Journal articles on the topic 'Directed search of options'
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Wadeson, Nigel. "Directed search with real options." Economics of Innovation and New Technology 19, no. 6 (September 2010): 569–82. http://dx.doi.org/10.1080/10438599.2010.486527.
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Solway, Alec, and Matthew M. Botvinick. "Evidence integration in model-based tree search." Proceedings of the National Academy of Sciences 112, no. 37 (August 31, 2015): 11708–13. http://dx.doi.org/10.1073/pnas.1505483112.
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Research on the dynamics of reward-based, goal-directed decision making has largely focused on simple choice, where participants decide among a set of unitary, mutually exclusive options. Recent work suggests that the deliberation process underlying simple choice can be understood in terms of evidence integration: Noisy evidence in favor of each option accrues over time, until the evidence in favor of one option is significantly greater than the rest. However, real-life decisions often involve not one, but several steps of action, requiring a consideration of cumulative rewards and a sensitivity to recursive decision structure. We present results from two experiments that leveraged techniques previously applied to simple choice to shed light on the deliberation process underlying multistep choice. We interpret the results from these experiments in terms of a new computational model, which extends the evidence accumulation perspective to multiple steps of action.
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Fernández Eire, Luis, and Antonio López Castedo. "La tipología RIASEC y las modalidades de bachillerato." REOP - Revista Española de Orientación y Psicopedagogía 17, no. 1 (January 28, 2014): 49. http://dx.doi.org/10.5944/reop.vol.17.num.1.2006.11339.
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RESUMENLa teoría de Holland permite clasificar e identificar personas y ambientes conforme a la Tipología RIASEC. Utilizando una adaptación del Self-Directed Search (Holland, 1994) a adolescentes gallegos,Búsqueda Encaminada, 1998 (Eire, 1998) se obtuvieron códigos diferenciados correspondientes a cada una de las opciones académicas que se pueden dar en Bachillerato (Ciencias, Letras y Mixtas) que permiten establecer el grado de congruencia entre el Código Holland de un aspirante y la opción académica. Se discuten diversas implicaciones para orientadores y responsables de los servicios de orientación.ABSTRACTHollands theory allows to classify and to identify people and environmennts according to the RIASEC typology. Using an adaptation of the Self-Directed Search (Hollannd, 1994) to Galician adolescents Búsqueda Encamiñada, 1998-BE-98 (Eire, 1998) differentiated codes were obtained corresponding to each one of the academic options that there exist in High School (Sciences, Mixed and Letters) and that allow to establish the congruence degree between the Code Holland of an aspirantand the academic option. Different implications for the careers guidance and the orientation servicesare discussed.
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Schulz, Eric, Charley M. Wu, Azzurra Ruggeri, and Björn Meder. "Searching for Rewards Like a Child Means Less Generalization and More Directed Exploration." Psychological Science 30, no. 11 (October 25, 2019): 1561–72. http://dx.doi.org/10.1177/0956797619863663.
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How do children and adults differ in their search for rewards? We considered three different hypotheses that attribute developmental differences to (a) children’s increased random sampling, (b) more directed exploration toward uncertain options, or (c) narrower generalization. Using a search task in which noisy rewards were spatially correlated on a grid, we compared the ability of 55 younger children (ages 7 and 8 years), 55 older children (ages 9–11 years), and 50 adults (ages 19–55 years) to successfully generalize about unobserved outcomes and balance the exploration–exploitation dilemma. Our results show that children explore more eagerly than adults but obtain lower rewards. We built a predictive model of search to disentangle the unique contributions of the three hypotheses of developmental differences and found robust and recoverable parameter estimates indicating that children generalize less and rely on directed exploration more than adults. We did not, however, find reliable differences in terms of random sampling.
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Torra, Roser, and Mónica Furlano. "New therapeutic options for Alport syndrome." Nephrology Dialysis Transplantation 34, no. 8 (June 13, 2019): 1272–79. http://dx.doi.org/10.1093/ndt/gfz131.
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Abstract Alport syndrome (AS) is the most frequent inherited kidney disease after autosomal dominant polycystic kidney disease. It has three different patterns of inheritance—autosomal dominant, autosomal recessive and X-linked—which in part explains the wide spectrum of disease, ranging from isolated microhaematuria to end-stage renal disease early in life. The search for a treatment for AS is being pursued vigorously, not only because of the obvious unmet need but also because AS is a rare disease and any drug approved will have an orphan drug designation with its various benefits. Moreover, AS patients are quite young with very few comorbidities, which facilitates clinical trials. This review identifies the particularities of each pattern of inheritance but focuses mainly on new drugs or therapeutic targets for the disease. Most treatment-related investigations are directed not at the main abnormality in AS, namely collagen IV composition, but rather at the associated inflammation and fibrosis. Thus, AS may serve as a proof of concept for numerous drugs of potential value in many diseases that cause chronic kidney disease.
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Conlon, Luke, Zarrukh Baig, and Michael A. J. Moser. "What Information Are Patients Receiving from the Internet about the Operative and Nonoperative Management of Acute Appendicitis?" Digestive Surgery 37, no. 6 (2020): 480–87. http://dx.doi.org/10.1159/000510383.
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<b><i>Introduction:</i></b> Recent studies suggest that nonoperative management of appendicitis (NOMA) may be a reasonable option for managing uncomplicated acute appendicitis. We examined the Internet to see if patients are likely to find the information they need to make an informed decision between the 2 options. <b><i>Methods:</i></b> A list of 29 search terms was established by a focus group and then entered into Google, resulting in 49 unique webpages, each reviewed by 3 reviewers. Consensus was obtained for bias (surgery, NOMA, or balanced), webpage type, JAMA score, reading grade, and DISCERN score, a measure of quality of written information for patients. <b><i>Results:</i></b> Thirty of the 49 websites (61%) favored surgery, while 13 (27%) favored NOMA, and 6 sites (12%) provided balanced information. Twelve of 49 sites (24%) did not list NOMA as an option. The majority of patient-directed (11/12 = 92%) and physician-directed (7/9 = 78%) webpages favored surgery, whereas academic webpages presented a more balanced distribution. Academic and physician-directed webpages ranked higher than commercial and news webpages (median ranks 3 and 4 vs. 7.5 and 8). Only 8/49 sites (16%) mentioned that the presence of a fecalith predicts the failure of NOMA. Reading grades were almost all well above the recommended grade 8 level. <b><i>Conclusion:</i></b> Most of the webpages available on the Internet do not provide enough information, nor are they sufficiently understandable to allow most patients to make an informed decision about the current options for the management of acute appendicitis.
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Last, Briana S., Alison M. Buttenheim, Carter E. Timon, Nandita Mitra, and Rinad S. Beidas. "Systematic review of clinician-directed nudges in healthcare contexts." BMJ Open 11, no. 7 (July 2021): e048801. http://dx.doi.org/10.1136/bmjopen-2021-048801.
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ObjectiveNudges are interventions that alter the way options are presented, enabling individuals to more easily select the best option. Health systems and researchers have tested nudges to shape clinician decision-making with the aim of improving healthcare service delivery. We aimed to systematically study the use and effectiveness of nudges designed to improve clinicians’ decisions in healthcare settings.DesignA systematic review was conducted to collect and consolidate results from studies testing nudges and to determine whether nudges directed at improving clinical decisions in healthcare settings across clinician types were effective. We systematically searched seven databases (EBSCO MegaFILE, EconLit, Embase, PsycINFO, PubMed, Scopus and Web of Science) and used a snowball sampling technique to identify peer-reviewed published studies available between 1 January 1984 and 22 April 2020. Eligible studies were critically appraised and narratively synthesised. We categorised nudges according to a taxonomy derived from the Nuffield Council on Bioethics. Included studies were appraised using the Cochrane Risk of Bias Assessment Tool.ResultsWe screened 3608 studies and 39 studies met our criteria. The majority of the studies (90%) were conducted in the USA and 36% were randomised controlled trials. The most commonly studied nudge intervention (46%) framed information for clinicians, often through peer comparison feedback. Nudges that guided clinical decisions through default options or by enabling choice were also frequently studied (31%). Information framing, default and enabling choice nudges showed promise, whereas the effectiveness of other nudge types was mixed. Given the inclusion of non-experimental designs, only a small portion of studies were at minimal risk of bias (33%) across all Cochrane criteria.ConclusionsNudges that frame information, change default options or enable choice are frequently studied and show promise in improving clinical decision-making. Future work should examine how nudges compare to non-nudge interventions (eg, policy interventions) in improving healthcare.
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Fluck, Friederika, Anne Marie Augustin, Thorsten Bley, and Ralph Kickuth. "Current Treatment Options in Acute Limb Ischemia." RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren 192, no. 04 (August 28, 2019): 319–26. http://dx.doi.org/10.1055/a-0998-4204.
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Background Acute limb ischemia represents a clinical emergency with eventual limb loss and life-threatening consequences. It is characterized by a sudden decrease in limb perfusion. Acute ischemia is defined as a duration of symptoms for less than 14 days. Aging of the population increases the prevalence of acute limb ischemia. The two principal etiologies are arterial embolism and in situ thrombosis of an atherosclerotic artery. Immediate diagnosis, accurate assessment and urgent intervention when needed are crucial to save the limb and to prevent a major amputation. Delay in diagnosis and therapy may lead to irreversible ischemic damage. Method To assess the current treatment options in acute limb ischemia, this review is based on a selective literature search in PubMed representing the current state of research. Results and Conclusion Patients with acute limb ischemia should receive immediate anticoagulation. Treatment depends on the classification based on the degree of ischemia and limb viability. Especially acute (< 14 days symptom duration) Rutherford Categories IIa and IIb with marginally and immediately threatened limbs require definitive therapeutic intervention and are salvageable, if promptly revascularized. The current literature suggests that open surgical revascularization is more time effective then catheter-directed thrombolysis. However, with the advent of thrombolytic delivery systems and mechanical thrombectomy devices, treatment time can be minimized and successful utilization in patients with Category IIb (Rutherford Classification for Acute Limb Ischemia) has been reported with promising limb-salvage and survival rates. Large randomized studies are still missing, and guidelines suggest choosing the method of revascularization depending on anatomic location, etiology, and local practice patterns, with the time to restore the blood flow being an important factor to consider. Key points: Citation Format
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Paulavičiūtė-Baikštienė, Daiva, Rūta Baršauskaitė, and Ingrida Janulevičienė. "New Insights Into Pathophysiological Mechanisms Regulating Conventional Aqueous Humor Outflow." Medicina 49, no. 4 (May 5, 2013): 26. http://dx.doi.org/10.3390/medicina49040026.
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The aim of the article was to overview the pathophysiology of the conventional outflow pathway, trabecular meshwork, and intraocular pressure and to discuss the options of future glaucoma treatment directed to improvement in aqueous outflow. The literature search in the Medline, Embase, and Cochrane databases from April to May 2012 was performed; a total of 47 articles analyzed. The diminished conventional pathway may be altered by several pathophysiological mechanisms like TM obstruction caused by transforming growth factor-β2, clastic nondeformable cells, macrophages leaking from hypermature cataract, iris pigment, lens capsular fragments after YAG-laser posterior capsulotomy, proteins and their subfragments. It is known that trabecular meshwork contraction reduces outflow, and the actomyosin system is directly linked to this mechanism. New glaucoma drugs are still under investigation, but it is already proven that agents such as latranculin-B are effective in improving aqueous drainage. Selective Rho-associated coiled coilforming protein kinase inhibitors have been shown to cause a significant improvement in outflow facility and may become a new option for glaucoma treatment. Caldesmon negatively regulates actin-myosin interactions and thus increases outflow. Stem cells may replace missing or nonfunctional trabecular meshwork cells and hopefully will bring a new treatment solution. Pathophysiological mechanisms regulating conventional aqueous humor outflow are still not fully understood and require further investigations. Future treatment decisions should be directed to a specific mechanism regulating an elevation in intraocular pressure.
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Denisova, Oxana V., Laura Kakkola, Lin Feng, Jakob Stenman, Ashwini Nagaraj, Johanna Lampe, Bhagwan Yadav, et al. "Obatoclax, Saliphenylhalamide, and Gemcitabine Inhibit Influenza A Virus Infection." Journal of Biological Chemistry 287, no. 42 (August 21, 2012): 35324–32. http://dx.doi.org/10.1074/jbc.m112.392142.
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Influenza A viruses (IAVs) infect humans and cause significant morbidity and mortality. Different treatment options have been developed; however, these were insufficient during recent IAV outbreaks. Here, we conducted a targeted chemical screen in human nonmalignant cells to validate known and search for novel host-directed antivirals. The screen validated saliphenylhalamide (SaliPhe) and identified two novel anti-IAV agents, obatoclax and gemcitabine. Further experiments demonstrated that Mcl-1 (target of obatoclax) provides a novel host target for IAV treatment. Moreover, we showed that obatoclax and SaliPhe inhibited IAV uptake and gemcitabine suppressed viral RNA transcription and replication. These compounds possess broad spectrum antiviral activity, although their antiviral efficacies were virus-, cell type-, and species-specific. Altogether, our results suggest that phase II obatoclax, investigational SaliPhe, and FDA/EMEA-approved gemcitabine represent potent antiviral agents.
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Sun, Hongbo, and Ling Ma. "Generative Design by Using Exploration Approaches of Reinforcement Learning in Density-Based Structural Topology Optimization." Designs 4, no. 2 (May 1, 2020): 10. http://dx.doi.org/10.3390/designs4020010.
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A central challenge in generative design is the exploration of vast number of solutions. In this work, we extend two major density-based structural topology optimization (STO) methods based on four classes of exploration algorithms of reinforcement learning (RL) to STO problems, which approaches generative design in a new way. The four methods are: first, using ε -greedy policy to disturb the search direction; second, using upper confidence bound (UCB) to add a bonus on sensitivity; last, using Thompson sampling (TS) as well as information-directed sampling (IDS) to direct the search, where the posterior function of reward is fitted by Beta distribution or Gaussian distribution. Those combined methods are evaluated on some structure compliance minimization tasks from 2D to 3D, including the variable thickness design problem of an atmospheric diving suit (ADS). We show that all methods can generate various acceptable design options by varying one or two parameters simply, except that IDS fails to reach the convergence for complex structures due to the limitation of computation ability. We also show that both Beta distribution and Gaussian distribution work well to describe the posterior probability.
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Gusev, Alexander, Dmitry Ilin, and Evgeny Nikulchev. "The Dataset of the Experimental Evaluation of Software Components for Application Design Selection Directed by the Artificial Bee Colony Algorithm." Data 5, no. 3 (July 8, 2020): 59. http://dx.doi.org/10.3390/data5030059.
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The paper presents the swarm intelligence approach to the selection of a set of software components based on computational experiments simulating the desired operating conditions of the software system being developed. A mathematical model is constructed, aimed at the effective selection of components from the available alternative options using the artificial bee colony algorithm. The model and process of component selection are introduced and applied to the case of selecting Node.js components for the development of a digital platform. The aim of the development of the platform is to facilitate countrywide simultaneous online psychological surveys in schools in the conditions of unstable internet connection and the large variety of desktop and mobile client devices, running different operating systems and browsers. The module whose development is considered in the paper should provide functionality for the archiving and checksum verification of the survey forms and graphical data. With the swarm intelligence approach proposed in the paper, the effective set of components was identified through a directional search based on fuzzy assessment of the three experimental quality indicators. To simulate the desired operating conditions and to guarantee the reproducibility of the experiments, the virtual infrastructure was configured. The application of swarm intelligence led to reproducible results for component selection after 312 experiments instead of the 1080 experiments needed by the exhaustive search algorithm. The suggested approach can be widely used for the effective selection of software components for distributed systems operating in the given conditions at this stage of their development.
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Afshar, M. H. "Rebirthing particle swarm optimization algorithm: application to storm water network design." Canadian Journal of Civil Engineering 35, no. 10 (October 2008): 1120–27. http://dx.doi.org/10.1139/l08-056.
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Stochastic search methods, such as the particle swarm optimization (PSO) algorithm, are primarily directed by two main features — exploration and exploitation. Exploration is the ability of the algorithm to broadly search through the solution space for new quality solutions, whereas exploitation is responsible for refining the search in the neighborhood of the good solutions found previously. Proper balance between these features is sought, to obtain good performance of these algorithms. An explorative mechanism is introduced in this paper to improve the performance of the PSO algorithm. The method is based on introducing artificial exploration into the algorithm by randomly repositioning the particles approaching stationary status. A velocity measure is used to distinguish between flying and stationary particles. This can be sought as a sudden death followed by a rebirth of these particles. Two options are tested for the rebirthing mechanism, which are (i) clearing and (ii) keeping the memory of rebirthing particles. The global best particle is exempted from rebirthing process so that the most useful of the swarm’s past experiences is not lost. The method is applied to a benchmark storm water network design problem and the results are presented and compared with those of the original algorithm and other methods. The proposed method, though simple, is shown to be very effective in avoiding local optima, leading to an improved version of the algorithm at no extra computational effort.
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Shmal, Vadim N., and Liliya R. Aysina. "SEARCH FOR THE OPTIMAL SOLUTION FOR ASSIGNING SUBURBAN-URBAN TRAINS ON BRANCHED LINES ON EACH OF THE POSSIBLE ROUTES." T-Comm 14, no. 11 (2020): 39–45. http://dx.doi.org/10.36724/2072-8735-2020-14-11-39-45.
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The article describes the problem of organizing train traffic on line with branches, analyzes possible separate routes on the "trunk" and "branch" sections, and brunched routes. The development of a mathematical model which consider the interests of passengers in a service provided and economic interest of passenger companies are elements of scientific novelty of presented researching. The insufficient disclosure in the existing theoretical base of the issues of train traffic organization on lines with branches confirms the relevance of the research. The deficit of clear requirements for the organization of such lines leads to empirical decisions when operating such facilities. Adhering to the goal of providing a comfortable service for passengers and taking into account economic aspects in the interests of suburban companies, the objective function is minimize the difference between the mileage of available seats (as a condition that reflects the interests of a commuter company) and the overcrowding of the train (as a criterion that ensures a comfortable ride for the passenger). The authors suggest using a genetic algorithm for solve this problem. Genetic algorithm is a tool that allows you to perform a directed search of competitive options. The article describes the method of applying the genetic algorithm, the formation of "parent" variants and "offspring" variants, compliance with a number of restrictions and ranking of offspring variants for the selection of the best "individuals". Before testing the proposed method on a real example, the authors make a preliminary analysis to identify possible shortcomings that require improvement. The possibility of using a mathematical model and a genetic algorithm to find the optimal (or close to optimal) option for organizing traffic on a line with branches is considered on an arbitrary example. The presented calculations can be performed in any analytical software package. In this research, the search for the optimal method to organize traffic on a line with branches was performed in the MS Excel product. Successful calculations on an arbitrary option using the proposed mathematical model and genetic algorithms (as a tool to determine the optimal option of movement), allows us to assume that calculations can be made based on real source data for suburban directions of railway junctions that have lines with branches.
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Yousef, Ejaz, Yelena Korotkaya, and Alyson B. Simpson. "Eosinophilic esophagitis in children: Updates and practical aspects of management for allergists in a non‐tertiary care private practice setup." Allergy and Asthma Proceedings 43, no. 1 (January 1, 2022): 5–11. http://dx.doi.org/10.2500/aap.2022.43.210084.
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Background: Eosinophilic esophagitis (EoE) is a chronic immune and/or antigen-mediated disease characterized by eosinophilic infiltration of mucosa (≥15 eosinophils per high power field) without any secondary etiology. Non‐immunoglobulin E mediated mechanisms predominate in EoE. Objective: This review concentrated on a stepwise approach for the allergist working in non‐tertiary care private practice. Methods: A medical literature search that focused on several areas of the latest developments in the diagnosis and management of EoE was conducted. Results: There has been a steady increase in the prevalence and incidence of EoE. Clinical symptoms can vary from dysphagia to failure to thrive, depending on the age at presentation; some children develop adaptive behaviors to compensate for dysphagia, such as food preferences and slow eating. The diagnosis is based on a high index of clinical suspicion and is confirmed with endoscopy with biopsies after ruling out other causes of esophageal eosinophilia. Treatment options may include dietary therapy, pharmacologic therapies, or combination therapy. Therapeutic options may also include endoscopic dilation for stricturing disease. Conclusion: Providers should be aware of recent recommendation changes in the diagnostic workup, the role of skin-prick testing, and role of the proton-pump inhibitor as first-line therapy for EoE. Also, clinicians should be aware of the emerging role of empiric dietary therapy as a preferable therapeutic option when compared with the testing-directed diet and the elemental diet. Furthermore, topical glucocorticoid therapies are available, and new developing therapies are being investigated. Reevaluation of esophageal mucosa with biopsies is required approximately 2 months after therapy for a response and after a change in therapies to confirm continued resolution.
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Lee, Ser Yee, Peng Chung Cheow, Jin Yao Teo, and London L. P. J. Ooi. "Surgical Treatment of Neuroendocrine Liver Metastases." International Journal of Hepatology 2012 (2012): 1–13. http://dx.doi.org/10.1155/2012/146590.
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Management of Neuroendocrine liver metastases (NELM) is challenging. The presence of NELM worsens survival outcome and almost 10% of all liver metastases are neuroendocrine in origin. There is no firm consensus on the optimal treatment strategy for NELM. A systematic search of the PubMed database was performed from 1995–2010, to collate the current evidence and formulate a sound management algorithm. There are 22 case series with a total of 793 patients who had undergone surgery for NELM. The overall survival ranges from 46–86% at 5 years, 35–79% at 10 years, and the median survival ranges from 52–123 months. After successful cytoreductive surgery, the mean duration of symptom reduction is between 16–26 months, and the 5-year recurrence/progression rate ranges from 59–76%. Five studies evaluated the efficacy of a combination cytoreductive strategy reporting survival rate of ranging from 83% at 3 years to 50% at 10 years. To date, there is no level 1 evidence comparing surgery versus other liver-directed treatment options for NELM. An aggressive surgical approach, including combination with additional liver-directed procedures is recommended as it leads to long-term survival, significant long-term palliation, and a good quality of life. A multidisciplinary approach should be established as the platform for decision making.
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Chen, Zexin, Songnian Fu, Ming Tang, Zhenrong Zhang, and Yuwen Qin. "Maximum probability directed blind phase search for PS-QAM with variable shaping factors." Optics Express 30, no. 1 (December 22, 2021): 550. http://dx.doi.org/10.1364/oe.448613.
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Sher, Ellen R., Jacqueline A. Ross, Douglas M. Weine, and Arundhati Chandini Arjun. "Current and emerging therapies for eosinophilic esophagitis." Allergy and Asthma Proceedings 43, no. 3 (May 1, 2022): 178–86. http://dx.doi.org/10.2500/aap.2022.43.220014.
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Background: Eosinophilic esophagitis (EoE) is a Type-2 chronic inflammatory food antigen‐driven disease of the esophagus, characterized by eosinophilic predominant inflammation and a constellation of symptoms. The incidence and prevalence of EoE has increased over the past 2 decades. There is an unmet need for approved less burdensome treatment options. Objective: To describe the underlying pathophysiology and diagnosis of EoE and discuss the currently available treatment options. We also aim to review the new and emerging therapies for EoE. Methods: A search of a medical literature data base was performed for articles that discuss treatment for EoE. Results: A comparison of current therapies showed that dietary elimination, swallowed topical corticosteroids, and proton-pump inhibitor therapy are all effective for different populations. Emerging therapies that were reviewed include new topical corticosteroids and biologics directed against Type 2 inflammation. Conclusion: EoE is a chronic inflammatory disorder that can be debilitating, with long-term sequelae. There are no current approved therapies in the United States. Numerous new treatments are on the horizon. Increasing amounts of data are helping to tailor treatment for each patient. Ultimately, shared decision-making is the best approach to guide treatment choices with patients to manage the ever-increasing burden of this disease.
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Hodge, Frank D., Jane Jollineau Kennedy, and Laureen A. Maines. "Does Search-Facilitating Technology Improve the Transparency of Financial Reporting?" Accounting Review 79, no. 3 (July 1, 2004): 687–703. http://dx.doi.org/10.2308/accr.2004.79.3.687.
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XBRL (eXtensible Business Reporting Language) is an emerging technology that facilitates directed searches and simultaneous presentation of related financial statement and footnote information. We investigate whether using an XBRL-enhanced search engine helps nonprofessional financial statement users acquire and integrate related financial information when making an investment decision. We conduct our investigation in the context of recognition versus disclosure of stock option compensation. Our results reveal that many users do not access the technology, but those who do use it are better able to acquire and integrate information. Specifically, we find that when stock option accounting varies between firms, the use of an XBRL-enhanced search engine increases the likelihood that individuals acquire information about stock option compensation disclosed in the footnotes. We also find that XBRL helps individuals integrate the implications of this information, resulting in different investment decisions between individuals who use and do not use the search engine. Our results suggest that search-facilitating technologies, such as XBRL, aid financial statement users by improving the transparency of firms' financial statement information and managers' choices for reporting that information. Our results also reveal that wide publicity about the benefits of using search-facilitating technology may be needed to induce financial statement users to access the technology.
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Johnson, Mark E., Grace Reynolds, Dennis G. Fisher, and Colin R. Harbke. "Vocational Interests and Needs of Unemployed, Low-Education Adults with Severe Substance Abuse Problems in Anchorage, Alaska." International Journal of Adult Vocational Education and Technology 2, no. 2 (April 2011): 1–10. http://dx.doi.org/10.4018/javet.2011040101.
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Vocational assessment data were collected from 94 low-education adults with severe substance abuse problems not currently in treatment. Participants completed the My Vocational Situation (MVS), Self-Directed Search (SDS), and Reading-Free Vocational Interest Inventory (R-FVII). Lower scores than the normative sample were revealed on all MVS scales, with scores for men being significantly lower than the normative sample. These findings indicate that these participants, particularly the men, lack a clear and stable view of their occupational future, need information to clarify their occupational options and goals, and perceive multiple barriers in attaining employment. SDS and R-FVII results provide detailed information about these participants’ occupational interests and vocational likes and dislikes. These findings highlight vocational counseling and guidance as critical needs for individuals with severe substance abuse problems who are unable or unwilling to seek treatment. Providing vocational services to this out-of-treatment population may be an essential pathway for their long-term recovery.
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Rehman, Ayesha, Peter John, and Attya Bhatti. "Biogenic Selenium Nanoparticles: Potential Solution to Oxidative Stress Mediated Inflammation in Rheumatoid Arthritis and Associated Complications." Nanomaterials 11, no. 8 (August 5, 2021): 2005. http://dx.doi.org/10.3390/nano11082005.
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Rheumatoid arthritis (RA) is a common chronic inflammation-mediated disorder having systematic complications. RA triggers a self-directed inflammatory and immunological cascade that culminates in joint destruction. Though a range of treatment options are available, none of them are without adverse effects and this has led researchers to search for alternative solutions. Nanomedicine has emerged as a powerful therapeutic alternative, and selenium (Se) is an essential micronutrient trace element that has a crucial role in human health and disease. Selenium nanoparticles (SeNPs) derived from biological sources, such as plants, bacteria, fungi, and proteins, have exhibited remarkable candidate properties and toxicological profiles, and hence have shown potential to be used as antirheumatic agents. The potential of SeNPs can be attributed to the effect of functional groups bound to them, concentration, and most importantly to their nano range size. The antirheumatic effect of SeNPs is considerable due to its potential in amelioration of oxidative stress-mediated inflammation via downregulation of radical and nonradical species, markers of inflammation, and upregulation of inherent antioxidant defenses. The size and concentration impact of SeNPs has been shown in the subsequent antioxidant and anti-inflammatory properties. Moreover, the article emphasizes the role of these biogenic SeNPs as a notable option in the nanomedicine arena that needs to be further studied as a prospective remedial alternative to cure RA and medication-related adverse events.
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Medland, Julia E., Steven L. Marks, and Joanne L. Intile. "Discharge summaries provided to owners of pets newly diagnosed with cancer exceed recommended readability levels." Journal of the American Veterinary Medical Association 260, no. 6 (March 15, 2022): 657–61. http://dx.doi.org/10.2460/javma.21.09.0410.
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Abstract OBJECTIVE To analyze the readability of discharge summaries distributed to owners of pets newly diagnosed with cancer. SAMPLE 118 discharge summaries provided to pet owners following initial consultation. PROCEDURES A database search identified records of new patients that had been presented to the North Carolina State Veterinary Hospital medical oncology service between June 2017 and January 2019. Owner-directed portions of the summaries provided at the time of discharge were copied and pasted into a document and stripped of all identifying information. Readability of summaries was assessed with the use of 2 previously established readability calculators: the Flesch-Kincaid Grade Level (FKGL) and Flesch Reading Ease (FRE) tests. RESULTS Mean ± SD FKGL was 11.9 ± 1.1 (median, 11.9; range, 8.6 to 15.5; target ≤ 6), and the mean ± SD FRE score was 43 ± 5.9 (median, 42.7; range, 25.5 to 58.1; target ≥ 60). There were no significant differences in FKGL or FRE scores among discharge summaries for patients with the 4 most common tumor types diagnosed or the described treatment options. Ninety-three percent (110/118) of summaries were scored as difficult or very difficult to read. CLINICAL RELEVANCE Owner-directed written information regarding a diagnosis of cancer at a single teaching hospital exceeded readability levels recommended by the American Medical Association and NIH and was above the average reading level of most US adults. Efforts to improve readability are an important component of promoting relationship-centered care and may improve owner compliance and patient outcomes.
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Tatar, M. S. "The Process-based Socio-Economic Interaction of Economic Entities in the Context of Global Challenges." Business Inform 10, no. 525 (2021): 165–76. http://dx.doi.org/10.32983/2222-4459-2021-10-165-176.
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In the context of global challenges, the issue of modification of mechanisms of socio-economic interaction of economic entities, the search for a new, innovative mechanism of interaction of economic entities during socio-behavioral restrictions becomes actualized. The article is aimed at analyzing the process-based socio-economic interaction of industrial economic entities, which involves a study of the subject composition, interaction options and desired results during the implementation of various business processes by industrial economic entities. The main features of socio-economic interaction, as well as the list of entities of socio-economic interaction of industrial enterprises are presented. It is proposed to consider the socio-economic interaction of industrial economic entities within business processes, since each business process is characterized by its subject composition, intensity of interaction, place of implementation, direction of interaction, etc. Differentiation of interaction within business processes will allow to identify its features and options of influence, and determining further on the impact of global challenges on each business process will make it possible to adjust the results of interaction between entities depending on scenarios of global challenges and offer a selective strategy for mutual coordination of actions of economic entities directed towards counteracting global challenges. In the terms of further research, it is planned to determine the degree of interaction of various entities with the enterprise, namely: suppliers, consumers, competitors, the State (direction and strength of regulation, control, assistance to the enterprise, the possibility and instruments of the enterprise’s influence on the decisions of the authorities), etc., as well as define the nature of the change of entities, options and composition of interaction under the influence of global challenges and analyze the communicative aspects of interaction of entities.
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Jain, A., A. Aggarwal, D. Gulati, and MP Singh. "Controversies in Orthopaedic Trauma- Management of Fractures of Shaft of Femur in Children Between 6 and 12 Years of Age." Kathmandu University Medical Journal 12, no. 1 (October 12, 2015): 77–84. http://dx.doi.org/10.3126/kumj.v12i1.13647.
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The management of femoral shaft fractures in children is largely directed by the age and built of the child. There is wide consensus on the non operative treatment of children less than six years of age. Operative treatment is recommended for children more than 12 years of age, only the surgical options vary. The age group of 6-12 years remains a controversial area with multiple studies advocating different lines of treatment.We studied the literature on treatment of femoral shaft fractures in 6 to 12 year age group over the past 25 years through PubMed search and found 79 studies dealing with management of paediatric shaft femur fractures in this age group. Studies dealing with other age groups, animal studies and languages other than English were excluded. The treatment modalities included early or immediate hip spica, traction alone, external fixator, plating (open/minimally invasive), intramedullary nailing- rigid/flexible and intramedullary Kirschner wire. The short listed articles were studied for rate and time of union, complications such as non-union and malunion, leg length discrepancy, infection, implant impingement, refracture and cost analysis.Operative treatment is usually the preferred treatment option in this age group, as it decreases hospitalization time, decreases morbidity and allows early return of child to school. Flexible intramedullary nailing is recommended for length stable fractures. Submuscular bridge plating (minimally invasive) is reserved for comminuted fractures. External fixator is reserved for open fractures and initial stabilization of femoral shaft fractures in polytrauma pediatric patients. Intramedullary K wire is a viable option in resource contrained centres where specialized implants and instrumentation is not available.Kathmandu University Medical Journal Vol.12(1) 2014: 77-84
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Shuravin, Alexander Petrovich, and Sergey Valentinovich Vologdin. "STUDYING CHARACTERISTICS OF GENETIC ALGORITHM FOR OPTIMIZING TEMPERATURE REGIME OF HEATED ROOMS." Vestnik of Astrakhan State Technical University. Series: Management, computer science and informatics 2020, no. 4 (October 31, 2020): 49–61. http://dx.doi.org/10.24143/2072-9502-2020-4-49-61.
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The article discusses the problems of energy-saving, which can be solved by using mathematical optimization methods, and the mathematical optimization algorithms related to these problems. There has been given the review of Russian and foreign works on energy saving and energy optimization. The need for solving the problems of optimizing the thermohydraulic regimes of buildings is explained. There is given the mathematical formulation of the problem of optimizing the temperature regime of indoor areas using adjustable devices and two methods for solving the problem: the directed search method and the genetic algorithm. The above algorithms including the mathematical apparatus are described. The objective function is described as the standard deviation of the temperature of the heated rooms. Various options for using the genetic algorithm have been investigated. A modification of the genetic algorithm is proposed, which allows obtaining the best results in relation to the problem under consideration. The results of a computation experiment for the considered optimization methods are presented. The calculations were carried out for a typical building in Izhevsk under average design conditions, taking into account the actual condition of the enclosing structures, the heating system of the building, and heating devices of indoor areas.
A comparative analysis of the convergence of the iterative process for various options for the application of the genetic algorithm and directional search has been carried out. It is concluded that the new modification allows us to improve the quality of the genetic algorithm. The dependence of the convergence of the genetic algorithm on its parameters was investigated and a modification of this algorithm was proposed in relation to the problem of optimizing the thermo-hydraulic modes of heated rooms. The study is of practical value in terms of using the proposed methodology of saving heat energy in the system of housing and communal services.Practical value is the ability to use in the housing and communal services to save thermal energy.
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Papakonstantinou, Doxa. "Relationships between individual characteristics and occupational possibilities for young adults with visual impairments." British Journal of Visual Impairment 38, no. 2 (December 30, 2019): 137–50. http://dx.doi.org/10.1177/0264619619896005.
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Individuals with disabilities highlight the importance of having career options, as these people are more likely to have narrowed occupational possibilities and to be employed in part-time and contingent jobs. This study explores (a) the range of occupational possibilities that according to Holland’s Self- Directed Search (SDS) Questionnaire most closely resemble the personality types of 55 young adults with visual impairments, b) the impact of individual characteristics on occupational possibilities, and c) the differences between sighted adults and adults with visual impairments regarding the SDS Questionnaire scores for the six personality types (Realistic, Investigative, Artistic, Social, Enterprising, Conventional). The research instrument was the SDS Questionnaire of Holland. The study results showed that the occupational possibilities for young adults with visual impairments relate mostly to social occupations. Individual characteristics also were found to be significant predictors of individual types according to the SDS Questionnaire. In addition, differences emerged from the comparison between adults with visual impairments and sighted adults in regard to the six personality types identified by Holland, based on the normative data. The study revealed that individual characteristics of young adults with visual impairments play an important role in their occupational possibilities.
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Saykin, A. M., and S. E. Buznikov. "Principles of building competitive motion control systems for highly automated vehicles." Journal of Physics: Conference Series 2061, no. 1 (October 1, 2021): 012133. http://dx.doi.org/10.1088/1742-6596/2061/1/012133.
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Abstract The relevance of the issue of development of efficient motion control systems for highly automated vehicles capable to successfully compete with foreign systems of similar purpose is defined by importance of the issue of creation of competitive high-tech products under modern market economy conditions. The research objective was to scientifically justify the building principles for motion control systems for highly automated vehicles providing directed search for solution options for the issue of multi-criterion optimization in the software and hardware space. The research involved methods of system analysis and modern control theory. The research result is a set or complex of building principles for motion control systems for highly automated vehicles providing minimization of hardware environment while keeping observability of all vehicle state coordinates significant for safe control and their dynamic boundaries, as well as ensuring controllability via the channels of traction, braking and direction. The conceptual core or base of such integrated intelligent control systems is mathematical and programming support (software) of indirect measurements of the parameters of motion and control of traction, brakes and direction adapting to the vehicle state and environment changes.
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Vähämurto, Pauli, Marjukka Pollari, Michael R. Clausen, Francesco d’Amore, Sirpa Leppä, and Susanna Mannisto. "Low Absolute Lymphocyte Counts in the Peripheral Blood Predict Inferior Survival and Improve the International Prognostic Index in Testicular Diffuse Large B-Cell Lymphoma." Cancers 12, no. 7 (July 20, 2020): 1967. http://dx.doi.org/10.3390/cancers12071967.
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Low absolute lymphocyte counts (ALC) and high absolute monocyte counts (AMC) are associated with poor survival in patients with diffuse large B-cell lymphoma (DLBCL). We studied the prognostic impact of the ALC and AMC in patients with testicular DLBCL (T-DLBCL). T-DLBCL patients were searched using Southern Finland University Hospital databases and the Danish lymphoma registry. The progression free survival (PFS) and overall survival (OS) were assessed using Kaplan-Meier and Cox proportional hazards methods. We identified 178 T-DLBCL patients, of whom 78 (44%) had a low ALC at diagnosis. The ALC did not correlate with survival in the whole cohort. However, among the patients treated with rituximab (R) containing regimen, a pre-therapeutic low ALC was associated with an increased risk of progression (HR 1.976, 95% CI 1.267–3.086, p = 0.003). Conversely, intravenous (iv) CNS directed chemotherapy translated to favorable outcome. In multivariate analyses, the advantage of an iv CNS directed chemotherapy was sustained (PFS, HR 0.364, 95% CI 0.175–0.757, p = 0.007). The benefit of R and intravenous CNS directed chemotherapy was observed only in non-lymphopenic patients. The AMC did not correlate with survival. A low ALC is an adverse prognostic factor in patients with T-DLBCL. Alternative treatment options for lymphopenic patients are needed.
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Wessely, Anja, Theresa Steeb, Franz Heppt, Annkathrin Hornung, Matthias D. Kaufmann, Elias A. T. Koch, Frédéric Toussaint, Michael Erdmann, Carola Berking, and Markus V. Heppt. "A Critical Appraisal of Evidence- and Consensus-Based Guidelines for Actinic Keratosis." Current Oncology 28, no. 1 (February 19, 2021): 950–60. http://dx.doi.org/10.3390/curroncol28010093.
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Actinic keratoses (AK) are common lesions of the skin that can be effectively treated with several lesion- and field-directed treatments. Clinical practice guidelines assist physicians in choosing the appropriate treatment options for their patients. Here, we aimed to systematically identify and evaluate the methodological quality of currently available guidelines for AK. Guidelines published within the last 5 years were identified in a systematic search of guideline databases, Medline and Embase. Then, six independent reviewers evaluated the methodological quality using the tools “Appraisal of Guidelines for Research and Evaluation” (AGREE II) and “Recommendation EXcellence” (AGREE-REX). The Kruskal–Wallis (H) test was used to explore differences among subgroups and Spearman’s correlation to examine the relationship between individual domains. Three guidelines developed by consortia from Canada, Germany and the United Kingdom were eligible for the evaluation. The German guideline achieved the highest scores, fulfilling 65 to 92% of the criteria in AGREE II and 67 to 84% in AGREE-REX, whereas the Canadian guideline scored 31 to 71% of the criteria in AGREE II and 33 to 46% in AGREE-REX. The domains “stakeholder involvement“ and “values and preferences“ were identified as methodological weaknesses requiring particular attention and improvement in future guideline efforts.
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Coleman, D. A. "Replacement migration, or why everyone is going to have to live in Korea: a fable for our times from the United Nations." Philosophical Transactions of the Royal Society of London. Series B: Biological Sciences 357, no. 1420 (April 29, 2002): 583–98. http://dx.doi.org/10.1098/rstb.2001.1034.
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This paper considers international migration in the context of population ageing. In many Western countries, the search for appropriate responses to manage future population ageing and population decline has directed attention to international migration. It seems reasonable to believe that international migrants, mostly of young working age, can supply population deficits created by low birth rates, protect European society and economy from the economic costs of elderly dependency, and provide a workforce to care for the elderly. Particular prominence has been given to this option through the publicity attendant on a report from the UN Population Division in 2000 on ‘replacement migration’, which has been widely reported and widely misunderstood. Although immigration can prevent population decline, it is already well known that it can only prevent population ageing at unprecedented, unsustainable and increasing levels of inflow, which would generate rapid population growth and eventually displace the original population from its majority position. This paper reviews these arguments in the context of the causes and inevitability of population ageing, with examples mostly based on UK data. It discusses various options available in response to population ageing through workforce, productivity, pensions reform and other means. It concludes that there can be no ‘solution’ to population ageing, which is to a considerable degree unavoidable. However, if the demographic regime of the United Kingdom continues to be relatively benign, future population ageing can be managed with tolerable inconvenience without recourse to increased immigration for ‘demographic’ purposes. At present (2001), net immigration to the United Kingdom is already running at record levels and is now the main engine behind UK population and household growth. By itself, population stabilization, or even mild reduction, is probably to be welcomed in the United Kingdom, although the issue has attracted little attention since the 1970s.
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Lim, Sungho, Pegge M. Halandras, Carlos Bechara, Bernadette Aulivola, and Paul Crisostomo. "Contemporary Management of Acute Mesenteric Ischemia in the Endovascular Era." Vascular and Endovascular Surgery 53, no. 1 (October 25, 2018): 42–50. http://dx.doi.org/10.1177/1538574418805228.
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Objective: Acute mesenteric ischemia is a rare disease entity associated with high morbidity and mortality. Disparate etiologies and nonspecific symptoms make the diagnosis challenging and often result in delayed diagnosis and intervention. Open laparotomy with mesenteric revascularization and resection of necrotic bowel has been considered the gold standard of care. With recent advances in percutaneous catheter-directed techniques, multiple retrospective studies have demonstrated the outcomes of endovascular therapy. Herein, we review the etiology, presentation, and diagnosis of acute mesenteric ischemia with contemporary outcomes associated with both open and endovascular treatments. Methods: The PubMed electronic database was queried in the English language using the search words mesenteric, acute ischemia, embolism, thromboembolism, thrombosis, revascularization, and endovascular in various combinations. Abstracts of the relevant titles were examined to confirm their relevance and the full articles then extracted. References from extracted articles were checked for any additional relevant articles. This systematic review encompassed literature for the past 5 years (between 2011 and 2016). Results: Early diagnosis and intervention improves acute mesenteric ischemia outcomes. Early restoration of mesenteric flow minimizes morbidity and mortality. In comparison to open laparotomy with mesenteric revascularization and resection of necrotic bowel, several retrospective studies using administrative data and single-center chart reviews demonstrate noninferior outcomes of an endovascular first approach in acute arterial mesenteric occlusion. Conclusions: For acute mesenteric arterial occlusive disease, both endovascular and open revascularization techniques are viable options. Although there is lack of level 1 evidence, single-center retrospective studies and administrative database studies demonstrated that an endovascular first approach may have improved outcomes in the immediate postoperative period. However, selection and other bias in these studies necessitate the need for definitive randomized prospective studies between endovascular and open mesenteric intervention. In contrast, mesenteric venous thrombosis may be treated with systemic anticoagulation without surgical revascularization. Catheter-directed thrombectomy and thrombolysis can be considered at the discretion of the clinician.
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Findling, James W., and Hershel Raff. "Cushing’s Syndrome: Important Issues in Diagnosis and Management." Journal of Clinical Endocrinology & Metabolism 91, no. 10 (October 1, 2006): 3746–53. http://dx.doi.org/10.1210/jc.2006-0997.
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Abstract Context: The diagnosis, differential diagnosis, and treatment of Cushing’s syndrome are challenging problems in clinical endocrinology. We focus on critical questions addressing screening for Cushing’s syndrome, differentiation of Cushing’s subtypes, and treatment options. Evidence Acquisition: Ovid’s MEDLINE (1996 through April 2006) was used to search the general literature. We also relied on previously published reviews and a recent monograph and cite a mix of primary articles and recent reviews. Evidence Synthesis: Although this article represents our opinion, it draws heavily on a recent consensus statement from experts in the field and a recent monograph on Cushing’s syndrome. Conclusions: We concluded that: 1) measurement of late-night or bedtime salivary cortisol is a useful approach to screen for Cushing’s syndrome; 2) measurement of suppressed plasma ACTH by immunometric assay is useful to differentiate ACTH-dependent and -independent Cushing’s syndrome; 3) inferior petrosal sinus sampling for ACTH should be performed in patients with ACTH-dependent hypercortisolism in whom a pituitary magnetic resonance imaging is normal or equivocal (in the absence of a pituitary ACTH gradient, prolactin levels should be measured to confirm the integrity of venous sampling); 4) computed tomography of the chest and abdomen and somatostatin receptor scintigraphy should be performed in patients with the occult ectopic ACTH syndrome; and 5) patients with Cushing’s disease should be referred to a neurosurgeon with extensive experience operating on corticotroph microadenomas. Bilateral laparoscopic adrenalectomy should be considered in patients with Cushing’s disease who fail therapies directed at the pituitary.
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Herranz, Pedro, Colin Morton, Thomas Dirschka, Rosario Rodríguez Azeredo, and Rodrigo Roldán-Marín. "Low-Dose 0.5% 5-Fluorouracil/10% Salicylic Acid Topical Solution in the Treatment of Actinic Keratoses." Journal of Cutaneous Medicine and Surgery 20, no. 6 (July 26, 2016): 555–61. http://dx.doi.org/10.1177/1203475416659259.
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Background: Actinic keratosis (AK) lesions have the potential to develop into invasive squamous cell carcinomas (SCCs), and approaches to treatment are evolving to try to reduce the burden of SCC. Objective: To present the published clinical research surrounding the use of 0.5% 5-fluorouracil with 10% salicylic acid (low-dose 5-FU/SA) for the treatment of hyperkeratotic AKs. Method: A review of published clinical evidence for low-dose 5-FU/SA for the treatment of AKs. The articles were selected following a MEDLINE database search of the combined terms fluorouracil, salicylic acid and actinic keratosis which represent the peer review publications of clinical studies that primarily investigate the use of Actikerall in AK. Results: Combining low-dose 5-FU with keratolytic SA is associated with high rates of histologic clearance, reduction in lesion number/area, and sustained clinical response in clinical study and the clinical practice setting. Low-dose 5-FU/SA has also been evaluated using imaging to detect the progression of subclinical AK lesions through a course of the field-directed treatment. Conclusion: Low-dose 5-FU/SA is an effective and well-tolerated treatment option licensed for the lesion-directed treatment of mild-to-moderate hyperkeratotic AK lesions.
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Schuurman, Donna L. "Literature for Adults to Assist Them in Helping Bereaved Children." OMEGA - Journal of Death and Dying 48, no. 4 (June 2004): 415–24. http://dx.doi.org/10.2190/ya5m-xffg-lrrf-24c3.
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The assignment sounded simple enough: “Describe, analyze, and evaluate literature available for adults to help them in their efforts to assist bereaved children.” Plodding into it, however, proved daunting. A Google search yielded 143,000 matches for “bereaved children” and 283,000 for “grieving children.” Reviews of death-related catalogs and books available through Amazon.com unveiled a dizzying array of options. Clearly, boundaries would need to be set. Having been instructed to include only written publications and not videos, DVDs, or other media, this is the question I opted to address: What are the “Top 20” publications for a professional wanting to start a library of written resources directed at adults who help grieving children? In my search, I enlisted the input of over 200 professionals and para-professionals in the field, in person (at the 7th Annual Children's Grief Symposium in San Antonio, Texas; among my colleagues at The Dougy Center, with a collective 40 years of work with bereaved children), and by e-mail (to selected members of the Association for Death Education and Counseling, and a gathering of Women in Thanatology). I filtered through their recommendations, and landed on the 20 listed here. I also decided to focus on two reading populations: professionals and parents. In so doing, I asked myself the following questions: What kinds of publications ought a person in a professional helping role, whether a psychologist, aftercare provider, counselor, therapist, or educator, be minimally familiar with to better assist bereaved children? And, what resources might those professionals recommend to individuals who are parenting children grieving a loss through death? You will note that I have excluded publications solely geared to classroom teachers or the school environment, not because they aren't important or voluminous, but because that topic is a full article in itself, and outside the scope of my assignment. Another qualifier: with the exceptions of co-editors, I chose to limit an author to one selection in order to broaden the range of topics and contributors. Caveat emptor!
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Umeria, Rishi, Oliver Mowforth, Ben Grodzinski, Zahabiya Karimi, Iwan Sadler, Helen Wood, Irina Sangeorzan, et al. "A scoping review of information provided within degenerative cervical myelopathy education resources: Towards enhancing shared decision making." PLOS ONE 17, no. 5 (May 19, 2022): e0268220. http://dx.doi.org/10.1371/journal.pone.0268220.
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Background Degenerative cervical myelopathy (DCM) is a chronic neurological condition estimated to affect 1 in 50 adults. Due to its diverse impact, trajectory and management options, patient-centred care and shared decision making are essential. In this scoping review, we aim to explore whether information needs in DCM are currently being met in available DCM educational resources. This forms part of a larger Myelopathy.org project to promote shared decision making in DCM. Methods A search was completed encompassing MEDLINE, Embase and grey literature. Resources relevant to DCM were compiled for analysis. Resources were grouped into 5 information types: scientific literature, videos, organisations, health education websites and patient information leaflets. Resources were then further arranged into a hierarchical framework of domains and subdomains, formed through inductive analysis. Frequency statistics were employed to capture relative popularity as a surrogate marker of potential significance. Results Of 2674 resources, 150 information resources addressing DCM were identified: 115 scientific literature resources, 28 videos, 5 resources from health organisations and 2 resources from health education websites. Surgical management was the domain with the largest number of resources (66.7%, 100/150). The domain with the second largest number of resources was clinical presentation and natural history (28.7%, 43/150). Most resources (83.3%, 125/150) were designed for professionals. A minority (11.3% 17/150) were written for a lay audience or for a combined audience (3.3%, 5/150). Conclusion Educational resources for DCM are largely directed at professionals and focus on surgical management. This is at odds with the needs of stakeholders in a lifelong condition that is often managed without surgery, highlighting an unmet educational need.
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John, Sonia, Mohammed Abdul Muqeet Adnan, Mohammad O. Khalil, George Selby, Adam S. Asch, Mohamad Cherry, and Mohamad Khawandanah. "Mediastinal Germ Cell Tumor and Acute Megakaryoblastic Leukemia– a Systematic Review of Cases Reported in the Literature." Blood 124, no. 21 (December 6, 2014): 3694. http://dx.doi.org/10.1182/blood.v124.21.3694.3694.
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Abstract Background and Aim: The association of mediastinal germ cell tumors and acute megakaryoblastic leukemia has been known for many years. Characterization of this association is not well reported systematically in the literature. We hereby present this systematic review to describe the salient features of this association, treatment options and overall prognosis. Material and Methods: A systematic review of PUBMED, Medline and EMBASE databases via OVID engine was conducted to search for primary articles and case reports under keywords “germ cell tumors” and “acute myeloid leukemia”. Search was extensive from 1946 to 2014; all the cases that were written in English language in pediatric and adult patients were included. The search yielded 679 results and was individually examined by two authors. All the studies that described acute lymphoblastic leukemia or other malignancies aside from AML were excluded. A total of 25 studies reported mediastinal germ cell tumors (MGCT) and acute megakaryoblastic leukemia (M7). We also included in this analysis, one additional case with mediastinal germ cell tumor with subsequent development of acute megakaryoblastic leukemia that was recently diagnosed and treated at our institution. Results: After our extensive review of the literature a total of 25 previous patients with MGCT + M7 were found from 1946-2014. With the inclusion of our case we report a total of 26 cases from 1946-2014.Twenty of the included patients were males and in 6 cases there was no mention of the gender. Median age at diagnosis of MGCT was 23 years (range - 15 to 36 y). In 92 % of cases the germ cell tumor was of non-seminomatous origin with 27% cases reporting teratoma and 40.7 % of cases reporting embryonal carcinoma. All the reported cases were stage III and had elevated tumor markers with significant elevation in serum AFP compared to beta-HCG. MGCT occurred prior to appearance of leukemia in 46% of cases and concomitantly in 30% of cases. The rest of the cases did not describe the sequence of disease occurrence. M7 leukemia was never reported prior to the appearance of GCT. All the patients were treated with platinum based chemotherapy which was primarily directed towards management of the germ cell tumors. The time from diagnosis of MGCT to development of M7 leukemia ranged from 9 weeks to 39 months with the median time being 4 months. Median time to death from the initial diagnosis of NSGCT was 6 months (range - 3 to 39 months). Only one reported case with MGCT+M7 combination was successfully treated with an allogenic stem cell transplant for the M7 leukemia with surgical resection of the mediastinal mass. Among the cases that reported cytogenetic abnormalities, trisomy 8 and complex cytogenetics were reported in 18.6 % cases each and hyperdiploidy was reported in 22 % cases. Surprisingly, Klinefelters syndrome (47, XXY) that is historically associated in 20 % of cases of mediastinal germ cell tumors was only reported in one case in this review. The i(12p) abnormality was reported only in 14.8 % of cases. Conclusion: Patients with history of mediastinal germ cell tumors are at higher risk of developing acute leukemia especially the megakaryoblastic subtype. This warrants long term follow up of such patients with regular monitoring of blood counts and a high degree of suspicion for hematological malignancies. In selected cases, allogeneic stem cell transplant may be considered in those who achieve leukemia remission after optimal surgical resection. In spite of the advances in chemotherapeutic options, the overall outcome in patients with mediastinal germ cell tumors who have acute megakaryoblastic leukemia remains poor. Disclosures No relevant conflicts of interest to declare.
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Zotova, I. I., and S. V. Gritsaev. "Pathogenetic justification for the therapy of idiopathic thrombocytopenic purpura (primary immune thrombocytopenia) in adults." Kazan medical journal 99, no. 2 (April 15, 2018): 279–86. http://dx.doi.org/10.17816/kmj2018-279.
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The review presents current data on key mechanisms of the pathogenesis of idiopathic thrombocytopenic purpura and comparative characteristics of main therapy methods. In recent years, the interest in studying this long known disease has significantly increased, and basic approaches to diagnosis and treatment have been revised. Recognition of the importance of immune-mediated mechanism of development of this disease led to the replacement of the term used for many years «idiopathic thrombocytopenic purpura» to «immune thrombocytopenia». Moreover, development of hemorrhagic manifestations (purpura) is known to be characteristic not for all patients. The basis for the disease development is imbalance between the process of platelet production and destruction, as reflected in decrease of platelet production and increase of their elimination. Conventional treatment methods such as corticosteroids and splenectomy are directed at the suppression of a complex of cell interactions that lead to increased platelet destruction. Modern therapy for idiopathic thrombocytopenic purpura - thrombopoietin receptor agonists, on the contrary, stimulate the platelet production and are recommended for the use when loss or lack of response to previous therapy are observed. Most likely the efficacy of these drugs in resistant idiopathic thrombocytopenic purpura is associated with a fundamentally different, alternative mechanism of action. The idiopathic thrombocytopenic purpura group of patients is heterogeneous both in the character of the disease course and possible response to treatment. A limited number of clinical trials of some treatment methods for idiopathic thrombocytopenic purpura and differing criteria for assessing the response to therapy complicate their direct comparison. The imperfection of certain treatment options, due to development of adverse events, and unpredictability of response to treatment necessitate the search for new approaches to the selection of the optimal variant of treatment of idiopathic thrombocytopenic purpura taking into account the individual characteristics of patients.
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Andrews, Carlota O., and Mary Lea Gora. "Pleural Effusions: Pathophysiology and Management." Annals of Pharmacotherapy 28, no. 7-8 (July 1994): 894–903. http://dx.doi.org/10.1177/106002809402800715.
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OBJECTIVE: To review the pathophysiology and management of pleural effusions, including available agents for pleural sclerosis. DATA SOURCES: A MEDLINE search (1966 to present) was performed that included clinical studies in the English language involving the pathophysiology and management of pleural effusions; references used in those articles were screened for additional published information. STUDY SELECTION: All clinical trials were considered for potential inclusion in the review. DATA SYNTHESIS: Pleural effusion is an accumulation of fluid in the pleural space that results when homeostatic forces that control the flow into and out of the area are disrupted. The management of transudative pleural effusions is primarily directed at treatment of the underlying disease. There are several treatment options for pleural effusions, including chemical pleurodesis. Many of the trials that examine the use of talc, bleomycin, and doxycycline have poorly described study designs and end points, with inconsistent evaluation of patients. Each agent is considered to be generally effective and safe, with fever and pain as the most frequently reported adverse effects. The use of talc requires sterilization, and many clinicians use general anesthesia with instillation, which increases the risk associated with the procedure. Bleomycin is generally safe; however, it should not be used in doses exceeding 40 mg/m2. Only uncontrolled trials support the use of doxycycline; however, it provides an effective, safe, and relatively inexpensive alternative. CONCLUSIONS: Pleural effusions are defined as an accumulation of fluid in the pleural space. Treatment is generally palliative. Intrapleural administration of talc, bleomycin, and doxycycline are effective sclerosing agents for treatment of recurrent, symptomatic pleural effusions. Although the most cost-effective agent has not been determined, doxycycline is an inexpensive alternative to bleomycin, and may have fewer adverse effects than talc.
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Han, Esther, Laura Nguyen, Larry Sirls, and Kenneth Peters. "Current best practice management of interstitial cystitis/bladder pain syndrome." Therapeutic Advances in Urology 10, no. 7 (March 19, 2018): 197–211. http://dx.doi.org/10.1177/1756287218761574.
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Introduction: Over the last 100 years, the terminology and diagnosis criteria for interstitial cystitis have evolved. Many therapeutic options have changed, but others have endured. This article will review the idea of separating ‘classic’ Hunner lesion interstitial cystitis (HL IC) from non-Hunner lesion interstitial cystitis and bladder pain syndrome (N-HL IC/BPS) and their respective treatment algorithms. Methods/Results: A literature search was performed to identify articles and research on HL IC and N-HL IC/BPS including definitions, etiological theories, and treatments. This article is an overview of the existing literature. We also offer insight into how HL IC and N-HL IC/BPS are approached at our tertiary referral center. Additionally, American Urological Association guidelines have been integrated and newer treatment modalities and research will be introduced at the conclusion. Conclusion: The AUA guidelines have mapped out a stepwise fashion to treat IC/BPS; at our institution we separate patients with HL IC from those with N-HL IC/BPS prior to them entering a treatment pathway. We identify the rarer patient with HL as having classic ‘IC’; this cystoscopic finding is critical in guiding treatment. We believe HL IC is a distinct disease from N-HL IC/BPS and therapy should focus on the bladder. The vast majority of patients with N-HL IC/BPS need management of their pelvic floor muscles as the primary therapy, complemented by bladder-directed therapies as needed as well as a multidisciplinary team to manage a variety of other regional/systemic symptoms. Ongoing research into IC/BPS will help us better understand the pathophysiology and phenotypes of this complex disease while exciting and novel research studies are developing promising treatments.
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Zhang, Mingwei, Weipeng Jing, Jingbo Lin, Nengzhen Fang, Wei Wei, Marcin Woźniak, and Robertas Damaševičius. "NAS-HRIS: Automatic Design and Architecture Search of Neural Network for Semantic Segmentation in Remote Sensing Images." Sensors 20, no. 18 (September 16, 2020): 5292. http://dx.doi.org/10.3390/s20185292.
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The segmentation of high-resolution (HR) remote sensing images is very important in modern society, especially in the fields of industry, agriculture and urban modelling. Through the neural network, the machine can effectively and accurately extract the surface feature information. However, using the traditional deep learning methods requires plentiful efforts in order to find a robust architecture. In this paper, we introduce a neural network architecture search (NAS) method, called NAS-HRIS, which can automatically search neural network architecture on the dataset. The proposed method embeds a directed acyclic graph (DAG) into the search space and designs the differentiable searching process, which enables it to learn an end-to-end searching rule by using gradient descent optimization. It uses the Gumbel-Max trick to provide an efficient way when drawing samples from a non-continuous probability distribution, and it improves the efficiency of searching and reduces the memory consumption. Compared with other NAS, NAS-HRIS consumes less GPU memory without reducing the accuracy, which corresponds to a large amount of HR remote sensing imagery data. We have carried out experiments on the WHUBuilding dataset and achieved 90.44% MIoU. In order to fully demonstrate the feasibility of the method, we made a new urban Beijing Building dataset, and conducted experiments on satellite images and non-single source images, achieving better results than SegNet, U-Net and Deeplab v3+ models, while the computational complexity of our network architecture is much smaller.
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Gandhi, S., G. G. Fletcher, A. Eisen, M. Mates, O. C. Freedman, S. F. Dent, and M. E. Trudeau. "Adjuvant chemotherapy for early female breast cancer: A systematic review of the evidence for the 2014 Cancer Care Ontario systemic therapy guideline." Current Oncology 22 (December 18, 2014): 82. http://dx.doi.org/10.3747/co.22.2321.
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BackgroundThe Program in Evidence-Based Care (PEBC) of Cancer Care Ontario (CCO) has recently created an evidence-based consensus guideline on the systemic treatment of early breast cancer. The evidence for this guideline was compiled using a systematic review to answer the question: “What is the optimal systemic therapy for patients with early-stage, operable breast cancer, when patient and disease factors are considered?” This question was addressed in three parts: cytotoxic chemotherapy, endocrine treatment, and human epidermal growth factor receptor 2 (HER2) directed therapy.MethodsA systematic review was performed using the MEDLINE and EMBASE databases for the period January 2008 to May 2014. The SAGE Directory of Cancer Guidelines and websites of major oncology guideline organizations were also searched. The basic search terms were “breast cancer” and “systemic therapy” (chemotherapy, endocrine therapy, targeted agents, ovarian suppression), and was limited to randomized controlled trials (RCTs), guidelines, systematic reviews, and meta-analyses. ResultsSeveral hundred documents were retrieved that met the inclusion criteria; the Early Breast Cancer Trialists Collaborative Group (EBCTCG) meta-analyses encompassed many of the RCTs found. Several additional studies which met the inclusion criteria were included, as well as other guidelines and systematic reviews. Chemotherapy was largely reviewed as three classes of agents: anti-metabolite based regimens (e.g., CMF), anthracyclines, and taxane-based regimens. Single-agent chemotherapy in general is not recommended for the adjuvant treatment of breast cancer in any patient population. Anthracycline and taxane-based polychemotherapy regimens are overall considered superior to earlier generation regimens, with the most significant impact on patient survival outcomes. Various regimens with disparate anthracycline and taxane doses and schedules are options; in general, paclitaxel given every 3 weeks is inferior. Evidence does not support the use of bevacizumab in the adjuvant setting; other systemic therapy agents such as metformin and vaccines remain under investigation. Adjuvant bisphosphonates for menopausal women will be discussed in later work. ConclusionThe results of this systematic review represent a comprehensive compilation of high-level evidence which was the basis for the 2014 PEBC CCO guideline on systemic therapy for early breast cancer. The use of cytotoxic chemotherapy is presented here; the results addressing endocrine therapy and HER-2 targeted treatment, as well as the final clinical practice recommendations, are published separately in this issue.
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Mardegan, José Carlos, and Brigida Maria Nogueira Cervantes. "Sistema de registro de termos: proposta de contribuição à pesquisa terminológica temática." RDBCI: Revista Digital de Biblioteconomia e Ciência da Informação 13, no. 1 (January 30, 2015): 81. http://dx.doi.org/10.20396/rdbci.v13i1.1582.
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A pesquisa terminológica temática é o ponto de partida para a criação de vocabulários controlados. Apresenta uma proposta de construção de um sistema de registro de termos com base em um banco de dados relacional para automatizar algumas das etapas da pesquisa terminológica temática. Para concretizar essa experiência foi necessária a elaboração de uma pesquisa terminológica temática que serviu de teste para a ferramenta proposta. Este estudo tem natureza exploratória, e o corpus da coleta foi composto por vinte duas referências, incluindo os dicionários e glossários usados na validação dos termos. A fundamentação teórica foi direcionada à compreensão dos conceitos capazes de explicar os pressupostos teóricos envolvidos tanto na pesquisa terminológica temática quanto na construção do sistema de registro de termos. Cento e onze termos foram extraídos do corpus da coleta durante a pesquisa terminológica temática, obtendo-se um índice de validação de 72% número considerado relevante no contexto geral. O sistema de registro de termos demonstrou-se eficiente apresentando soluções de recuperação dos termos cadastrados em várias opções de buscas e emissão de relatórios. O estudo enunciou, ainda, procedimento visando à continuidade do projeto com a criação de outros mecanismos para a manutenção da base de dados, disponibilizando-a, inclusive, para a comunidade em geral por meio da internet.AbstractThematic terminology searches are the starting point for the creation of controlled vocabularies. To introduce a construction method for the recording system terms with grounds in a relational database to automate some steps of the thematic terminology search. To materialize this experiment it was necessary to elaborate thematic terminology searches that served as a trial to the proposed tool. This study has an exploratory nature, and the collection corpus was composed of twenty-two references, including dictionaries and glossaries used for the terms validation. The theoretical grounding was directed towards the understanding of concepts able to explain the theoretical assumptions involved in both thematic terminology searches and also in the construction of recording system terms. A hundred and eleven terms were extracted from the collection corpus during the thematic terminology research obtaining a validation figure of around 72% a relevant number in the global context. The recording system terms were shown to be efficient at presenting recovered solutions of recorded terms in various search options and report emissions. The study even found a process that enhanced the continuity of the project with the creation of other mechanisms for maintaining the database, and making it available to the general public via the Internet.KeywordsControlled vocabulary; Registration System terms; thematic terminology Research.
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Kelly, Michael J., Thomas A. Trikalinos, D. Matthew Gianferante, and Susan K. Parsons. "Cranial Irradiation for Pediatric T-Lineage Acute Lymphoblastic Leukemia: A Systematic Review and Meta-Analysis." Blood 120, no. 21 (November 16, 2012): 2580. http://dx.doi.org/10.1182/blood.v120.21.2580.2580.
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Abstract Abstract 2580 Background There is currently a heterogeneous approach to the use of cranial irradiation (CRT) for central nervous system (CNS) directed therapy for T-lineage acute lymphoblastic leukemia (T-ALL) by pediatric cooperative groups. We sought to explore the association of CRT and event-free survival (EFS) in children with T-ALL by means of a systematic review and meta-analysis. Methods We searched MEDLINE from 1949 to 2012 without geographic restrictions, to identify English language randomized trials or cohort studies reporting EFS in children with T-ALL who received CNS directed therapy. For studies to be eligible a CRT strategy needed to be described (intrathecal chemotherapy +/− cranial irradiation) and at least 3-year EFS (or longer) needed to be reported. Studies need to include at least 10 pediatric subjects with T-ALL; there was not a minimum proportion of T-ALL subjects needed to meet eligibility criteria. The following study characteristics were extracted for each study: eligibility criteria, patient number, CRT strategy, intrathecal chemotherapy administered and number of doses, steroid administered in induction, cumulative doses of high-dose methotrexate, asparaginase, and anthracyclines, definition of event-free survival, median follow-up, and event-free survival. We conducted subgroup analyses (random effects) and random effects meta-regressions to explore associations between EFS and the following study-level factors: (i) CRT strategy, categorized as cranial irradiation for all subjects, cranial irradiation administered in a risk-directed fashion (often stratified by age and WBC count at diagnosis), cranial irradiation for CNS positive patients only, and omission of CRT for all patients; (ii) enrollment year (continuous); (iii) intrathecal chemotherapy (methotrexate vs. triple intrathecal chemotherapy); (iv) maximum number of intrathecal chemotherapy dose (<10 vs. 10–19 vs. > 20); (v) high-dose methotrexate (dose > 1 gram/m2) present or absent; (vi) high cumulative dose of asparaginase (> 400,000 IU/m2) present or absent, (vii) high cumulative dose of anthracyclines (doxorubicin plus daunorubicin total > 300 mg/m2)present or absent; (viii) induction steroid (prednisone vs. dexamethasone). Results The search returned 2383 abstracts, 491 of which were reviewed in full text. Eligible were 59 articles (5726 T-ALL patients enrolled between 1973 and 2005). The overall 3-year EFS was 62.1% (95% CI: 58.9% to 65.3%). There was significant heterogeneity among the treatment studies (I2̂ = 80%, p < 0.001). An improvement in EFS was significantly associated with the year study enrollment began (p< 0.001); based on a meta-regression model of EFS versus year of enrollment start, the average EFS improved from 44% for studies that began in 1980 to 71% for studies that began in 2000. The EFS was significantly different across the 4 CRT categories (omnibus p-value=0.02): CRT to all patients (EFS: 63%, 95% CI: 58% to 67%) risk-directed CRT (EFS: 59%, 95% CI: 53% to 65%), CRT for CNS positive patients only (EFS: 55%, 95% CI: 41% to 68%), CRT omitted for all patients (EFS: 74%, 95% CI: 67% to 80%). The association of EFS and CRT strategies remained in the same direction after adjusting for year of enrollment. The following factors were also associated with an increased odds of EFS on univariate analysis: the administration of 10–19 or > 20 doses of intrathecal chemotherapy (OR: 1.84, 95% CI: 1.32 to 2.58 and OR: 1.95, 95% CI: 1.31 to 2.94, respectively), the administration of high dose methotrexate (OR: 1.43, 95% CI: 1.06 to 1.93), and the administration of more than 400,000 IU/m2 of asparaginase (OR: 1.79, 95% CI: 1.27 to 2.51). However after adjusting for the year of enrollment, only high doses of asparaginase remained significantly associated with EFS. Conclusion Our systematic review and meta-analysis found that CRT strategy is associated with EFS for children with T-ALL. Studies that omitted CRT were associated with superior EFS; however, these studies were more recent, and there was an improvement in EFS with time. The administration of more than 400,000 IU/m2 of asparaginase was also associated with lower relapse rates. Although these noncausal associations are congruent with the notion that CRT may not offer an improvement in survival for children with T-ALL given current chemotherapeutic options, the existing evidence-based is not sufficient to draw such a conclusion. Disclosures: Off Label Use: asparaginase is a a drug used to treat acute lymphoblastic leukemia.
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Patel, Amit, and Yeong Jer Lim. "Long-Term Safety and Efficacy of Autologous or Allogeneic Donor Stem Cell Transplantation in Patients with Behçet's Syndrome." Blood 132, Supplement 1 (November 29, 2018): 3444. http://dx.doi.org/10.1182/blood-2018-99-115815.
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Abstract Background. Behçet's disease (BD) or syndrome is a rare chronic multisystem inflammatory condition with most manifestations attributed to vasculitis, including ulceration, skin lesions, with joint and other organ involvement. The poorest prognosis is reported in a small subgroup of BD patients with vascular, neurological, ocular, and gastrointestinal (GI) manifestations. The main aims of treatment are to suppress inflammatory exacerbations and recurrences, to prevent irreversible organ damage.1 There are few trial data supporting treatment options because of disease rarity and clinical heterogeneity. There are no previous or current clinical trials of hematopoietic stem cell transplantation (SCT) for BD, with only a few individual reported cases. Objective. To assess the safety and efficacy of SCT with the research question: "what is the overall survival and progression free survival (PFS) of patients with BD post autologous SCT (autoSCT) and allogeneic SCT (alloSCT), including those with the primary indication of refractory disease". Design. Systematic review of reported cases, with updated data for 4 patients treated at our centre in Liverpool, UK. Data sources: PubMed, PubMed Central, Web of Science, OvidSP, Cochrane central register of controlled trials (CENTRAL), clinicaltrials.gov, eudract.ema.europa.eu, controlled-trials.com, free Google search, relevant conference proceedings, hand searching of reference lists, and contact with authors as necessary. Search terms were "behcet" and "transplant". The search was last updated on 31 July 2018. Eligibility criteria. Cases of BD treated with autoSCT or alloSCT with available information on survival and PFS. Data extraction. Two reviewers independently assessed articles for inclusion, extracted data to assess patients, interventions, comparisons, and outcomes. Primary outcome measures. PFS and overall survival. Results. 32 patients with BD were reported in 25 identified articles, from Europe (47%), Asia (47%), and North America (6%). Median age was 36 years (range 6-60 years old), with 53% females, and 75% had had poor prognosis BD manifestations including vascular, neurological, ocular, and GI. Median time from BD diagnosis to SCT was 48 months (range 3-132), with a median of 3 (range 0-8) prior lines of BD-directed immune therapy.1 The primary indication for SCT was refractory BD in 41% of patients, and 59% of SCTs were primarily for other hematology indications. AlloSCT accounted for 59% of BD patients, the rest being autoSCT. Overall survival was 97% (Fig 1), after a median follow up of 31 months (range 0.2-135 months), with no difference between SCT types (p=0.36). The only death was from infection and sepsis prior to engraftment post alloSCT. ORR was 93%, and PFS was 112 months (95% CI 94-130) (Fig 2), with no difference by SCT donor types (p=0.46). Refractory BD was the main indication for autoSCT in 85%, and myeloma accounting for the remainder. Reported autoSCT conditioning regimens included melphalan 140-200 mg/m2 (54%), carmustine/etoposide/cytarabine/melphalan (BEAM) (23%), and cyclophosphamide combinations (23%), with 46% incorporating additional anti-thymocyte globulin (ATG). OOR was 92%, with complete remission (CR) achieved in 62%, partial remission (PR) in 31%, and stable disease (SD) in 8%. Refractory BD was the main indication for 11% of alloSCTs, and 5% had relapsed post autoSCT. Other hematology primary indications accounted for 89% of alloSCTs, with 69% for MDS, 11% AML, and 11% aplastic anemia. Trisomy 8 was recorded in 59%. Myeloablative conditioning was reported in 58%, with 26% using total body irradiation (TBI). OOR was 94%, with CR accounting of 84%. Acute or chronic graft versus host disease (GvHD) requiring therapy was poorly reported and lower than expected at 32%, with grade III-IV acute GvHD of 11%. Conclusion. SCT in BD appears to be safe and effective, with no clear difference in long-term survival or PFS by SCT type. AutoSCT is a beneficial treatment option for refractory BD. AlloSCT is also advantageous in BD, with less data in the refractory BD or post autoSCT salvage settings. Given the lack of a clinical trial, we present the most comprehensive evidence available supporting the practice changing role of SCT as a treatment option in BD. References. 1. Hatemi G, et al. 2018 update of the EULAR recommendations for the management of Behçet's syndrome. Annals of the Rheumatic Diseases 2018;77:808-18. Disclosures No relevant conflicts of interest to declare.
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Camera, Gabriele, and Jaehong Kim. "Dynamic directed search." Economic Theory 62, no. 1-2 (March 29, 2015): 131–54. http://dx.doi.org/10.1007/s00199-015-0872-0.
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Rosero Salazar, Doris Haydee, Mario Alejandro Ortiz Salazar, and Liliana Salazar Monsalve. "Miocardiocitos conducentes ventriculares." Universidad y Salud 17, no. 2 (April 26, 2015): 262. http://dx.doi.org/10.22267/rus.151702.10.
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Resumen Objetivo: Exponer las características histológicas y funcionales que se presentan en el tejido muscular estriado cardíaco especializado en la conducción del estímulo eléctrico y sus implicaciones actuales en las arritmias cardíacas. Materiales y métodos: Se seleccionaron publicaciones en revistas indexadas en las bases PubMed, Wiley, Ovid-Medline y Science Direct. Los descriptores MESH utilizados para la búsqueda fueron cardiac myocytes, myocardium, heart conduction system. Se acoplaron los conceptos histology y arrhythmia. Se revisaron artículos publicados entre 1990 a 2014, originales, reportes de caso y revisiones, relacionados con los conceptos de desarrollo embrionario, diferenciación celular, morfología normal y alteración de los miocardiocitos conducentes ventriculares. Se revisó el resumen de 317 artículos, de los que se clasificaron 75 para lectura completa y de estos, 52 se seleccionaron para la redacción del presente artículo. Conclusión: Los estudios actuales se encaminan hacia las simulaciones del sistema de conducción para establecer otras causas de arritmia y opciones de tratamiento. La terapia con células indiferenciadas y las técnicas moleculares de modificación genética hacen parte de estos estudios, así como la implementación de terapias alternativas no invasivas en el tratamiento de las arritmias cardíacas.Abstract Objective: To expose the histological and functional characteristics that occur in heart striated muscle tissue specialized in the conduction of electrical stimulation and its current implications for cardiac arrhythmias. Materials and methods: Publications in indexed journals in PubMed, Wiley, Ovid-Medline and Science Direct databases were selected. The MESH descriptors used for the search were cardiac myocytes, myocardium and heart conduction system. The concepts of histology and arrhythmia were mated. Articles published from 1990 to 2014 were reviewed as well as the original ones, case reports and reviews related to the concepts of embryonic development, cell differentiation and normal morphology alteration of the leading ventricular cardiomyocytes. The summary of 317 articles were read, from which 75 were classified to complete reading and finally 52 were selected for the drafting of this article. Conclusion: Current studies are directed towards the driving system simulation to establish other causes of arrhythmia and its treatment options. Not only therapies with undifferentiated cells and molecular genetic modification techniques are part of these studies but also the implementation of alternative therapies that are not invasive in the treatment of cardiac arrhythmias.
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Hasan, Mohammed Zaki, and Hussain Al-Rizzo. "Beamforming Optimization in Internet of Things Applications Using Robust Swarm Algorithm in Conjunction with Connectable and Collaborative Sensors." Sensors 20, no. 7 (April 6, 2020): 2048. http://dx.doi.org/10.3390/s20072048.
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The integration of the Internet of Things (IoT) with Wireless Sensor Networks (WSNs) typically involves multihop relaying combined with sophisticated signal processing to serve as an information provider for several applications such as smart grids, industrial, and search-and-rescue operations. These applications entail deploying many sensors in environments that are often random which motivated the study of beamforming using random geometric topologies. This paper introduces a new algorithm for the synthesis of several geometries of Collaborative Beamforming (CB) of virtual sensor antenna arrays with maximum mainlobe and minimum sidelobe levels (SLL) as well as null control using Canonical Swarm Optimization (CPSO) algorithm. The optimal beampattern is achieved by optimizing the current excitation weights for uniform and non-uniform interelement spacings based on the network connectivity of the virtual antenna arrays using a node selection scheme. As compared to conventional beamforming, convex optimization, Genetic Algorithm (GA), and Particle Swarm Optimization (PSO), the proposed CPSO achieves significant reduction in SLL, control of nulls, and increased gain in mainlobe directed towards the desired base station when the node selection technique is implemented with CB.
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Santos, Leyna Leite, Fernando José Camello de Lima, Célio Fernando de Sousa-Rodrigues, and Fabiano Timbó Barbosa. "Use of SGLT-2 inhibitors in the treatment of type 2 diabetes mellitus." Revista da Associação Médica Brasileira 63, no. 7 (July 2017): 636–41. http://dx.doi.org/10.1590/1806-9282.63.07.636.
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Summary Introduction: Diabetes mellitus is one of the most common chronic diseases in the world, with high morbidity and mortality rates, resulting in a greatly negative socioeconomic impact. Although there are several classes of oral antidiabetic agents, most of the patients are outside the therapeutic goal range. Objective: To review the use of SGLT-2 inhibitors in the treatment of type 2 diabetes mellitus, focusing on their favorable and unfavorable effects, as well as on cardiovascular profile. Method: A literature search on Pubmed database was performed using the following keywords: "SGLT-2 inhibitors," "dapagliflozin," "empagliflozin," "canagliflozin." Results: SGLT-2 inhibitors are a class of oral antidiabetic drugs directed to the kidney. Their mechanism of action is to reduce blood glucose by inducing glycosuria. Extra-glycemic benefits have been described, such as weight loss, decline in blood pressure and levels of triglycerides and uric acid, and they can slow the progression of kidney disease. Genitourinary infections are the main side effects. There is a low risk of hypotension and hypoglycemia. Diabetic ketoacidosis is a serious adverse effect, although rare. Empagliflozin has already had its cardiovascular benefit demonstrated and studies with other drugs are currently being performed. Conclusion: SGLT-2 inhibitors are a new treatment option for type 2 diabetes mellitus, acting independently of insulin. They have potential benefits other than the reduction of blood glucose, but also carry a risk for adverse effects.
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Coles, Melvyn G., and Jan Eeckhout. "Indeterminacy and directed search." Journal of Economic Theory 111, no. 2 (August 2003): 265–76. http://dx.doi.org/10.1016/s0022-0531(03)00086-3.
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Ding, Yucheng, and Tianle Zhang. "Price-directed consumer search." International Journal of Industrial Organization 58 (May 2018): 106–35. http://dx.doi.org/10.1016/j.ijindorg.2018.03.009.
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