473 research outputs found
Sinter-crystallisation kinetics of a SiO2âAl2O3âCaOâMgOâSrO glass-ceramic glaze
This paper examines the microstructural development and kinetics of the sintering and crystallisation processes of a SiO2âAl2O3âRO (R = Ca, Mg, Sr) glass-ceramic glaze. Crystallisation and sintering kinetics were studied by DTA and HSM, respectively, at different heating rates. The kinetic parameters of crystallisation were determined by the usual methods (Kissinger, Kissinger-Akahira-Sunose, Ozawa and Augis-Bennet methods), and the JohnsonâMehlâAvramiâKolmogorov (JMAK) model, with an Avrami index of n = 3, characteristic of the surface crystallisation of very fine glass particles, was found to describe crystallisation kinetics very well. Sintering could also be described by the JMAK model, but with n < 1. Assuming the effect of temperature on the sintering rate to be the same as that of this variable on the inverse of glass matrix viscosity, a model was developed, based on the JMAK model, which only required a single fitting parameter. As the heating rate increased, the degree of overlap between the sintering and crystallisation processes was verified to decrease
Switching from natalizumab to fingolimod: an observational study
Background â Multiple sclerosis patients who discontinue using
natalizumab are at risk of a rebound in disease activity. However, the
optimal alternative therapy is not currently known. Aims of the
study â We report on clinical and MRI data and patient safety in a
group of relapsingâremitting multiple sclerosis patients who tested
seropositive for the JC virus and who have switched from
natalizumab to fingolimod because of concerns regarding PML risks.
Methods â The test for JC virus antibodies was performed in 18
relapsingâremitting multiple sclerosis patients who were being treated
with natalizumab for more than 1 year. Eight seropositive patients
switched to fingolimod while the seronegative patients continued with
natalizumab. Results â After switching to fingolimod, five of eight
patients (63%) experienced clinical relapses, and MRI activity was
detected in six of eight patients (75%). Neither clinical relapses nor
MRI activity was observed in the patients who continued with
natalizumab. No serious adverse effects were detected. Conclusions â
Natalizumab is an effective treatment for relapsingâremitting multiple
sclerosis, but its discontinuation continues to be a complex problem.
All of the therapies tried thus far, including fingolimod, have been
unable to control the reactivation of the disease. Further studies
addressing alternative therapies after natalizumab discontinuation are
necessary
Fifteen years controlling unwanted thoughts: A systematic review of the thought control ability questionnaire (TCAQ)
Thought control ability is a vulnerability factor implicated in the etiology and maintenance of emotional disorders. This manuscript aims to systematically review the use and psychometric performance of the Thought Control Ability Questionnaire (TCAQ), designed to assess people's ability to control unwanted thoughts. Three electronic databases were searched for papers administering the TCAQ published in indexed peer-reviewed journals. Data (participants characteristics, country, study design, etc.) were extracted from the results for qualitative synthesis. The TCAQ's content validity, dimensionality, internal consistency, test-retest reliability, convergent/divergent validity, floor/ceiling effects, and interpretability were summarized. Two reviewers independently screened articles and assessed quality taking COSMIN criteria into account. Finally, the review included 17 papers. The TCAQ has been administered to healthy individuals, students, and adult patients, in six languages from nine countries. We found that the TCAQ, and its shorter versions, demonstrate robust reliability and adequate content validity. Of interest is the TCAQ's capacity to predict performance in diverse experimental tasks focused on thought control. The TCAQ unidimensionality has been supported in exploratory and confirmatory factor analyses. Regarding construct validity, the TCAQ is significantly related to a wide range of psychopathological measures of anxiety, worry, depression, obsessive-compulsive symptoms, etc. However, as only a few of the included studies had a longitudinal design, we are unable to draw firm conclusions about the measure's temporal stability. Moreover, psychometric aspects such as factorial invariance across different samples have not been analyzed. Despite these limitations, based on available psychometric evidence we can recommend using the TCAQ for measuring perceived control of unwanted thoughts
Dedicated versus mainstreaming approaches in local climate plans in Europe
Cities are gaining prominence committing to respond to the threat of climate change, e.g., by developing local climate plans or strategies. However, little is known regarding the approaches and processes of plan development and implementation, or the success and effectiveness of proposed measures. Mainstreaming is regarded as one approach associated with (implementation) success, but the extent of integration of local climate policies and plans in ongoing sectoral and/or development planning is unclear. This paper analyses 885 cities across the 28 European countries to create a first reference baseline on the degree of climate mainstreaming in local climate plans. This will help to compare the benefits of mainstreaming versus dedicated climate plans, looking at policy effectiveness and ultimately delivery of much needed climate change efforts at the city level. All core cities of the European Urban Audit sample were analyzed, and their local climate plans classified as dedicated or mainstreamed in other local policy initiatives. It was found that the degree of mainstreaming is low for mitigation (9% of reviewed cities; 12% of the identified plans) and somewhat higher for adaptation (10% of cities; 29% of plans). In particular horizontal mainstreaming is a major effort for local authorities; an effort that does not necessarily pay off in terms of success of action implementation. This study concludes that climate change issues in local municipalities are best tackled by either, developing a dedicated local climate plan in parallel to a mainstreamed plan or by subsequently developing first the dedicated and later a mainstreaming plan (joint or subsequent âdual track approachâ). Cities that currently provide dedicated local climate plans (66% of cities for mitigation; 26% of cities for adaptation) may follow-up with a mainstreaming approach. This promises effective implementation of tangible climate actions as well as subsequent diffusion of climate issues into other local sector policies. The development of only broad sustainability or resilience strategies is seen as critical.We thank the many council representatives that supported the datacollection. Special thanks to Birgit Georgi who helped in setting up this large net work of researchers across the EU-28. We also thank the EU COST Action TU 0902 (ledbyRichardDawson) that established the core research network and the positive engagement and interaction of th emembers of this group. OH is Fellow of the Tyndall Centre for Climate Change Research and was funded by the UK EPSRC LC Transforms: Low Carbon Transitions of Fleet Operations in Metropolitan Sites Project (grant number EP/N010612/1). EKL was supported by the Ministry of Education, Youth and Sports, Czechia, within the National Sustainability Program I (NPU I) (grant number LO1415). DG ac-knowledges support by the Ministry of Education, University and Research (MIUR), Italy ("Departments of Excellence" grant L. 232/2016). HO was supported by the Ministry of Education and Research, Estonia (grantnumberIUT34-17). MO acknowledges funding from the Ministry of Economy and Competitiveness (MINECO), Spain (grant number IJCI-2016-28835). SS acknowledges that CENSE's research is partially funded by the Science Foundation, Portugal (grant number UID/AMB/04085/2019). The paper reflects only the views of the authors. The European Union, the European Environment Agency or other supporting bodies are not liable for any use that may be made of the information that is provided in this manuscript
Cost-Utility of Mindfulness-Based Stress Reduction for Fibromyalgia versus a Multicomponent Intervention and Usual Care: A 12-Month Randomized Controlled Trial (EUDAIMON Study)
Fibromyalgia (FM) is a prevalent, chronic, disabling, pain syndrome that implies high healthcare costs. Economic evaluations of potentially effective treatments for FM are needed. The aim of this study was to analyze the cost-utility of Mindfulness-Based Stress Reduction (MBSR) as an add-on to treatment-as-usual (TAU) for patients with FM compared to an adjuvant multicomponent intervention (FibroQoL) and to TAU. We performed an economic evaluation alongside a 12 month, randomized, controlled trial; data from 204 (68 per study arm) of the 225 patients (90.1%) were included in the cost-utility analyses, which were conducted both under the government and the public healthcare system perspectives. The main outcome measures were the EuroQol (EQ-5D-5L) for assessing Quality-Adjusted Life Years (QALYs) and improvements in health-related quality of life, and the Client Service Receipt Inventory (CSRI) for estimating direct and indirect costs. Incremental cost-effectiveness ratios (ICERs) were also calculated. Two sensitivity analyses (intention-to-treat, ITT, and per protocol, PPA) were conducted. The results indicated that MBSR achieved a significant reduction in costs compared to the other study arms (p < 0.05 in the completers sample), especially in terms of indirect costs and primary healthcare services. It also produced a significant incremental effect compared to TAU in the ITT sample (Delta QALYs = 0.053, p < 0.05, where QALYs represents quality-adjusted life years). Overall, our findings support the efficiency of MBSR over FibroQoL and TAU specifically within a Spanish public healthcare context
Prognostic evaluation in patients with advanced cancer in the last months of life:ESMO Clinical Practice Guideline
: âą This ESMO Clinical Practice Guideline provides key recommendations for using prognostic estimates in advanced cancer. âą The guideline covers recommendations for patients with cancer and an expected survival of months or less. âą An algorithm for use of clinical predictions, prognostic factors and multivariable risk prediction models is presented. âą The author group encompasses a multidisciplinary group of experts from different institutions in Europe, USA and Asia. âą Recommendations are based on available scientific data and the authorsâ collective expert opinion
Mathematical and Statistical Techniques for Systems Medicine: The Wnt Signaling Pathway as a Case Study
The last decade has seen an explosion in models that describe phenomena in
systems medicine. Such models are especially useful for studying signaling
pathways, such as the Wnt pathway. In this chapter we use the Wnt pathway to
showcase current mathematical and statistical techniques that enable modelers
to gain insight into (models of) gene regulation, and generate testable
predictions. We introduce a range of modeling frameworks, but focus on ordinary
differential equation (ODE) models since they remain the most widely used
approach in systems biology and medicine and continue to offer great potential.
We present methods for the analysis of a single model, comprising applications
of standard dynamical systems approaches such as nondimensionalization, steady
state, asymptotic and sensitivity analysis, and more recent statistical and
algebraic approaches to compare models with data. We present parameter
estimation and model comparison techniques, focusing on Bayesian analysis and
coplanarity via algebraic geometry. Our intention is that this (non exhaustive)
review may serve as a useful starting point for the analysis of models in
systems medicine.Comment: Submitted to 'Systems Medicine' as a book chapte
Prognostic evaluation in patients with advanced cancer in the last months of life: ESMO Clinical Practice Guideline
Electrochemical Behavior, Microstructural Analysis, and Morphological Observations in Reinforced Mortar Subjected to Chloride Ingress
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