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Number of Pages: 2Integrative BiologyGeological Science
Interventional cardiology : Cost-effectiveness of PCI guided by fractional flow reserve
Coronary revascularization strategies have been evaluated in numerous clinical trials. As coronary revascularization has become more common, concerns over financial costs have increased
Determining Follower Aircraft's Optimal Trajectory in Relation to a Dynamic Formation Ring
The specific objective of this paper is to develop a tool that calculates the
optimal trajectory of the follower aircraft as it completes a formation rejoin,
and then maintains the formation position, defined as a ring of points, until a
fixed final time. The tool is designed to produce optimal trajectories for a
variety of initial conditions and leader trajectories. Triple integrator
dynamics are used to model the follower aircraft in three dimensions. Control
is applied directly to the rate of acceleration. Both the follower's and
leader's velocities and accelerations are bounded, as dictated by the
aircraft's performance envelope. Lastly, a path constraint is used to ensure
the follower avoids the leader's jet wash region. This optimal control problem
is solved through numerical analysis using the direct orthogonal collocation
solver GPOPS-II. Two leader trajectories are investigated, including a
descending spiral and continuous vertical loops. Additionally, a study of the
effect of various initial guesses is performed. All trajectories displayed a
direct capture of the formation position, however changes in solver initial
conditions demonstrate various behaviors in how the follower maintains the
formation position. The developed tool has proven adequate to support future
research in crafting real-time controllers capable of determining near-optimal
trajectories.Comment: 11 pages, 20 figures, 2 table
The neuropsychiatry of Parkinson's disease: advances and challenges
In people with Parkinson's disease, neuropsychiatric signs and symptoms are common throughout the disease course. These symptoms can be disabling and as clinically relevant as motor symptoms, and their presentation can be similar to, or distinct from, their counterparts in the general population. Correlates and risk factors for developing neuropsychiatric signs and symptoms include demographic, clinical, and psychosocial characteristics. The underlying neurobiology of these presentations is complex and not well understood, with the strongest evidence for neuropathological changes associated with Parkinson's disease, mechanisms linked to dopaminergic therapy, and effects not specific to Parkinson's disease. Assessment instruments and formal diagnostic criteria exist, but there is little routine screening of these signs and symptoms in clinical practice. Mounting evidence supports a range of pharmacological and non-pharmacological interventions, but relatively few efficacious treatment options exist. Optimising the management of neuropsychiatric presentations in people with Parkinson's disease will require additional research, raised awareness, specialised training, and development of innovative models of care
Eleven years of crop diversification alters decomposition dynamics of litter mixtures incubated with soil
Agricultural crop rotations have been shown to increase soil carbon (C), nitrogen (N), and microbial biomass. The mechanisms behind these increases remain unclear, but may be linked to the diversity of crop residue inputs to soil organic matter (SOM). We used a residue mixture incubation to examine how variation in long-term diversity of plant communities in agroecosystems influences decomposition of residue mixtures, thus providing a comparison of the effects of plant diversification on decomposition in the long term (via crop rotation) and short term (via residue mixtures). Three crop residue mixtures, ranging in diversity from two to four species, were incubated for 360 d with soils from five crop rotations, ranging from monoculture corn (mC) to a complex five-crop rotation. In response, we measured fundamental soil pools and processes underlying C and N cycling. These included soil respiration, inorganic N, microbial biomass, and extracellular enzymes. We hypothesized that soils with more diverse cropping histories would show greater synergistic mixture effects than mC. For most variables (except extracellular enzymes), crop rotation history, or the long-term history of plant diversity in the field, had a stronger effect on soil processes than mixture composition. In contrast to our hypothesis, the mC soil had nearly three and seven times greater synergistic mixture effects for respiration and microbial biomass N, respectively, compared with soils from crop rotations. This was due to the low response of the mC soils to poor quality residues (corn and wheat), likely resulting from a lack of available C and nutrients to cometabolize these residues. These results indicate that diversifying crop rotations in agricultural systems alter the decomposition dynamics of new residue inputs, which may be linked to the benefits of increasing crop rotation diversity on soil nutrient cycling, SOM dynamics, and yields
Pramipexole for the treatment of depressive symptoms in patients with Parkinson disease: a randomized, double blind, placebo controlled trial
Background: Depression is common in patients with Parkinson's disease, but evidence on the efficacy of antidepressants in this population is lacking. Because depression in patients with Parkinson's disease might be related to dopaminergic dysfunction, we aimed to assess the efficacy of the dopamine agonist pramipexole for treatment of depressive symptoms in patients with Parkinson's disease.
METHODS:
We did a 12-week randomised, double-blind, placebo-controlled (1:1 ratio) trial of pramipexole (0.125-1.0 mg three times per day) compared with placebo in patients with mild-to-moderate Parkinson's disease. Patients from 76 centres in 12 European countries and South Africa were included if they were on stable antiparkinsonian therapy without motor fluctuations and had depressive symptoms (15-item geriatric depression scale score > or =5 and unified Parkinson's disease rating scale [UPDRS] part 1 depression item score > or =2). Patients were randomly assigned by centre in blocks of four by use of a randomisation number generating system. Clinical monitors, the principal investigator, and patients were masked to treatment allocation. The primary endpoint was change in Beck depression inventory (BDI) score and all treated patients who had at least one post-baseline efficacy assessment were included in the primary analysis. We also did a pre-specified path analysis with regression models to assess the relation between BDI and UPDRS part 3 (motor score) changes. This trial is registered with ClinicalTrials.gov, number NCT00297778, and EudraCT, number 2005-003788-22.
FINDINGS:
Between March, 2006, and February, 2008, we enrolled 323 patients. Of 296 patients randomly assigned to pramipexole or placebo, 287 were included in the primary analysis: 139 in the pramipexole group and 148 in the placebo group. BDI scores decreased by an adjusted mean 5.9 (SE 0.5) points in the pramipexole group and 4.0 (0.5) points in the placebo group (difference 1.9, 95% CI 0.5-3.4; p=0.01, ANCOVA). The UPDRS motor score decreased by an adjusted mean 4.4 (0.6) points in the pramipexole group and 2.2 (0.5) points in the placebo group (difference 2.2, 95% CI 0.7-3.7; p=0.003, ANCOVA). Path analysis showed the direct effect of pramipexole on depressive symptoms accounted for 80% of total treatment effect (p=0.04). Adverse events were reported in 105 of 144 patients in the pramipexole group and 101 of 152 in the placebo group. Adverse events in the pramipexole group were consistent with the known safety profile of the drug.
INTERPRETATION:
Pramipexole improved depressive symptoms in patients with Parkinson's disease, mainly through a direct antidepressant effect. This effect should be considered in the clinical management of patients with Parkinson's disease
Characteristics of EGRET Blazars in the VLBA Imaging and Polarimetry Survey (VIPS)
We examine the radio properties of EGRET-detected blazars observed as part of
the VLBA Imaging and Polarimetry Survey (VIPS). VIPS has a flux limit roughly
an order of magnitude below the MOJAVE survey and most other samples that have
been used to study the properties of EGRET blazars. At lower flux levels, radio
flux density does not directly correlate with gamma-ray flux density. We do
find that the EGRET-detected blazars tend to have higher brightness
temperatures, greater core fractions, and possibly larger than average jet
opening angles. A weak correlation is also found with jet length and with
polarization. All of the well-established trends can be explained by
systematically larger Doppler factors in the gamma-ray loud blazars, consistent
with the measurements of higher apparent velocities found in monitoring
programs carried out at radio frequencies above 10 GHz.Comment: 20 pages, 7 figures, accepted to Ap
New evidence on the management of Lewy body dementia
This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this recordNote that the article title of the accepted author manuscript is different to that of the final published version.Dementia with Lewy bodies and Parkinson’s disease dementia, jointly known as Lewy body dementia (LBD), are common neurodegenerative conditions. Patients with LBD present with a wide range of cognitive, neuropsychiatric, sleep, motor, and autonomic symptoms. The expression of these varies between individual patients, and over time. Treatments may benefit one symptom, but at the expense of worsening another, making management difficult. Often symptoms are managed in isolation and by different specialists, which undermines high quality care.
Clinical trials and meta-analyses now provide an improved evidence base for the treatment of cognitive, neuropsychiatric and motor symptoms in LBD, in addition to which expert consensus opinion supports the application of treatments from related conditions such as Parkinson’s disease (PD) for the management of, for example, autonomic symptoms. There remain however clear evidence gaps and there is a high need for future clinical trials focused on specific symptoms in LBD.National Institute for Health Research (NIHR
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