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Selected AbstractsPhenobarbital for the Treatment of Epilepsy in the 21st Century: A Critical ReviewEPILEPSIA, Issue 9 2004Patrick Kwan Summary:, Phenobarbital (PB) is the most widely used antiepileptic drug (AED) in the developing world and remains a popular choice in many industrialized countries. Meta-analyses of randomized controlled trials suggest that few differences in efficacy exist between PB and other established AEDs, but its possible deleterious cognitive and behavioral side effects remain a concern in the developed world. In contrast, high degrees of efficacy and tolerability in everyday clinical use have been demonstrated consistently in observational studies in developing countries. We propose that a pragmatic, comprehensive outcomes program be carried out, perhaps under the aegis of the Global Campaign Against Epilepsy, to optimize the conditions of the use of PB, so that more people around the world can benefit from this cost-effective medication and live more fulfilling lives. [source] Herbal product use in a sample of Turkish patients undergoing haemodialysisJOURNAL OF CLINICAL NURSING, Issue 15 2009Belgüzar Kara Aim., To examine herbal product use among patients with end-stage renal disease undergoing haemodialysis. Background., Herbal therapy is a very popular choice for many patients. However, little information is available about herbal product use in renal patients. Design., The study was designed as a cross-sectional survey. The data were obtained from 114 end-stage renal disease patients in two haemodialysis centres in Ankara, Turkey between June,August 2007. Methods., Data were collected through face-to-face structured interviews. Descriptive statistics and the chi-square test were conducted. Results., Approximately one-third of the patients (28·1%) used a herbal product after the diagnosis of chronic kidney disease. Of these, 13·2% reported currently taking herbal products. A minority of participants (12·5%) informed their physician of herbal product use. Marital status was the only variable significantly associated with herbal product use. Conclusions., The results of this study showed that many patients used herbal products, but most did not disclose this use to their physician. Herbal product use was more prevalent among the participants who were married. Relevance to clinical practice., Understanding the patterns and reasons of herbal use is beneficial in efforts to improve the care of patients with end-stage renal disease. Nurses should be aware of the potential health risks caused by herbal products and should educate the patient and the family. [source] Permethrin Spot-On Toxicoses in CatsJOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 2 2000Jill A. Richardson DVM Summary Spot-on insecticides are becoming a popular type of flea control for pets. Spot-on products available include those containing fipronil, imidicloprid, methoprene, and permethrin. Currently, over 15 brands of permethrin spot-on products are labeled for "use in dogs only." These products contain high concentrations (45,65%) of permethrin insecticide and are becoming a very popular choice for flea and tick control for dogs. Cats are highly sensitive to permethrin and inappropriate or accidental application of these products would be fatal. Though they have a wise margin of safety when used appropriately on dogs, even small amount of permethrin spot-on products can cause severe clinical signs in cats. Indications of this species sensitivity have been documented by the National Animal Poison Control Center (NAPCC). In most cases, the owner applied the concentrated permethrin-containing poduct to cats accidentally or intentionally. In some situations, the exposure seems to have resulted when the product was used on the dog and cats were playing with dog. (ASPCA, NAPCC, Unpublished data, 1995,1997). [source] A survey of staff attitudes to increasing medical undergraduate education in a district general hospitalMEDICAL EDUCATION, Issue 7 2005John Macdonald Introduction, Medical student numbers in Britain are increasing rapidly, beyond the capacity of most teaching hospitals, with more clinical teaching taking place in district general hospitals (DGHs). Surveys show that students value the intensive clinical teaching, smaller student numbers and perceived greater friendliness in DGHs. This paper explores DGH staff attitudes to teaching , their level of initial enthusiasm, their attitudes to current teaching, its effect on the hospital and to the sustainability of DGH undergraduate teaching , as both student numbers and service workloads continue to rise. Methods, Semi-structured interviews with 6 key informants were used to generate themes for a 19-question pre-piloted anonymous postal questionnaire sent to all 68 staff involved in undergraduate medical teaching in Northampton General Hospital. Results, The total response included 85% of consultants. Responses in the 3 staff groups were similar. Most respondents felt enthusiastic at the prospect of medical students, although they realised that this would be intellectually challenging and increase time pressures. These predictions were largely fulfilled. Respondents felt that in comparison to teaching hospitals the DGH teaching was more clinically based and consultant-led, with more approachable staff. Currently 41 respondents (82%) felt that they had inadequate teaching time. A majority felt that the arrival of students had improved patient care and that their department had benefited. Thirty-seven responders (74%) felt that the planned doubling of student numbers would impose an unsustainable departmental load, and would compromise teaching quality. The change felt most necessary to support additional teaching was increased clinical medical staff. Better co-ordination between the DGH and the medical school was also felt necessary. The most popular choice for the distribution of extra teaching finance was to the teacher's directorate, i.e. speciality [33 (66%)]. Forty-four (86%) felt that increased student numbers would have a significant impact on the character of the hospital. The 108 free-text comments (2.1 per respondent) centred on hospital character and the benefits of students. Conclusions, This study shows a considerable initial enthusiasm for teaching in DGH staff, which is persisting despite increasing student numbers. However, the current teaching load is seen to be substantial. Teaching more students is likely to produce major problems, based on lack of teaching time and increasingly heavy service commitments rather than lack of patients. This is likely to be a widespread problem for DGHs. Failure to ensure adequate teaching staff and facilities as well as co-ordination could threaten the sustainability of this potentially valuable teaching initiative. [source] PREDICTION-FOCUSED MODEL SELECTION FOR AUTOREGRESSIVE MODELSAUSTRALIAN & NEW ZEALAND JOURNAL OF STATISTICS, Issue 4 2007Gerda Claeskens Summary In order to make predictions of future values of a time series, one needs to specify a forecasting model. A popular choice is an autoregressive time-series model, for which the order of the model is chosen by an information criterion. We propose an extension of the focused information criterion (FIC) for model-order selection, with emphasis on a high predictive accuracy (i.e. the mean squared forecast error is low). We obtain theoretical results and illustrate by means of a simulation study and some real data examples that the FIC is a valid alternative to the Akaike information criterion (AIC) and the Bayesian information criterion (BIC) for selection of a prediction model. We also illustrate the possibility of using the FIC for purposes other than forecasting, and explore its use in an extended model. [source] Improved Logrank-Type Tests for Survival Data Using Adaptive WeightsBIOMETRICS, Issue 1 2010Song Yang Summary For testing for treatment effects with time-to-event data, the logrank test is the most popular choice and has some optimality properties under proportional hazards alternatives. It may also be combined with other tests when a range of nonproportional alternatives are entertained. We introduce some versatile tests that use adaptively weighted logrank statistics. The adaptive weights utilize the hazard ratio obtained by fitting the model of Yang and Prentice (2005,,Biometrika,92, 1,17). Extensive numerical studies have been performed under proportional and nonproportional alternatives, with a wide range of hazard ratios patterns. These studies show that these new tests typically improve the tests they are designed to modify. In particular, the adaptively weighted logrank test maintains optimality at the proportional alternatives, while improving the power over a wide range of nonproportional alternatives. The new tests are illustrated in several real data examples. [source] Do electrostatic interactions destabilize protein,nucleic acid binding?BIOPOLYMERS, Issue 2 2007Sanbo Qin Abstract The negatively charged phosphates of nucleic acids are often paired with positively charged residues upon binding proteins. It was thus counter-intuitive when previous Poisson,Boltzmann (PB) calculations gave positive energies from electrostatic interactions, meaning that they destabilize protein,nucleic acid binding. Our own PB calculations on protein,protein binding have shown that the sign and the magnitude of the electrostatic component are sensitive to the specification of the dielectric boundary in PB calculations. A popular choice for the boundary between the solute low dielectric and the solvent high dielectric is the molecular surface; an alternative is the van der Waals (vdW) surface. In line with results for protein,protein binding, in this article, we found that PB calculations with the molecular surface gave positive electrostatic interaction energies for two protein,RNA complexes, but the signs are reversed when the vdW surface was used. Therefore, whether destabilizing or stabilizing effects are predicted depends on the choice of the dielectric boundary. The two calculation protocols, however, yielded similar salt effects on the binding affinity. Effects of charge mutations differentiated the two calculation protocols; PB calculations with the vdW surface had smaller deviations overall from experimental data. © 2007 Wiley Periodicals, Inc. Biopolymers 86: 112,118, 2007. This article was originally published online as an accepted preprint. The "Published Online" date corresponds to the preprint version. You can request a copy of the preprint by emailing the Biopolymers editorial office at biopolymers@wiley.com [source] Expedited partner therapy for Chlamydia trachomatis at the community pharmacyBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 9 2010ST Cameron Please cite this paper as: Cameron S, Glasier A, Muir A, Scott G, Johnstone A, Quarrell H, Oroz C, McIntyre M, Miranda D, Todd G. Expedited partner therapy for Chlamydia trachomatis at the community pharmacy. BJOG 2010;117:1074,1079. Objective, Expedited partner treatment (EPT) for uncomplicated Chlamydia trachomatis at the pharmacy is an alternative approach to partner notification that has not yet been evaluated within the UK. The aim of this study was to evaluate EPT for partners using pharmacies in Lothian. Design, A pilot study over 18 months. Setting, Selected healthcare settings and community pharmacies in Lothian, Scotland, UK. Population, Sexual partners of index cases with uncomplicated C. trachomatis. Methods, Index cases with uncomplicated C. trachomatis were given a pharmacy voucher to pass onto sexual partners. Partners could redeem vouchers for free treatment (azithromycin) at one of 90 pharmacies in the area. Main outcome measures, The main outcome measure was the proportion of vouchers redeemed. Secondary outcomes included patient satisfaction, as determined at a telephone follow-up of a subgroup of female index cases from one study site, 1 month later. Results, In total 577 vouchers were issued to chlamydia-positive index patients of mean age 22.9 years (range 15,47 years). A total of 231 vouchers were redeemed (40%), at a median of 2 days after issue. Only 4% of partners attended a clinic for treatment. Most index patients surveyed reported that partners were satisfied with this method of treatment (48 out of 55; 87%). Conclusions, Expedited partner treatment for uncomplicated chlamydia at a pharmacy is a popular choice, and increases options on where, when and how partners are treated. [source] Preliminary testing for normality: some statistical aspects of a common conceptCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 6 2006V. Schoder Summary Background., Statistical methodology has become an increasingly important topic in dermatological research. Adequacy of the statistical procedure depends among others on distributional assumptions. In dermatological articles, the choice between parametric and nonparametric methods is often based on preliminary goodness-of-fit tests. Aim., For the special case of the assumption of normally distributed data, the Kolmogorov,Smirnov test is the most popular choice. We investigated the performance of this test on four types of non-normal data, representing the majority of real data in dermatological research. Methods., Simulations were run to assess the performance of the Kolmogorov,Smirnov test, depending on sample size and severity of violations of normality. Results., The Kolmogorov,Smirnov test performs badly on data with single outliers, 10% outliers and skewed data at sample sizes <,100, whereas normality is rejected to an acceptable degree for Likert-type data. Conclusion., Preliminary testing for normality is not recommended for small-to-moderate sample sizes. [source] Accurate garbage collection in uncooperative environments revisited,CONCURRENCY AND COMPUTATION: PRACTICE & EXPERIENCE, Issue 12 2009J. Baker Abstract Implementing a concurrent programming language such as Java by means of a translator to an existing language is attractive as it provides portability over all platforms supported by the host language and reduces development time,as many low-level tasks can be delegated to the host compiler. The C and C++ programming languages are popular choices for many language implementations due to the availability of efficient compilers on a wide range of platforms. For garbage-collected languages, however, they are not a perfect match as no support is provided for accurately discovering pointers to heap-allocated data on thread stacks. We evaluate several previously published techniques and propose a new mechanism, lazy pointer stacks, for performing accurate garbage collection in such uncooperative environments. We implemented the new technique in the Ovm Java virtual machine with our own Java-to-C/C++ compiler using GCC as a back-end compiler. Our extensive experimental results confirm that lazy pointer stacks outperform existing approaches: we provide a speedup of 4.5% over Henderson's accurate collector with a 17% increase in code size. Accurate collection is essential in the context of real-time systems, we thus validate our approach with the implementation of a real-time concurrent garbage collection algorithm. Copyright © 2009 John Wiley & Sons, Ltd. [source] | |||||||||||||