Intramachine and intermachine variability in transesophageal color doppler images of pulsatile jets: in vitro studies

Background: Color Doppler flow mapping is widely used as a marker of severity of valvular regurgitation, and the transesophageal approach has provided high-quality images in patients with poor acoustic windows. However, different instruments produce significantly variable images. Techniques that use jet spatial information to determine the severity of the lesion may need to be derived specifically for the instrument used. Given a lack of standardization of the many commonly used instruments, the goal of this study was to quantify variability between instruments by imaging well-defined jet flow fields created in vitro. Methods and Results: Pulsatile jets were created in vitro using a blood analogue fluid through physiological orifice diameters and imaged from a distal window using six commonly used color Doppler instruments. Transesophageal transducers (5.0 MHz) were used with all instruments studied. Peak jet areas were planimetered and averaged with systematic variations in Nyquist limit, color filter, and sector angle (which produced variations in frame rate). Changes in instrument settings produced significant variation in jet size for all instruments studied. Comparisons within instruments and among instruments were difficult because of preset and ambiguous setting levels. When comparisons were possible between similar settings, variability was dramatic (eg, 57% variability between instruments with very similar Nyquist limits). Conclusions: A lack of standardized color Doppler instrument settings prohibits translation of jet area techniques from one instrument to another. This should be taken into consideration when using different machines for clinical study

Measuring the impact of the Capital Card®, a novel form of contingency management, on substance misuse treatment outcomes:A retrospective evaluation

Background The Capital Card, developed by WDP, is a digital innovation which acts as a form of contingency management, and aims to significantly improve service user outcomes. WDP is a substance misuse treatment provider commissioned by local authorities across the UK to support service users and their families affected by addiction. The Capital Card, much like commercial loyalty cards, uses a simple earn-spend points system which incentivises and rewards service users for engaging with services e.g. by attending key work sessions, Blood Borne Virus appointments or group-work sessions. The Spend activities available to service users are designed to improve overall wellbeing and build social and recovery capital, and include activities such as educational classes, fitness classes, driving lessons, and cinema tickets. Methods and findings We compared successful completion rates of 1,545 service users accessing one of WDP’s London based community services over a two-year period; before and after the Capital Card was introduced. Client demographics (age, sex and primary substance) were controlled for during the analysis. Once client demographics were controlled for, analysis showed that clients with a Capital Card were 1.5 times more likely to successfully complete treatment than those who had not had the Capital Card (OR = 1.507, 95% CI = 1.194 to 1.902). Conclusions The results of this initial evaluation are of particular interest to commissioners and policy makers as it indicates that the Capital Card can be used effectively as a form of contingency management to enhance recovery outcomes for service users engaging in community-based substance misuse services

Pengaruh Sistem Olah Tanah Dan Pemberian Herbisida Terhadap Aliran Permukaan Dan Erosi Pada Fase Generatif Tanaman Singkong (Manihot Utilissima)

Aliran permukaan dan erosi merupakan penyebab kerusakan tanah yang paling besar akibatnya. Curah hujan merupakan faktor yang paling berpengaruh terhadap terjadinya aliran permukaaan dan erosi. Jika intensitas hujan melebihi kapasitas infiltrasi tanah atau telah melewati titik jenuhnya, maka sebagian besar kelebihan air tersebut akan mengalir menjadi aliran permukaan dan aliran tersebut akan menyebabkan terjadinya erosi. Penelitian ini bertujuan untuk mengetahui pengaruh sistem olah tanah dan pemberian herbisida terhadap aliran permukaan dan erosi pada fase generatif tanaman singkong. Penelitian ini menggunakan Rancangan faktorial 2x2, dengan menggunakan 4 kali ulangan. Faktor pertama adalah sistem olah tanah yaitu pengolahan tanah minimum (M) dan pengolahan tanah penuh (F). Faktor kedua yaitu pemberian herbisida (H1) dan tanpa pemberian herbisida (H0). Pengukuran aliran permukaan dan erosi dilakukan dengan menggunakan metode petak kecil dengan ukuran 4x4 meter. Pengolahan tanah tidak nyata mempengaruhi aliran permukaan dan erosi. Pemberian herbisida nyata mempengaruhi erosi yang terjadi, tetapi tidak nyata mempengaruhi aliran permukaan. Pengolahan tanah dan pemberian herbisida tidak nyata mempengaruhi tinggi tanaman, diameter batang, dan produksi umbi singkong

Update on the management of ulcerative colitis: treatment and maintenance approaches focused on MMX® mesalamine

Ulcerative colitis (UC) is a chronic inflammatory disease of the colon that typically manifests as diarrhea, abdominal pain, and bloody stool. Complications, such as colorectal cancer and extraintestinal manifestations, may also develop. The goals of management are to induce and maintain clinical remission and to screen for complications of this disease. Mesalamine is a 5-aminosalicylic acid compound that is the first-line therapy to induce and maintain clinical remission in patients with mild-to-moderate UC. For patients who are refractory to mesalamine or have more severe disease, steroids, azathioprine/mercaptopurine, cyclosporine, or infliximab may be used, induce and/or maintain remission. The various formulations of mesalamine available are primarily differentiated by the methods of delivery of the active compound of the drug to the colon. Mesalamine with Multi-Matrix System® (MMX) technology (Cosmo SpA, Milan, Italy) is an oral (1.2 g), once-daily tablet formulation of mesalamine used for the treatment of UC (Lialda® or Mezavant®, Shire Pharmaceuticals Inc, Wayne, PA). In clinical studies, MMX mesalamine (taken as a once-daily dose of 2.4 or 4.8 g) effectively induced and maintained clinical remission in patients with active mild-to-moderate UC. The overall safety profile of MMX mesalamine is similar to other oral mesalamine formulations. The use of such once-daily formulations has led to intense interest in whether simplified pill regimens can improve patient adherence to mesalamine therapy

SOME LESS KNOWN ANTI-DIABETIC MEDICINAL PLANTS-AN EXPLORATION OF TRADITIONAL LORE AND EXPERIMENTS

The fast growing Diabetes health problem is at risk to about 422 million estimated people in world scenario. As the people suffering from diabetes since ages and no definite medicine could be able to control the disease safely except insulin as a hope for sustaining life. Several herbal drugs are in practice for limited preventive and curative aspect. Ayurveda emphasize on the preventive aspects and provides managerial approach through lifestyle intervention since inception. Herbal products have always played vital role in drug research in every sphere. Several medicinal plants are being used in different way either by traditional healers or by practitioners in India and Abroad on the basis of known anti-diabetic activities but, so many other plants are there which are either used by traditional physicians which are not tested in the clinical laboratory and sometimes several medicinal plants have been tested as Anti-diabetic in R&D study but not known/less known to practitioners. In this paper attempts have been made to identify those medicinal plants with R&D experimental study but are less known to practitioners. Moreover such medicinal plants were also verified in classical references for anti-diabetic effect if any. The present paper deals with the comparison of classical references with modern R&D as far as possible. Review was focused on such limited number of medicinal plants which are commonly not known is having hypoglycemic effect. Observation was also noted through several experimental studies done by the scientists earlier which signifies the merit of study. Such herbal study models are attributed here to provide newer initiatives in future and it can also focus for better solution in the field of diabetes control.

SHOTHAHARA ACTIVITIES OF DASHAMOOLA DRAVYAS AS AN ANTI INFLAMMATORY FORMULATION WITH SPECIAL REFERENCE TO CHARAK- A REVIEW

In Ayurveda texts, Charak Samhita deals with 50 different group of 10 herbs each with specific action and uses. It also deals with different basic formulations like Swarasa (juice), Kalka (paste), Kashaya (decoction) etc. Dashamoola is one of such 50 group of herbs as the name contains root of ten different plants i.e. Bilva, Gambhari, Shyonaka, Patala, Agnimantha, Prishniparni, Salparni, Kantakari, Vrihati & Gokshura. Of these, first five’s are known as Brihad panchamoola and the remaining as Laghoo panchamoola. It is used in the form of Kwath or  Arishta (fermented decoction) or Kashaya according to Ayurveda. This formulation is used primarily for headache, relief of pain and swelling related to arthritis, pyrexia, abdominal distension and costo-chondral pain etc. It is also described as an analgesic used in arthritis and rheumatic conditions by the Ayurvedic practitioners. It is believed that the 10 ingredients of  Dashamoola may be serving different roles like adjuvant, carrier agent and stabilizer etc. evident from several studies. After reviewing the different published literatures studies on experimental models have shown to possess anti-inflammatory and anti-analgesic activities which are enumerated in this paper

Designing IS Curricula for Practical Relevance: Applying Baseball\u27s Moneyball Theory

Baseball\u27s Moneyball theory states that the baseball market undervalues some attributes (and players with these attributes) that are key contributors to wins while overvaluing other attributes. Teams who correctly evaluate attributes that contribute to wins have higher winning percentages with relatively low payrolls. We applied the Moneyball theory for designing an Information Systems curriculum that could contribute to successful practice. First, we conducted a field study using six organizational case studies to identify skills, traits and attributes valued by IS practitioners as key contributors to successful practice. Next, we compared the skills, traits and attributes emphasized in traditional IS academic curricula (as specified in IS \u2797 and IS 2002 curricula) with those valued by practitioners. Our case study findings suggest a need for categorizing IS curricula into a framework consisting of three broad categories for practical relevance: (1) Foundational courses based on the traditional IS curricula such as IS \u2797 and IS 2002, (2) Localized and customized courses that meet the needs of local and regional employers of graduates of each IS program, and (3) Business assessment and systems thinking courses that enable IS graduates to (a) assess and understand organizational requirements and opportunities in ambiguous and messy organizational situations and (b) design systems that accomplish requirements and leverage opportunities. Our case study findings also suggest that the business assessment and systems thinking courses category is considered the most valuable for successful IS practice