Lack of effect of aspirin in primary CV prevention in type 2 diabetic patients with nephropathy:results from 8 years follow-up of NID-2 study

The risk-to-benefit ratio for the use of low dose of aspirin in primary cardiovascular (CV) prevention in patients with diabetes mellitus remains to be clarified. We assessed the effect of aspirin on risk of CV events in type 2 diabetic patients with nephropathy, in order to verify the usefulness of Guidelines in clinical practice. We carried out a prospective multicentric study in 564 patients with type 2 diabetic nephropathy free of CV disease attending outpatient diabetes clinics. A total of 242 patients received antiplatelet treatment with aspirin 100 mg/day (group A), and 322 were not treated with antiplatelet drugs (group B). Primary end point was the occurrence of total major adverse cardio-vascular events (MACE). Secondary end points were the relative occurrence of fatal MACE. The average follow-up was 8 years. Total MACE occurred in 49 patients from group A and in 52 patients from group B. Fatal MACE occurred in 22 patients from group A and in 20 from group B; nonfatal MACE occurred in 27 patients from group A and in 32 patients from group B. Kaplan-Meier analysis did not show a statistically significant difference of cumulative MACE between the two groups. A not statistically significant difference in the incidence of both fatal (p = 0.225) and nonfatal CV events (p = 0.573) between the two groups was observed. These results were confirmed after adjustment for confounders (HR for MACE 1.11, 95 % CI 0.91-1.35). These findings suggest that low dose of aspirin is ineffective in primary prevention for patients with nephropathy. © 2014 Springer-Verlag Italia.

An efficient, approximate path-following algorithm for elastic net based nonlinear spike enhancement

Unwanted spike noise in a digital signal is a common problem in digital filtering. However, sometimes the spikes are wanted and other, superimposed, signals are unwanted, and linear, time invariant (LTI) filtering is ineffective because the spikes are wideband - overlapping with independent noise in the frequency domain. So, no LTI filter can separate them, necessitating nonlinear filtering. However, there are applications in which the noise includes drift or smooth signals for which LTI filters are ideal. We describe a nonlinear filter formulated as the solution to an elastic net regularization problem, which attenuates band-limited signals and independent noise, while enhancing superimposed spikes. Making use of known analytic solutions a novel, approximate path-following algorithm is given that provides a good, filtered output with reduced computational effort by comparison to standard convex optimization methods. Accurate performance is shown on real, noisy electrophysiological recordings of neural spikes.

How does the alcohol industry attempt to influence marketing regulations? A systematic review

Aim: To systematically review, using a qualitative, narrative synthesis approach, papers examining alcohol industry efforts to influence alcohol marketing policy, and compare with those used by the tobacco industry. Methods: Literature searches were conducted between April and July 2011, and updated in March 2013. Papers were included if they: made reference to alcohol industry efforts to influence (a) policy debates concerning marketing regulations, (b) new specific marketing policies or (c) broad alcohol policy which included marketing regulations; were written in English; and concerned the period 1990-2013. Alcohol industry political activity was categorized into strategies/tactics and frames/arguments. Data extraction was undertaken by the lead author and 100% of the papers were fully second-reviewed. Seventeen papers met the review criteria. Results: Five main political strategies and five main frames were identified. The alcohol industry argues against marketing regulation by emphasizing industry responsibility and the effectiveness of self-regulation, questioning the effectiveness of statutory regulation and by focusing on individual responsibility. Arguments relating to industry responsibility are often reinforced through corporate social responsibility activities. The industry primarily conveys its arguments through manipulating the evidence base and by promoting ineffective voluntary codes and non-regulatory initiatives. Conclusions: The alcohol industry's political activity is more varied than existing models of corporate political activity suggest. The industry's opposition to marketing regulation centres on claims that the industry is responsible and that self regulation is effective. There are considerable commonalities between tobacco and alcohol industry political activity, with differences due potentially to differences in policy contexts and perceived industry legitimacy.

Evaluating techniques to improve visual performance with and assessment of premium intraocular lenses

Premium Intraocular Lenses (IOLs) such as toric IOLs, multifocal IOLs (MIOLs) and accommodating IOLs (AIOLs) can provide better refractive and visual outcomes compared to standard monofocal designs, leading to greater levels of post-operative spectacle independence. The principal theme of this thesis relates to the development of new assessment techniques that can help to improve future premium IOL design. IOLs designed to correct astigmatism form the focus of the first part of the thesis. A novel toric IOL design was devised to decrease the effect of toric rotation on patient visual acuity, but found to have neither a beneficial or detrimental impact on visual acuity retention. IOL tilt, like rotation, may curtail visual performance; however current IOL tilt measurement techniques require the use of specialist equipment not readily available in most ophthalmological clinics. Thus a new idea that applied Pythagoras’s theory to digital images of IOL optic symmetricality in order to calculate tilt was proposed, and shown to be both accurate and highly repeatable. A literature review revealed little information on the relationship between IOL tilt, decentration and rotation and so this was examined. A poor correlation between these factors was found, indicating they occur independently of each other. Next, presbyopia correcting IOLs were investigated. The light distribution of different MIOLs and an AIOL was assessed using perimetry, to establish whether this could be used to inform optimal IOL design. Anticipated differences in threshold sensitivity between IOLs were not however found, thus perimetry was concluded to be ineffective in mapping retinal projection of blur. The observed difference between subjective and objective measures of accommodation, arising from the influence of pseudoaccommodative factors, was explored next to establish how much additional objective power would be required to restore the eye’s focus with AIOLs. Blur tolerance was found to be the key contributor to the ocular depth of focus, with an approximate dioptric influence of 0.60D. Our understanding of MIOLs may be limited by the need for subjective defocus curves, which are lengthy and do not permit important additional measures to be undertaken. The use of aberrometry to provide faster objective defocus curves was examined. Although subjective and objective measures related well, the peaks of the MIOL defocus curve profile were not evident with objective prediction of acuity, indicating a need for further refinement of visual quality metrics based on ocular aberrations. The experiments detailed in the thesis evaluate methods to improve visual performance with toric IOLs. They also investigate new techniques to allow more rapid post-operative assessment of premium IOLs, which could allow greater insights to be obtained into several aspects of visual quality, in order to optimise future IOL design and ultimately enhance patient satisfaction.

An empirical study on uncertainty identification in social media context

Uncertainty text detection is important to many social-media-based applications since more and more users utilize social media platforms (e.g., Twitter, Facebook, etc.) as information source to produce or derive interpretations based on them. However, existing uncertainty cues are ineffective in social media context because of its specific characteristics. In this paper, we propose a variant of annotation scheme for uncertainty identification and construct the first uncertainty corpus based on tweets. We then conduct experiments on the generated tweets corpus to study the effectiveness of different types of features for uncertainty text identification. © 2013 Association for Computational Linguistics.

Direct activation of microcrystalline zeolites

In this work a direct activation route of zeolites is assessed. It consists of NH4-exchanging the as-synthesized solids before removing the organic template. Calcination afterwards serves to combust the organic template and creates the Brønsted sites directly; thus applying merely a single thermal step. This method simplifies their activation and the material suffers less thermal stress. The approach was particularly effective for microcrystalline beta and ferrierite zeolites. Thorough investigation of the template content and materials' texture points out to three relevant effects that can explain the effective exchange process: partial removal of the template during exchange creates substantial microporosity (ferrierite), the remaining template is reorganized within the pores (ferrierite) and finally, void space can exist due to the non-perfect matching between the network and template (beta). This shorter method appears suited for microcrystalline zeolites; it was ineffective for crystalline MFI types. © 2013 Elsevier B.V. All rights reserved.

The factors affecting the international judgement of the Forint and Zloty in the light of the financial crisis of year 2008

The financial crisis of 2007-2009 has shaken both money and capital markets. Its consequences have not even left European markets untouched and divided spirits in the financial world. In some countries efforts by the monetary policy to protect the national currency throughout the crisis seemed to be ineffective. In the present paper we are investigating the effect of the most important macroeconomic and economic policy factors on the exchange rate of the forint and zloty in the last decade. For an analysis of exchange rates we are relying on some preceding research results based on equilibrium exchange rate theories.

Rainforests at the beginning of the 21st century

Rainforests are situated at low latitude where forests enjoy steady and strong radiation. Biodiversity in rainforests has been very high, for historical and climatic reasons. The number of species is very high and tends to increase with precipitation and decrease with seasonality. Disturbance, soil fertility and forest stature also influence the species richness and high turnover of species contribute to diversity. Field observation and studies revealed that large scale deforestation could alter the regional and global climate significantly. Deforestation alters the surface albedo which leads to climate change. Regional land use contributes to climate change through surface-energy budget, as well as the carbon cycle. Forest fragmentation, logging, overhunting, fire and the expanding agriculture threaten the biodiversity. Rainforest covered area has significantly shrunk in the last decades. It is hard to protect the forests because of the growing demand for agricultural area and forest-derived products. Most measures proved ineffective to slow down the destruction. Hence, more forest will be lost in the future. Conservationists should take into consideration the secondary forests because biodiversity can be high enough and it is worth protecting them.

New Public Management Reforms: Institutions matter!

New Public Management (NPM) has played a decisive role and has had a radical effect on the productivity and efficiency of the public sector in the Anglo-Saxon countries. However, the effective introduction of the NPM reforms is not an easy task. The scientific community is zealously analyzing the experiences of the developing countries. The stories, they tell, are full of failures, and ineffective reforms. The goal of the current study is to uncover the factors that might influence the successful implementation of the NPM reforms. In our analysis, by relying on the theories of new institutional economics, we developed a model with which we wish to prove that in regards to the success of the reforms the informal and the formal institutions characteristic of the given country are the decisively determining factors. When answering the question, we introduced a new indicator based on public choice theory – the politicians’ interest index – by which we could measure the success of the NPM. We tested our hypothesis by a comparative statistical analysis using the data from 31 countries. Based on our results, we find that informal institutions, the culture shared by the members of society, fundamentally determine the probability of the successful implementation of the NPM reforms, these results having a significant practical relevance.

Sexual harassment of Miami-Dade County Public School students by school personnel

The purpose of this research was to assess the type and extent of sexual harassment of Miami-Dade County Public School (M-DCPS) students by school employees. In addition, the school system's existing procedures for handling such harassment were investigated, including students' awareness of and willingness to follow such procedures.^ Over 500 seniors from fourteen high schools around the county completed surveys which asked them to indicate whether or not they had received training on the topic of sexual harassment, whether or not they were aware of their school's policy on sexual harassment, whether or not they would feel comfortable reporting an incident of sexual harassment, whether or not they had experienced various forms of sexual harassment, and if they had been harassed, whether or not they reported the incident to a school official.^ Results indicated that sexual harassment of M-DCPS students by school employees is widespread, and the procedures that are currently in place to deal with this harassment are ineffective. Sixty-eight percent (68%) of the sample population indicated that a school employee had sexually harassed them; however, only four percent (4%) reported the incident to a school official. Responses indicated that this discrepancy exists because few students have received any training, few are aware of their schools' policies, and few are comfortable with the existing reporting procedures. ^

Determinants of confidence and their effect on epistemic judgments: Implications for auditor calibration bias

Auditor decisions regarding the causes of accounting misstatements can have an audit effectiveness and efficiency. Specifically, overconfidence in one's decision can lead to an ineffective audit, whereas underconfidence in one's decision can lead to an inefficient audit. This dissertation explored the implications of providing various types of information cues to decision-makers regarding an Analytical Procedure task and investigated the relationship between different types of evidence cues (confirming, disconfirming, redundant or non-redundant) and the reduction in calibration bias. Information was collected using a laboratory experiment, from 45 accounting students participants. Research questions were analyzed using a 2 x 2 x 2 between-subject and within-subject analysis of covariance (ANCOVA). ^ Results indicated that presenting subjects with information cues dissimilar to the choice they made is an effective intervention in reducing the common overconfidence found in decision-making. In addition, other information characteristics, specifically non-redundant information can help in reducing a decision-maker's overconfidence/calibration bias for difficulty (compared to easy) decision-tasks. ^

Evaluating and improving the opposing expert safeguard against junk science

In Daubert, the Supreme Court opined that opposing expert testimony is an effective safeguard against junk science in the courtroom. Although jurors maybe unable to identify flaws in scientific research without some assistance, social psychological research suggests that people can be trained to make more sophisticated judgments about scientific quality. Further, previous research demonstrated that an opposing expert who addresses the methodology of proffered expert testimony may not enable jurors to evaluate scientific validity. In three studies, I tested why this safeguard was ineffective using a variety of stimulus materials. In the first study, I examined the mediating effect of attitudes on juror decisions within the context of a sexual harassment trial. In the second study, I examined the moderating effect of the presentation of expert credentials on participant decisions regarding child suggestibility literature. In the third study, I tested several improvements to the safeguard using improvements designed to correct for the effects of attitudes and credential presentation on juror decisions within the context of a first-degree murder trial. I found that while opposing expert testimony may have potential as a safeguard, in its current form it is ineffective. That is, a traditional opposing expert caused jurors to be skeptical of all expert testimony rather than sensitizing them to the validity of the research presented at trial. Further, while the improvements tested in this study may have potential to assist jurors in making scientifically sound decisions, more research is needed to further test and refine these improvements. ^