190 research outputs found
Dexamethasone and long-term outcome in adults with bacterial meningitis
This follow-up study of the European Dexamethasone Study was designed to examine the potential harmful effect of adjunctive dexamethasone treatment on long-term neuropsychological outcome in adults with bacterial meningitis. METHODS: Neurological, audiological, and neuropsychological examinations were performed in adults who survived pneumococcal or meningococcal meningitis. RESULTS: Eighty-seven of 99 (88%) eligible patients were included in the follow-up study; 46 (53%) were treated with dexamethasone and 41 (47%) with placebo. Median time between meningitis and testing was 99 months. Neuropsychological evaluation showed no significant differences between patients treated with dexamethasone and placebo. The proportions of patients with persisting neurological sequelae or hearing loss were similar in the dexamethasone and placebo groups. The overall rate of cognitive dysfunction did not differ significantly between patients and control subjects; however, patients after pneumococcal meningitis had a higher rate of cognitive dysfunction (21 vs 6%; p = 0.05) and experienced more impairment of everyday functioning due to physical problems (p = 0.05) than those after meningococcal meningitis. INTERPRETATION: Treatment with adjunctive dexamethasone is not associated with an increased risk for long-term cognitive impairment. Adults who survive pneumococcal meningitis are at significant risk for long-term neuropsychological abnormalities
BCS to Bose Crossover in Anisotropic Superconductors
In this work we use functional integral techniques to examine the nearest
neighbour attractive Hubbard model on a quasi-2D lattice. It is a simple
phenomenological model for the high-Tc cuprates that allows both extended
(non-local) s- and d-wave singlet superconductivity as well as mixed symmetry
states. The Hartree-Gor'kov mean field theory of the model has a finite
temperature phase diagram which shows a transition from pure s-wave to pure
d-wave superconductivity, via a mixed symmetry s+id state, as a function of
doping. Including Gaussian fluctuations we examine the crossover from
weak-coupling BCS superconductivity to the strong-coupling Bose-Einstein
condensation of composite s- or d-wave bosons and comment on the origin and
symmetry of the pseudogap.Comment: 20 pages inc. 13 figure
The design of a project to assess bilateral versus unilateral hearing aid fitting
Binaural hearing provides advantages over monaural in several ways, particularly in difficult listening situations. For a person with bilateral hearing loss, the bilateral fitting of hearing aids thus seems like a natural choice. However, surprisingly few studies have been reported in which the additional benefit of bilateral versus unilateral hearing aid use has been investigated based on real-life experiences. Therefore, a project has been designed to address this issue and to find tools to identify people for whom the drawbacks would outweigh the advantages of bilateral fitting. A project following this design is likely to provide reliable evidence concerning differences in benefit between unilateral and bilateral fitting of hearing aids by evaluating correlations between entrance data and outcome measures and final preferences
Real-Time Contrast Enhancement to Improve Speech Recognition
An algorithm that operates in real-time to enhance the salient features of speech is described and its efficacy is evaluated. The Contrast Enhancement (CE) algorithm implements dynamic compressive gain and lateral inhibitory sidebands across channels in a modified winner-take-all circuit, which together produce a form of suppression that sharpens the dynamic spectrum. Normal-hearing listeners identified spectrally smeared consonants (VCVs) and vowels (hVds) in quiet and in noise. Consonant and vowel identification, especially in noise, were improved by the processing. The amount of improvement did not depend on the degree of spectral smearing or talker characteristics. For consonants, when results were analyzed according to phonetic feature, the most consistent improvement was for place of articulation. This is encouraging for hearing aid applications because confusions between consonants differing in place are a persistent problem for listeners with sensorineural hearing loss
Subleading-twist effects in single-spin asymmetries in semi-inclusive deep-inelastic scattering on a longitudinally polarized hydrogen target
Single-spin asymmetries in the semi-inclusive production of charged pions in
deep-inelastic scattering from transversely and longitudinally polarized proton
targets are combined to evaluate the subleading-twist contribution to the
longitudinal case. This contribution is significantly positive for (\pi^+)
mesons and dominates the asymmetries on a longitudinally polarized target
previously measured by \hermes. The subleading-twist contribution for (\pi^-)
mesons is found to be small
A retrospective analysis of noise-induced hearing loss in the Dutch construction industry
Purpose Noise exposure is an important and highly prevalent occupational hazard in the construction industry. This study examines hearing threshold levels of a large population of Dutch construction workers and compares their hearing thresholds to those predicted by ISO-1999. Methods In this retrospective study, medical records of periodic occupational health examinations of 29,644 construction workers are analysed. Pure-tone audiometric thresholds of noise-exposed workers are compared to a non-exposed control group and to ISO-1999 predictions. Regression analyses are conducted to explore the relationship between hearing loss and noise intensity, noise exposure time and the use of hearing protection. Results Noise-exposed workers had greater hearing losses compared to their non-noise-exposed colleagues and to the reference population reported in ISO-1999. Noise exposure explained only a small proportion of hearing loss. When the daily noise exposure level rose from 80 dB(A) towards 96 dB(A), only a minor increase in hearing loss is shown. The relation of exposure time and hearing loss found was similar to ISO-1999 predictions when looking at durations of 10 years or more. For the first decade, the population medians show poorer hearing than predicted by ISO-1999. Discussion Duration of noise exposure was a better predictor than noise exposure levels, probably because of the limitations in noise exposure estimations. In this population, noise-induced hearing loss was already present at the beginning of employment and increased at the same rate as is predicted for longer exposure duration
Double hadron leptoproduction in the nuclear medium
First measurement of double-hadron production in deep-inelastic scattering
has been measured with the HERMES spectrometer at HERA using a 27.6 GeV
positron beam with deuterium, nitrogen, krypton and xenon targets. The
influence of the nuclear medium on the ratio of double-hadron to single-hadron
yields has been investigated. Nuclear effects are clearly observed but with
substantially smaller magnitude and reduced -dependence compared to
previously measured single-hadron multiplicity ratios. The data are in fair
agreement with models based on partonic or pre-hadronic energy loss, while they
seem to rule out a pure absorptive treatment of the final state interactions.
Thus, the double-hadron ratio provides an additional tool for studying
modifications of hadronization in nuclear matter
First Measurement of the Tensor Structure Function of the Deuteron
The \Hermes experiment has investigated the tensor spin structure of the
deuteron using the 27.6 GeV/c positron beam of \Hera. The use of a tensor
polarized deuteron gas target with only a negligible residual vector
polarization enabled the first measurement of the tensor asymmetry \At and
the tensor structure function \bd for average values of the Bj{\o}rken
variable and of the squared four-momentum transfer . The quantities \At and \bd are found to be
non-zero. The rise of \bd for decreasing values of can be interpreted to
originate from the same mechanism that leads to nuclear shadowing in
unpolarized scattering
Substituting abacavir for hyperlipidemia-associated protease inhibitors in HAART regimens improves fasting lipid profiles, maintains virologic suppression, and simplifies treatment
BACKGROUND: Hyperlipidemia secondary to protease inhibitors (PI) may abate by switching to anti-HIV medications without lipid effects. METHOD: An open-label, randomized pilot study compared changes in fasting lipids and HIV-1 RNA in 104 HIV-infected adults with PI-associated hyperlipidemia (fasting serum total cholesterol >200 mg/dL) who were randomized either to a regimen in which their PI was replaced by abacavir 300 mg twice daily (n = 52) or a regimen in which their PI was continued (n = 52) for 28 weeks. All patients had undetectable viral loads (HIV-1 RNA <50 copies/mL) at baseline and were naïve to abacavir and non-nucleoside reverse transcriptase inhibitors. RESULTS: At baseline, the mean total cholesterol was 243 mg/dL, low density lipoprotein (LDL)-cholesterol 149 mg/dL, high density lipoprotein (HDL)-cholesterol 41 mg/dL, and triglycerides 310 mg/dL. Mean CD4+ cell counts were 551 and 531 cells/mm(3 )in the abacavir-switch and PI-continuation arms, respectively. At week 28, the abacavir-switch arm had significantly greater least square mean reduction from baseline in total cholesterol (-42 vs -10 mg/dL, P < 0.001), LDL-cholesterol (-14 vs +5 mg/dL, P = 0.016), and triglycerides (-134 vs -36 mg/dL, P = 0.019) than the PI-continuation arm, with no differences in HDL-cholesterol (+0.2 vs +1.3 mg/dL, P = 0.583). A higher proportion of patients in the abacavir-switch arm had decreases in protocol-defined total cholesterol and triglyceride toxicity grades, whereas a smaller proportion had increases in these toxicity grades. At week 28, an intent-to treat: missing = failure analysis showed that the abacavir-switch and PI-continuation arms did not differ significantly with respect to proportion of patients maintaining HIV-1 RNA <400 or <50 copies/mL or adjusted mean change from baseline in CD4+ cell count. Two possible abacavir-related hypersensitivity reactions were reported. No significant changes in glucose, insulin, insulin resistance, C-peptide, or waist-to-hip ratios were observed in either treatment arm, nor were differences in these parameters noted between treatments. CONCLUSION: In hyperlipidemic, antiretroviral-experienced patients with HIV-1 RNA levels <50 copies/mL and CD4+ cell counts >500 cells/mm(3), substituting abacavir for hyperlipidemia-associated PIs in combination antiretroviral regimens improves lipid profiles and maintains virologic suppression over a 28-week period, and it simplifies treatment
Choosing between measures: comparison of EQ-5D, HUI2 and HUI3 in persons with hearing complaints
OBJECTIVES: To generate insight into the differences between utility measures EuroQol 5D (EQ-5D), Health Utilities Index Mark II (HUI2) and Mark III (HUI3) and their impact on the incremental cost-effectiveness ratio (ICER) for hearing aid fitting METHODS: Persons with hearing complaints completed EQ-5D, HUI2 and HUI3 at baseline and, when applicable, after hearing aid fitting. Practicality, construct validity, agreement, responsiveness and impact on the ICER were examined. RESULTS: All measures had high completion rates. HUI3 was capable of discriminating between clinically distinctive groups. Utility scores (n = 315) for EQ-5D UK and Dutch tariff (0.83; 0.86), HUI2 (0.77) and HUI3 (0.61) were significantly different, agreement was low to moderate. Change after hearing aid fitting (n = 70) for HUI2 (0.07) and HUI3 (0.12) was statistically significant, unlike the EQ-5D UK (0.01) and Dutch (0.00) tariff. ICERs varied from 647,209 euros/QALY for the EQ-5D Dutch tariff to 15,811 euros/QALY for HUI3. CONCLUSION: Utility scores, utility gain and ICERs heavily depend on the measure that is used to elicit them. This study indicates HUI3 as the instrument of first choice when measuring utility in a population with hearing complaints, but emphasizes the importance of a clear notion of what constitutes utility with regard to economic analyse
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