A comparison of placebo response with major depressive disorder in patients recruited through newspaper advertising versus consultation referrals

Recent evidence indicates few differences between patients recruited through advertising and by consultation referral, and there is some suggestion that those recruited through advertising are more representative of the target community population. However little has been reported on differences in placebo response and compliance in these two patient groups. We conducted a retrospective chart review of 49 patients with major depressive disorder (MDD), recruited through advertising or consultation, randomized to placebo in five clinical trials. Variables included demographics, clinical history, efficacy, compliance, and completion data. Homogeneity was demonstrated for most variables. Differences in placebo groups included significantly lower Hamilton Rating Scale for Depression (HAM-D) scores for the advertisement group throughout the trials. Advertisement patients were also more likely to be early placebo responders and in remission at Days 14 and 28. No differences were found in completion rates or reasons for early termination. Compliance was excellent for both groups. Early placebo response of the advertisement group reinforces the need for trials of at least 8 weeks. In addition, consultation patients may have a more severe illness and be treatment resistant, suggesting they are less generalizable to community practice populations.     

Implementations of a four-level mechanical architecture for fault-tolerant robots

This paper describes a fault tolerant mechanical architecture with four levels devised and implemented in concert with NASA (Tesar, D. & Sreevijayan, D., Four-level fault tolerance in manipulator design for space operations. In First Int. Symp. Measurement and Control in Robotics (ISMCR '90), Houston, Texas, 20–22 June 1990.) Subsequent work has clarified and revised the architecture. The four levels proceed from fault tolerance at the actuator level, to fault tolerance via in-parallel chains, to fault tolerance using serial kinematic redundancy, and finally to the fault tolerance multiple arm systems provide. This is a subsumptive architecture because each successive layer can incorporate the fault tolerance provided by all layers beneath. For instance a serially-redundant robot can incorporate dual fault-tolerant actuators. Redundant systems provide the fault tolerance, but the guiding principle of this architecture is that functional redundancies actively increase the performance of the system. Redundancies do not simply remain dormant until needed. This paper includes specific examples of hardware and/or software implementation at all four levels.     

Molecular and geographic patterns of tuberculosis transmission after 15 years of directly observed therapy

Stevioside is a sweet-tasting glycoside, composed of stevia, a diterpenic carboxylic alcohol with three glucose molecules, mainly used as a substitute for non-alcoholic sweetener. It has previously been shown to reduce blood pressure in studies in animals and human. The effect of intravenous stevioside on the blood pressure was studied in spontaneously hypertensive rats (SHR). The hypotensive effect on both systolic and diastolic blood pressure was dose-dependent for intravenous doses of 50, 100 and 200 mg/kg in conscious SHR. The maximum reductions in systolic and diastolic blood pressure were 31.4 +/- 4.2% and 40.8 +/- 5.6% (mean +/- SEM) respectively and the hypotensive effect lasted for more than 60 min with a dose of 200 mg/kg. Serum dopamine, norepinephrine and epinephrine levels were not changed significantly 60 min after intravenous injection of stevioside 100 mg/kg in anesthetized SHR. The present data show that stevioside given intravenously to conscious SHR was effective in blood pressure reduction and there was no change in serum catecholamines in anaesthetized animals with this natural compound.     

Nucleation and crystallization of polypropylene by mineral fillers: relationship to impact strength

The mechanical properties of mineral-filled polypropylene (PP) are determined not only by the size, shape and modulus of the filler particles, but also by microstructure. For example, poor impact strength is correlated with a high capacity for nucleation of crystallization. In the present study, optical microscopy has been used to measure the growth rate of spherulites in PP. In tandem with this, isothermal d.s.c. measurements have been made of the crystallization of the PP filled with talc, calcium carbonate and stearate-coated carbonate at different loading levels. Computer simulation of spherulite growth has been used to derive the number of nucleating sites per unit volume of polymer and, using surface area measurements, the number of sites per unit area of mineral surface was obtained. Values for talc were, as expected, considerably higher than those for carbonate (and especially coated carbonate) fillers. The presence of filler affects not only the nucleation and kinetics of the crystallization process but also the crystallinity and orientation indices and the proportion of β-phase crystallites present. The connection between these factors and impact strength is discussed. It is concluded that impact properties are determined by inter alia crack pinning and blocking by filler particles, stress concentrations at the edges of the filler particles, and the nucleating ability of the filler.     

Indentation Creep in Single-Crystal Cubic Zirconia at Room Temperature

Indentation creep of yttria- and calcia-fully-stabilized single-crystal zirconia has been observed at room temperature. The Knoop hardnesses decreased by 15% and 12% of their conventional short-time values, respectively, for indentation times of 100000 s.     

Adhesive bonding of stainless steel water tubing

The use of an adhesive to bond stainless steel water tubing, allowing stainless steel fittings to be employed, is considered and compared with the more conventional use of compression or capillary copper fittings together with a soft solder. Tests carried out to determine environmental effects on adhesively bonded stainless steel tubing suitable for domestic water supply, and the strengths of these joints, are described. It has been found that acrylic anaerobic adhesives are suitable for bonding tubing carrying cold water, the joints attaining superior strength to the copper-soldered ones; a reasonable degree of flexing can also be tolerated. It would appear that certain selected adhesives may also be used in joints carrying hot water.     

BPL: A set-based language for distributed system prototyping

Rapid prototyping of software and hardware is recognized as a very important step in timely, cost-effective system development. The complexity inherent in designing distributed computing systems and distributed problem solutions emphasizes the need for effective rapid prototyping tools. ADL/ADS is a testbed user interface tool for experimentation with critical research and design issues pertaining to distributed data processing (DDP). The experimenter expresses a candidate distributed system in terms of experiment objects, along with attributes and relationships. The experiment objects represent hardware, software, and behavior. This paper provides a brief overview of ADL/ADS, and gives especial emphasis to the Behavior Prototyping Language (BPL) within ADL/ADS. BPL is designed for expressing Behavior Modules (B_MODULEs)—the most versatile of the behavior objects. BPL incorporates set-theoretical approaches, and provides syntax designed for effectively describing manipulations of experiment objects, and their attributes and relationships.     

Adherence to antiretroviral therapy and its impact on clinical outcome in HIV-infected patients.

We analyse data on patient adherence to prescribed regimens and surrogate markers of clinical outcome for 168 human immunodeficiency virus infected patients treated with antiretroviral therapy. Data on patient adherence consisted of dose-timing measurements collected for an average of 12 months per patient via electronic monitoring of bottle opening events. We first discuss how such data can be presented to highlight suboptimal adherence patterns and between-patient differences, before introducing two novel methods by which such data can be statistically modelled. Correlations between adherence and subsequent measures of viral load and CD4+T-cell counts are then evaluated. We show that summary measures of short-term adherence, which incorporate pharmacokinetic and pharmacodynamic data on the monitored regimen, predict suboptimal trends in viral load and CD4+T-cell counts better than measures based on adherence data alone.     

Heat stress affects the expression of key genes in the placenta,placental characteristics,and efficiency of Saanen goats and the survival and growth of their kids

Heat stress is detrimental during gestation; however, the effects of heat stress on goat placental characteristics and kid survival remain unclear. The objective of this study was to evaluate the effects of heat stress at final gestation on cortisol concentration, placenta characteristics, and the expression of genes related to placenta. Forty-six primiparous and multiparous Saanen goats were subjected to control (CT; under a thermoneutral environment: air temperature between 12°C and 25°C and the relative humidity from 45 to 73%, n = 23) or heat stress (HS; under a climatic chamber: air temperature at 37°C and the relative humidity at 60 to 70% from 0800 to 1600 h, n = 23) from the last 60 d of pregnancy until the first colostrum suckling. The heat challenge imposed on HS goats during the prepartum period increased their rectal temperature, respiratory frequency, and cortisol levels in plasma and amniotic fluid versus CT goats. In the placenta, HS treatment also increased the expression of the HSPA1A gene. Heat-stressed goats also showed significantly lower expression of HSD11B2 and greater expression of MC2R and NR3C1 than CT goats, suggesting that heat stress decreased the effectiveness by which the HSD11B2 enzyme converts cortisol to cortisone and increased placental responsiveness to cortisol. The HS goats took longer to release the placenta with lighter placental cotyledons, and HS goats had a lower ratio between the kid's weight at birth and placenta weight than CT goats. There was no treatment effect on the kids' survival or weights at birth, but the kids from goats subjected to HS presented lesser cortisol concentration and greater mortality rates at weaning than kids from CT goats. Finally, the overexpression of HSPA1A by HS goats suggests a protective response of placenta. However, the heat stress negatively affected the placenta's expulsion length, placental cotyledons number, weight and area, the ratio between kid's weight and placenta weight, and cortisol signaling. Indeed, the upregulation of MC2R and NR3C1 and downregulation of HSD11B2 on placenta caused by heat stress were associated with greater cortisol concentrations in the amniotic fluid of HS goats. Although HS and CT kids had adequate weights and survival rate during the first weeks of life, the heat stress increased the mortality at weaning of HS kids versus CT kids, suggesting that the heat stress effect persists and can change the ability of kids to respond to weaning challenge.