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Modest Reduction (modest + reduction)
Selected AbstractsModelling two-dimensional steady-state groundwater flow and flow sensitivity to boundary conditions in blanket peat complexesHYDROLOGICAL PROCESSES, Issue 2 2005D. R. Lapen Abstract This study used a two-dimensional steady-state finite-element groundwater flow model to simulate groundwater flow in two Newfoundland blanket peat complexes and to examine flow system sensitivity to changes in water table recharge and aquifer properties. The modelling results were examined within the context of peat-forming processes in the two complexes. Modelled flow compared favourably with observed flow. The sensitivity analyses suggested that more highly decomposed bog peat along bog margins probably has/had a positive impact on net peat accumulation within bog interiors. Peat with lower hydraulic conductivity along bog margins effectively impedes lateral drainage, localizes water table drawdown to extreme bog margins, and elevates water tables along bog interiors. Peat formation and elevated water tables in adjacent poor fens/laggs currently rely on placic and ortstein horizons impeding vertical drainage and water flow inputs from adjacent bogs. Modest reductions in atmospheric recharge were found to govern bog-flow-system geometries in a way that would adversely affect paludification processes in adjacent fens/laggs. Copyright © 2004 John Wiley & Sons, Ltd. [source] Alcohol consumption patterns and risk factors among childhood cancer survivors compared to siblings and general population peersADDICTION, Issue 7 2008E. Anne Lown ABSTRACT Aims This study describes alcohol consumption among adult survivors of pediatric cancer compared to sibling controls and a national sample of healthy peers. Risk factors for heavy drinking among survivors are described. Design, setting and participants Cross-sectional data were utilized from the Childhood Cancer Survivor Study including adult survivors of pediatric cancer (n = 10 398) and a sibling cohort (n = 3034). Comparison data were drawn from the National Alcohol Survey (n = 4774). Measurement Alcohol consumption, demographic, cancer diagnosis, treatment and psychosocial factors were measured. Findings Compared to peers, survivors were slightly less likely to be risky [adjusted odds ratio (ORadj) = 0.9; confidence interval (CI) 0.8,1.0] and heavy drinkers (ORadj = 0.8; CI 0.7,0.9) and more likely to be current drinkers. Compared to siblings, survivors were less likely to be current, risky and heavy drinkers. Risk factors for survivors' heavy drinking included being age 18,21 years (ORadj = 2.0; 95% CI 1.5,2.6), male (ORadj = 2.1; 95% CI 1.8,2.6), having high school education or less (ORadj = 3.4; 95% CI 2.7,4.4) and drinking initiation before age 14 (ORadj = 6.9; 95% CI 4.4,10.8). Among survivors, symptoms of depression, anxiety or somatization, fair or poor self-assessed health, activity limitations and anxiety about cancer were associated with heavy drinking. Cognitively compromising treatment, brain tumors and older age at diagnosis were protective. Conclusions Adult survivors of childhood cancer show only a modest reduction in alcohol consumption compared to peers despite their more vulnerable health status. Distress and poorer health are associated with survivor heavy drinking. Screening for alcohol consumption should be instituted in long-term follow-up care and interventions among survivors and siblings should be established to reduce risk for early drinking. [source] Oral contraceptive use, hormone replacement therapy, reproductive history and risk of colorectal cancer in womenINTERNATIONAL JOURNAL OF CANCER, Issue 3 2008Geoffrey C. Kabat Abstract Evidence from epidemiologic studies suggests a possible role of exogenous and endogenous hormones in colorectal carcinogenesis in women. However, with respect to exogenous hormones, in contrast to hormone replacement therapy, few cohort studies have examined oral contraceptive use in relation to colorectal cancer risk. We used data from a large cohort study of Canadian women enrolled in a randomized controlled trial of breast cancer screening to assess the association of oral contraceptive use, hormone replacement therapy and reproductive factors with risk of colorectal cancer, overall and by subsite within the colorectum. Cancer incidence and mortality were ascertained by linkage to national databases. Among 89,835 women aged 40,59 at enrollment and followed for an average of 16.4 years, we identified 1,142 incident colorectal cancer cases. Proportional hazards models were used to estimate the associations between the exposures of interest and risk of colorectal cancer. Ever use of oral contraceptives at baseline was associated with a modest reduction in the risk of colorectal cancer (hazard ratio 0.83, 95% confidence interval 0.73,0.94), with similar effects for different subsites within the colorectum. No trend was seen in the hazard ratios with increasing duration of oral contraceptive use. No associations were seen with use of hormone replacement therapy (ever use or duration of use) or reproductive factors. Our results are suggestive of an inverse association between oral contraceptive use and colorectal carcinogenesis. However, given the lack of a dose,response relationship and the potential for confounding, studies with more complete assessment of exogenous hormone use throughout the life course are needed to clarify this association. © 2007 Wiley-Liss, Inc. [source] REVIEW OF THE EXTENT TO WHICH ORCHIDOPEXY IS PERFORMED AT THE OPTIMAL AGE: IMPLICATIONS FOR HEALTH SERVICESANZ JOURNAL OF SURGERY, Issue 11 2008Christine J. P. Bruijnen Background: In recent decades, the recommended age for orchidopexy for primary undescended testes has decreased, in the expectation that this might improve subsequent fertility. The aim of this study was to investigate whether this is reflected in a reduction in the age at which orchidopexies are carried out, and the implications for child health services. Methods: All boys who underwent an orchidopexy for an undescended testis carried out by the Christchurch-based paediatric surgical service between January 1997 and December 2007 were identified through a prospectively collected database. They were analysed according to the age at time of operation and year of surgery to determine whether there was any trend over time. The proportions of children younger than 2 years and between 2 and 5 years of age were calculated for each year. Results: In total, 788 boys underwent orchidopexies for primary undescended testes, with 335 (42.5%) boys having surgery before the age of 2 (mean age 54.3 months, median 31.1 months). During the whole 11-year period, there was no significant change in age at orchidopexy, whereas from 2003, a significant trend towards lower age at operation (Spearman's rank ,0.1112, P = 0.0071) and a significant increase in the proportion of boys having surgery before the age of 2 (Spearman's rank 0.9000, P = 0.0374) were seen. Conclusions: Although there has been a modest reduction in the mean age of orchidopexy since 2003, overall, the mean age at orchidopexy remains well above the recommended optimal age, implying that more attention should be paid towards earlier diagnosis and referral for primary undescended testes. [source] Effect of an oral contraceptive preparation containing ethinylestradiol and gestodene on CYP3A4 activity as measured by midazolam 1,-hydroxylationBRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue 4 2000Sanna Palovaara Aims,To characterize the effect of an oral contraceptive (OC) containing ethinylestradiol and gestodene on the activity of CYP3A4 in vivo as measured by the 1,-hydroxylation of midazolam. Methods,In this randomised, double-blind, cross-over trial nine healthy female subjects received either a combined OC (30 µg ethinylestradiol and 75 µg gestodene) or placebo once daily for 10 days. On day 10, a single 7.5 mg dose of midazolam was given orally. Plasma concentrations of midazolam and 1,-hydroxymidazolam were determined up to 24 h and the effects of midazolam were measured with three psychomotor tests up to 8 h. Results,The combined OC increased the mean AUC of midazolam by 21% (95% CI 2% to 40%; P = 0.03) and decreased that of 1,-hydroxymidazolam by 25% (95% CI 10% to 41%; P = 0.01), compared with placebo. The metabolic ratio (AUC of 1,-hydroxymidazolam/AUC of midazolam) was 36% smaller (95% CI 19% to 53%; P = 0.01) in the OC phase than in the placebo phase. There were no significant differences in the Cmax, tmax, t½ or effects of midazolam between the phases. Conclusions,A combined OC preparation caused a modest reduction in the activity of CYP3A4, as measured by the 1,-hydroxylation of midazolam, and slightly increased the AUC of oral midazolam. This study suggests that, at the doses used, ethinylestradiol and gestodene have a relatively small effect on CYP3A4 activity in vivo. [source] The effect of carbamazepine on the steady-state pharmacokinetics of ziprasidone in healthy volunteersBRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue S1 2000J. J. Miceli Aims, To evaluate the effect of steady-state carbamazepine administration on the steady-state pharmacokinetics of ziprasidone in healthy young adults, in an open, randomised, parallel-group study. Methods, Twenty-five subjects were randomized to one of two treatment groups. Group 1 received 20 mg ziprasidone twice daily on days 1 and 2, and a single dose on day 3. A single 100 mg dose of carbamazepine was given once daily on days 5 and 6 and twice daily on days 7 and 8, followed by 200 mg twice daily until day 28 and on the morning only on day 29. Ziprasidone 20 mg was also administered twice daily on days 26 and 27 and in the morning only on day 28. Group 2 received the same treatment regimen with carbamazepine replaced by placebo. Pharmacokinetic data were obtained on days 3 and 28. Results, Nine subjects in group 1 and 10 in group 2 completed all three treatment periods (ziprasidone, carbamazepine or placebo; and ziprasidone plus carbamazepine or placebo). Carbamazepine administration to group 1 was associated with modest reductions in ziprasidone exposure, with mean decreases in ziprasidone AUC(0,12 h) and Cmax values of 36% and 27%, respectively, on day 28 compared with day 3 (P<0.03). The mean differences between day 28 and day 3 ziprasidone AUC(0,12 h) and Cmax values were also statistically significantly greater in the carbamazepine group than in the placebo group. The mean half-life of ziprasidone decreased by 1 h from day 3 to day 28 in the subjects receiving carbamazepine, compared with virtually no change in the placebo group. All adverse events were mild or moderate in severity and there were no serious adverse events, or clinically significant changes in ECGs and vital signs throughout the study. Conclusions, Induction of CYP3A4 with carbamazepine led to a modest reduction (<36%) in steady-state exposure to ziprasidone that is believed to be clinically insignificant. [source] The basis for treatment in multiple sclerosisACTA NEUROLOGICA SCANDINAVICA, Issue 2006A. Compston Contemporary licensed treatments for multiple sclerosis fail to provide a solution for the disease because their effects are limited to a modest reduction in the frequency of new episodes. They do not reduce disability or materially influence the progressive phase of the disease. A contemporary strategy for management requires a more detailed analysis of the separate contributions to the clinical features and overall course made by inflammation, axonal injury, compensatory mechanisms, and remyelination. From this formulation emerges the need either for early and fully effective suppression of the inflammatory response, limiting the damage to all components of the axon-glial unit; or the development of strategies for axonal and myelin repair that solve the issues of controlled differentiation, delivery and timing of these cell and growth factor-based interventions. [source] Breast-feeding and a subsequent diagnosis of measlesACTA PAEDIATRICA, Issue 4 2009SA Silfverdal Abstract Background: Breast-feeding protects against many infectious diseases and may also influence immunization outcomes. Aim: This study investigated if breast-feeding protects against clinical measles and if it modified the effect of immunization. Methods: We used logistic regression with data for 10 207 individuals from the 1970 British Cohort study (BCS70). Breast-feeding data were collected at five years of age, and information on clinical measles infection, as well as socio-economic measures was collected at the age of ten years. Breast feeding was categorized as: breast-fed <1 month (n = 1611), breast-fed for 1,3 months (n = 1016), breast-fed for more than three months (n = 1108), breast-feeding of uncertain duration (n = 21) and never breast-fed (n = 6451). Results: Breast-feeding for more than three months was negatively associated with a diagnosis of clinical measles infection after adjustment for crowding, social class, measles vaccination, parity and sex with an odds ratio (95% confidence interval) of 0.69 (0.60,0.81) compared with those who never breast-fed. Measles vaccination was highly associated with low risk for measles with: 0.14 (0.13,0.16). Age at acute measles infection was not associated with breastfeeding. Breast-feeding did not notably alter measles immunization efficacy. Conclusion: Immunization against measles provides effective protection against the disease. A more modest reduction in the risk of a measles diagnosis is associated with breast-feeding. The associations with a diagnosis of measles for breast-feeding and measles immunization are independent of each other. [source] Treating Chronic Tension-type Headache Not Responding to Amitriptyline Hydrochloride With Paroxetine Hydrochloride: A Pilot EvaluationHEADACHE, Issue 9 2003Kenneth A. Holroyd PhD Context.,In some individuals, chronic tension-type headache fails to respond to tricyclic antidepressant medications that often serve as first-line therapy. Objective.,To evaluate the clinical efficacy of paroxetine hydrochloride for chronic tension-type headache not responding to amitriptyline hydrochloride. Design and Setting.,Open-label trial of paroxetine conducted at 2 outpatient sites in Ohio. Participants and Intervention.,Thirty-one adults (mean age, 37 years; 20 women) with chronic tension-type headache (mean, 25 headache days per month) who had failed to respond (less than 30% improvement) to treatment with either amitriptyline (n = 13) or matched placebo (n = 18). All participants were treated with paroxetine (up to 40 mg per day) in a 9-month protocol. Outcome Measures.,Monthly headache index calculated as the mean of pain ratings (0 to 10 scale) recorded by participants in a diary 4 times per day, number of days per month with at least moderate pain (pain rating of 5 or greater), and analgesic medication use. Results.,In patients who had not responded to amitriptyline, paroxetine failed to reduce chronic tension-type headaches or analgesic medication use. In patients who had not responded to placebo, paroxetine produced modest reductions in chronic tension-type headaches and analgesic use. Conclusions.,We found no evidence that chronic tension-type headaches that failed to respond to tricyclic antidepressant therapy with amitriptyline improved when subsequently treated with paroxetine. More support was found for the efficacy of paroxetine in patients with chronic tension-type headaches who had failed to respond to placebo. [source] Early detection of acute kidney injury: Emerging new biomarkers (Review Article)NEPHROLOGY, Issue 2 2008ZOLTAN H ENDRE SUMMARY: Acute kidney injury (AKI) has recently become the preferred term to describe the syndrome of acute renal failure (ARF) with ,failure' or ,ARF' restricted to patients who have AKI and need renal replacement therapy.1 This allows capture of the broader clinical spectrum of modest reductions in creatinine, which are themselves known to be associated with major increases in both short- and long-term mortality risk.2,5 It is hoped that this change in nomenclature will facilitate an expansion of our understanding of the underlying pathophysiology and also facilitate definitions of AKI, which allow comparisons among clinical trials of patients with similar duration and severity of illness. This review will cover the need for early detection of AKI and the role of urinary and plasma biomarkers, including enzymuria. The primary message is that use of existing criteria to diagnose AKI, namely elevation of the serum creatinine with or without oliguria, results in identification that is too late to allow successful intervention. New biomarkers are essential to change the dire prognosis of this common condition. [source] Narrow rows reduce biomass and seed production of weeds and increase maize yieldANNALS OF APPLIED BIOLOGY, Issue 2 2009A.B. Mashingaidze Abstract Smallholder farmers in southern African countries rely primarily on cultural control and hoe weeding to combat weeds, but often times, they are unable to keep up with the weeding requirements of the crop because of its laboriousness, causing them to incur major yield losses. Optimisation of crop planting pattern could help to increase yield and suppress weeds and to reduce the critical period of weed control and the weeding requirements to attain maximum yield. Experiments were carried out in Zimbabwe during two growing seasons to assess the effect of maize density and spatial arrangement on crop yield, growth and seed production of weeds and to determine the critical period for weeding. Planting maize at 60 cm row distance achieved higher yields and better weed suppression than planting at 75 or 90 cm row distance. Increasing crop densities beyond the customary three to four plants m,2 gave modest reductions in weed biomass but also diminished crop yields, probably because of increased competition for water and nutrient resources. Maize planted in narrow rows (60 cm) intercepted more radiation and suffered less yield reduction from delaying hoe weeding than those planted in wider rows (75 or 90 cm), and the duration of the weed-free period required to attain maximum grain yield was 3 weeks shorter in the narrow spacing than that in the 75- and 90-cm row spacings. Weeding was more effective in curtailing weed seed production in the narrow row spatial arrangements than in the wide row planting. The results of these studies show that narrow row spacings may reduce weeding requirements and increase yields. [source] Climate change: a rational choice politics view,AUSTRALIAN JOURNAL OF AGRICULTURAL & RESOURCE ECONOMICS, Issue 3 2009Geoffrey Brennan Reduction in carbon dioxide emissions constitutes a global public good; and hence there will be strong incentives for countries to free ride in the provision of CO2 emission reductions. In the absence of more or less binding international agreements, we would expect carbon emissions to be seriously excessive, and climate change problems to be unsolvable. Against this obvious general point, we observe many countries acting unilaterally to introduce carbon emission policies. That is itself an explanatory puzzle, and a source of possible hope. Both aspects are matters of ,how politics works', i.e. ,public choice' problems are central. The object of this paper is to explain the phenomenon of unilateral policy action and to evaluate the grounds for ,hope'. One aspect of the explanation lies in the construction of policy instruments that redistribute strategically in favour of relevant interests. Another is the ,expressive' nature of voting and the expressive value of environmental concerns. Both elements , elite interests and popular (expressive) opinion , are quasi-constraints on politically viable policy. However, the nature of expressive concerns is such that significant reductions in real GDP are probably not sustainable in the long term , which suggests that much of the CO2 reduction action will be limited to modest reductions of a largely token character. In that sense, the grounds for hope are, although not non-existent, decidedly thin. [source] The effect of carbamazepine on the steady-state pharmacokinetics of ziprasidone in healthy volunteersBRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue S1 2000J. J. Miceli Aims, To evaluate the effect of steady-state carbamazepine administration on the steady-state pharmacokinetics of ziprasidone in healthy young adults, in an open, randomised, parallel-group study. Methods, Twenty-five subjects were randomized to one of two treatment groups. Group 1 received 20 mg ziprasidone twice daily on days 1 and 2, and a single dose on day 3. A single 100 mg dose of carbamazepine was given once daily on days 5 and 6 and twice daily on days 7 and 8, followed by 200 mg twice daily until day 28 and on the morning only on day 29. Ziprasidone 20 mg was also administered twice daily on days 26 and 27 and in the morning only on day 28. Group 2 received the same treatment regimen with carbamazepine replaced by placebo. Pharmacokinetic data were obtained on days 3 and 28. Results, Nine subjects in group 1 and 10 in group 2 completed all three treatment periods (ziprasidone, carbamazepine or placebo; and ziprasidone plus carbamazepine or placebo). Carbamazepine administration to group 1 was associated with modest reductions in ziprasidone exposure, with mean decreases in ziprasidone AUC(0,12 h) and Cmax values of 36% and 27%, respectively, on day 28 compared with day 3 (P<0.03). The mean differences between day 28 and day 3 ziprasidone AUC(0,12 h) and Cmax values were also statistically significantly greater in the carbamazepine group than in the placebo group. The mean half-life of ziprasidone decreased by 1 h from day 3 to day 28 in the subjects receiving carbamazepine, compared with virtually no change in the placebo group. All adverse events were mild or moderate in severity and there were no serious adverse events, or clinically significant changes in ECGs and vital signs throughout the study. Conclusions, Induction of CYP3A4 with carbamazepine led to a modest reduction (<36%) in steady-state exposure to ziprasidone that is believed to be clinically insignificant. [source] Obesity and polycystic ovary syndromeCLINICAL ENDOCRINOLOGY, Issue 2 2006T. M. Barber Summary The aetiology of Polycystic Ovary Syndrome (PCOS) is complex and multifactorial. There is much evidence, however, to suggest that adipose tissue plays an important role in the development and maintenance of PCOS pathology. There is a close correlation between adiposity and symptom severity in women with PCOS, and even modest reductions in weight generally translate into significant improvements in menstrual regularity, fertility and hyperandrogenic features. This review article considers the various mechanisms that might underlie this link between excess adiposity and PCOS , including the effects of differential insulin sensitivity, abnormal steroid hormone metabolism and adipocytokine secretion. Greater attention to the therapeutic options available to reduce the impact of excess adiposity on ovarian and metabolic function is essential to the management of PCOS. [source] | ||||||||||