- Global Improvement: The Five Focusing Steps

1998 ◽  
pp. 184-193
Keyword(s):  
Global Improvement

scholarly journals Avolition as the core negative symptom in schizophrenia: relevance to pharmacological treatment development

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Gregory P. Strauss ◽  
Lisa A. Bartolomeo ◽  
Philip D. Harvey
Keyword(s):  
Negative Symptom ◽  
Negative Symptoms ◽  
Clinical Trial Design ◽  
Core Component ◽  
Treatment Target ◽  
Global Improvement ◽  
Treatment Development ◽  
The Core ◽  
Current Review ◽  
Symptom Domains

AbstractNegative symptoms have long been considered a core component of schizophrenia. Modern conceptualizations of the structure of negative symptoms posit that there are at least two broad dimensions (motivation and pleasure and diminished expression) or perhaps five separable domains (avolition, anhedonia, asociality, blunted affect, alogia). The current review synthesizes a body of emerging research indicating that avolition may have a special place among these dimensions, as it is generally associated with poorer outcomes and may have distinct neurobiological mechanisms. Network analytic findings also indicate that avolition is highly central and interconnected with the other negative symptom domains in schizophrenia, and successfully remediating avolition results in global improvement in the entire constellation of negative symptoms. Avolition may therefore reflect the most critical treatment target within the negative symptom construct. Implications for targeted treatment development and clinical trial design are discussed.

scholarly journals A Random Forest Model for the Prediction of FOG Content in Inlet Wastewater from Urban WWTPs

Water ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 1237
Author(s):  
Vanesa Mateo Pérez ◽  
José Manuel Mesa Fernández ◽  
Joaquín Villanueva Balsera ◽  
Cristina Alonso Álvarez
Keyword(s):  
Random Forest ◽  
Wastewater Treatment Plants ◽  
Learning Algorithm ◽  
Global Improvement ◽  
Treatment Processes ◽  
Early Adoption ◽  
Novel Approach ◽  
Number Of Factors ◽  
Initial Stage ◽  
Correct Design

The content of fats, oils, and greases (FOG) in wastewater, as a result of food preparation, both in homes and in different commercial and industrial activities, is a growing problem. In addition to the blockages generated in the sanitary networks, it also represents a difficulty for the performance of wastewater treatment plants (WWTP), increasing energy and maintenance costs and worsening the performance of downstream treatment processes. The pretreatment stage of these facilities is responsible for removing most of the FOG to avoid these problems. However, so far, optimization has been limited to the correct design and initial installation dimensioning. Proper management of this initial stage is left to the experience of the operators to adjust the process when changes occur in the characteristics of the wastewater inlet. The main difficulty is the large number of factors influencing these changes. In this work, a prediction model of the FOG content in the inlet water is presented. The model is capable of correctly predicting 98.45% of the cases in training and 72.73% in testing, with a relative error of 10%. It was developed using random forest (RF) and the good results obtained (R2 = 0.9348 and RMSE = 0.089 in test) will make it possible to improve operations in this initial stage. The good features of this machine learning algorithm had not been used, so far, in the modeling of pretreatment parameters. This novel approach will result in a global improvement in the performance of this type of facility allowing early adoption of adjustments to the pretreatment process to remove the maximum amount of FOG.

scholarly journals SURG-03. IMMERSIVE VIRTUAL REALITY APPLICATIONS IN NEUROSURGICAL ONCOLOGY

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii461-iii461
Author(s):  
Andrea Carai ◽  
Angela Mastronuzzi ◽  
Giovanna Stefania Colafati ◽  
Paul Voicu ◽  
Nicola Onorini ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Real Time ◽  
New Technologies ◽  
Young Patients ◽  
Spatial Relationship ◽  
3D Models ◽  
Immersive Virtual Reality ◽  
Global Improvement ◽  
3D Rendering ◽  
Before And After

Abstract Tridimensional (3D) rendering of volumetric neuroimaging is increasingly been used to assist surgical management of brain tumors. New technologies allowing immersive virtual reality (VR) visualization of obtained models offer the opportunity to appreciate neuroanatomical details and spatial relationship between the tumor and normal neuroanatomical structures to a level never seen before. We present our preliminary experience with the Surgical Theatre, a commercially available 3D VR system, in 60 consecutive neurosurgical oncology cases. 3D models were developed from volumetric CT scans and MR standard and advanced sequences. The system allows the loading of 6 different layers at the same time, with the possibility to modulate opacity and threshold in real time. Use of the 3D VR was used during preoperative planning allowing a better definition of surgical strategy. A tailored craniotomy and brain dissection can be simulated in advanced and precisely performed in the OR, connecting the system to intraoperative neuronavigation. Smaller blood vessels are generally not included in the 3D rendering, however, real-time intraoperative threshold modulation of the 3D model assisted in their identification improving surgical confidence and safety during the procedure. VR was also used offline, both before and after surgery, in the setting of case discussion within the neurosurgical team and during MDT discussion. Finally, 3D VR was used during informed consent, improving communication with families and young patients. 3D VR allows to tailor surgical strategies to the single patient, contributing to procedural safety and efficacy and to the global improvement of neurosurgical oncology care.

scholarly journals The value of regional myocardial function assessment in patients with acute myocarditis at baseline and mid term follow-up

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Boidol ◽  
M Koziel ◽  
K Miszalski-Jamka ◽  
J Klys ◽  
Z Kalarus ◽  
...  
Keyword(s):  
Longitudinal Strain ◽  
Ventricular Remodeling ◽  
Clinical Course ◽  
Troponin T ◽  
Global Longitudinal Strain ◽  
Cardiac Resynchronization ◽  
Global Improvement ◽  
Myocardial Disease ◽  
Mechanical Dispersion

Abstract Background The clinical course and ventricular remodeling in inflammatory myocardial disease could be unpredictable. No single functional parameter has been confirmed as a powerful predictor of clinical course and functional recovery assessment in patients with acute inflammatory myocardial disease. Purpose The aim of the study was to assess the mechanical properties of the myocardium in patients with active myocarditis at baseline and follow-up. Methods Database from a high volume, tertiary cardiology center was analysed to identify patients with active myocarditis, based on clinical presentation and ≥1 diagnostic criteria from different categories (including electrocardiography/holter, elevated troponin T/I levels, functional or structural abnormalities on cardiac imaging or tissue characterization by cardiac magnetic resonance) between 2016 and 2019. Conventional and speckle tracking echocardiography including global longitudinal strain (GLS) mechanical dispersion (MD) was completed at baseline and at 17±13 months follow-up. MD was calculated as a standard deviation of time to peak longitudinal strain derived from all left ventricle segments in 3 apical views. Results 61 consecutive patients [50 M, 11F, end-diastolic volume 212±84 ml, end-systolic volume 130±90ml, ejection fraction (EF) 42±16%] were enrolled. During the entire follow-up 1 patient died at early observation. Implantable cardioverter-defibrillator was implanted in 5 patients (primary prevention 4, secondary 1), cardiac resynchronization therapy pacemaker in 1 patient. Despite of significant global improvement (EF 42±16% vs 52±10%, p<0.001) the limited regional improvement was noticed (GLS 14±6% vs 15±4%, p = NS; MD 47±18 ms vs 45±20 ms, p=NS) in all patients at 17±13 months follow-up. There was a strong negative association between GLS and MD at baseline (Figure 1), and slightly weaker at follow-up (R=0.47, Pearson's correlation). Moreover, the GLS correlated well the change of MD in each individual patient. Conclusions Mechanical dispersion and global longitudinal strain may serve as an additional markers of myocardial damage and potential predictive markers in non ischemic cardiomyopathy patients with proven inflammatory origin. Funding Acknowledgement Type of funding source: None

scholarly journals Multi-Step Energy Demand and Generation Forecasting with Confidence Used for Specification-Free Aggregate Demand Optimization

Energies ◽  
2021 ◽  
Vol 14 (11) ◽  
pp. 3162
Author(s):  
Nikolaos Kolokas ◽  
Dimosthenis Ioannidis ◽  
Dimitrios Tzovaras
Keyword(s):  
Optimization Algorithm ◽  
Energy Demand ◽  
Aggregate Demand ◽  
Multiple Model ◽  
Peak Shaving ◽  
Global Improvement ◽  
Forecasting Models ◽  
Consumption Cost ◽  
Model Training ◽  
Time Point

Energy demand and generation are common variables that need to be forecast in recent years, due to the necessity for energy self-consumption via storage and Demand Side Management. This work studies multi-step time series forecasting models for energy with confidence intervals for each time point, accompanied by a demand optimization algorithm, for energy management in partly or completely isolated islands. Particularly, the forecasting is performed via numerous traditional and contemporary machine learning regression models, which receive as input past energy data and weather forecasts. During pre-processing, the historical data are grouped into sets of months and days of week based on clustering models, and a separate regression model is automatically selected for each of them, as well as for each forecasting horizon. Furthermore, the multi-criteria optimization algorithm is implemented for demand scheduling with load shifting, assuming that, at each time point, demand is within its confidence interval resulting from the forecasting algorithm. Both clustering and multiple model training proved to be beneficial to forecasting compared to traditional training. The Normalized Root Mean Square Error of the forecasting models ranged approximately from 0.17 to 0.71, depending on the forecasting difficulty. It also appeared that the optimization algorithm can simultaneously increase renewable penetration and achieve load peak shaving, while also saving consumption cost in one of the tested islands. The global improvement estimation of the optimization algorithm ranged approximately from 5% to 38%, depending on the flexibility of the demand patterns.

The effects of a tactical games model unit on students’ volleyball performances in elementary school

2021 ◽  
pp. 1356336X2110058
Author(s):  
Francesco Sgrò ◽  
Roberto Coppola ◽  
Rosaria Schembri ◽  
Mario Lipoma
Keyword(s):  
Elementary School ◽  
Repeated Measures ◽  
Skill Level ◽  
Assessment Procedure ◽  
School Students ◽  
Post Intervention ◽  
Summer Learning ◽  
Global Improvement ◽  
Summer Vacation ◽  
Tactical Games

The purpose of this study was to examine the effects of a tactical games model instructional plan on game-play volleyball performances of elementary school students, taking into account their skill level. In total, 39 fourth-grade students (average age: 8.9 years) participated in a 13-week unit, in which each lesson exaggerated the use of small-sided games. In-game performances were assessed via the Team Sport Assessment Procedure, while students played a 10-minute modified game (four versus four). Data were collected pre- and post-intervention, and after the summer vacation (retention test). A 2 (skill level) × 3 (time) analysis of variance with repeated measures was used to compare students’ performance, and the relevant effects were interpreted mainly by means of confidence intervals and effect size measures. At the end of the instructional period, all participants had an overall moderate to large improvement, and this global improvement seems to have remained at least until the end of the summer vacation. Lower-skilled students attained a larger and more established improvement than high-skilled students did. However, some detrimental effects on in-game students’ performance existed at the end of the instructional period. Therefore, teachers have to take into account students’ skill levels when designing their lessons because, if small-sided games are adequately considered and managed, students’ learning processes can be enhanced. Furthermore, the students should be assigned appropriate learning activities to avoid summer learning loss in physical education.

Irritable bowel syndrome and transplantation of fecal microbiota. Review

2021 ◽  
Author(s):  
G. D. Fadieienko ◽  
O. Y. Gridnyev
Keyword(s):  
Irritable Bowel Syndrome ◽  
Fecal Microbiota Transplantation ◽  
Positive Outcome ◽  
Fecal Microbiota ◽  
Cochrane Library ◽  
Placebo Control ◽  
Global Improvement ◽  
Recurrent Clostridium Difficile Infection ◽  
Significant Difference ◽  
Irritable Bowel

Objective — to perform analysis of the literature data as regards the efficacy of the use of fecal microbiota transplantation (FMT) in patients with the irritable bowel syndrome (IBS). Materials and methods. The systematic review of the literature (PubMed, MEDLINE, Cochrane Library) has been performed to assess the results of investigation on the use of FMT in adult IBS patients. Results. Currently, FMT is a safe and highly successful method of treatment for recurrent Clostridium difficile infection, and possibility to use FMT in the treatment of other diseases is under investigation. The results of FMT treatment of patients with IBS are contradictory. A number of authors outline fairly high FMT efficacy when used for the treatment of patients with IBS, refractory to the standard methods: it varies from 36 % to 70 % with a duration of adequate symptoms’ relief up to 1 year. However, other authors indicate that the positive FMT clinical effect lasted from 8 weeks to 3 months, after which there was a gradual recovery of symptoms. At the same time, the researchers noted that mostly often the positive outcome was reached after FMT from donors with a higher number of streptococci in the feces. Still others point out that there was no sustained, at least 50‑point reduction in the severity of IBS symptoms from baseline. Some authors did not reveal the advantages of FMT over placebo control and even reported about the higher placebo efficacy. After data generalization no significant difference was revealed in the global improvement in IBS symptoms in patients receiving donor FM versus placebo. However, the attention is drawn to the relationship between the results of FMT with methodology. Indeed, several studies have shown that placebo capsules were more effective than capsules containing donor feces, whereas FMT from donor stool delivered by colonoscopy was superior to FMF from autologous stool. This may be due to the excipients, containing in the capsulated FMT. A number of researchers also indicated that the use of a super donor is necessary for successful FMT and that the response to FMT is dose dependent. Conclusions. To resolve the issue of the expediency of using FMT in routine clinical practice in patients with IBS, more qualitative controlled studies, involving large cohorts of IBS patients and long‑term follow‑up, are required.  

scholarly journals Quantitative Effects of Repeated Muscle Vibrations on Gait Pattern in a 5-Year-Old Child with Cerebral Palsy

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Filippo Camerota ◽  
Manuela Galli ◽  
Claudia Celletti ◽  
Sara Vimercati ◽  
Veronica Cimolin ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Pelvic Tilt ◽  
Step Length ◽  
Gait Pattern ◽  
Triceps Surae ◽  
Knee Joints ◽  
Global Improvement ◽  
Positive Effects ◽  
Effective Option ◽  
Spatio Temporal

Objective. To investigate quantitatively and objectively the effects of repeated muscle vibration (rMV) of triceps surae on the gait pattern in a 5-year-old patient with Cerebral Palsy with equinus foot deformity due to calf spasticity.Methods. The patient was assessed before and one month after the rMV treatment using Gait Analysis.Results. rMV had positive effects on the patient's gait pattern, as for spatio-temporal parameters (the stance duration and the step length increased their values after the treatment) and kinematics. The pelvic tilt reduced its anteversion and the hip reduced the high flexion evidenced at baseline; the knee and the ankle gained a more physiological pattern bilaterally. The Gillette Gait Index showed a significant reduction of its value bilaterally, representing a global improvement of the child's gait pattern.Conclusions. The rMV technique seems to be an effective option for the gait pattern improvement in CP, which can be used also in very young patient. Significant improvements were displayed in terms of kinematics at all lower limb joints, not only at the joint directly involved by the treatment (i.e., ankle and knee joints) but also at proximal joints (i.e., pelvis and hip joint).

Escitalopram orally-disintegrating tablets (ODT) in major depression treatment

2016 ◽  
Vol 33 (S1) ◽  
pp. S158-S158
Author(s):  
M. Polikowska ◽  
B. Łoza
Keyword(s):  
Major Depression ◽  
Depressive Disorders ◽  
Rating Scale ◽  
Treatment Compliance ◽  
Well Being ◽  
Dropout Rate ◽  
Global Improvement ◽  
Orally Disintegrating Tablets ◽  
Long Term Treatment ◽  
Significant Difference

IntroductionThe growing rate of depressive disorders causes needs for more effective and more innovative solutions. The modern patients’ challenges make them fail mostly in the treatment compliance. Some reports have described that escitalopram orally disintegrating tablets (ODT) induce faster response and lower dropout rate than oral standard tablets (OST), although both forms have equal bioavailability.AimWe tried to clarify effectiveness rates between escitalopram ODT and OST treatments in depressive patients.MethodAn open-label, 6-month, randomized, flexible-dose study was conducted for direct comparison of the effects of escitalopram ODT (N16) and OST (N15) on dropout rate and clinical outcomes in patients with major depression.ResultsOutcome measures included Hamilton Depression Rating Scale (HDRS), Drug Attitude Inventory-10 (DAI), Clinical Global Improvement Scale (CGI), and Psychological General Well-Being Scale (PGWB). The tolerability was assessed by the UKU scale. No significant difference was found in HDRS, CGI, PGWB and GAF between the two forms of tablets. No significant difference was found in any tolerability rates. However, dropout rate favored escitalopram ODT group (N5, 31.3%) vs escitalopram OST (N7, 47.0%). DAI-10 outcomes, both in patients’ general attitude and subjective feelings, were significantly improved in ODT group (P = 0.000), comparing with OST.DiscussionEscitalopram in its classical form (OST) has become a leader in a group of antidepressants, thanks to safety of use, efficacy and tolerability. In the ODT form, escitalopram can meet additional needs, both clinical and lifestyle. ODT may reduce dropout rate and costs of long-term treatment improving the patients’ compliance.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The Efficacy and Tolerability of Combined Antidepressant Treatment in Different Depressive Subgroups

1993 ◽  
Vol 162 (3) ◽  
pp. 363-368 ◽  
Author(s):  
Sinead O'brien ◽  
Patrick McKeon ◽  
Myra O'regan
Keyword(s):  
Treatment Group ◽  
Side Effects ◽  
Major Depression ◽  
Orthostatic Hypotension ◽  
Antidepressant Treatment ◽  
Combined Treatment ◽  
Endogenous Depression ◽  
Double Blind Study ◽  
Double Blind ◽  
Global Improvement

Eighty patients admitted to hospital with major depression were randomly allocated to six weeks of treatment with tranylcypromine, amitriptyline, or tranylcypromine and amitriptyline in combination, in a double-blind study. Scores on the HRSD improved significantly in all three groups, but there were no differences between the three groups. Patients on tranylcypromine and amitriptyline combined improved more according to their self-ratings after six weeks, and response was earlier as measured by a clinical global improvement scale. Those with endogenous depression improved more than those with neurotic depression, irrespective of treatment group. Combined treatment was less well tolerated than single treatments and gave rise to more side-effects, although there was no serious toxicity. Orthostatic hypotension was observed more frequently in patients on combined treatment. This group also experienced a significant increase in weight and prolongation of the P-R interval on ECG.

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