4,657 research outputs found

    Outcomes of an RCT of video‐conference vs. in‐person or in‐clinic nutrition and exercise in midlife adults with obesity

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    Objective New communication technologies have shown some promise in lifestyle weight loss interventions, but may be most effective when leveraging face‐to‐face communications. The study reported here sought to test whether weight loss program attendance and outcomes are greater when offered in‐person at community sites or remotely via videoconference versus in federally qualified health centers (FHQCs). In a three‐arm randomized trial among 150 FQHC adults, intervention delivery in community‐sites or via videoconference were tested against a clinic‐based lifestyle intervention (enhanced usual care [EUC]). Methods Twice weekly, a nutrition topic was reviewed, and exercise sessions were held in a 20‐week program delivered either in community settings or via videoconference. The primary outcome was the proportion of participants losing more than 2 kg at 6 (end of treatment) and 12 months in intent‐to‐treat analyses. Results Mean (SD) age was 53 (7) years, 82% were female, 65% were African‐American, 50% reported $18,000 or less household income, 49% tested low in health literacy, and mean (SD) body mass index was 39 (6) kg/m2. The proportion losing more than 2 kg of weight in the community site, videoconference, and EUC groups was 33%, 34%, and 24%, respectively at 6 months, and 29%, 34%, and 29% at 12 months. No differences reached significance. Attendance was poor in all groups; 45% of community site, 58% of videoconference, and 16% of EUC participants attended at least one session. Conclusion Videoconference and community‐based delivery were as effective as an FQHC‐based weight loss program

    Order Effects of Ballot Position without Information-Induced Confirmatory Bias

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    Candidate list positions have been shown to influence decision making when voters have limited candidate information (e.g. Miller and Krosnick, 1998; Brockington, 2003). Here, a primacy advantage is observed due to a greater number of positive arguments generated for early list candidates (Krosnick, 1991). The present study examined list position effects when an absence of information precludes such a confirmatory bias heuristic. We report the first large scale low-information experimental election where candidate position is fully counterbalanced. Seven hundred and twenty participants voted in a mock election where the position of 6 fictitious and meaningless parties was counterbalanced across the electorate. Analysis by position revealed that significantly fewer votes were allocated to the terminal parties (Experiment 1). In addition, Experiment 1 reported preliminary evidence of an alphabetical bias (consistent with Bagley, 1966). However, this positional bias was not present in a methodological replication using six genuine UK political parties (Experiment 2). This suggests that in situations of pure guessing, the heuristic shifts from the primacy benefiting confirmatory bias to an alternative heuristic that prejudices the first and last parties. These findings suggest that whilst the UK general electoral process may be largely immune to positional prejudice, English local elections (in which there can be multiple candidates from the same party) and multiple preference ranking systems (Scottish Local Government and London Mayoral Elections) could be susceptible to both positional and alphabetical biases

    Long-term efficacy and safety of dichlorphenamide for treatment of primary periodic paralysis

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    Introduction/Aim: Long-term efficacy and safety of dichlorphenamide (DCP) were characterized in patients with primary periodic paralysis (PPP). Methods: Patients with PPP in a double-blind, placebo-controlled study were randomly assigned to receive DCP 50 mg twice daily or placebo for 9 weeks, followed by a 52-week open-label DCP treatment phase (DCP/DCP and placebo/DCP populations). Efficacy (attack rate, severity-weighted attack rate) and safety were assessed in patients completing the study (61 weeks). In this post hoc analysis, efficacy and safety data were pooled from hyperkalemic and hypokalemic substudies. Results: Sixty-three adults (age, 19-76 years) completed the double-blind phase; 47 (74.6%) of these patients completed 61 weeks. There were median decreases in weekly attack and severity-weighted attack rates from baseline to week 61 (DCP/DCP [n = 25], −1.00 [P < .0001]; placebo/DCP [n = 20], −0.63 [P = .01] and DCP/DCP, −2.25 [P < .0001]; placebo/DCP, −1.69 [P = .01]). Relatively smaller median decreases in weekly attack and severity-weighted attack rates occurred from weeks 9 to 61 among patients receiving DCP continuously (n = 26; −0.14 [P = .1] and −0.24 [P = .09]) than among those switching from placebo to DCP after 9 weeks (n = 16; −1.04 [P = .049] and −2.72 [P = .08]). Common adverse events (AEs) were paresthesia and cognition-related events, which typically first occurred within 1 month of blinded treatment initiation and in rare cases led to treatment discontinuation. Dose reductions were frequently associated with common AE resolution. Discussion: One-year open-label DCP treatment after a 9-week randomized, controlled study confirmed long-term DCP remains safe and effective for chronic use. Tolerability issues (paresthesia, cognition-related AEs) were manageable in most patients

    Safety and efficacy of fluticasone propionate in the topical treatment of skin diseases

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    Fluticasone propionate - the first carbothioate corticosteroid - has been classified as a potent anti-inflammatory drug for dermatological use. It is available as 0.05% cream and 0.005% ointment formulations for the acute and maintenance treatment of patients with dermatological disorders such as atopic dermatitis, psoriasis and vitiligo. This glucocorticoid is characterized by high lipophilicity, high glucocorticoid receptor binding and activation, and a rapid metabolic turnover in skin. Although skin blanching following fluticasone propionate exceeds that of corticosteroids of medium strength, several clinical trials demonstrate a low potential for cutaneous and systemic side-effects, even in difficult-to-treat areas like the face, the eyelids and intertriginous areas. Even among paediatric patients with atopic dermatitis, fluticasone propionate proved to be safe and effective. These pharmacological and clinical properties are reflected by the high therapeutic index of this glucocorticoid

    Cyclic dermal BMP signalling regulates stem cell activation during hair regeneration

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    In the age of stem cell engineering it is critical to understand how stem cell activity is regulated during regeneration. Hairs are mini-organs that undergo cyclic regeneration throughout adult life1, and are an important model for organ regeneration. Hair stem cells located in the follicle bulge2 are regulated by the surrounding microenvironment, or niche3. The activation of such stem cells is cyclic, involving periodic -catenin activity4, 5, 6, 7. In the adult mouse, regeneration occurs in waves in a follicle population, implying coordination among adjacent follicles and the extrafollicular environment. Here we show that unexpected periodic expression of bone morphogenetic protein 2 (Bmp2) and Bmp4 in the dermis regulates this process. This BMP cycle is out of phase with the WNT/-catenin cycle, thus dividing the conventional telogen into new functional phases: one refractory and the other competent for hair regeneration, characterized by high and low BMP signalling, respectively. Overexpression of noggin, a BMP antagonist, in mouse skin resulted in a markedly shortened refractory phase and faster propagation of the regenerative wave. Transplantation of skin from this mutant onto a wild-type host showed that follicles in donor and host can affect their cycling behaviours mutually, with the outcome depending on the equilibrium of BMP activity in the dermis. Administration of BMP4 protein caused the competent region to become refractory. These results show that BMPs may be the long-sought 'chalone' inhibitors of hair growth postulated by classical experiments. Taken together, results presented in this study provide an example of hierarchical regulation of local organ stem cell homeostasis by the inter-organ macroenvironment. The expression of Bmp2 in subcutaneous adipocytes indicates physiological integration between these two thermo-regulatory organs. Our findings have practical importance for studies using mouse skin as a model for carcinogenesis, intra-cutaneous drug delivery and stem cell engineering studies, because they highlight the acute need to differentiate supportive versus inhibitory regions in the host skin

    Ergodic Jacobi matrices and conformal maps

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    We study structural properties of the Lyapunov exponent γ\gamma and the density of states kk for ergodic (or just invariant) Jacobi matrices in a general framework. In this analysis, a central role is played by the function w=γ+iπkw=-\gamma+i\pi k as a conformal map between certain domains. This idea goes back to Marchenko and Ostrovskii, who used this device in their analysis of the periodic problem

    Application of emulsified acids on sandstone formation at elevated temperature conditions: an experimental study

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    Emulsified acid has attracted considerable attention of the oil and gas industry due to its delayed nature that allows deeper penetration of acid into the formation which essentially facilitate further enhancing the well productivity, and at the same time minimizes the corrosion issues. However, emulsified acid has only been extensively studied and applied on carbonate formations. Considering more than half of the reservoirs worldwide are sandstone reservoirs, studying the effects of emulsified acid on sandstone under high-temperature conditions would unlock the potential of emulsified acid and help generate more value for the oil and gas industry by improving the well productivity from sandstone reservoirs. To ensure the applicability of the emulsified acid on the real sandstone reservoir, which usually has a temperature higher than ambient conditions, the stability of emulsified acids is investigated under 300 °F. Then, the stable emulsified acid samples are developed and their impact on the properties of Berea sandstone core samples, including porosity, pore-size distribution, permeability and wettability, are investigated. The core samples have undergone pre-flush (10% HCl:5% CH3COOH) before the main flush (emulsified acid). The emulsified acids are prepared using hydrofluoric acid, hydrochloric acid, phosphoric acid, cationic surfactant and chelating agent. Fourteen core samples are saturated with different emulsified acids under vacuum conditions for 3 days to ensure maximum saturation. The porosity, permeability and wettability of each core sample are measured before and after the reaction with acid. Nuclear magnetic resonance analysis has been applied to evaluate the change in pore size distribution. This study has demonstrated that the emulsified acids are capable of improving the porosity and permeability of Berea sandstone core sample. The pore size distribution has also been affected by the application of emulsified acid, where more large pores have been evolved to the core samples due to the reaction of acids with the sandstone which ultimately helps in improving the productivity of hydrocarbons. This indicates less precipitation of the secondary reaction products resulting better enhancement in sandstone flow properties. These results demonstrate the potential of emulsified acid during sandstone acidizing as emulsified acid significantly improved the sandstone properties which can essentially enhance the well productivity

    Extremely long quasiparticle spin lifetimes in superconducting aluminium using MgO tunnel spin injectors

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    There has been an intense search in recent years for long-lived spin-polarized carriers for spintronic and quantum-computing devices. Here we report that spin polarized quasi-particles in superconducting aluminum layers have surprisingly long spin-lifetimes, nearly a million times longer than in their normal state. The lifetime is determined from the suppression of the aluminum's superconductivity resulting from the accumulation of spin polarized carriers in the aluminum layer using tunnel spin injectors. A Hanle effect, observed in the presence of small in-plane orthogonal fields, is shown to be quantitatively consistent with the presence of long-lived spin polarized quasi-particles. Our experiments show that the superconducting state can be significantly modified by small electric currents, much smaller than the critical current, which is potentially useful for devices involving superconducting qubits

    Polarization of coalitions in an agent-based model of political discourse

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    Political discourse is the verbal interaction between political actors in a policy domain. This article explains the formation of polarized advocacy or discourse coalitions in this complex phenomenon by presenting a dynamic, stochastic, and discrete agent-based model based on graph theory and local optimization. In a series of thought experiments, actors compute their utility of contributing a specific statement to the discourse by following ideological criteria, preferential attachment, agenda-setting strategies, governmental coherence, or other mechanisms. The evolving macro-level discourse is represented as a dynamic network and evaluated against arguments from the literature on the policy process. A simple combination of four theoretical mechanisms is already able to produce artificial policy debates with theoretically plausible properties. Any sufficiently realistic configuration must entail innovative and path-dependent elements as well as a blend of exogenous preferences and endogenous opinion formation mechanisms
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