National Implementation Group (NIG) - European Working Time Directive & Non Consultant Hospital Doctors - Final Report December 2008

National Implementation Group (NIG) - European Working Time Directive & Non Consultant Hospital Doctors - Final Report December 2008  

Non-Commercial State Agencies - Public Service Agreement Progress Report - October 2011

Non-Commercial State Agencies – Public Service Agreement Progress Report – October 2011 Click here to download PDF 35KB

Manual therapy followed by specific active exercises versus a placebo followed by specific active exercises on the improvement of functional disability in patients with chronic non specific low back pain: a randomized controlled trial.

BACKGROUND: Recent clinical recommendations still propose active exercises (AE) for CNSLBP. However, acceptance of exercises by patients may be limited by pain-related manifestations. Current evidences suggest that manual therapy (MT) induces an immediate analgesic effect through neurophysiologic mechanisms at peripheral, spinal and cortical levels. The aim of this pilot study was first, to assess whether MT has an immediate analgesic effect, and second, to compare the lasting effect on functional disability of MT plus AE to sham therapy (ST) plus AE. METHODS: Forty-two CNSLBP patients without co-morbidities, randomly distributed into 2 treatment groups, received either spinal manipulation/mobilization (first intervention) plus AE (MT group; n = 22), or detuned ultrasound (first intervention) plus AE (ST group; n = 20). Eight therapeutic sessions were delivered over 4 to 8 weeks. Immediate analgesic effect was obtained by measuring pain intensity (Visual Analogue Scale) before and immediately after the first intervention of each therapeutic session. Pain intensity, disability (Oswestry Disability Index), fear-avoidance beliefs (Fear-Avoidance Beliefs Questionnaire), erector spinae and abdominal muscles endurance (Sorensen and Shirado tests) were assessed before treatment, after the 8th therapeutic session, and at 3- and 6-month follow-ups. RESULTS: Thirty-seven subjects completed the study. MT intervention induced a better immediate analgesic effect that was independent from the therapeutic session (VAS mean difference between interventions: -0.8; 95% CI: -1.2 to -0.3). Independently from time after treatment, MT + AE induced lower disability (ODI mean group difference: -7.1; 95% CI: -12.8 to -1.5) and a trend to lower pain (VAS mean group difference: -1.2; 95% CI: -2.4 to -0.30). Six months after treatment, Shirado test was better for the ST group (Shirado mean group difference: -61.6; 95% CI: -117.5 to -5.7). Insufficient evidence for group differences was found in remaining outcomes. CONCLUSIONS: This study confirmed the immediate analgesic effect of MT over ST. Followed by specific active exercises, it reduces significantly functional disability and tends to induce a larger decrease in pain intensity, compared to a control group. These results confirm the clinical relevance of MT as an appropriate treatment for CNSLBP. Its neurophysiologic mechanisms at cortical level should be investigated more thoroughly. TRIAL REGISTRATION: Trial registration number: NCT01496144.

Non-invasive detection of cocaine dissolved in wine bottles by (1) H magnetic resonance spectroscopy.

Recently, a number of cases of smuggling dissolved cocaine in wine bottles have been reported. The aim of the present study was to determine whether cocaine dissolved in wine can be detected by proton magnetic resonance spectroscopy ((1) H MRS) on a standard clinical MR scanner, in intact (i.e. unopened) wine bottles. (1) H MRS experiments were performed with a 3 Tesla clinical scanner on wine phantoms with or without cocaine contamination. The aromatic protons of cocaine displayed resonance peaks in the 7-8 ppm region of the spectrum, where no overlapping resonances of wine were present. Additional cocaine resonances were detected in the 2-3 ppm region of the spectrum, between the resonances of ethanol and other wine constituents. Detection of cocaine in wine (at 5 mM, i.e. ∼1.5 g/L) was feasible in a scan time of 1 min. We conclude that dissolved cocaine can be detected in intact wine bottles, on a standard clinical MR scanner. Thus, (1) H MRS is the technique of choice to examine this type of suspicious cargo, since it allows for a non-destructive and rapid content characterization. Copyright © 2010 John Wiley & Sons, Ltd.

8-Methoxy-naphtho[2,3-b]thiophen-4,9-quinone, a non-competitive inhibitor of trypanothione reductase

The enzyme trypanothione reductase is a recognised drug target in trypanosomatids and has been used in the search of new compounds with potential activity against diseases such as leishmaniasis, Chagas disease and African trypanosomiasis. 8-Methoxy-naphtho [2,3-b] thiophen-4,9-quinone was selected in a screening of natural and synthetic compounds using an in vitro assay with the recombinant enzyme from Trypanosoma cruzi. Its mode of inhibition fits a non-competitive model with respect to the substrate (trypanothione) and to the co-factor (NADPH), with Ki-values of 5 and 3.6 µM, respectively. When tested against human glutathione reductase, this compound did not display any significant inhibition at 100 µM, indicating a good selectivity against the parasite enzyme.

Severe anemia affects both splenectomized and non-splenectomized Plasmodium falciparum-infected Aotus infulatus monkeys

Severe anemia is the earliest and a frequently fatal complication of Plasmodium falciparum infection. Here we describe Aotus infulatus as a primate model suitable to study this malaria complication. Both non-splenectomized and splenectomized monkeys receiving different inocula of P. falciparum FVO strain presented large (> 50%) decreases in hematocrit values during infection. Non-splenectomized animals were able to control parasite growth (parasitemia did not exceed 4%), but they had to be treated because of severe anemia. Three of 4 splenectomized monkeys did not control parasitemia and were treated, but developed severe anemia after treatment when presenting a negative blood film. Destruction of parasitized red blood cells alone cannot account for the degree of anemia. Non-splenectomized monkeys repeatedly infected with homologous parasites became rapidly and progressively resistant to reinfection and to the development of severe anemia. The data presented here point to A. infulatus as a suitable model for studying the pathogenesis of severe malarial infection.

Understanding consumers repurchase in the context of online shopping: an empirical study

L'utilisation de l'Internet comme medium pour faire ses courses et achats a vu une croissance exponentielle. Cependant, 99% des nouveaux business en ligne échouent. La plupart des acheteurs en ligne ne reviennent pas pour un ré-achat et 60% abandonnent leur chariot avant de conclure l'achat. En effet, après le premier achat, la rétention du consommateur en ligne devient critique au succès du vendeur de commerce électronique. Retenir des consommateurs peut sauver des coûts, accroître les profits, et permet de gagner un avantage compétitif.Les recherches précédentes ont identifié la loyauté comme étant le facteur le plus important dans la rétention du consommateur, et l'engagement ("commitment") comme étant un des facteurs les plus importants en marketing relationnel, offrant une réflexion sur la loyauté. Pourtant, nous n'avons pu trouver d'étude en commerce électronique examinant l'impact de la loyauté en ligne et de l'engagement en ligne ("online commitment") sur le ré-achat en ligne. Un des avantages de l'achat en ligne c'est la capacité à chercher le meilleur prix avec un clic. Pourtant, nous n'avons pu trouver de recherche empirique en commerce électronique qui examinait l'impact de la perception post-achat du prix sur le ré-achat en ligne.L'objectif de cette recherche est de développer un modèle théorique visant à comprendre le ré-achat en ligne, ou la continuité d'achat ("purchase continuance") du même magasin en ligne.Notre modèle de recherche a été testé dans un contexte de commerce électronique réel, sur un échantillon total de 1,866 vrais acheteurs d'un même magasin en ligne. L'étude est centrée sur le ré-achat. Par conséquent, les répondants sélectionnés aléatoirement devaient avoir acheté au moins une fois de ce magasin en ligne avant le début de l'enquête. Cinq mois plus tard, nous avons suivi les répondants pour voir s'ils étaient effectivement revenus pour un ré-achat.Notre analyse démontre que l'intention de ré-achat en ligne n'a pas d'impact significatif sur le ré-achat en ligne. La perception post-achat du prix en ligne ("post-purchase Price perception") et l'engagement normatif en ligne ("Normative Commitment") n'ont pas d'impact significatif sur l'intention de ré-achat en ligne. L'engagement affectif en ligne ("Affective Commitment"), l'attitude loyale en ligne ("Attitudinal Loyalty"), le comportement loyal en ligne ("Behavioral Loyalty"), l'engagement calculé en ligne ("Calculative Commitment") ont un impact positif sur l'intention de ré-achat en ligne. De plus, l'attitude loyale en ligne a un effet de médiation partielle entre l'engagement affectif en ligne et l'intention de ré-achat en ligne. Le comportement loyal en ligne a un effet de mediation partielle entre l'attitude loyale en ligne et l'intention de ré-achat en ligne.Nous avons réalisé deux analyses complémentaires : 1) Sur un échantillon de premiers acheteurs, nous trouvons que la perception post-achat du prix en ligne a un impact positif sur l'intention de ré-achat en ligne. 2) Nous avons divisé l'échantillon de l'étude principale entre des acheteurs répétitifs Suisse-Romands et Suisse-Allemands. Les résultats démontrent que les Suisse-Romands montrent plus d'émotions durant l'achat en ligne que les Suisse-Allemands. Nos résultats contribuent à la recherche académique mais aussi aux praticiens de l'industrie e-commerce.AbstractThe use of the Internet as a shopping and purchasing medium has seen exceptional growth. However, 99% of new online businesses fail. Most online buyers do not comeback for a repurchase, and 60% abandon their shopping cart before checkout. Indeed, after the first purchase, online consumer retention becomes critical to the success of the e-commerce vendor. Retaining existing customers can save costs, increase profits, and is a means of gaining competitive advantage.Past research identified loyalty as the most important factor in achieving customer retention, and commitment as one of the most important factors in relationship marketing, providing a good description of what type of thinking leads to loyalty. Yet, we could not find an e-commerce study investing the impact of both online loyalty and online commitment on online repurchase. One of the advantages of online shopping is the ability of browsing for the best price with one click. Yet, we could not find an e- commerce empirical research investigating the impact of post-purchase price perception on online repurchase.The objective of this research is to develop a theoretical model aimed at understanding online repurchase, or purchase continuance from the same online store.Our model was tested in a real e-commerce context with an overall sample of 1, 866 real online buyers from the same online store.The study focuses on repurchase. Therefore, randomly selected respondents had purchased from the online store at least once prior to the survey. Five months later, we tracked respondents to see if they actually came back for a repurchase.Our findings show that online Intention to repurchase has a non-significant impact on online Repurchase. Online post-purchase Price perception and online Normative Commitment have a non-significant impact on online Intention to repurchase, whereas online Affective Commitment, online Attitudinal Loyalty, online Behavioral Loyalty, and online Calculative Commitment have a positive impact on online Intention to repurchase. Furthermore, online Attitudinal Loyalty partially mediates between online Affective Commitment and online Intention to repurchase, and online Behavioral Loyalty partially mediates between online Attitudinal Loyalty and online Intention to repurchase.We conducted two follow up analyses: 1) On a sample of first time buyers, we find that online post-purchase Price perception has a positive impact on Intention. 2) We divided the main study's sample into Swiss-French and Swiss-German repeated buyers. Results show that Swiss-French show more emotions when shopping online than Swiss- Germans. Our findings contribute to academic research but also to practice.

Effect of Platinum-Based Chemoradiotherapy on Cellular Proliferation in Bone Marrow and Spleen, Estimated by 18F-FLT PET/CT in Patients with Locally Advanced Non-Small Cell Lung Cancer.

Historically, it has been difficult to monitor the acute impact of anticancer therapies on hematopoietic organs on a whole-body scale. Deeper understanding of the effect of treatments on bone marrow would be of great potential value in the rational design of intensive treatment regimens. 3'-deoxy-3'-(18)F-fluorothymidine ((18)F-FLT) is a functional radiotracer used to study cellular proliferation. It is trapped in cells in proportion to thymidine-kinase 1 enzyme expression, which is upregulated during DNA synthesis. This study investigates the potential of (18)F-FLT to monitor acute effects of chemotherapy on cellular proliferation and its recovery in bone marrow, spleen, and liver during treatment with 2 different chemotherapy regimens.

BlastR--fast and accurate database searches for non-coding RNAs.

We present and validate BlastR, a method for efficiently and accurately searching non-coding RNAs. Our approach relies on the comparison of di-nucleotides using BlosumR, a new log-odd substitution matrix. In order to use BlosumR for comparison, we recoded RNA sequences into protein-like sequences. We then showed that BlosumR can be used along with the BlastP algorithm in order to search non-coding RNA sequences. Using Rfam as a gold standard, we benchmarked this approach and show BlastR to be more sensitive than BlastN. We also show that BlastR is both faster and more sensitive than BlastP used with a single nucleotide log-odd substitution matrix. BlastR, when used in combination with WU-BlastP, is about 5% more accurate than WU-BlastN and about 50 times slower. The approach shown here is equally effective when combined with the NCBI-Blast package. The software is an open source freeware available from www.tcoffee.org/blastr.html.

Performance of an ICU ventilator and two turbin-based ventilators dedicated to non invasive ventilation (NIV) in simulated high inspiratory effort and rate: a NIV-bench-study.

INTRODUCTION. The role of turbine-based NIV ventilators (TBV) versus ICU ventilators with NIV mode activated (ICUV) to deliver NIV in case of severe respiratory failure remains debated. OBJECTIVES. To compare the response time and pressurization capacity of TBV and ICUV during simulated NIV with normal and increased respiratory demand, in condition of normal and obstructive respiratory mechanics. METHODS. In a two-chamber lung model, a ventilator simulated normal (P0.1 = 2 mbar, respiratory rate RR = 15/min) or increased (P0.1 = 6 mbar, RR = 25/min) respiratory demand. NIV was simulated by connecting the lung model (compliance 100 ml/mbar; resistance 5 or 20 l/mbar) to a dummy head equipped with a naso-buccal mask. Connections allowed intentional leaks (29 ± 5 % of insufflated volume). Ventilators to test: Servo-i (Maquet), V60 and Vision (Philips Respironics) were connected via a standard circuit to the mask. Applied pressure support levels (PSL) were 7 mbar for normal and 14 mbar for increased demand. Airway pressure and flow were measured in the ventilator circuit and in the simulated airway. Ventilator performance was assessed by determining trigger delay (Td, ms), pressure time product at 300 ms (PTP300, mbar s) and inspiratory tidal volume (VT, ml) and compared by three-way ANOVA for the effect of inspiratory effort, resistance and the ventilator. Differences between ventilators for each condition were tested by oneway ANOVA and contrast (JMP 8.0.1, p\0.05). RESULTS. Inspiratory demand and resistance had a significant effect throughout all comparisons. Ventilator data figure in Table 1 (normal demand) and 2 (increased demand): (a) different from Servo-i, (b) different from V60.CONCLUSION. In this NIV bench study, with leaks, trigger delay was shorter for TBV with normal respiratory demand. By contrast, it was shorter for ICUV when respiratory demand was high. ICUV afforded better pressurization (PTP 300) with increased demand and PSL, particularly with increased resistance. TBV provided a higher inspiratory VT (i.e., downstream from the leaks) with normal demand, and a significantly (although minimally) lower VT with increased demand and PSL.