this paper is to compare the communication performance and scalability of MPI communication routines on a Windows Cluster, a Linux Cluster, a Cray T3E-600, and an SGI Origin 2000. All tests in this paper were run using various numbers of processors and two message sizes. In spite of the fact that the Cray T3E-600 is about 7 years old, it performed best of all machines for most of the tests. The Linux Cluster with the Myrinet interconnect and Myricom's MPI performed and scaled quite well and, in most cases, performed better than the Origin 2000, and in some cases better than the T3E. The Windows Cluster using the Giganet Full Interconnect and MPI/Pro's MPI performed and scaled poorly for small messages compared with all of the other machines. Copyright © 2004 John Wiley & Sons, Ltd. [source] Tales Full of Sound and Fury: A Cultural Approach to Family Therapeutic Work and Research in Rural Scandinavia,FAMILY PROCESS, Issue 3 2000Michael R. Seltzer Ph.D. The concept of "culture" figured prominently in the development of family therapy. Recent conceptualizations, however, have tended to focus primarily on the ideational dimensions of culture. While not disputing that meanings and other ideas constitute significant features of group lifeways, this article proposes a return to earlier anthropological framings that incorporate material and ideational dimensions of cultures. To illustrate how his expanded concept may serve as a guide for therapeutic work, the article describes therapy with one family at a clinic in rural Scandinavia. We especially focus on the place of key symbols as historical links between the ideational and material dimensions of cultures. The perspective developed here is one of seeing cultures as sets of interpenetrating actions and ideas shaped by as well as shaping their practitioners. [source] Primary prevention of risk factors for eating disorders in adolescent girls: Learning from practiceINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 4 2002Catherine Steiner-Adair Abstract Objective This study evaluates the effectiveness and feasibility of a primary prevention program for risk factors for eating disorders in adolescent girls. Method Nearly 500 seventh-grade girls participated in "Full of Ourselves: Advancing Girl Power, Health, and Leadership," and were assessed at baseline, immediately after program completion, and 6 months later on several self-report measures of knowledge, body image, and eating and weight-related behaviors. Results Significant differences were found between participants and controls on measures of knowledge and weight-related body esteem, which were maintained at 6-month follow-up. Eating related behaviors, including skipping meals and dieting, appeared unaffected by program participation. Discussion The program was feasible, safe, and resulted in positive and maintained changes in knowledge and weight satisfaction for adolescent girls. © 2002 by Wiley Periodicals, Inc. Int J Eat Disord 32: 401,411, 2002. [source] Males with anorexia nervosa: A controlled study of eating disorders in first-degree relativesINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 3 2001Michael Strober Abstract Objective To compare lifetime rates of full and partial anorexia nervosa and bulimia nervosa in first-degree relatives of males with anorexia nervosa and in relatives of never-ill comparison subjects. Methods Rates of eating disorders were obtained for 747 relatives of 210 probands from personal structured clinical interviews and family history. Best-estimate diagnoses were determined blind to proband diagnosis and pedigree status. Results Full and partial syndromes of anorexia nervosa aggregated in female relatives of ill probands. For the full syndrome of anorexia nervosa, the crude relative risk was 20.3 among female relatives and for partial syndrome anorexia nervosa, the crude relative risk was 3.3. In contrast, bulimia nervosa was relatively uncommon among relatives of ill probands. Conclusion Although anorexia nervosa in males is exceedingly rare, there is a pattern of familial aggregation that is highly similar to that observed in recent family studies of affected females. On the basis of these findings, there is no evidence that familial-genetic factors distinguish the occurrence of anorexia nervosa in the two sexes. © 2001 by John Wiley & Sons, Inc. Int J Eat Disord 29: 263,269, 2001. [source] "No Thanks, We're Full": Individual Characteristics, National Context, and Changing Attitudes Toward Immigration1INTERNATIONAL MIGRATION REVIEW, Issue 2 2008Rima Wilkes In this paper we examine how individual-level characteristics and national context affect attitudes toward immigration. Although many previous studies have compared attitudes toward immigration across countries, little attention has been paid to how attitudes may be affected by changes within a country over time. We take advantage of seventeen national Canadian Gallup surveys to consider how differences in national economic conditions and changing immigration flows affect attitudes and changes in attitudes between 1975 and 2000. While the state of the national economy affects attitudes this is not the case for the rate of immigration. Rather than affecting some groups more than others the state of the economy has a relatively uniform effect across groups. Our results also show that far from being a continuum, being anti-immigration and being pro-immigration are qualitatively different. Interest, ideology, and the national economy affect anti-immigration sentiments, but only ideology affects pro-immigration sentiments. [source] ,Full of Improbable Lies': Gulliver's Travels and Jest BooksJOURNAL FOR EIGHTEENTH-CENTURY STUDIES, Issue 1 2003KATE LOVEMAN First page of article [source] A Basket Full of Mechanistic Insights into Pulmonary Vein Arrhythmogenicity: Reentry, Focal Activity, or Fibrillatory Conduction?JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 1 2007STEPHAN WILLEMS M.D. No abstract is available for this article. [source] Synthesis, characterization, and nucleotidic chain cleavage ability of uncharged water soluble poly(ethylene glycol)-fullerene derivatives with an amphiphilic characterJOURNAL OF POLYMER SCIENCE (IN TWO SECTIONS), Issue 6 2008Daniele Vitalini Abstract Water-soluble fullerenes containing two poly(ethylene glycol) branches [Full-(PEG)2] were prepared starting from commercial poly(ethylene glycol)-monomethyl ethers and C60 [Full-(PEG)2]s chemical characterization was made by FT-IR, NMR, and MALDI-TOF mass spectrometric analyses. Their thermal stability was determined by TGA experiments. The capability of C60 -derivatives to induce oligonucleotide cleavage under visible light irradiation was also ascertained. © 2008 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem 46: 2154,2153, 2008 [source] The Glass Half Empty or Half Full,How Effective Are Long-Term Intrathecal Opioids in Post-herpetic Neuralgia?NEUROMODULATION, Issue 3 2009A Case Series, Review of the Literature ABSTRACT Objectives.,Post-herpetic neuralgia (PHN) is a painful complication of herpes zoster infection and a common cause of chronic severe pain in elderly and/or debilitated patients. Although a wide range of treatments have been tried, a substantial number of patients continue to experience pain which remains refractory to all therapies. Increasingly, studies have demonstrated that oral opioids can have a beneficial effect on neuropathic pain. However, to date, few studies have examined the potential benefit(s) of chronic intrathecal opioids in the treatment of PHN. Methods.,Long-term outcome results of four PHN patients who had a successful intrathecal opioid trial and underwent implantation of an intrathecal opioid pump were examined. Data were analyzed using univariate analysis of variance. Results.,Duration of continuous intrathecal opioid therapy ranged from five to 50 months and mean pain reduction was 41% (range 27,50%) as measured by a verbal pain score (0,100), with the greatest benefit noticed earlier in therapy. Mean 24-hour intrathecal morphine dose was 2.29 mg (range 0.78,3.94 mg). Intrathecal therapy was discontinued in two patients because of opioid side-effects, depression, and loss of efficacy. Revision surgery was required in two cases. Patients most commonly reported improvement in the deep component of their pain, next allodynia, and less so superficial lancinating pain. Conclusions.,In conclusion, while a complex therapy, long-term use of intrathecal opioids is well tolerated, doses are titratable, administration is safe, and may help relieve severe short- and long-term neuropathic pain in selected PHN patients. Whether the addition of newer investigational intrathecal agents could improve these results is yet to be determined. [source] Metabolite identification of a new antitumor agent icotinib in rats using liquid chromatography/tandem mass spectrometryRAPID COMMUNICATIONS IN MASS SPECTROMETRY, Issue 14 2008Zhongmin Guan Icotinib, 4-[(3-ethynylphenyl)amino]-6,7-benzo-12-crown-4-quinazoline, is a new antitumor agent. The metabolic pathway of icotinib in rats was studied using liquid chromatography/tandem mass spectrometry (LC/MSn) analysis. Full scan and selected ion monitoring modes were used to profile the possible metabolites of icotinib in rat urine, feces and bile samples. Four phase I metabolites (M1,M4) and two phase II metabolites (M5, M6) were detected and characterized. Multiple-stage mass spectrometry and nuclear magnetic resonance (NMR) spectrometry were employed to elucidate structures of metabolites. Icotinib was metabolized to open the crown ether ring to form the main phase I metabolites. During metabolism, a reactive metabolite was formed. Using semicarbazide as a trapping agent, an intermediate arising from opening of the crown ether ring was detected as an aldehyde product by LC/MS/MS. These data indicated that ring opening of the crown ether was triggered by hydroxylation at the 8,-position of the ring to form a hemiacetal intermediate, which was further oxidized or reduced. Finally, the metabolic pathway of icotinib in rats was proposed. Copyright © 2008 John Wiley & Sons, Ltd. [source] Room Full of Mirrors: A Biography of Jimi HendrixTHE JOURNAL OF POPULAR CULTURE, Issue 4 2007Douglas Sherry No abstract is available for this article. [source] 13 Jade in Full: Prehispanic Domestic Production of Wealth Goods in the Middle Motagua Valley, GuatemalaARCHEOLOGICAL PAPERS OF THE AMERICAN ANTHROPOLOGICAL ASSOCIATION, Issue 1 2009Erick T. RochetteArticle first published online: 14 DEC 200 First page of article [source] Long chain polyunsaturated fatty acids (LC-PUFA) and perinatal developmentACTA PAEDIATRICA, Issue 4 2001B Koletzko This paper reports on the conclusions of a workshop on the role of long chain polyunsaturated fatty acids (LC-PUFA) in maternal and child health The attending investigators involved in the majority of randomized trials examining LC-PUFA status and functional outcomes summarize the current knowledge in the field and make recommendations for dietary practice. Only studies published in full or in abstract form were used as our working knowledge base. Conclusions: For healthy infants we recommend and strongly support breastfeeding as the preferred method of feeding, which supplies preformed LC-PUFA. Infant formulas for term infants should contain at least 0.2% of total fatty acids as docosahexaenoic acid (DHA) and 0.35% as arachidonic acid (AA). Since preterm infants are born with much less total body DHA and AA, we suggest that preterm infant formulas should include at least 0.35% DHA and 0.4% AA. Higher levels might confer additional benefits and should be further investigated because optimal dietary intakes for term and preterm infants remain to be defined. For pregnant and lactating women we consider it premature to recommend specific LC-PUFA intakes. However, it seems prudent for pregnant and lactating women to include some food sources of DHA in their diet in view of their assumed increase in LC-PUFA demand and the relationship between maternal and foetal DHA status. [source] Simulation of two-phase flow with sub-scale droplet and bubble effectsCOMPUTER GRAPHICS FORUM, Issue 2 2009Viorel Mihalef Abstract We present a new Eulerian-Lagrangian method for physics-based simulation of fluid flow, which includes automatic generation of sub-scale spray and bubbles. The Marker Level Set method is used to provide a simple geometric criterion for free marker generation. A filtering method, inspired from Weber number thresholding, further controls the free marker generation (in a physics-based manner). Two separate models are used, one for sub-scale droplets, the other for sub-scale bubbles. Droplets are evolved in a Newtonian manner, using a density-extension drag force field, while bubbles are evolved using a model based on Stokes' Law. We show that our model for sub-scale droplet and bubble dynamics is simple to couple with a full (macro-scale) Navier-Stokes two-phase flow model and is quite powerful in its applications. Our animations include coarse grained multiphase features interacting with fine scale multiphase features. [source] Applied Geometry:Discrete Differential Calculus for GraphicsCOMPUTER GRAPHICS FORUM, Issue 3 2004Mathieu Desbrun Geometry has been extensively studied for centuries, almost exclusively from a differential point of view. However, with the advent of the digital age, the interest directed to smooth surfaces has now partially shifted due to the growing importance of discrete geometry. From 3D surfaces in graphics to higher dimensional manifolds in mechanics, computational sciences must deal with sampled geometric data on a daily basis-hence our interest in Applied Geometry. In this talk we cover different aspects of Applied Geometry. First, we discuss the problem of Shape Approximation, where an initial surface is accurately discretized (i.e., remeshed) using anisotropic elements through error minimization. Second, once we have a discrete geometry to work with, we briefly show how to develop a full- blown discrete calculus on such discrete manifolds, allowing us to manipulate functions, vector fields, or even tensors while preserving the fundamental structures and invariants of the differential case. We will emphasize the applicability of our discrete variational approach to geometry by showing results on surface parameterization, smoothing, and remeshing, as well as virtual actors and thin-shell simulation. Joint work with: Pierre Alliez (INRIA), David Cohen-Steiner (Duke U.), Eitan Grinspun (NYU), Anil Hirani (Caltech), Jerrold E. Marsden (Caltech), Mark Meyer (Pixar), Fred Pighin (USC), Peter Schröder (Caltech), Yiying Tong (USC). [source] Volumetric Filtering, Modeling and Visualization for Nano-MedicineCOMPUTER GRAPHICS FORUM, Issue 3 2003Chandrajit Bajaj The 3D structures of individual proteins or small complexes, such as most of the Protein Data Bank entries, are still unable to yield the "full picture" of a functional biological complex. The study of large macromolecular complexes, such as viruses, ion channels, the ribosome and other macromolecular machines of various types, offer more complete structural and functional description of the nano-machinery of life. In addition to x-ray crystallography. NMR spectroscopy, electron cryomicroscopy (cryoEM) imaging of single particles, and in-vivo molecular tomographic imaging has become indispensable at revealing the structures of large macromolecular complexes at subnanometer resolutions. In this talk, I shall describe some of the recent computational advances in filtering, modeling, analysis and visualization, that have propelled structure determination by cryoEM and tomographic imaging, to steadily increasing accuracy. [source] Current density mapping approach for design of clinical magnetic resonance imaging magnetsCONCEPTS IN MAGNETIC RESONANCE, Issue 3 2002Stuart Crozier Abstract Novel current density mapping (CDM) schemes are developed for the design of new actively shielded, clinical magnetic resonance imaging (MRI) magnets. This is an extended inverse method in which the entire potential solution space for the superconductors has been considered, rather than single current density layers. The solution provides an insight into the required superconducting coil pattern for a desired magnet configuration. This information is then used as an initial set of parameters for the magnet structure, and a previously developed hybrid numerical optimization technique is used to obtain the final geometry of the magnet. The CDM scheme is applied to the design of compact symmetric, asymmetric, and open architecture 1.0,1.5 T MRI magnet systems of novel geometry and utility. A new symmetric 1.0-T system that is just 1 m in length with a full 50-cm diameter of the active, or sensitive, volume (DSV) is detailed, as well as an asymmetric system in which a 50-cm DSV begins just 14 cm from the end of the coil structure. Finally a 1.0-T open magnet system with a full 50-cm DSV is presented. These new designs provide clinically useful homogeneous regions and have appropriately restricted stray fields but, in some of the designs, the DSV is much closer to the end of the magnet system than in conventional designs. These new designs have the potential to reduce patient claustrophobia and improve physician access to patients undergoing scans. © 2002 Wiley Periodicals, Inc. Concepts in Magnetic Resonance (Magn Reson Engineering) 15: 208,215, 2002 [source] Education in peace agreements, 1989,2005CONFLICT RESOLUTION QUARTERLY, Issue 2 2008Kendra E. Dupuy Education has been on the minds of peacemakers since the end of the Cold War, contrary to expectations. An examination of how education is addressed in full and partial post-Cold War peace agreements shows that education is mentioned in a large number of the agreements. However, the way in which education is addressed and incorporated into peace agreements varies significantly in terms of what is mandated to occur in the education sector after the signing of the peace agreement, including what kind of education will be provided and to whom and how education is viewed in these agreements. [source] Experience With Implantable Loop Recorders for Recurrent Unexplained SyncopeCONGESTIVE HEART FAILURE, Issue 2008Michele Brignole MD Knowledge of what occurs during spontaneous syncope is the gold standard for evaluation. Initially, implantable loop recorders (ILRs) were used in patients with unexplained syncope at the end of unsuccessful full, conventional work-up. In pooled data regarding 247 patients, a correlation between syncope and electrocardiographic findings was found in 84 patients (34%); of these, 52% had a bradycardia or asystole at the time of the recorded event, 11% had tachycardia, and 37% had no arrhythmia. Presyncope-electrocardiography correlation was observed in another third of the patients; presyncope was much less likely to be associated with an arrhythmia than was syncope. The diagnostic yield was similar in patients with and without structural heart diseases and was higher in older than in younger patients. Recent studies showed that ILR implantation can be safely performed in an early phase of the diagnostic evaluation,provided that patients at risk for life-threatening events are carefully excluded,in the patients who have a severe presentation of syncope (because of high risk of trauma or high frequency of episodes) which can be a benefit of a mechanism-specific therapy. Congest Heart Fail. 2008;14:7,12. ©2008 Le Jacq [source] Understanding the Advantages of Open Innovation Practices in Corporate Venturing in Terms of Real OptionsCREATIVITY AND INNOVATION MANAGEMENT, Issue 4 2008Wim Vanhaverbeke Part of the advantages of using open innovation (compared to closed innovation) in corporate venturing can be explained by applying the real options approach. Open innovation in risk-laden activities such as corporate venturing has the following advantages: (i) benefits from early involvement in new technologies or business opportunities; (ii) delayed financial commitment; (iii) early exits reducing the downward losses; and (iv) delayed exit in case it spins off a venture. We furthermore argue that these benefits do not automatically materialize. Innovative firms have to learn new skills and routines to develop the full ,real option' potential of open innovation practices. [source] DEFINING DYSKARYOSIS , THE BSCC CLASSIFICATION IN 2006CYTOPATHOLOGY, Issue 2006K. Denton The terminology used for reporting cervical samples in the UK is the BSCC classification, which has evolved over many years. In 2002 the BSCC held a consensus conference to review the BSCC classification, with the intention of providing clearer results for women, improving concordance with other terminologies and facilitating consistency with new scientific developments and technologies. The consensus conference was well attended and robust. In the intervening years there have also been other further advances on morphometry, data on outcomes, data from EQA and other sources. Liquid Based cytology (LBC) has been implemented by the NHS CSP. All of these developments have impacted on the proposed classification, which will be presented in full. The term ,dyskaryosis' will be retained and several of the current reporting categories will be relatively unchanged, though additional information on LBC will be provided. The major proposed changes are: (1) A move to a single category of ,High Grade Dyskaryosis' to replace the existing categories of moderate and severe dyskaryosis. (2) Sub-division of Borderline change into three categories. Borderline change in glandular cells Borderline change ?high grade Borderline change, NOS (3) The current grades of Mild Dyskaryosis and Borderline change with Koilocytosis to be merged. Details of these proposals, together with illustrations and the evidence base for change will be presented. [source] Retinoids and Wound HealingDERMATOLOGIC SURGERY, Issue 10 2006MARK ABDELMALEK MD BACKGROUND Retinoids are widely used in dermatology and may play a role in wound healing. The exact role of retinoids in wounds is confusing and controversial, however. Systemic retinoids are presumed to be detrimental to wound healing; however, this standard is based on isolated reports. OBJECTIVE The objective was to provide a critical review of the available literature regarding the role of both topical and systemic retinoids in various aspects of wound healing. CONCLUSIONS Pretreatment with retinoids likely promotes wound healing after facial resurfacing procedures and full- or partial-thickness wounds. While the evidence is mixed regarding the effects of retinoids applied to fresh and healing wounds, the majority of the evidence available shows favorable wound-healing properties in this setting. The medical,legal standard regarding the avoidance of facial resurfacing and surgical procedures in patients on or recently completing a course of systemic retinoids was likely prematurely established. [source] Risperidone long-acting injection: a 6-year mirror-image study of healthcare resource useACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2009D. Taylor Objective:, To evaluate naturalistic use of risperidone long-acting injection (RLAI) and its effect on healthcare resource use. Method:, Mirror-image comparison of healthcare resource use for 3 years before RLAI initiation and 3 years after. Results:, In total, 211 of 277 patients consecutively prescribed RLAI were evaluable over the full 6-year study period. Median days in hospital/patient increased significantly in the 3 years after RLAI initiation [87 days (inter-quartile range 25,236) before vs. 192 days (47,426) after; P < 0.001]. Those 34 patients who continued RLAI for 3 years showed no change in median bed days [64 days (6.5,182) before vs. 64 days (12,180) after] and median number of admissions was decreased [1.5 (1,2.25) before vs. 1.00 (0,1.25) after; P = 0.001]. Healthcare costs more than doubled for the whole cohort (P < 0.001) and discontinuers (P < 0.001) and increased significantly for continuers (P = 0.010). Conclusion:, RLAI did not decrease either time spent in hospital or overall healthcare costs in this patient cohort. [source] Neurophysiology of hunger and satietyDEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 2 2008Pauline M. Smith Abstract Hunger is defined as a strong desire or need for food while satiety is the condition of being full or gratified. The maintenance of energy homeostasis requires a balance between energy intake and energy expenditure. The regulation of food intake is a complex behavior. It requires discrete nuclei within the central nervous system (CNS) to detect signals from the periphery regarding metabolic status, process and integrate this information in a coordinated manner and to provide appropriate responses to ensure that the individual does not enter a state of positive or negative energy balance. This review of hunger and satiety will examine the CNS circuitries involved in the control of energy homeostasis as well as signals from the periphery, both hormonal and neural, that convey pertinent information regarding short-term and long-term energy status of the individual. © 2008 Wiley-Liss, Inc. Dev Disabil Res Rev 2008;14:96,104. [source] Neuropharmacological basis of combining antidepressantsACTA PSYCHIATRICA SCANDINAVICA, Issue 2005J. de la Gándara Objective:, To review the neuropharmacological basis of antidepressant combination therapy. Method:, Literature searches and other relevant material were obtained and reviewed. Results:, The overall clinical aim of combining antidepressants is to increase the efficacy whilst minimizing the side effects. Although such prescriptions are frequently based on the previous experience and knowledge, a sound neuropharmacological basis to support these combinations is desirable. When combining antidepressants, it is important to combine mechanisms of action, rather than simply one drug with another, and to aim for synergistic effects. The possibilities of combining mechanisms of action should also be exploited to the full if necessary, and the potential exists for combining two independent actions that have synergistic effects on the serotonergic, noradrenergic and even the dopaminergic systems. Conclusion:, Unfortunately, there are still, as yet, insufficient data to categorically justify choosing one or other combination based only on the neuropharmacological evidence. [source] One-year outcome with antidepressant treatment of bipolar depression , is the glass half empty or half full?ACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2005Acta Psychiatrica Scandinavica No abstract is available for this article. [source] Long-term outcome of pediatric obsessive,compulsive disorder: a meta-analysis and qualitative review of the literatureACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2004S. E. Stewart Objective:, To review the extant literature on the long-term outcome of child/adolescent-onset obsessive,compulsive disorder (OCD). Method:, Medline and Psychlit databases were systematically searched for articles regarding long-term outcomes of child/adolescent-onset OCD. Meta-analysis regression was applied to evaluate predictors and persistence of OCD. Results:, Sixteen study samples (n = 6,132; total = 521 participants) in 22 studies had follow-up periods ranging between 1 and 15.6 years. Pooled mean persistence rates were 41% for full OCD and 60% for full or subthreshold OCD. Earlier age of OCD onset (z = ,3.26, P = 0.001), increased OCD duration (z = 2.22, P = 0.027) and in-patient vs. out-patient status (z = 2.94, P = 0.003) predicted greater persistence. Comorbid psychiatric illness and poor initial treatment response were poor prognostic factors. Although psychosocial function was frequently compromised, most studies lacked comprehensive outcome measures. Conclusion:, Long-term persistence of pediatric OCD may be lower than believed. Future studies should include broader measures of outcome including symptomatic persistence and functional impairment in multiple domains. [source] The mode of action of thiazolidinediones,DIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue S2 2002Hans Hauner Abstract The thiazolidinediones (TZDs) or ,glitazones' are a new class of oral antidiabetic drugs that improve metabolic control in patients with type 2 diabetes through the improvement of insulin sensitivity. TZDs exert their antidiabetic effects through a mechanism that involves activation of the gamma isoform of the peroxisome proliferator-activated receptor (PPAR,), a nuclear receptor. TZD-induced activation of PPAR, alters the transcription of several genes involved in glucose and lipid metabolism and energy balance, including those that code for lipoprotein lipase, fatty acid transporter protein, adipocyte fatty acid binding protein, fatty acyl-CoA synthase, malic enzyme, glucokinase and the GLUT4 glucose transporter. TZDs reduce insulin resistance in adipose tissue, muscle and the liver. However, PPAR, is predominantly expressed in adipose tissue. It is possible that the effect of TZDs on insulin resistance in muscle and liver is promoted via endocrine signalling from adipocytes. Potential signalling factors include free fatty acids (FFA) (well-known mediators of insulin resistance linked to obesity) or adipocyte-derived tumour necrosis factor-, (TNF-,), which is overexpressed in obesity and insulin resistance. Although there are still many unknowns about the mechanism of action of TZDs in type 2 diabetes, it is clear that these agents have the potential to benefit the full ,insulin resistance syndrome' associated with the disease. Therefore, TZDs may also have potential benefits on the secondary complications of type 2 diabetes, such as cardiovascular disease. Copyright © 2002 John Wiley & Sons, Ltd. [source] ORIGINAL INVESTIGATIONS: Tissue Harmonic Imaging in Echocardiography: Better Valve Imaging, But at What Cost?ECHOCARDIOGRAPHY, Issue 2 2008Karin Hawkins M.D. Background: Tissue harmonic imaging (THI) improves echocardiographic image quality and is widely utilized. Unfortunately it also makes structures appear artificially thickened. We sought to examine its impact on the imaging of left-sided heart valves. Methods: A large echocardiographic database was searched for full, standard transthoracic echocardiographic exams performed 12-month periods before (n = 3,786) and after (n = 3,914) transition to THI at a single institution. Patients with prosthetic valves were excluded. Results: The mean age of patients was 63 ± 17 years and 65% were men. No appreciable difference in demographics was observed between time periods. While inadequate visualization of the mitral valve was reduced by 30% using THI (P = 0.014), reports of leaflet thickening increased by 28% (P = 0.005). Similarly, inadequate aortic valve visualization was reduced by 53% with THI (P < 0.001), at the expense of more aortic sclerosis (+6%, P = 0.034). Among the 480 patients with echocardiograms using each modality (time interval between studies: 370 ± 143 days), THI did not appreciably improve visualization of the either valve. Although no significant increase in mitral thickness was seen with THI, aortic sclerosis was increased by at least one grade in 24.5% (P < 0.006). Conclusion: This study suggests that while THI enhances imaging of difficult to visualize valves, it may overestimate mitral and aortic valve thickness. This could lead to overdiagnosis and unnecessary follow-up studies. Cardiologists interpreting THI echocardiograms should become familiar with the modality's shortcomings. [source] Challenges to antagonist blockade during sustained-release naltrexone treatmentADDICTION, Issue 9 2010Nikolaj Kunře ABSTRACT Aims Naltrexone is a competitive opioid antagonist that effectively blocks the action of heroin and other opioid agonists. Sustained-release naltrexone formulations are now available that provide long-acting opioid blockade. This study investigates the use of heroin and other opioids among opioid-dependent patients receiving treatment with long-acting naltrexone implants, their subjective experience of drug ,high' after opioid use, and factors associated with opioid use. Methods Participants (n = 60) were opioid-dependent patients receiving treatment with naltrexone implants. Outcome data on substance use, drug ,high', depression and criminal activity were collected over a 6-month period. Blood samples were taken to monitor naltrexone plasma levels, and hair samples to verify self-reported opioid use. Findings More than half [n = 34 or 56%; 95% confidence interval (CI) 44,68%)] the patients challenged the blockade with illicit opioids during the 6-month treatment period; 44% (n = 26; 95% CI 32,56%) were abstinent from opioids. Mean opioid use was reduced from 18 [standard deviation (SD)13] days during the month preceding treatment to 6 days (SD 11) after 6 months. Of the respondents questioned on opioid ,high' (n = 31), nine patients (30%; 95% CI 16,47%) reported partial drug ,high' following illicit opioid use, and three (12%; 95% CI 3,26%) reported full ,high'. Opioid use was associated with use of non-opioid drugs and criminal behaviour. Conclusions Challenging naltrexone blockade with heroin on at least one occasion is common among sustained-release naltrexone patients, but only a minority of patients use opioids regularly. Challenges represent a warning sign for poor outcomes and often occur in the context of polydrug use and social adjustment problems. [source] | |||||||||||||||||||||||||||||||||||||||||||