A Martian Quarantine Risk Model

Structured model using loss functions to assess risk of using given decontamination procedure on all Martian unmanned landing craf

RISPOSTA TERAPEUTICA A TETRAIDROCANNABINOLO/CANNABIDIOLO NELLA SPASTICITA' ASSOCIATA A SCLEROSI MULTIPLA

Sativex® è un spray oromucosale atto alla terapia della spasticità in corso di sclerosi multipla. Esso contiene due principi attivi, il Δ9-tetraidrocannabinolo (THC) e il cannabidiolo (CBD), entrambi derivati dalla pianta di Cannabis Sativa, i quali agiscono modulando il sistema endocannabinoide umano. L'obiettivo della nostra analisi retrospettiva è stato quello di valutare la risposta terapeutica a tale farmaco in 35 pazienti, che non avevano precedentemente risposto ad altri trattamenti antispastici. Per tale valutazione, ci siamo avvalsi di 4 parametri (NRS per la spasticità, EDSS, Ambulation Index, test dei 10 metri), valutati prima e dopo un periodo di terapia di 4 settimane. Tale analisi ha mostrato efficacia nel ridurre l'NRS per la spasticità (riduzione del 26,6% nei responders), ma scarsa efficacia sugli altri paramentri. Il farmaco ha inoltre dimostrato una discreta efficacia sul dolore associato alla spasticità. Inoltre, valutando la terapia nel lungo termine, si è notato che tale trattamento mantiene la sua efficacia anche dopo molti cicli di terapia. Sativex® is a oromucosal spray for the treatment of spasticity in course of multiple sclerosis. It contains Δ9 - tetrahydrocannabinol (THC) and cannabidiol (CBD) , both derived from the plant "Cannabis sativa". The aim of our retrospective analysis was to evaluate the therapeutic response to Sativex® in 35 patients , who had not previously responded to other antispasticity agents .For this evaluation , we used four parameters ( NRS for spasticity , EDSS , Ambulation Index, tests of 10 meters ) , checked before and after a treatment period of 4 weeks .This analysis has shown effectiveness in reducing NRS for spasticity (26.6% reduction in responders) , but little effect on other parameters . The drug also showed a fairly effective on pain, associated with spasticity. Moreover , considering the long-term therapy , it has been noted that such treatment remains effective

Relationships between climate change perceptions and climate adaptation actions:policy support, information seeking, and behaviour

People are increasingly exposed to climate-related hazards, including floods, droughts, and vector-borne diseases. A broad repertoire of adaptation actions is needed to adapt to these various hazards. It is therefore important to identify general psychological antecedents that motivate people to engage in many different adaptation actions, in response to different hazards, and in different contexts. We examined if people’s climate change perceptions act as such general antecedents. Questionnaire studies in the Netherlands (n = 3,546) and the UK (n = 803) revealed that the more people perceive climate change as real, human-caused, and having negative consequences, the more likely they are to support adaptation policy and to seek information about local climate impacts and ways to adapt. These relationships were stronger and more consistent when the information and policies were introduced as measures to adapt to risks of climate change specifically. However, the three types of climate change perceptions were inconsistently associated with intentions to implement adaptation behaviours (e.g. installing a green roof). This suggests that climate change perceptions can be an important gateway for adaptation actions, especially policy support and information seeking, but that it may be necessary to address additional barriers in order to fully harness the potential of climate change perceptions to promote widespread adaptation behaviour

Has the frequency of bleeding changed over time for patients presenting with an acute coronary syndrome? The Global Registry of Acute Coronary Events

AIMS: To determine whether changes in practice, over time, are associated with altered rates of major bleeding in acute coronary syndromes (ACS). METHODS AND RESULTS: Patients from the Global Registry of Acute Coronary Events were enrolled between 2000 and 2007. The main outcome measures were frequency of major bleeding, including haemorrhagic stroke, over time, after adjustment for patient characteristics, and impact of major bleeding on death and myocardial infarction. Of the 50 947 patients, 2.3% sustained a major bleed; almost half of these presented with ST-elevation ACS (44%, 513). Despite changes in antithrombotic therapy (increasing use of low molecular weight heparin, P < 0.0001), thienopyridines (P < 0.0001), and percutaneous coronary interventions (P < 0.0001), frequency of major bleeding for all ACS patients decreased (2.6 to 1.8%; P < 0.0001). Most decline was seen in ST-elevation ACS (2.9 to 2.1%, P = 0.02). The overall decline remained after adjustment for patient characteristics and treatments (P = 0.002, hazard ratio 0.94 per year, 95% confidence interval 0.91-0.98). Hospital characteristics were an independent predictor of bleeding (P < 0.0001). Patients who experienced major bleeding were at increased risk of death within 30 days from admission, even after adjustment for baseline variables. CONCLUSION: Despite increasing use of more intensive therapies, there was a decline in the rate of major bleeding associated with changes in clinical practice. However, individual hospital characteristics remain an important determinant of the frequency of major bleeding

Contrasting the beam interaction characteristics of selected lasers with a partially stabilised zirconia (PSZ) bio-ceramic

Differences in the beam interaction characteristics of a CO2 laser, a Nd:YAG laser, a high power diode laser (HPDL) and an excimer laser with a partially stabilised zirconia (PSZ) bio-ceramic have been studied. A derivative of Beer-Lambert’s law was applied and the laser beam absorption lengths of the four lasers were calculated as 33.55 x 10-3 cm for the CO2 laser, 18.22 x 10-3 cm for the Nd:YAG laser, 17.17 x 10-3 cm for the HPDL and 8.41 x 10-6 cm for the excimer laser. It was determined graphically that the fluence threshold values at which significant material removal was effected by the CO2 laser, the Nd:YAG laser, the HPDL and the excimer laser were 52 J/cm2, 97 J/cm2, 115 J/cm2 and 0.48 J/cm2 respectively. The thermal loading value for the CO2 laser, the Nd:YAG laser, the HPDL and the excimer laser were calculated as being 1.55 kJ/cm3, 5.32 kJ/cm3, 6.69 kJ/cm3 and 57.04 kJ/cm3 respectively

Metabolism of ticagrelor in patients with acute coronary syndromes.

© The Author(s) 2018Ticagrelor is a state-of-the-art antiplatelet agent used for the treatment of patients with acute coronary syndromes (ACS). Unlike remaining oral P2Y12 receptor inhibitors ticagrelor does not require metabolic activation to exert its antiplatelet action. Still, ticagrelor is extensively metabolized by hepatic CYP3A enzymes, and AR-C124910XX is its only active metabolite. A post hoc analysis of patient-level (n = 117) pharmacokinetic data pooled from two prospective studies was performed to identify clinical characteristics affecting the degree of AR-C124910XX formation during the first six hours after 180 mg ticagrelor loading dose in the setting of ACS. Both linear and multiple regression analyses indicated that ACS patients presenting with ST-elevation myocardial infarction or suffering from diabetes mellitus are more likely to have decreased rate of ticagrelor metabolism during the acute phase of ACS. Administration of morphine during ACS was found to negatively influence transformation of ticagrelor into AR-C124910XX when assessed with linear regression analysis, but not with multiple regression analysis. On the other hand, smoking appears to increase the degree of ticagrelor transformation in ACS patients. Mechanisms underlying our findings and their clinical significance warrant further research.Peer reviewedFinal Published versio

Buildings behaving badly:A behavioral experiment on how different motivational frames influence residential energy label adoption in the Netherlands

Heating buildings contributes to approximately 36% of Europe’s energy demand and several EU member states have adopted mandatory energy labels to improve energy efficiency by promoting home weatherization investments. This paper focuses on the perception of the energy label for residential buildings in the Netherlands and the role of different frames (egoistic, biospheric and social norms and neutral frames) in motivating adoption of energy labels for housing. We used a behavioral email experiment and an online survey to investigate these motivational factors. We find that biospheric frames are weaker than the other three motivational frames in terms of engaging interest in the energy label, but that the biospheric frame results in higher willingness to pay (WTP) for the energy label. We also find that age (rather than income) correlates with higher willingness to pay for home energy labels