Conversion to lanthanum carbonate monotherapy effectively controls serum phosphorus with a reduced tablet burden: a multicenter open-label study

<p>Abstract</p> <p>Background</p> <p>Lanthanum carbonate (FOSRENOL^®) is an effective, well-tolerated phosphate binder. The ability of lanthanum to reduce serum phosphorus levels to ≤5.5 mg/dL in patients with end-stage renal disease (ESRD) was assessed in a clinical practice setting.</p> <p>Methods</p> <p>A 16-week, phase IV study enrolled 2763 patients at 223 US sites to evaluate the efficacy of lanthanum carbonate in controlling serum phosphorus in patients with ESRD, and patient and physician satisfaction with, and preference for, lanthanum carbonate after conversion from other phosphate-binder medications. Patients received lanthanum carbonate prescriptions from physicians. These prescriptions were filled at local pharmacies rather than obtaining medication at the clinical trial site. Changes from serum phosphorus baseline values were analyzed using paired <it>t </it>tests. Patient and physician preferences for lanthanum carbonate versus previous medications were assessed using binomial proportion tests. Satisfaction was analyzed using the McNemar test. Daily dose, tablet burden, and laboratory values including albumin-adjusted serum calcium, calcium × phosphorus product, and parathyroid hormone levels were secondary endpoints.</p> <p>Results</p> <p>Serum phosphorus control (≤5.5 mg/dL) was effectively maintained in patients converting to lanthanum carbonate monotherapy; 41.6% of patients had controlled serum phosphate levels at 16 weeks. Patients and physicians expressed markedly higher satisfaction with lanthanum carbonate, and preferred lanthanum carbonate over previous medication. There were significant reductions in daily dose and daily tablet burden after conversion to lanthanum carbonate.</p> <p>Conclusions</p> <p>Serum phosphorus levels were effectively maintained in patients converted from other phosphate-binder medications to lanthanum carbonate, with increased satisfaction and reduced tablet burden.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT0016012">NCT0016012</a></p

Evaluation of seismic displacement demand for unreinforced masonry shear walls

Unreinforced, non-engineered low-strength brick masonry structures comprise a large percentage of buildings in the Himalayan region and have been extensively damaged in recent earthquakes. Due to the high seismic hazard of the region and the inherent vulnerability of non-engineered masonry structures, a seismic assessment of masonry construction in this region is imperative. In this study, a suite of strong ground motions is developed using data from major Himalayan earthquakes. Using a mechanistic-based procedure for predicting the monotonic load envelope which identifies limit states of cracking, strength, and collapse using stress-based criteria, a hysteretic model was calibrated to experimental data of unreinforced masonry shear walls. Nonlinear time history analyses are performed on the validated single degree of freedom models of two unreinforced masonry walls. The analytical results correlate well with observed damage to masonry structures in Himalayan earthquakes. Peak ground acceleration of ground motion is observed to be the key parameter influencing displacement of walls. A linearly increasing trend is observed between the PGA and the observed displacement up to a PGA value of 0.1g. A weak correlation is observed between displacement and ground motion frequency parameters

Experimental study of the delayed threshold phenomenon in a semiconductor laser

An experimental study of the delayed threshold phenomenon in a Vertical Extended Cavity Semiconductor Emitting Laser is carried out. Under modulation of the pump power, the laser intensity exhibits a hysteresis behavior in the vicinity of the threshold. The temporal width of this hysteresis is measured as a function of the modulation frequency, and is proved to follow the predicted scaling law. A model based on the rate equations is derived and used to analyze the experimental observations. A frequency variation of the laser around the delayed threshold and induced by the phase-amplitude coupling is predicted and estimated

Matched Pulse Propagation in a Three-Level System

The B\"{a}cklund transformation for the three-level Maxwell-Bloch equation is presented in the matrix potential formalism. By applying the B\"{a}cklund transformation to a constant electric field background, we obtain a general solution for matched pulses (a pair of solitary waves) which can emit or absorb a light velocity solitary pulse but otherwise propagate with their shapes invariant. In the special case, this solution describes a steady state pulse without emission or absorption, and becomes the matched pulse solution recently obtained by Hioe and Grobe. A nonlinear superposition rule is derived from the B\"{a}cklund transformation and used for the explicit construction of two solitons as well as nonabelian breathers. Various new features of these solutions are addressed. In particular, we analyze in detail the scattering of "invertons", a specific pair of different wavelength solitons one of which moving with the velocity of light. Unlike the usual case of soliton scattering, the broader inverton changes its sign through the scattering. Surprisingly, the light velocity inverton receives time advance through the scattering thereby moving faster than light, which however does not violate causality.Comment: 20 pages, Latex, 12 eps figure files some comments and references are added. postscript file with 12 figures can be obtained at http://photon.kyunghee.ac.kr/~qhpark

Phase-dependent spectra in a driven two-level atom

We propose a method to observe phase-dependent spectra in resonance fluorescence, employing a two-level atom driven by a strong coherent field and a weak, amplitude-fluctuating field. The spectra are similar to those which occur in a squeezed vacuum, but avoid the problem of achieving squeezing over a $4\pi$ solid angle. The system shows other interesting features, such as pronounced gain without population inversion.Comment: 4 pages and 4 figures. Submitted to Phys. Rev. Let

An Augmented Interface to Display Industrial Robot Faults

Technology advancement is changing the way industrial factories have to face an increasingly complex and competitive market. The fourth industrial revolution (known as industry 4.0) is also changing how human workers have to carry out tasks and actions. In fact, it is no longer impossible to think of a scenario in which human operators and industrial robots work side-by-side, sharing the same environment and tools. To realize a safe work environment, workers should trust robots as well as they trust human operators. Such goal is indeed complex to achieve, especially when workers are under stress conditions, such as when a fault occurs and the human operators are no longer able to understand what is happening in the industrial manipulator. Indeed, Augmented Reality (AR) can help workers to visualize in real-time robots’ faults. This paper proposes an augmented system that assists human workers to recognize and visualize errors, improving their awareness of the system. The system has been tested using both an AR see-through device and a smartphone

Physiological parameter estimation from multispectral images unleashed

Multispectral imaging in laparoscopy can provide tissue reflectance measurements for each point in the image at multiple wavelengths of light. These reflectances encode information on important physiological parameters not visible to the naked eye. Fast decoding of the data during surgery, however, remains challenging. While model-based methods suffer from inaccurate base assumptions, a major bottleneck related to competing machine learning-based solutions is the lack of labelled training data. In this paper, we address this issue with the first transfer learning-based method to physiological parameter estimation from multispectral images. It relies on a highly generic tissue model that aims to capture the full range of optical tissue parameters that can potentially be observed in vivo. Adaptation of the model to a specific clinical application based on unlabelled in vivo data is achieved using a new concept of domain adaptation that explicitly addresses the high variance often introduced by conventional covariance-shift correction methods. According to comprehensive in silico and in vivo experiments our approach enables accurate parameter estimation for various tissue types without the need for incorporating specific prior knowledge on optical properties and could thus pave the way for many exciting applications in multispectral laparoscopy