363 research outputs found
Evaluating integrated sustainable urban development strategies: a methodological framework applied in Portugal
This paper debates the evolution and importance of the urban dimension of EU policies and in particular EU Cohesion Policy in the past three decades. It discusses the growing relevance for supporting a Urban Agenda for the EU, and the gradual adoption and implementation of Integrated Sustainable Urban Development Strategies (ISUDS), by pointing out their advantages vis-Ă -vis mainstream sectoral-focused policy strategies. In this light, the article proposes an evaluation framework to assess and compare ISUDS across Europe. Based on the Portuguese case-study this analysis argues that despite their limited impacts, EU financed urban programmes (URBAN, POLIS, ISUDS) contributed positively to promoting a policy integrated approach, and enhanced urban physical and social environment of deprived urban neighbourhoods. More concretely, the initial results from the recent implementation of the 103 Integrated Sustainable Urban Development Strategies reveal a gradual adoption by the urban and local authorities of more holistic and integrated urban development policy approaches to increasing policy effectiveness and efficiency.info:eu-repo/semantics/acceptedVersio
A randomised trial of honey barrier cream versus zinc oxide ointment
In this single-blind multicentre, intervention study, 31 patients with symmetrical intertrigo in large skin folds were included to study the clinical effect of two topical treatments, i.e. standard therapy with zinc oxide ointment versus honey barrier cream. Patients were treated twice daily for 21 days, and the severity of intertrigo was scored in an observation period of 21 days. Patients were used as their own controls by treating symmetrical skin folds, on the left and right side. There was no significant difference in treatment effect between intervention groups. For the majority of patients, both treatments were effective. However, the use of honey barrier cream showed lower pruritus complaints (12.9% versus 29.0%). Honey barrier cream is a suitable alternative in the treatment of intertrigo, and promotes patient comfort
The Effect of Multidisciplinary Lifestyle Intervention on the Pre- and Postprandial Plasma Gut Peptide Concentrations in Children with Obesity
Objective. This study aims to evaluate the effect of a multidisciplinary treatment of obesity on plasma concentrations of several gut hormones in fasting condition and in response to a mixed meal in children.
Methods. Complete data were available from 36 obese children (age 13.3 ± 2.0âyr). At baseline and after the 3-month multidisciplinary treatment, fasting and postprandial blood samples were taken for glucose, insulin, ghrelin, peptide YY (PYY), and glucagon-like peptide 1 (GLP-1).
Results. BMI-SDS was significantly reduced by multidisciplinary treatment (from 4.2 ± 0.7 to 4.0 ± 0.9, P < .01). The intervention significantly increased the area under the curve (AUC) of ghrelin (from 92.3 ± 18.3 to 97.9 ± 18.2 pg/L, P < .01), but no significant changes were found for PYY or GLP-1 concentrations (in fasting or postprandial condition). The insulin resistance index (HOMA-IR) remained unchanged as well.
Conclusion. Intensive multidisciplinary treatment induced moderate weight loss and increased ghrelin secretion, but serum PYY and GLP-1 concentrations and insulin sensitivity remained unchanged
Comparing perimenstrual and nonperimenstrual migraine attacks using an e-diary
Background and Objectives Endogenous and exogenous female sex hormones are considered important contributors to migraine pathophysiology. Previous studies have cautiously suggested that perimenstrual migraine attacks have a longer duration and are associated with higher disability compared to nonperimenstrual attacks, but they showed conflicting results on acute therapy efficacy, pain intensity, and associated symptoms. We compared perimenstrual and nonperimenstrual migraine attack characteristics and assessed premenstrual syndrome (PMS) in women with migraine. Methods Women with migraine were invited to complete a headache e-diary. Characteristics of perimenstrual attacks and nonperimenstrual attacks were compared. The primary outcome was attack duration. Secondary outcomes were headache intensity, accompanying symptoms, acute medication intake, and pain coping. Mixed effects models were used to account for multiple attacks within patients. PMS was assessed in patients without hormonal contraceptives. Subgroup analyses were performed for women with menstrually related migraine (MRM) and nonmenstrually related migraine (non-MRM) and women with a natural menstrual cycle and women using hormonal contraceptives. Results A representative group of 500 participants completed the e-diary for at least 1 month. Perimenstrual migraine attacks (n = 998) compared with nonperimenstrual attacks (n = 4097) were associated with longer duration (20.0 vs 16.1 hours, 95% confidence interval 0.2-0.4), higher recurrence risk (odds ratio [OR] 2.4 [2.0-2.9]), increased triptan intake (OR 1.2 [1.1-1.4]), higher headache intensity (OR 1.4 [1.2-1.7]), less pain coping (mean difference -0.2 [-0.3 to -0.1]), more pronounced photophobia (OR 1.3 [1.2-1.4]) and phonophobia (OR 1.2 [1.1-1.4]), and less aura (OR 0.8 [0.6-1.0]). In total, 396/500 women completed the diary for >= 3 consecutive menstrual cycles, of whom 56% (221/396) fulfilled MRM criteria. Differences in attack characteristics became more pronounced when focusing on women with MRM and women using hormonal contraceptives. Prevalence of PMS was not different for women with MRM compared to non-MRM (11% vs 15%). Discussion The longer duration of perimenstrual migraine attacks in women (with MRM) is associated with higher recurrence risk and increased triptan use. This may increase the risk of medication overuse and emphasizes the need to develop female-specific prophylactic treatment.Development and application of statistical models for medical scientific researc
Sequence structure emission in The Red Rectangle Bands
We report high resolution (R~37,000) integral field spectroscopy of the
central region (r<14arcsec) of the Red Rectangle nebula surrounding HD44179.
The observations focus on the 5800A emission feature, the bluest of the
yellow/red emission bands in the Red Rectangle. We propose that the emission
feature, widely believed to be a molecular emission band, is not a molecular
rotation contour, but a vibrational contour caused by overlapping sequence
bands from a molecule with an extended chromophore. We model the feature as
arising in a Polycyclic Aromatic Hydrocarbon (PAH) with 45-100 carbon atoms.Comment: 13 pages, 9 figures, accepted for publication in ApJ. A version of
the paper with full resolution figures is available at:
http://www.aao.gov.au/local/www/rgs/Sequence-Structure
Depression and treatment with anti-calcitonin gene related peptide (CGRP) (ligand or receptor) antibodies for migraine
Background and purposeThe aim was to evaluate the effect of anti-calcitonin gene related peptide (CGRP) (ligand or receptor) antibodies on depressive symptoms in subjects with migraine and to determine whether depressive symptoms predict treatment response.MethodsPatients with migraine treated with erenumab and fremanezumab at the Leiden Headache Centre completed daily E-headache diaries. A control group was included. Depressive symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS) and the Center for Epidemiological Studies Depression Scale (CES-D) questionnaires at baseline (T0) and after 3âmonths (T1). First, the effect of treatment on the reduction in HADS-D and CES-D scores was assessed, with reduction in depression scores as the dependent variable and reduction in monthly migraine days (MMD) and treatment with anti-CGRP medication as independent variables. Second, depression as a predictor of treatment response was investigated, using the absolute reduction in MMD as a dependent variable and age, gender, MMD, active depression, impact, stress and locus of control scores as independent variables.ResultsIn total, nâ=â108 patients were treated with erenumab, nâ=â90 with fremanezumab and nâ=â68 were without active treatment. Treatment with anti-CGRP medication was positively associated with a reduction in the HADS-D (ÎČâ=â1.65, pâ=â0.01) compared to control, independent of MMD reduction. However, the same effect was not found for the CES-D (ÎČâ=â2.15, pâ=â0.21). Active depression predicted poorer response to erenumab (pâ=â0.02) but not to fremanezumab (pâ=â0.09).ConclusionAnti-CGRP (ligand or receptor) monoclonals lead to improvement of depressive symptoms in individuals with migraine, independent of migraine reduction. Depression may predict treatment response to erenumab but not to fremanezumab.Paroxysmal Cerebral Disorder
Role of the rdxA and frxA genes in oxygen-dependent metronidazole resistance of Helicobacter pylori
Almost 50 % of all Helicobacter pylori isolates are resistant to
metronidazole, which reduces the efficacy of metronidazole-containing
regimens, but does not make them completely ineffective. This discrepancy
between in vitro metronidazole resistance and treatment outcome may
partially be explained by changes in oxygen pressure in the gastric
environment, as metronidazole-resistant (MtzR) H. pylori isolates become
metronidazole-susceptible (MtzS) under low oxygen conditions in vitro. In
H. pylori the rdxA and frxA genes encode reductases which are required for
the activation of metronidazole, and inactivation of these genes results
in metronidazole resistance. Here the role of inactivating mutations in
these genes on the reversibility of metronidazole resistance under low
oxygen conditions is established. Clinical H. pylori isolates containing
mutations resulting in a truncated RdxA and/or FrxA protein were selected
and incubated under anaerobic conditions, and the effect of these
conditions on the MICs of metronidazole, amoxycillin, clarithromycin and
tetracycline, and cell viability were determined. While anaerobiosis had
no effect on amoxycillin, clarithromycin and tetracycline resistance, all
isolates lost their metronidazole resistance when cultured under anaerobic
conditions. This loss of metronidazole resistance also occurred in the
presence of the protein synthesis inhibitor chloramphenicol. Thus,
factor(s) that activate metronidazole under low oxygen tension are not
specifically induced by low oxygen conditions, but are already present
under microaerophilic conditions. As there were no significant differences
in cell viability between the clinical isolates, it is likely that neither
the rdxA nor the frxA gene participates in the reversibility of
metronidazole resistance
Workplace learning from a socio-cultural perspective: creating developmental space during the general practice clerkship
Workplace learning in undergraduate medical education has predominantly been studied from a cognitive perspective, despite its complex contextual characteristics, which influence medical studentsâ learning experiences in such a way that explanation in terms of knowledge, skills, attitudes and single determinants of instructiveness is unlikely to suffice. There is also a paucity of research which, from a perspective other than the cognitive or descriptive one, investigates student learning in general practice settings, which are often characterised as powerful learning environments. In this study we took a socio-cultural perspective to clarify how students learn during a general practice clerkship and to construct a conceptual framework that captures this type of learning. Our analysis of group interviews with 44 fifth-year undergraduate medical students about their learning experiences in general practice showed that students needed developmental space to be able to learn and develop their professional identity. This space results from the intertwinement of workplace context, personal and professional interactions and emotions such as feeling respected and self-confident. These forces framed studentsâ participation in patient consultations, conversations with supervisors about consultations and studentsâ observation of supervisors, thereby determining the opportunities afforded to students to mind their learning. These findings resonate with other conceptual frameworks and learning theories. In order to refine our interpretation, we recommend that further research from a socio-cultural perspective should also explore other aspects of workplace learning in medical education
Evidence for the naphthalene cation in a region of the interstellar medium with anomalous microwave emission
We report high resolution spectroscopy of the moderately reddened (A=3)
early type star Cernis 52 located in a region of the Perseus molecular cloud
complex with anomalous microwave emission. In addition to the presence of the
most common diffuse interstellar bands (DIBs) we detect two new interstellar or
circumstellar bands coincident to within 0.01% in wavelength with the two
strongest bands of the naphthalene cation (CH) as measured in
gas-phase laboratory spectroscopy at low temperatures and find marginal
evidence for the third strongest band.
Assuming these features are caused by the naphthalene cation, from the
measured intensity and available oscillator strengths we find that 0.008 % of
the carbon in the cloud could be in the form of this molecule. We expect
hydrogen additions to cause hydronaphthalene cations to be abundant in the
cloud and to contribute via electric dipole radiation to the anomalous
microwave emission. The identification of new interstellar features consistent
with transitions of the simplest polycyclic aromatic hydrocarbon adds support
to the hypothesis that this type of molecules are the carriers of both diffuse
interstellar bands and anomalous microwave emission.Comment: Accepted for publication in The Astrophysical Journa
The effect of a fibrin sealant on knee function after total knee replacement surgery. Results from the FIRST trial. A multicenter randomized controlled trial
Clinical epidemiolog
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