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Gradual Introduction (gradual + introduction)

Distribution by Scientific Domains

Medical Sciences	50%

Selected Abstracts

A Multicenter, Randomized Clinical Study to Evaluate the Effect on Cognitive Function of Topiramate Compared with Valproate as Add-On Therapy to Carbamazepine in Patients with Partial-Onset Seizures

EPILEPSIA, Issue 9 2000
A. P. Aldenkamp
Summary: Purpose: This study compares the cognitive effects of topiramate (TPM) with those of valproate (VPA) using efficacious doses of each drug when used as adjunctive therapy to carbamazepine (CBZ). A key question of the study is to what extent a more gradual introduction of TPM improves tolerabil-ity and prevents cognitive impairment. Methods: The study is a multicenter, randomized, observer-blinded, parallel-group clinical trial with VPA or TPM given as first-line add-on therapy to steady-state treatment with CBZ. TPM is introduced at 25 mg and increased with weekly 25-mg/d increments to a minimum dosage of 200 mg/d. The target dosage ranges from 200 to 400 mg/d for TPM and is 1800 mg/d for VPA. The study evaluates cognitive function changes from baseline to end point (after 20 weeks of treatment) and during titration (after 8 weeks of treatment). The primary outcome measure is the difference between the treatments (TPM versus VPA) in change from baseline to end point and change from baseline to titration, using a 95% confidence interval approach. Results: For the 10 baseline-to-end point comparisons, one test measuring short-term verbal memory (Rey Auditory Verbal Learning Test) yields a statistically significant difference between the treatments (p = 0.02), showing worsening for TPM and improvement of scores for VPA. The 10 baseline-to-titration comparisons also show one statistically significant difference, again for a test measuring short-term memory (Recognition of Words; p = 0.04), showing a larger change in the negative direction for TPM. None of the mood tests or the test for subjective complaints shows statistically significant differences between the treatments, although more scores are in the negative direction for TPM during titration. Conclusion: Although the pattern of changes in the negative direction seems consistent with clinical information, the differences found between the treatments are small. An important finding of our study is that, when the results are compared with those of other studies, it is clear that gradual introduction of TPM can reduce the extent of cognitive impairment (with a maximum of about 0.6 SD). [source]

Safety and supply of haemophilia products: worldwide perspectives

HAEMOPHILIA, Issue 4 2004
A. Farrugia
Summary., The survival and well-being of people with haemophilia depends on the supply of safe therapeutic products. Safety and supply are entirely intertwined principles; in the absence of adequate amounts of coagulation products, safety measures may be compromised in order to enhance supply, leading to risks which may result in morbidity and mortality. As haemophilia therapy has emerged through the development of blood transfusion and plasma fractionation, the safety of the blood supply in general has had a strong effect on haemophilia care. Despite the gradual detachment of haemophilia care from blood transfusion through the use of recombinant products, the majority of the world's population with haemophilia in the developing world will be reliant on blood products for the foreseeable future. It is, therefore, important to continue efforts for a safe and sufficient blood supply worldwide. As such a blood supply develops, possibly in tandem with an independent plasma fractionation industry, the level of haemophilia care should improve with the gradual introduction of concentrates for the ultimate goal of covering all aspects of care. Constant vigilance for the threat of blood-borne pathogens should be linked to considerations of how these products are to be manufactured. This should be governed entirely by considerations of safety and pharmaceutical competence. Of equal importance is a governmental capacity to oversee the entry and maintenance of these products on the market. While it is not possible for all countries to have a regulatory authority of the same status as that of the developed countries, it is perfectly feasible to develop a set of basic principles which allow an assessment of basic product safety, quality and efficacy to be made. [source]

Back-contact solar cells: a review

PROGRESS IN PHOTOVOLTAICS: RESEARCH & APPLICATIONS, Issue 2 2006
Emmanuel Van Kerschaver
Abstract Ever since the first publications by R.J. Schwartz in 1975, research into back-contact cells as an alternative to cells with a front and rear contact has remained a research topic. In the last decade, interest in back-contact cells has been growing and a gradual introduction to industrial applications is emerging. The goal of this review is to present a comprehensive summary of results obtained throughout the years. Back-contact cells are divided into three main classes: back-junction (BJ), emitter wrap-through (EWT) and metallisation wrap-through (MWT), each introduced as logical descendents from conventional solar cells. This deviation from the chronology of the developments is maintained during the discussion of technological results. In addition to progress on manufacturing these cells, aspects of cell modelling and module manufacturing are discussed and an outlook towards industrial implementation is presented. Copyright © 2005 John Wiley & Sons, Ltd. [source]

Empirical Challenges and Concept Formation in the History of Hydrodynamics

CENTAURUS, Issue 3 2008
Olivier Darrigol
Abstract Although the fundamental equations of hydrodynamics were known at an early stage of its history, this theory long remained irrelevant to most of the practical problems of flow. The advent of a more efficient fluid mechanics in the early twentieth century depended on conceptual schemes that could not be read directly from the basic equations. Attention to concrete problems of flow, rather than purely mathematical deduction or purely intuitive guessing, permitted the gradual introduction of relevant substructures and their ultimate combination in powerful approximation schemes. This history is in part singular, owing to the extreme difficulty of dealing with non-linear systems with infinitely many degrees of freedom. But it is also typical as an illustration of the futility of reducing a physico-mathematical theory to its fundamental equations. Any advanced theory of physics must include an evolving modular structure that plays an essential role in melding the formal with the empirical. [source]