Effectiveness of integrated cognitive remediartion therapy for schizophrenia outpatients: Early versus long-term course of illness – results from an international RCT

Background Nowadays there is extensive evidence available showing the efficacy of cognitive remediation therapies. Integrative approaches seem superior regarding the maintenance of proximal outcome at follow-up as well as generalization to other areas of functioning. To date, only limited evidence about the efficacy of CRT is available concerning elder schizophrenia patients. The Integrated Neurocognitive Therapy (INT) represents a new developed cognitive remediation approach. It is a manualized group therapy approach targeting all 11 NIMH-MATRICS dimensions within one therapy concept. In this study we compared the effects of INT on an early course group (duration of disease<5 years) to a long-term group of schizophrenia outpatients (duration of disease>15 years). Methods An international multicenter study carried out in Germany, Switzerland and Austria with a total of 90 outpatients diagnosed with Schizophrenia (DSM-IV-TR) were randomly assigned either to an INT-Therapy or to Treatment-As-Usual (TAU). 50 of the 90 Patients were an Early-Course (EC) group, suffering from schizophrenia for less than 5 years (Mean age=29 years, Mean duration of illness=3.3 years). The other 40 were a Long-term Course (LC) group, suffering from schizophrenia longer than 15 years (Mean age= 45 years, Mean duration of illness=22 years). Treatment comprised of 15 biweekly sessions. An extensive assessment battery was conducted before and after treatment and at follow up (1 year). Multivariate General Linear Models (GLM) (duration of illness x treatment x time) examined our hypothesis, if an EC group of schizophrenia outpatients differ in proximal and distal outcome from a LC group. Results Irrespective of the duration of illness, both groups (EC & LC) were able to benefit from the INT. INT was superior compared to TAU in most of the assessed domains. Dropout rate of EC group was much higher (21.4%) than LC group (8%) during therapy phase. However, interaction effects show that the LC group revealed significantly higher effects in the neurocognitive domains of speed of processing (F>3.6) and vigilance (F>2.4). In social cognition the EC group showed significantly higher effects in social schema (F>2.5) and social attribution (blame; F>6.0) compared to the LC group. Regarding more distal outcome, patients treated with INT obtained reduced general symptoms unaffected by the duration of illness during therapy phase and at follow-up (F>4.3). Discussion Results suggest that INT is a valid goal-oriented treatment to improve cognitive functions in schizophrenia outpatients. Irrespective of the duration of illness significant treatment, effects were evident. Against common expectations, long-term, more chronic patients showed higher effects in basal cognitive functions compared to younger patients and patients without any active therapy (TAU). Consequently, more integrated therapy offers are also recommended for long-term course schizophrenia patients.

Integrated testing strategy (ITS) for bioaccumulation assessment under REACH

REACH (registration, evaluation, authorisation and restriction of chemicals) regulation requires that all the chemicals produced or imported in Europe above 1 tonne/year are registered. To register a chemical, physicochemical, toxicological and ecotoxicological information needs to be reported in a dossier. REACH promotes the use of alternative methods to replace, refine and reduce the use of animal (eco)toxicity testing. Within the EU OSIRIS project, integrated testing strategies (ITSs) have been developed for the rational use of non-animal testing approaches in chemical hazard assessment. Here we present an ITS for evaluating the bioaccumulation potential of organic chemicals. The scheme includes the use of all available data (also the non-optimal ones), waiving schemes, analysis of physicochemical properties related to the end point and alternative methods (both in silico and in vitro). In vivo methods are used only as last resort. Using the ITS, in vivo testing could be waived for about 67% of the examined compounds, but bioaccumulation potential could be estimated on the basis of non-animal methods. The presented ITS is freely available through a web tool.

Advances in understanding energy consumption behavior and the governance of its change - Outline of an integrated framework

Transforming today’s energy systems in industrialized countries requires a substantial reduction of the total energy consumption at the individual level. Selected instruments have been found to be effective in changing people’s behavior in single domains. However, the so far weak success story on reducing overall energy consumption indicates that our understanding of the determining factors of individual energy consumption as well as of its change is far from being conclusive. Among others, the scientific state of the art is dominated by analyzing single domains of consumption and by neglecting embodied energy. It also displays strong disciplinary splits and the literature often fails to distinguish between explaining behavior and explaining change of behavior. Moreover, there are knowledge gaps regarding the legitimacy and effectiveness of the governance of individual consumption behavior and its change. Against this backdrop, the aim of this paper is to establish an integrated interdisciplinary framework that offers a systematic basis for linking the different aspects in research on energy related consumption behavior, thus paving the way for establishing a better evidence base to inform societal actions. The framework connects the three relevant analytical aspects of the topic in question: (1) It systematically and conceptually frames the objects, i.e. the energy consumption behavior and its change (explananda); (2) it structures the factors that potentially explain the energy consumption behavior and its change (explanantia); (3) it provides a differentiated understanding of change inducing interventions in terms of governance. Based on the existing states of the art approaches from different disciplines within the social sciences the proposed framework is supposed to guide interdisciplinary empirical research.

MIRACLE’s Ad-Hoc and Geographical IR Approaches for CLEF 2006

This paper presents the 2006 Miracle team’s approaches to the Ad-Hoc and Geographical Information Retrieval tasks. A first set of runs was obtained using a set of basic components. Then, by putting together special combinations of these runs, an extended set was obtained. With respect to previous campaigns some improvements have been introduced in our system: an entity recognition prototype is integrated in our tokenization scheme, and the performance of our indexing and retrieval engine has been improved. For GeoCLEF, we tested retrieving using geo-entity and textual references separately, and then combining them with different approaches.

HERMES: Towards an Integrated Toolbox to Characterize Functional and Effective Brain Connectivity

The analysis of the interdependence between time series has become an important field of research in the last years, mainly as a result of advances in the characterization of dynamical systems from the signals they produce, the introduction of concepts such as generalized and phase synchronization and the application of information theory to time series analysis. In neurophysiology, different analytical tools stemming from these concepts have added to the ‘traditional’ set of linear methods, which includes the cross-correlation and the coherency function in the time and frequency domain, respectively, or more elaborated tools such as Granger Causality. This increase in the number of approaches to tackle the existence of functional (FC) or effective connectivity (EC) between two (or among many) neural networks, along with the mathematical complexity of the corresponding time series analysis tools, makes it desirable to arrange them into a unified-easy-to-use software package. The goal is to allow neuroscientists, neurophysiologists and researchers from related fields to easily access and make use of these analysis methods from a single integrated toolbox. Here we present HERMES (http://hermes.ctb.upm.es), a toolbox for the Matlab® environment (The Mathworks, Inc), which is designed to study functional and effective brain connectivity from neurophysiological data such as multivariate EEG and/or MEG records. It includes also visualization tools and statistical methods to address the problem of multiple comparisons. We believe that this toolbox will be very helpful to all the researchers working in the emerging field of brain connectivity analysis.

HERMES: towards an integrated toolbox to characterize functional and effective brain connectivity

The analysis of the interdependence between time series has become an important field of research in the last years, mainly as a result of advances in the characterization of dynamical systems from the signals they produce, the introduction of concepts such as generalized and phase synchronization and the application of information theory to time series analysis. In neurophysiology, different analytical tools stemming from these concepts have added to the ?traditional? set of linear methods, which includes the cross-correlation and the coherency function in the time and frequency domain, respectively, or more elaborated tools such as Granger Causality. This increase in the number of approaches to tackle the existence of functional (FC) or effective connectivity (EC) between two (or among many) neural networks, along with the mathematical complexity of the corresponding time series analysis tools, makes it desirable to arrange them into a unified, easy-to-use software package. The goal is to allow neuroscientists, neurophysiologists and researchers from related fields to easily access and make use of these analysis methods from a single integrated toolbox. Here we present HERMES (http://hermes.ctb.upm.es), a toolbox for the Matlab® environment (The Mathworks, Inc), which is designed to study functional and effective brain connectivity from neurophysiological data such as multivariate EEG and/or MEG records. It includes also visualization tools and statistical methods to address the problem of multiple comparisons. We believe that this toolbox will be very helpful to all the researchers working in the emerging field of brain connectivity analysis.

Integrated deterministic-probabilistic safety assessment methodologies

(ENG) IDPSA (Integrated Deterministic-Probabilistic Safety Assessment) is a family of methods which use tightly coupled probabilistic and deterministic approaches to address respective sources of uncertainties, enabling Risk informed decision making in a consistent manner. The starting point of the IDPSA framework is that safety justification must be based on the coupling of deterministic (consequences) and probabilistic (frequency) considerations to address the mutual interactions between stochastic disturbances (e.g. failures of the equipment, human actions, stochastic physical phenomena) and deterministic response of the plant (i.e. transients). This paper gives a general overview of some IDPSA methods as well as some possible applications to PWR safety analyses (SPA)DPSA (Metodologías Integradas de Análisis Determinista-Probabilista de Seguridad) es un conjunto de métodos que utilizan métodos probabilistas y deterministas estrechamente acoplados para abordar las respectivas fuentes de incertidumbre, permitiendo la toma de decisiones Informada por el Riesgo de forma consistente. El punto de inicio del marco IDPSA es que la justificación de seguridad debe estar basada en el acoplamiento entre consideraciones deterministas (consecuencias) y probabilistas (frecuencia) para abordar la interacción mutua entre perturbaciones estocásticas (como por ejemplo fallos de los equipos, acciones humanas, fenómenos físicos estocásticos) y la respuesta determinista de la planta (como por ejemplo los transitorios). Este artículo da una visión general de algunos métodos IDSPA así como posibles aplicaciones al análisis de seguridad de los PWR.

Evaluation of air quality impacts with an integrated assessment model for Spain

The present paper describes the advancement and evaluation of air quality-related impacts with the Atmospheric Evaluation and Research Integrated system for Spain (AERIS). In its current version, AERIS is able to provide estimates on the impacts of air quality over human health (PM2.5 and O3), crops and vegetation (O3). The modules that allow quantifying the before mentioned impacts were modeled by applying different approaches (mostly for the European context) present in scientific literature to the conditions of the Iberian Peninsula. This application was supported by reliable data sources, as well as by the good predictive capacity of AERIS for ambient concentrations. For validation purposes, the estimates of AERIS for impacts on human health (change in the statistical life expectancy-PM2.5) and vegetation (loss of wheat crops-O3) were compared against results from the SERCA project and GAINS estimates for two emission scenarios. In general, good results evidenced by reasonable correlation coefficients were obtained, therefore confirming the adequateness of the followed modeling approaches and the quality of AERIS predictions.

Application of a SPH depth-integrated model to landslide run-out analysis

Hazard and risk assessment of landslides with potentially long run-out is becoming more and more important. Numerical tools exploiting different constitutive models, initial data and numerical solution techniques are important for making the expert’s assessment more objective, even though they cannot substitute for the expert’s understanding of the site-specific conditions and the involved processes. This paper presents a depth-integrated model accounting for pore water pressure dissipation and applications both to real events and problems for which analytical solutions exist. The main ingredients are: (i) The mathematical model, which includes pore pressure dissipation as an additional equation. This makes possible to model flowslide problems with a high mobility at the beginning, the landslide mass coming to rest once pore water pressures dissipate. (ii) The rheological models describing basal friction: Bingham, frictional, Voellmy and cohesive-frictional viscous models. (iii) We have implemented simple erosion laws, providing a comparison between the approaches of Egashira, Hungr and Blanc. (iv) We propose a Lagrangian SPH model to discretize the equations, including pore water pressure information associated to the moving SPH nodes

Evaluation of the Implementation of CLIL (Content and Language Integrated Learning) Methodology in the Didactics of the English Language in Preschool Education Course Taught in the Preschool Education Teacher Undergraduate Program at the University of Alicante

Although it is known that the Spanish current Educative System promotes using the Communicate Approach to teach foreign languages in schools, other recently designed approaches are also used to help students improve their skills when communicating in a foreign language. One of these approaches is Content and Language Integrated Learning, also known as CLIL, which is used to teach content courses using the English language as the language of instruction. This approach improves the students’ skills in English as the same time as they learn content from other areas. The goal of this thesis is to present a research project carried out at the University of Alicante during the academic year 2011-2012. With this research we obtained results that provide quantitative and qualitative data which explains how the use of the CLIL methodology affects the English level of students in the “Didactics of the English Language in Preschool Education” course in Preschool Education Teacher Undergraduate Program as students acquire the contents of the course.

Approaches and Strategy for Cancer Research and Surveillance Data: Integration, Information Pipeline, Data Models, and Informatics Opportunities

Thesis (Ph.D.)--University of Washington, 2016-04

Mediated approaches for influencing physical activity: Update of the evidence on mass media, print, telephone and website delivery of interventions

The aim of this paper is to review evidence published since 1997 on the effectiveness of mass media, print, telephone and website-delivered physical activity (PA) interventions. For mass media, there is consistent evidence for impacts on recall of campaign tag lines and message content and modest evidence of short-term impacts on behaviour in some population subgroups. Print-based delivery of programs can have a modest impact on behaviour; research is needed on supplementary strategies to support print programs. Although there is a strong case for the potential of telephone and Internet delivered interventions, there is as yet little evidence that they can be effective. All of these 'mediated' approaches to PA program delivery are likely to be important elements of future public health interventions. The body of evidence for their effectiveness in changing behaviour is currently modest, however, and it is clear that these approaches have not yet been fully developed and evaluated. Combinations of different media and mutually supportive, integrated strategies are likely to be more effective and need to be developed and evaluated systematically, building on the current research evidence base.

An integrated analysis of five double-blind, randomized controlled trials evaluating the safety and efficacy of a hyaluronan product for intra-articular injection in osteoarthritis of the kneel

Objective: Five double-blind, randomized, saline-controlled trials (RCTs) were included in the United States marketing application for an intra-articular hyaluronan (IA-HA) product for the treatment of osteoarthritis (OA) of the knee. We report an integrated analysis of the primary Case Report Form (CRF) data from these trials. Method. Trials were similar in design, patient population and outcome measures - all included the Lequesne Algofunctional Index (LI), a validated composite index of pain and function, evaluating treatment over 3 months. Individual patient data were pooled; a repeated measures analysis of covariance was performed in the intent-to-treat (ITT) population. Analyses utilized both fixed and random effects models. Safety data from the five RCTs were summarized. Results: A total of 1155 patients with radiologically confirmed knee OA were enrolled: 619 received three or five IA-HA injections; 536 received. placebo saline injections. In the active and control groups, mean ages were 61.8 and 61.4 years; 62.4% and 58.8% were women; baseline total Lequesne scores 11.03 and 11.30, respectively. Integrated analysis of the pooled data set found a statistically significant reduction (P < 0.001) in total Lequesne score with hyaluronan (HA) (-2.68) vs placebo (-2.00); estimated difference -0.68 (95% CI: -0.56 to -0.79), effect size 0.20. Additional modeling approaches confirmed robustness of the analyses. Conclusions: This integrated analysis demonstrates that multiple design factors influence the results of RCTs assessing efficacy of intra-articular (IA) therapies, and that integrated analyses based on primary data differ from meta-analyses using transformed data. (C) 2006 OsteoArthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Using integrated metamodeling to define OO design patterns with object-z and UML

Three important goals in describing software design patterns are: generality, precision, and understandability. To address these goals, this paper presents an integrated approach to specifying patterns using Object-Z and UML. To achieve the generality goal, we adopt a role-based metamodeling approach to define patterns. With this approach, each pattern is defined as a pattern role model. To achieve precision, we formalize role concepts using Object-Z (a role metamodel) and use these concepts to define patterns (pattern role models). To achieve understandability, we represent the role metamodel and pattern role models visually using UML. Our pattern role models provide a precise basis for pattern-based model transformations or refactoring approaches.