865 resultados para new cross over concept


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UNLABELLED The FREEDOM study and its Extension provide long-term information about the effects of denosumab for the treatment of postmenopausal osteoporosis. Treatment for up to 8 years was associated with persistent reduction of bone turnover, continued increases in bone mineral density, low fracture incidence, and a favorable benefit/risk profile. INTRODUCTION This study aims to report the results through year 5 of the FREEDOM Extension study, representing up to 8 years of continued denosumab treatment in postmenopausal women with osteoporosis. METHODS Women who completed the 3-year FREEDOM study were eligible to enter the 7-year open-label FREEDOM Extension in which all participants are scheduled to receive denosumab, since placebo assignment was discontinued for ethical reasons. A total of 4550 women enrolled in the Extension (2343 long-term; 2207 cross-over). In this analysis, women in the long-term and cross-over groups received denosumab for up to 8 and 5 years, respectively. RESULTS Throughout the Extension, sustained reduction of bone turnover markers (BTMs) was observed in both groups. In the long-term group, mean bone mineral density (BMD) continued to increase significantly at each time point measured, for cumulative 8-year gains of 18.4 and 8.3 % at the lumbar spine and total hip, respectively. In the cross-over group, mean BMD increased significantly from the Extension baseline for 5-year cumulative gains of 13.1 and 6.2 % at the lumbar spine and total hip, respectively. The yearly incidence of new vertebral and nonvertebral fractures remained low in both groups. The incidence of adverse and serious adverse events did not increase over time. Through Extension year 5, eight events of osteonecrosis of the jaw and two events of atypical femoral fracture were confirmed. CONCLUSIONS Denosumab treatment for up to 8 years was associated with persistent reductions of BTMs, continued BMD gains, low fracture incidence, and a consistent safety profile.

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Background: Adjustment disorders (also known as mental distress in response to a stressor) are among the most frequently diagnosed mental disorders in psychiatry and clinical psychology worldwide. They are also commonly diagnosed in clients engaging in deliberate self-harm and in those consulting general practitioners. However, their reputation in research-oriented mental health remains weak since they are largely underresearched. This may change when the International Statistical Classification of Diseases-11 (ICD-11) by the World Health Organization is introduced, including a new conceptualization of adjustment disorders as a stress-response disorder with positively defined core symptoms. Objective: This paper provides an overview of evidence-based interventions for adjustment disorders. Methods: We reviewed the new ICD-11 concept of adjustment disorder and discuss the the rationale and case study of an unguided self-help protocol for burglary victims with adjustment disorder, and its possible implementation as an eHealth intervention. Results: Overall, the treatment with the self-help manual reduced symptoms of adjustment disorder, namely preoccupation and failure to adapt, as well as symptoms of depression, anxiety, and stress. Conclusions: E-mental health options are considered uniquely suited for offering early intervention after the experiences of stressful life events that potentially trigger adjustment disorders.

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Structural composite lumber (SCL) products often possess significantly higher design values than the top grades of solid lumber, making it a popular choice for both residential and commercial applications. The enhanced mechanical properties of SCL are mainly due to defect randomization and densification of the wood fiber, both largely functions of the size, shape and composition (species) of the wood element. Traditionally, SCL manufacturers have used thin, rectangular elements produced from either moderate density softwoods or low density hardwoods. Higher density hardwood species have been avoided, as they require higher pressures to adequately densify and consolidate the wood furnish. These higher pressures can lead to increased manufacturing costs, damage to the wood fiber and/or a product that is too dense, making it heavy and unreceptive to common mechanical fastening techniques. In the northeastern United States high density, diffuse-porous hardwoods (such as maple, beech and birch) are abundant. Use of these species as primary furnish for a SCL product may allow for a competitive advantage in terms of resource cost against products that rely on veneer grade logs. Proximity to this abundant and relatively inexpensive resource may facilitate entry of SCL production facilities in the northeastern United States, where currently none exist. However, modifications to current strand sizes, geometries or production techniques will likely be required to allow for use of these species. A new SCL product concept has been invented allowing for use of these high density hardwoods. The product, referred to as long-strand structural composite lumber (LSSCL), uses strands of significantly larger cross sectional areas and volumes than existing SCL products. In spite of the large strand size, satisfactory consolidation is achieved without excessive densification of the wood fiber through use of a symmetrical strand geometric cross-section. LSSCL density is similar to that of existing SCL products, but is due mainly to the inherent density of the species, rather than through densification. An experiment was designed and conducted producing LSSCL from both large (7/16”) and small (1/4”) strands, of both square and triangular geometric cross sections. Testing results indicate that the large, triangular strands produce LSSCL beams with projected design values of: Modulus of elasticity (MOEapp) – 1,750,000 psi; Allowable bending stress (Fb) – 2750 psi; Allowable shear stress (Fv) – 260 psi. Several modifications are recommended which may lead to improvement of these values, likely allowing for competition against existing SCL products.

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Atoll islands are subject to a variety of processes that influence their geomorphological development. Analysis of historical shoreline changes using remotely sensed images has become an efficient approach to both quantify past changes and estimate future island response. However, the detection of long-term changes in beach width is challenging mainly for two reasons: first, data availability is limited for many remote Pacific islands. Second, beach environments are highly dynamic and strongly influenced by seasonal or episodic shoreline oscillations. Consequently, remote-sensing studies on beach morphodynamics of atoll islands deal with dynamic features covered by a low sampling frequency. Here we present a study of beach dynamics for nine islands on Takú Atoll, Papua New Guinea, over a seven-decade period. A considerable chronological gap between aerial photographs and satellite images was addressed by applying a new method that reweighted positions of the beach limit by identifying "outlier" shoreline positions. On top of natural beach variability observed along the reweighted beach sections, we found that one third of the analyzed islands show a statistically significant decrease in reweighted beach width since 1943. The total loss of beach area for all islands corresponds to 44% of the initial beach area. Variable shoreline trajectories suggest that changes in beach width on Takú Atoll are dependent on local control (that is, human activity and longshore sediment transport). Our results show that remote imagery with a low sampling frequency may be sufficient to characterize prominent morphological changes in planform beach configuration of reef islands.

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PURPOSE: To report the case of a patient with recurrent, acute posterior multifocal placoid pigment epitheliopathy. To the best of our knowledge, this is the longest documented course with the greatest number of recurrences reported. METHODS: Observational case report of one patient. A 27-year-old otherwise healthy male patient presented with recurrence of new scotomata over 15 years. Fundus photography, fluorescein angiography, indocyanine green angiography, fundus autofluorescence, and optical coherence tomography documented his clinical course. RESULTS: Over the course of 15 years, the patient developed 11 symptomatic (5 imaging-documented) recurrences of acute, posterior multifocal placoid pigment epitheliopathy affecting both eyes. Each episode manifested with new subjective scotomata and new lesions noted on imaging. Symptoms mostly resolved after each episode, and visual outcome remained excellent (20/20 in the right eye and 20/25 left eye at the last follow-up). CONCLUSION: Although typically monophasic, acute posterior multifocal placoid pigment epitheliopathy can rarely present with a recurrent course over a prolonged period of time and should be considered as a diagnosis in patients presenting with recurrent visual symptoms and new placoid lesions on imaging. In recurrent cases, visual recovery may still remain excellent.

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Introduction. The Chinese leader Xi Jinping presented the concept of the New Silk Road – a collection of land and maritime routes – in autumn 2013. Initially, it envisaged the creation of a network of infrastructural connections, mainly transport corridors, between China and its most important economic partner – Europe. The concept grew in importance throughout 2014 to become the key instrument of China’s foreign policy, especially in the areas of public diplomacy and soft power. Towards the end of 2014, the Chinese government announced it would establish a Silk Road Fund worth US$40 billion. The New Silk Road idea is a flexible formula used by China in its dialogue with many other countries. Its inclusive nature helps contribute to diluting the negative impression caused by China’s rapid economic expansion and assertiveness in foreign policy, especially with regard to its neighbours. The process of implementing the New Silk Road concept will allow China to expand its influence within its neighbourhood: in Central and South-Eastern Asia. The New Silk Road will be an alternative point of reference to the US dominance and Russian integration projects in these regions. The concept will legitimise and facilitate the growth of China’s influence in the transit countries on the route to Western Europe, i.e. in the Middle East (Arab countries, Israel and Turkey, the Horn of Africa and Central Europe (the Balkans and the Visegrad Group countries). This concept is also essential for China’s domestic policy. It has become one of Xi Jinping’s main political projects. It will boost the development of China’s central and western provinces. The fact that the concept is open and not fully defined means that it will be a success regardless of the extent to which it will be implemented in practice. Its flexible nature allows China to continue investments already initiated bilaterally and to present them as components of the New Silk Road concept.

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The concept of 'masculinity' has over more years received increased attention within consumer research discourse suggesting the potential of a 'crisis of masculinity', symptomatic of a growing feminisation, or 'queering' of visual imagery and consumption (e.g. Patterson & Elliott, 2002). Although this corpus of research has served to enrich the broader gender identity debate, it is, arguably, still relatively underdeveloped and therefore warrants further insight and elaboration. The aim of this paper is, therefore, to explore how masculinity is represented and interpreted by men using the Dolce et Gabbana men's 2005 print advertising campaign. The rationale for using this particular campaign is that it is one of the most homoerotic, provocative, and well publicised campaigns to cross over from the 'gay' media to more mainstream UK men's magazines. Masculinity, and what it means to be 'masculine', manifests itself within particular ideological, moral, cultural and hegemonic discourses. Masculinity is not a homogenous term which can be simply reduced, and ascribed, to those born as 'male' rather than 'female'.

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The creation of new ventures is a process characterized by the need to decide and take action in the face of uncertainty, and this is particularly so in the case of technology-based ventures. Effectuation theory (Sarasvathy, 2001) has advanced two possible approaches for making decisions while facing uncertainty in the entrepreneurial process. Causation logic is based on prediction and aims at lowering uncertainty, whereas effectuation logic is based on non-predictive action and aims at working with uncertainty. This study aims to generate more fine-grained insight in the dynamics of effectuation and causation over time. We address the following questions: (1) What patterns can be found in effectual and causal behaviour of technology-based new ventures over time? And (2) How may patterns in the dynamics of effectuation and causation be explained?

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Microposts are small fragments of social media content that have been published using a lightweight paradigm (e.g. Tweets, Facebook likes, foursquare check-ins). Microposts have been used for a variety of applications (e.g., sentiment analysis, opinion mining, trend analysis), by gleaning useful information, often using third-party concept extraction tools. There has been very large uptake of such tools in the last few years, along with the creation and adoption of new methods for concept extraction. However, the evaluation of such efforts has been largely consigned to document corpora (e.g. news articles), questioning the suitability of concept extraction tools and methods for Micropost data. This report describes the Making Sense of Microposts Workshop (#MSM2013) Concept Extraction Challenge, hosted in conjunction with the 2013 World Wide Web conference (WWW'13). The Challenge dataset comprised a manually annotated training corpus of Microposts and an unlabelled test corpus. Participants were set the task of engineering a concept extraction system for a defined set of concepts. Out of a total of 22 complete submissions 13 were accepted for presentation at the workshop; the submissions covered methods ranging from sequence mining algorithms for attribute extraction to part-of-speech tagging for Micropost cleaning and rule-based and discriminative models for token classification. In this report we describe the evaluation process and explain the performance of different approaches in different contexts.

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In response to widespread water quality and quantity issues, the New Zealand Government has recently embarked on a number of comprehensive freshwater management reforms, developing a raft of national discussion and policy documents such as “Freshwater Reform 2013 and Beyond” and a National Policy Statement for freshwater management (NPS-FM 2014). Recent resource management reforms and amendments (RMA 2014), based on previous overarching resource management legislation (RMA 1991), set out a new approach and pathway to manage freshwater nationwide. Internationally, there is an increasing trend to engage with indigenous communities for research and collaboration, including indigenous groups as active participants in resource management decision making. What is driving this change toward more engagement and collaboration with indigenous communities is different for each country, and we document the progress and innovation made in this area in New Zealand. The indigenous rights of Māori in New Zealand are stated in the 1840 Treaty of Waitangi and in many forms of New Zealand's legislation. Local and central governments are eager to include local indigenous Māori groups (iwi/hapū) in freshwater management planning processes through meaningful engagement and collaboration. Key to the success of collaborative planning processes for Māori are enduring relationships between local government and Māori, along with adequate resourcing for all partners contributing to the collaborative process. A large number of shared governance and management models for natural resource management have emerged in New Zealand over the past 20 years, and some recent examples are reviewed. We provide some discussion to improve understanding and use of the terms used in these management models such as cogovernance, comanagement, and coplanning, and describe some of the more important frameworks and tools being developed with Māori groups (e.g., iwi/hapū), to strengthen Māori capacity in freshwater management and to support good collaborative process and planning.

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In a range test, one party holds a ciphertext and needs to test whether the message encrypted in the ciphertext is within a certain interval range. In this paper, a range test protocol is proposed, where the party holding the ciphertext asks another party holding the private key of the encryption algorithm to help him. These two parties run the protocol to implement the test. The test returns TRUE if and only if the encrypted message is within the certain interval range. If the two parties do not conspire, no information about the encrypted message is revealed from the test except what can be deduced from the test result. Advantages of the new protocol over the existing related techniques are that it achieves correctness, soundness, °exibility, high e±ciency and privacy simultaneously.

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Objectives: To report on the design, significance and potential impacts of the first documented human clinical trial assessing the anxiolytic and thymoleptic efficacy of an aqueous monoextract of Piper methysticum (kava). The significance of the qualitative element of our clinical trial is also explored. The Kava Anxiety Depression Spectrum Study (KADSS) is a 3-week placebocontrolled, double-blind, cross-over trial involving 60 adult participants (18—65) with elevated stable anxiety and varying levels of depressive symptoms. Aims: The aims of KADSS are: (1) to determine whether an aqueous standardised extract of kava is effective for the treatment of anxiety; (2) to assess the effects of kava on differing levels of depression; and (3) to explore participants’ experience of taking kava via qualitative research. The study also provides preliminary assessment of the safety of an aqueous extract of kava in humans. Conclusion: If results reveal that the aqueous kava preparation exerts significant anxiolytic effects and appears safe, potentially beneficial impacts may occur. Data supporting a safe and effective kava extract may encourage a re-introduction of kava to Europe, UK and Canada. This may provide a major socioeconomic benefit to Pacific Island nations, and to sufferers of anxiety disorders.

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The field was the design of cross-cultural media art exhibition outcomes for the Japanese marketplace. The context was improved understandings of spatial, temporal and contextual exhibition design procedures as they ultimately impact upon the augmentation of cross-cultural understanding. The research investigated cross-cultural new media exhibition practices suited to the specific sensitivies of Japanese exhibition practices. The methodology was principally practice-led. The research drew upon seven years of prior exhibition design practices in order to generate new Japanese exhibition design methodologies. It also empowered Zaim Artpsace’s Japanese curators to later present a range of substantial new media shows. The project also succeeded in developing new cross-cultural alliances that led to significant IDA projects in Beijing, Australia and Europe in the years 2008-10. Through invitations from external curators the new versions of the exhibition work subsequently travelled to 4 other major venues including the prestigious Songzhang Art Museum, Beijing in 07/08, the Block, QUT, Brisbane and the Tokyo International Film festival. Inspiration Art Press printed a major catalogue for the event extensively featuring this exhibition. This project also led to the Sudamalis (2007) paper, ‘Building Capacity: Literacy And Creative Workforce Development Through International Digital Arts Projects’ (IDAprojects) Exhibition Programs And Partnerships’.

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Recombinant glucagon-like peptide-1 (7–36)amide (rGLP-1) was recently shown to cause significant weight loss in type 2 diabetics when administered for 6 weeks as a continuous subcutaneous infusion. The mechanisms responsible for the weight loss are not clarified. In the present study, rGLP-1 was given for 5d by prandial subcutaneous injections (PSI) (76nmol 30min before meals, four times daily; a total of 302·4nmol/24h) or by continuous subcutaneous infusion (CSI) (12·7nmol/h; a total of 304·8nmol/24h). This was performed in nineteen healthy obese subjects (mean age 44·2 (sem 2·5) years; BMI 39·0 (sem 1·2)kg/m2) in a prospective randomised, double-blind, placebo-controlled, cross-over study. Compared with the placebo, rGLP-1 administered as PSI and by CSI generated a 15% reduction in mean food intake per meal (P=0·02) after 5d treatment. A weight loss of 0·55 (sem 0·2) kg (P<0·05) was registered after 5d with PSI of rGLP-1. Gastric emptying rate was reduced during both PSI (P<0·001) and CSI (P<0·05) treatment, but more rapidly and to a greater extent with PSI of rGLP-1. To conclude, a 5d treatment of rGLP-1 at high doses by PSI, but not CSI, promptly slowed gastric emptying as a probable mechanism of action of increased satiety, decreased hunger and, hence, reduced food intake with an ensuing weight loss.

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Purpose: The aim was to construct and advise on the use of a cost-per-wear model based on contact lens replacement frequency, to form an equitable basis for cost comparison. ---------- Methods: The annual cost of professional fees, contact lenses and solutions when wearing daily, two-weekly and monthly replacement contact lenses is determined in the context of the Australian market for spherical, toric and multifocal prescription types. This annual cost is divided by the number of times lenses are worn per year, resulting in a ‘cost-per-wear’. The model is presented graphically as the cost-per-wear versus the number of times lenses are worn each week for daily replacement and reusable (two-weekly and monthly replacement) lenses.---------- Results: The cost-per-wear for two-weekly and monthly replacement spherical lenses is almost identical but decreases with increasing frequency of wear. The cost-per-wear of daily replacement spherical lenses is lower than for reusable spherical lenses, when worn from one to four days per week but higher when worn six or seven days per week. The point at which the cost-per-wear is virtually the same for all three spherical lens replacement frequencies (approximately AUD$3.00) is five days of lens wear per week. A similar but upwardly displaced (higher cost) pattern is observed for toric lenses, with the cross-over point occurring between three and four days of wear per week (AUD$4.80). Multifocal lenses have the highest price, with cross-over points for daily versus two-weekly replacement lenses at between four and five days of wear per week (AUD$5.00) and for daily versus monthly replacement lenses at three days per week (AUD$5.50).---------- Conclusions: This cost-per-wear model can be used to assist practitioners and patients in making an informed decision in relation to the cost of contact lens wear as one of many considerations that must be taken into account when deciding on the most suitable lens replacement modality.