82 research outputs found

    Duloxetine compared with fluoxetine and venlafaxine: use of meta-regression analysis for indirect comparisons

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    BACKGROUND: Data comparing duloxetine with existing antidepressant treatments is limited. A comparison of duloxetine with fluoxetine has been performed but no comparison with venlafaxine, the other antidepressant in the same therapeutic class with a significant market share, has been undertaken. In the absence of relevant data to assess the place that duloxetine should occupy in the therapeutic arsenal, indirect comparisons are the most rigorous way to go. We conducted a systematic review of the efficacy of duloxetine, fluoxetine and venlafaxine versus placebo in the treatment of Major Depressive Disorder (MDD), and performed indirect comparisons through meta-regressions. METHODS: The bibliography of the Agency for Health Care Policy and Research and the CENTRAL, Medline, and Embase databases were interrogated using advanced search strategies based on a combination of text and index terms. The search focused on randomized placebo-controlled clinical trials involving adult patients treated for acute phase Major Depressive Disorder. All outcomes were derived to take account for varying placebo responses throughout studies. Primary outcome was treatment efficacy as measured by Hedge's g effect size. Secondary outcomes were response and dropout rates as measured by log odds ratios. Meta-regressions were run to indirectly compare the drugs. Sensitivity analysis, assessing the influence of individual studies over the results, and the influence of patients' characteristics were run. RESULTS: 22 studies involving fluoxetine, 9 involving duloxetine and 8 involving venlafaxine were selected. Using indirect comparison methodology, estimated effect sizes for efficacy compared with duloxetine were 0.11 [-0.14;0.36] for fluoxetine and 0.22 [0.06;0.38] for venlafaxine. Response log odds ratios were -0.21 [-0.44;0.03], 0.70 [0.26;1.14]. Dropout log odds ratios were -0.02 [-0.33;0.29], 0.21 [-0.13;0.55]. Sensitivity analyses showed that results were consistent. CONCLUSION: Fluoxetine was not statistically different in either tolerability or efficacy when compared with duloxetine. Venlafaxine was significantly superior to duloxetine in all analyses except dropout rate. In the absence of relevant data from head-to-head comparison trials, results suggest that venlafaxine is superior compared with duloxetine and that duloxetine does not differentiate from fluoxetine

    Geographical perspectives on location for location based services

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    In this position paper the question of how location is employed in location based services (LBS) is considered. The importance of the notion of location is highlighted as a means of blurring the boundary between forms of experiences that are direct, and sensed in the environment, and those that are indirect, and learned from information. It is suggested that current methods for modeling location are limited by their lack of strong theoretical underpinning. To help bridge this gap the notions of Space, Place, and Region, from geographical theory, are proposed and implications of these for considering location in LBS outlined

    Analysing and aggregating visitor tracks in a protected area

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    The advent of location-based technologies deployed in protected areas provides both visitors and managers of such areas with new opportunities. In this paper we investigate the potential for mining individual tracks of visitors’ geospatial lifelines to both extract information describing aggregated patterns of group behaviour and characterise individual actions. Methods to spatio-temporally cluster individual behaviour and identify potential locations for specific actions (e.g. do visitors stop here to look at wildlife), whilst handling uncertainty in location, are described and applied to test the hypotheses that firstly, visitor behaviour is altered by the provision of information, and secondly whether the mode of information provision (e.g. in the form of a paper map or though an location-based service) influences visitor behaviour. The results of experiments with 140 visitors to a nature trail on the island of Texel in the Netherlands show statistically significant differences in time spent at locations where information was “pushed” to the visitors

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    Techniques for on the-fly generalisation of thematic point data usin

    Road network selection using an extended stroke-mesh combination algorithm

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    The road network is an essential feature class in topographic maps and databases. Road network selection for smaller scales forms a prerequisite for all other generalization operators and is thus a fundamental operation in the overall process of topographic map and database production. The objective of this paper was to develop an algorithm for automated road network selection from a large-scale (1:10,000) to a medium-scale database (1:50,000). The project was pursued in collaboration with swisstopo, the national mapping agency of Switzerland. Three algorithms (a stroke-based, a mesh-based, and a combined stroke-mesh algorithm) were implemented from the literature and analyzed using swisstopo’s large-scale TLM3D spatial database, with requirements set forth by expert cartographers. Initial experiments showed that the combination algorithm performed best, yet still it could not meet all requirements. Therefore, extensions to the basic stroke-mesh algorithm were developed, significantly improving the selection result with real-world, large test databases. Three extensions introduce modifications to the stroke-mesh combination algorithm. Furthermore, two extensions include external feature classes, ensuring accessibility of points of interest and appropriate network density representation in settlement areas, respectively. The results were evaluated by expert cartographers, who concluded that the proposed approach is ready to be deployed in production at swisstopo

    Analysing and aggregating visitor tracks in a protected area (Chapter 20)

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    Web service approaches for providing enriched data structures to generalisation operators

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    Web service technologies can be used to establish an interoperable framework between different generalisation systems. In a previous article three categories of generalisation web services were identified, including support services, operator services and processing services. This paper focuses on the category of support services. In a service-based generalisation system, the purpose of support services is to assist the generalisation process by providing auxiliary measures, procedures and data structures that allow the representation of structural cartographic knowledge. The structural knowledge of the spatial and semantic context and the modelling of structural and spatial relationships is critical for the understanding of the role of cartographic features and thus for automated generalisation. Support services should extract and model this knowledge from the raw data and make it available to other generalisation operators. On the one hand the structural knowledge can be expressed by enriching map features with additional geometries or attributes. On the other hand, there exist various hierarchical and nonhierarchical relationships between map features, many of which can be represented by graph data structures. After a brief introduction to the interoperable web service framework, this paper proposes a taxonomy of generalisation support services and discusses its elements. It is then shown how the complex output of such services can be represented for use with web services and stored in a reusable fashion. Finally, the utilisation of support services is illustrated on four implementation examples of support services that also highlight the interactions with the generalisation operators that use these auxiliary services
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