44 research outputs found

    Strategies for measuring long-term control in atopic dermatitis trials: a systematic review

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    Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease. There are no standardised methods for capturing long-term control of AD. Objective: To identify how long-term control has been captured in published randomised controlled trials (RCTs). Resultswill initiate consensus discussions on how best to measure long-term control in the core outcome set for AD. Methods: Systematic review of RCTs of AD treatments published between 2000 and 2013, with a follow-up period of ≄3 months, at least one outcome measure recorded at ≄3 time-points, full paper available, and published in English. Results: 101/ 353 RCTs were eligible. Methods to capture long-term control included: repeated measurement of AD outcomes (92 RCTs; 91%), use of AD medication (29 RCTs; 28.7%); and AD flares/remissions (26 RCTs; 25.7%). Repeated measurements of AD outcomes were typically collected 3 to 5 times during a trial, but analysis methods often failed to make best use of the data. Time to first flare was most commonly for trials including flare data (21/52). Medication-use was recorded based on quantity, potency and frequency of application. Limitations: Included RCT data only Conclusion: This review illustrates the difficulties in measuring long-term control, and points to the need for improved harmonization of outcomes

    Clinical phenotype and outcome of hepatitis E virus - associated neuralgic amyotrophy

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    Objective: To determine the clinical phenotype and outcome in hepatitis E virus–associated neuralgic amyotrophy (HEV-NA). Methods: Cases of NA were identified in 11 centers from 7 European countries, with retrospective analysis of demographics, clinical/laboratory findings, and treatment and outcome. Cases of HEV-NA were compared with NA cases without evidence of HEV infection. Results: Fifty-seven cases of HEV-NA and 61 NA cases without HEV were studied. Fifty-six of 57 HEV-NA cases were anti-HEV IgM positive; 53/57 were IgG positive. In 38 cases, HEV RNA was recovered from the serum and in 1 from the CSF (all genotype 3). Fifty-one of 57 HEV-NA cases were anicteric; median alanine aminotransferase 259 IU/L (range 12–2,961 IU/L); in 6 cases, liver function tests were normal. HEV-NA cases were more likely to have bilateral involvement (80.0% vs 8.6%, p < 0.001), damage outside the brachial plexus (58.5% vs 10.5%, p < 0.01), including phrenic nerve and lumbosacral plexus injury (25.0% vs 3.5%, p = 0.01, and 26.4% vs 7.0%, p = 0.001), reduced reflexes (p = 0.03), sensory symptoms (p = 0.04) with more extensive damage to the brachial plexus. There was no difference in outcome between the 2 groups at 12 months. Conclusions: Patients with HEV-NA are usually anicteric and have a distinct clinical phenotype, with predominately bilateral asymmetrical involvement of, and more extensive damage to, the brachial plexus. Involvement outside the brachial plexus is more common in HEV-NA. The relationship between HEV and NA is likely to be causal, but is easily overlooked. Patients presenting with NA should be tested for HEV, irrespective of liver function test results. Prospective treatment/outcome studies of HEV-NA are warranted

    Ambient-noise tomography of the wider Vienna Basin region

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    We present a new 3-D shear-velocity model for the top 30 km of the crust in the wider Vienna Basin region based on surface waves extracted from ambient-noise cross-correlations. We use continuous seismic records of 63 broad-band stations of the AlpArray project to retrieve interstation Green’s functions from ambient-noise cross-correlations in the period range from 5 to 25 s. From these Green’s functions, we measure Rayleigh group traveltimes, utilizing all four components of the cross-correlation tensor, which are associated with Rayleigh waves (ZZ, RR, RZ and ZR), to exploit multiple measurements per station pair. A set of selection criteria is applied to ensure that we use high-quality recordings of fundamental Rayleigh modes. We regionalize the interstation group velocities in a 5 km × 5 km grid with an average path density of ∌20 paths per cell. From the resulting group-velocity maps, we extract local 1-D dispersion curves for each cell and invert all cells independently to retrieve the crustal shear-velocity structure of the study area. The resulting model provides a previously unachieved lateral resolution of seismic velocities in the region of ∌15 km. As major features, we image the Vienna Basin and Little Hungarian Plain as low-velocity anomalies, and the Bohemian Massif with high velocities. The edges of these features are marked with prominent velocity contrasts correlated with faults, such as the Alpine Front and Vienna Basin transfer fault system. The observed structures correlate well with surface geology, gravitational anomalies and the few known crystalline basement depths from boreholes. For depths larger than those reached by boreholes, the new model allows new insight into the complex structure of the Vienna Basin and surrounding areas, including deep low-velocity zones, which we image with previously unachieved detail. This model may be used in the future to interpret the deeper structures and tectonic evolution of the wider Vienna Basin region, evaluate natural resources, model wave propagation and improve earthquake locations, among others

    Arrival angles of teleseismic fundamental mode Rayleigh waves across the AlpArray

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    The dense AlpArray network allows studying seismic wave propagation with high spatial resolution. Here we introduce an array approach to measure arrival angles of teleseismic Rayleigh waves. The approach combines the advantages of phase correlation as in the two-station method with array beamforming to obtain the phase-velocity vector. 20 earthquakes from the first two years of the AlpArray project are selected, and spatial patterns of arrival-angle deviations across the AlpArray are shown in maps, depending on period and earthquake location. The cause of these intriguing spatial patterns is discussed. A simple wave-propagation modelling example using an isolated anomaly and a Gaussian beam solution suggests that much of the complexity can be explained as a result of wave interference after passing a structural anomaly along the wave paths. This indicates that arrival-angle information constitutes useful additional information on the Earth structure, beyond what is currently used in inversions

    In situ oxygen isotope micro-analysis of faunal material and human teeth using a SHRIMP II: A new tool for palaeo-ecology and archaeology

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    A Sensitive High Resolution Ion MicroProbe (SHRIMP II) has been used to make high spatial resolution in situ micro-analyses of oxygen isotopes in fish otoliths, and teeth from fossil herbivores and a Neanderthal. Large intra-tooth variations in the oxygen isotopic composition (up to 9‰) were observed in the enamel of herbivores from the Neanderthal fossil site of Payre, consistent with preservation of seasonal cyclicity. The range of isotopic compositions observed in Neanderthal tooth enamel was much smaller (∌3‰), possibly the result of a longer enamel maturation time averaging out variability. An archaeological otolith from a Preceramic site in Northern Peru exhibited marked changes in ÎŽ 18O over life, due either to the fish occasionally migrating from the sea to a lower salinity habitat, or to short-lived rises in sea water temperature. A fish otolith from Australia's Willandra Lakes World Heritage Area showed clear seasonal variations, but also a general trend towards isotopically heavier and more saline water, as indicated by higher ÎŽ 18O and Sr/Ca values resulting from increased evaporation. The results of these case studies are compared to results of oxygen isotope analysis using more conventional methods and demonstrate the ability of the SHRIMP II to provide precise high spatial resolution in-situ oxygen isotope analyses of a variety of biogenic materials. This approach has major advantages over conventional methods. It can provide rapid, micro-scale isotopic analyses of sub-permil precision without the need for chemical preparation of the sample

    Probing the micellar solubilisation and inter-micellar exchange of polyphenols using the DPPH center dot free radical

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    Encapsulation of polyphenols can be used for improving their stability and targeting. We present here a spectrophotometric method to probe the micellar solubilisation and inter-micellar exchange of polyphenols using the 2,2-diphenyl-1-picrylhydrazyl (DPPH center dot) free radical as a visible probe. Our method relies on the partitioning of DPPH center dot into micelles, on the reduction of DPPH center dot by polyphenols, and on the change in absorbance of DPPH center dot when reduced/oxidised. Hence, an absorbance drop at 528 nm gives evidence of the co-localisation of polyphenols and DPPH center dot in micelles. Using catechin and sodium dodecyl sulfate (SOS) as model molecules, we have shown that the reduction stoichiometry increases up to the critical micelle concentration (CMC) of SDS, where it reaches a plateau: this is due to the solubilisation of catechin in pre-micellar aggregates and then in micelles. The initial rate of reduction increases with increasing SDS concentration up to the CMC and then decreases due to a dilution effect

    Risk of cancer associated with cardiac catheterization procedures during childhood: a cohort study in France

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    Background: Radiation can be used effectively for diagnosis and medical treatment, but it can also cause cancers later on. Children with congenital heart disease frequently undergo cardiac catheterization procedures for diagnostic or treatment purposes. Despite the clear clinical benefit to the patient, the complexity of these procedures may result in high cumulative radiation exposure. Given children's greater sensitivity to radiation and the longer life span during which radiation health effects can develop, an epidemiological cohort study is being launched in France to evaluate the risks of leukaemia and solid cancers in this specific population. Methods/design: The study population will include all children who have undergone at least one cardiac catheterization procedure since 2000 and were under 10 years old and permanent residents of France at the time of the procedure. Electronically stored patient records from the departments of paediatric cardiology of the French national network for complex congenital heart diseases (M3C) are being searched to identify the children to be included. The minimum dataset will comprise: identification of the subject (file number in the centre or department, full name, sex, date and place of birth), and characteristics of the intervention (date, underlying disease, type of procedure, technical details, such as fluoroscopy time and dose area product, (DAP), which are needed to reconstruct the doses received by each child). The cohort will be followed up through linkage with the two French paediatric cancer registries, which have recorded all cases of childhood leukaemia and solid cancers in France since 1990 and 2000, respectively. Radiation exposure will be estimated retrospectively for each child. 4500 children with catherizations between 2000 and 2011 have been already included in the cohort, and recruitment is ongoing at the national level. The study is expected to finally include a total of 8000 children. Discussion: This French cohort study is specifically designed to provide further knowledge about the potential cancer risks associated with paediatric cardiac catheterization procedures. It will also provide new information on typical dose levels associated with these procedures in France. Finally, it should help improve awareness of the importance of radiation protection in these procedures.</p
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