Antidepressants for anorexia nervosa

Background Anorexia Nervosa ( AN) is an illness characterised by extreme concern about body weight and shape, severe self-imposed weight loss, and endocrine dysfunction. In spite of its high mortality, morbidity and chronicity, there are few intervention studies on the subject.Objectives The aim of this review was to evaluate the efficacy and acceptability of antidepressant drugs in the treatment of acute AN.Search strategy The strategy comprised of database searches of the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register, MEDLINE (1966 to April 28th, 2005), EMBASE (1980 to week 36, 2004), PsycINFO (1969 to August week 5, 2004), handsearching the International Journal of Eating Disorders and searching the reference lists of all papers selected. Personal letters were sent to researchers in the field requesting information on unpublished or in-progress trials.Selection criteria All randomised controlled trials of antidepressant treatment for AN patients, as de fined by the Diagnostic and Statistical Manual, fourth edition (DSM-IV) or similar international criteria, were selected.Data collection and analysis Quality ratings were made giving consideration to the strong relationship between allocation concealment and potential for bias in the results; studies meeting criteria A and B were included. Trials were excluded if non-completion rates were above 50%. The standardised mean difference and relative risk were used for continuous data and dichotomous data comparisons, respectively. Whenever possible, analyses were performed according to intention- to-treat principles. Heterogeneity was tested with the I-squared statistic. Weight change was the primary outcome. Secondary outcomes were severity of eating disorder, depression and anxiety symptoms, and global clinical state. Acceptability of treatment was evaluated by considering non-completion rates.Main results Only seven studies were included. Major methodological limitations such as small trial size and large confidence intervals decreased the power of the studies to detect differences between treatments, and meta-analysis of data was not possible for the majority of outcomes. Four placebo-controlled trials did not find evidence that antidepressants improved weight gain, eating disorder or associated psychopathology. Isolated findings, favouring amineptine and nortriptyline, emerged from the antidepressant versus antidepressant comparisons, but cannot be conceived as evidence of efficacy of a specific drug or class of antidepressant in light of the findings from the placebo comparisons. Non-completion rates were similar between the compared groups.Authors' conclusions A lack of quality information precludes us from drawing de finite conclusions or recommendations on the use of antidepressants in acute AN. Future studies testing safer and more tolerable antidepressants in larger, well designed trials are needed to provide guidance for clinical practice.

Zinc supplementation for the prevention of type 2 diabetes mellitus in adults with insulin resistance

BackgroundDiabetes is associated with long-term damage, dysfunction and failure of various organs, especially the eyes, kidneys, nerves, heart and blood vessels. The risk of developing type 2 diabetes increases with age, obesity and lack of physical activity. Insulin resistance is a fundamental aspect of the aetiology of type 2 diabetes. Insulin resistance has been shown to be associated with atherosclerosis, dyslipidaemia, glucose intolerance, hyperuricaemia, hypertension and polycystic ovary syndrome. The mineral zinc plays a key role in the synthesis and action of insulin, both physiologically and in diabetes mellitus. Zinc seems to stimulate insulin action and insulin receptor tyrosine kinase activity.ObjectivesTo assess the effects of zinc supplementation for the prevention of type 2 diabetes mellitus in adults with insulin resistance.Search methodsThis review is an update of a previous Cochrane systematic review published in 2007. We searched the Cochrane Library (2015, Issue 3), MEDLINE, EMBASE, LILACS and the ICTRP trial register (frominception toMarch 2015). There were no language restrictions. We conducted citation searches and screened reference lists of included studies.Selection criteriaWe included studies if they had a randomised or quasi-randomised design and if they investigated zinc supplementation compared with placebo or no intervention in adults with insulin resistance living in the community.Data collection and analysisTwo review authors selected relevant trials, assessed risk of bias and extracted data.Main resultsWe included three trials with a total of 128 participants in this review. The duration of zinc supplementation ranged between four and 12 weeks. Risk of bias was unclear for most studies regarding selection bias (random sequence generation, allocation concealment) and detection bias (blinding of outcome assessment). No study reported on our key outcome measures (incidence of type 2 diabetes mellitus, adverse events, health-related quality of life, all-cause mortality, diabetic complications, socioeconomic effects). Evaluation of insulin resistance as measured by the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) showed neutral effects when comparing zinc supplementation with control (two trials; 114 participants). There were neutral effects for trials comparing zinc supplementation with placebo for total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol and triglycerides (2 studies, 70 participants). The one trial comparing zinc supplementation with exercise also showed neutral effects for total cholesterol, HDL and LDL cholesterol, and a mean difference in triglycerides of -30 mg/dL (95% confidence interval (CI) -49 to -10) in favour of zinc supplementation (53 participants). Various surrogate laboratory parameters were also analysed in the included trials.Authors'conclusionsThere is currently no evidence on which to base the use of zinc supplementation for the prevention of type 2 diabetes mellitus. Future trials should investigate patient-important outcome measures such as incidence of type 2 diabetes mellitus, health-related quality of life, diabetic complications, all-cause mortality and socioeconomic effects.

Allocation of protective devices in distribution circuits using nonlinear programming models and genetic algorithms

The optimized allocation of protective devices in strategic points of the circuit improves the quality of the energy supply and the system reliability index. This paper presents a nonlinear integer programming (NLIP) model with binary variables, to deal with the problem of protective device allocation in the main feeder and all branches of an overhead distribution circuit, to improve the reliability index and to provide customers with service of high quality and reliability. The constraints considered in the problem take into account technical and economical limitations, such as coordination problems of serial protective devices, available equipment, the importance of the feeder and the circuit topology. The use of genetic algorithms (GAs) is proposed to solve this problem, using a binary representation that does (1) or does not (0) show allocation of protective devices (reclosers, sectionalizers and fuses) in predefined points of the circuit. Results are presented for a real circuit (134 busses), with the possibility of protective device allocation in 29 points. Also the ability of the algorithm in finding good solutions while improving significantly the indicators of reliability is shown. (C) 2003 Elsevier B.V. All rights reserved.

A quantitative and qualitative evaluation of reports of clinical trials published in six Brazilian dental journals indexed in the Scientific Electronic Library Online (SciELO)

Introduction: Open access publishing is becoming increasingly popular within the biomedical sciences. SciELO, the Scientific Electronic Library Online, is a digital library covering a selected collection of Brazilian scientific journals many of which provide open access to full-text articles. This library includes a number of dental journals some of which may include reports of clinical trials in English, Portuguese and/or Spanish. Thus, SciELO could play an important role as a source of evidence for dental healthcare interventions especially if it yields a sizeable number of high quality reports. Objective: The aim of this study was to identify reports of clinical trials by handsearching of dental journals that are accessible through SciELO, and to assess the overall quality of these reports. Material and methods: Electronic versions of six Brazilian dental Journals indexed in SciELO were handsearched at www.scielo.br in September 2008. Reports of clinical trials were identified and classified as controlled clinical trials (CCTs - prospective, experimental studies comparing 2 or more healthcare interventions in human beings) or randomized controlled trials (RCTs - a random allocation method is clearly reported), according to Cochrane eligibility criteria. Criteria to assess methodological quality included: method of randomization, concealment of treatment allocation, blinded outcome assessment, handling of withdrawals and losses and whether an intention-to-treat analysis had been carried out. Results: The search retrieved 33 CCTs and 43 RCTs. A majority of the reports provided no description of either the method of randomization (75.3%) or concealment of the allocation sequence (84.2%). Participants and outcome assessors were reported as blinded in only 31.2% of the reports. Withdrawals and losses were only clearly described in 6.5% of the reports and none mentioned an intention-to-treat analysis or any similar procedure. Conclusions: The results of this study indicate that a substantial number of reports of trials and systematic reviews are available in the dental journals listed in SciELO, and that these could provide valuable evidence for clinical decision making. However, it is clear that the quality of a number of these reports is of some concern and that improvement in the conduct and reporting of these trials could be achieved if authors adhered to internationally accepted guidelines, e. g. the CONSORT statement.

Sex allocation in the polydomous leaf-cutting ant Acromyrmex balzani

Logistic regression analysis was used to analyse sex allocation in a population of the leaf-cutting ant Acromyrmex balzani occurring in a pasture in southern Brazil. The field sample consisted of 151 fungus-garden chambers (18 queenright and 133 queenless), belonging to 50 nests with three vertically stacked chambers per nest on average. Taking nest chamber as the unit of analysis, seven predictor variables were considered: sampling date, chamber depth, chamber volume, weight of fungus garden, presence of a queen, number of large workers, and number of small to medium workers. The population-level numerical proportion of females was 0.548 and the inferred proportional energetic investment in females 0.672. The former was not significantly different from 0.5 (P=0.168), but the latter was (P=0.0003). The proportional investment in females per fungus garden increased with the number of large workers present (P=0.0002) and decreased with the dry weight of the fungus garden (P=0.012). This implies that resource acquisition through foraging is likely to be a major proximate determinant of sex allocation. The negative correlation between female bias and fungus garden weight might be due to developing adult females requiring more food than males, but this hypothesis could not be confirmed by direct statistical evidence.

Z(bus) transmission network cost allocation

This paper addresses the problem of allocating the cost of the transmission network to generators and demands. A physically-based network usage procedure is proposed. This procedure exhibits desirable apportioning properties and is easy to implement and understand. A case study based on the IEEE 24-bus system is used to illustrate the working of the proposed technique. Some relevant conclusions are finally drawn.

Allocation of the costs of transmission losses

An analysis of the performance of six major methods of loss allocation for generators and demands was conducted, based on pro-rata (two), on incremental factors (two), on proportional sharing (PS) (one), and on electric circuit theory (one). Using relatively simple examples which can easily be checked, the advantages and disadvantages of each were ascertained and the results confirmed using a larger sample system (IEEE-118). The discussion considers the location and size of generators and demands, as well as the merits of the location of these agents for each configuration based on an analysis of the effect of various network modifications. Furthermore, an application in the South-Southeastern Brazilian Systems is performed. Conclusions and recommendations are presented. (C) 2004 Elsevier B.V. All rights reserved.

A cooperative game theory analysis for transmission loss allocation

This paper presents an analysis and discussion, based on cooperative game theory, for the allocation of the cost of losses to generators and demands in transmission systems. We construct a cooperative game theory model in which the players are represented by equivalent bilateral exchanges and we search for a unique loss allocation solution, the Core. Other solution concepts, such as the Shapley Value, the Bilateral Shapley Value and the Kernel are also explored. Our main objective is to illustrate why is not possible to find an optimal solution for allocating the cost of losses to the users of a network. Results and relevant conclusions are presented for a 4-bus system and a 14-bus system. (c) 2007 Elsevier B.V. All rights reserved.

An overview on network cost allocation methods

This work is devoted to Study and discuss the main methods to solve the network cost allocation problem both for generators and demands. From the presented, compared and discussed methods, the first one is based on power injections, the second deals with proportional sharing factors, the third is based upon Equivalent Bilateral Exchanges, the fourth analyzes the power How sensitivity in relation to the power injected, and the last one is based on Z(bus) network matrix. All the methods are initially illustrated using a 4-bus system. In addition, the IEEE 24-bus RTS system is presented for further comparisons and analysis. Appropriate conclusions are finally drawn. (C) 2008 Elsevier B.V. All rights reserved.

Optimized Allocation of Control and Protective Devices in Electric Distribution Systems

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Optimized allocation of sectionalizing switches and control and protection devices for reliability indices improvement in distribution systems

Reliability of power supply is related, among other factors, to the control and protection devices allocation in feeders of distribution systems. In this way, optimized allocation of sectionalizing switches and protection devices in strategic points of distribution circuits, improves the quality of power supply and the system reliability indices. In this work, it is presented a mixed integer non-linear programming (MINLP) model, with real and binary variables, for the sectionalizing switches and protection devices allocation problem, in strategic sectors, aimed at improving reliability indices, increasing the utilities billing and fulfilling exigencies of regulatory agencies for the power supply. Optimized allocation of protection devices and switches for restoration, allows that those faulted sectors of the system can be isolated and repaired, re-managing loads of the analyzed feeder into the set of neighbor feeders. Proposed solution technique is a Genetic Algorithm (GA) developed exploiting the physical characteristics of the problem. Results obtained through simulations for a real-life circuit, are presented. © 2004 IEEE.

PMUs optimized allocation using a tabu search algorithm for fault location in electric power distribution system

Phasor Measurement Units (PMUs) optimized allocation allows control, monitoring and accurate operation of electric power distribution systems, improving reliability and service quality. Good quality and considerable results are obtained for transmission systems using fault location techniques based on voltage measurements. Based on these techniques and performing PMUs optimized allocation it is possible to develop an electric power distribution system fault locator, which provides accurate results. The PMUs allocation problem presents combinatorial features related to devices number that can be allocated, and also probably places for allocation. Tabu search algorithm is the proposed technique to carry out PMUs allocation. This technique applied in a 141 buses real-life distribution urban feeder improved significantly the fault location results. © 2004 IEEE.

Network reconfiguration and loss allocation for distribution systems with distributed generation

Distribution systems with distributed generation require new analysis methods since networks are not longer passive. Two of the main problems in this new scenario are the network reconfiguration and the loss allocation. This work presents a distribution systems graphic simulator, developed with reconfiguration functions and a special focus on loss allocation, both considering the presence of distributed generation. This simulator uses a fast and robust power flow algorithm based on the current summation backward-forward technique. Reconfiguration problem is solved through a heuristic methodology and the losses allocation function, based on the Zbus method, is presented as an attached result for each obtained configuration. Results are presented and discussed, remarking the easiness of analysis through the graphic simulator as an excellent tool for planning and operation engineers, and very useful for training. © 2004 IEEE.

Comparison of algorithms for loss allocation in transmission networks considering power redispatch

An analysis of the performances of three important methods for generators and loads loss allocation is presented. The discussed methods are: based on pro-rata technique; based on the incremental technique; and based on matrices of circuit. The algorithms are tested considering different generation conditions, using a known electric power system: IEEE 14 bus. Presented and discussed results verify: the location and the magnitude of generators and loads; the possibility to have agents well or poorly located in each network configuration; the discriminatory behavior considering variations in the power flow in the transmission lines. © 2004 IEEE.