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2.
Sensors (Basel) ; 19(1)2018 Dec 20.
Artículo en Inglés | MEDLINE | ID: mdl-30577499

RESUMEN

Rotary-wing small unmanned aircraft systems (sUAS) are increasingly being used for sampling thermodynamic and chemical properties of the Earth's atmospheric boundary layer (ABL) because of their ability to measure at high spatial and temporal resolutions. Therefore, they have the potential to be used for long-term quasi-continuous monitoring of the ABL, which is critical for improving ABL parameterizations and improving numerical weather prediction (NWP) models through data assimilation. Before rotary-wing aircraft can be used for these purposes, however, their performance and the sensors used therein must be adequately characterized. In the present study, we describe recent calibration and validation procedures for thermodynamic sensors used on two rotary-wing aircraft: A DJI S-1000 and MD4-1000. These evaluations indicated a high level of confidence in the on-board measurements. We then used these measurements to characterize the spatiotemporal variability of near-surface (up to 300-m AGL) temperature and moisture fields as a component of two recent field campaigns: The Verification of the Origins of Rotation in Tornadoes Experiment in the Southeast U.S. (VORTEX-SE) in Alabama, and the Land Atmosphere Feedback Experiment (LAFE) in northern Oklahoma.

3.
J Clin Psychiatry ; 69(4): 546-54, 2008 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-18312060

RESUMEN

OBJECTIVE: The goal of this study was to evaluate the efficacy and safety of levetiracetam versus placebo for tardive dyskinesia (TD). METHOD: This double-blind, placebo-controlled, randomized study was conducted at the Connecticut Mental Health Center between September 2004 and April 2006. Antipsychotic-treated patients meeting Glazer-Morgenstern criteria for TD were assigned at random to receive levetiracetam 500 mg/day to 3000 mg/day or placebo for 12 weeks. After completion of 12 weeks, patients were permitted to receive open-label levetiracetam for a further 12 weeks. The principal efficacy outcome measure was improvement in the Abnormal Involuntary Movement Scale (AIMS) total score. Safety was assessed with an adverse event scale, psychiatric symptom rating scales, weight, and hematologic tests. RESULTS: A total of 50 patients were randomly assigned to treatment. AIMS total scores were moderate in severity at baseline. Mixed regression models revealed that AIMS total scores declined 43.5% from baseline in the levetiracetam group compared to 18.7% for placebo (p = .022). Patients continuing levetiracetam in the open-label phase continued to improve, and patients crossed over to open-label levetiracetam improved to a similar degree as those initially assigned. Levetiracetam was well tolerated. CONCLUSION: Levetiracetam appeared effective for TD in this study. The mechanisms of its therapeutic effect are unclear but may involve reducing neuronal hypersynchrony in basal ganglia. Future studies should attempt to replicate the current results. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00291213.


Asunto(s)
Discinesia Inducida por Medicamentos/tratamiento farmacológico , Nootrópicos/uso terapéutico , Piracetam/análogos & derivados , Algoritmos , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Método Doble Ciego , Esquema de Medicación , Discinesia Inducida por Medicamentos/diagnóstico , Femenino , Humanos , Levetiracetam , Masculino , Persona de Mediana Edad , Piracetam/uso terapéutico , Resultado del Tratamiento
4.
Arch Gen Psychiatry ; 62(9): 961-70, 2005 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-16143728

RESUMEN

CONTEXT: It has been suggested that the need for concurrent placebo control groups in new schizophrenia studies might be minimized by making comparisons with external placebo. This strategy requires an assumption of constancy, that the novel medication will perform the same way in a study with only active controls as it would have in a placebo-controlled trial. OBJECTIVE: To test this constancy assumption in active- and low dose-controlled trials vs placebo-controlled trials of atypical antipsychotic medications. DATA SOURCES: A comprehensive search of bibliographic databases, conference proceedings, and Food and Drug Administration databases through November 24, 2003. STUDY SELECTION: English-language, randomized, double-blind clinical trials of newer atypical antipsychotic medications in otherwise unselected acutely ill adults with schizophrenia or schizoaffective disorder that reported baseline and intent-to-treat end point change values for the Brief Psychiatric Rating Scale. DATA EXTRACTION: Study number, sample size, reported dosage for each arm, trial duration, percentage of men, average age, trial arm treatment completion rate, baseline and within-arm end point change in the Brief Psychiatric Rating Scale, method of scoring the Brief Psychiatric Rating Scale, and date of publication were extracted from each study independently by 2 of us (S.W.W. and C.B.B.) each. DATA SYNTHESIS: There were 32 studies comprising 66 risperidone, olanzapine, quetiapine, and ziprasidone arms including 7264 patients. Random-effects analysis revealed that in atypical antipsychotic medication arms, the degree of improvement was nearly double in active-controlled trials than that seen with the same drugs and dosages in placebo-controlled studies. An effect of design was also observed in low dose-controlled studies vs placebo-controlled studies in ineffective and intermediate antipsychotic medication dose ranges. CONCLUSIONS: The observed control group bias indicates that the constancy assumption does not hold in recent antipsychotic medication trials. These results suggest that caution is indicated when considering active- or low dose-controlled studies requiring comparisons with external placebo as alternatives to placebo-controlled trials for establishing efficacy of new medications for schizophrenia.


Asunto(s)
Antipsicóticos/uso terapéutico , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Esquizofrenia/tratamiento farmacológico , Sesgo de Selección , Factores de Edad , Escalas de Valoración Psiquiátrica Breve/estadística & datos numéricos , Método Doble Ciego , Esquema de Medicación , Femenino , Humanos , Masculino , Placebos , Trastornos Psicóticos/tratamiento farmacológico , Trastornos Psicóticos/psicología , Ensayos Clínicos Controlados Aleatorios como Asunto/normas , Proyectos de Investigación/normas , Esquizofrenia/diagnóstico , Psicología del Esquizofrénico , Índice de Severidad de la Enfermedad , Factores Sexuales , Resultado del Tratamiento
5.
Gen Hosp Psychiatry ; 26(3): 233-6, 2004.
Artículo en Inglés | MEDLINE | ID: mdl-15121352

RESUMEN

The aim of this study was to determine whether bipolar patients who had been stabilized on combined antipsychotic and mood-stabilizer medications and were currently in remission benefited from continuation of the antipsychotic medication. Remitted bipolar patients were randomly assigned to either remain on adjunctive antipsychotic medication or to taper to placebo. Antipsychotic/placebo medication assignment was double-blind. Subjects were outpatients at a university-affiliated community mental health center. Fifteen subjects consented and proceeded with eligibility assessments. Five subjects were never randomized. One of these was excluded when the Structured Clinical Interview for DSM-IV interview revealed schizoaffective disorder. The remaining four subjects were not randomized for other reasons. Three randomized subjects never received study medications, or were withdrawn by the investigator within 1 week after beginning study medications. The seven remaining subjects received study medication for more than 1 week. Five subjects were randomized to taper to placebo and two to antipsychotic continuation. Of the five randomized to taper to placebo, three successfully tapered and completed the year of follow-up in continuous remission. One subject became manic 4 months after taper was completed, and one subject became psychotic, in the absence of a mood episode, during taper. Of the two subjects randomized to double-blind antipsychotic continuation, both completed the year of follow-up in continuous remission. When adjunctive antipsychotic medications are discontinued, bipolar patients' clinical symptoms can remain unchanged. Others are, however, at risk for manic relapse.


Asunto(s)
Antimaníacos/uso terapéutico , Antipsicóticos/uso terapéutico , Trastorno Bipolar/tratamiento farmacológico , Centros Médicos Académicos , Antimaníacos/administración & dosificación , Antimaníacos/efectos adversos , Antipsicóticos/administración & dosificación , Antipsicóticos/efectos adversos , Trastorno Bipolar/patología , Centros Comunitarios de Salud Mental , Toma de Decisiones , Método Doble Ciego , Quimioterapia Combinada , Humanos , Entrevista Psicológica , Placebos , Recurrencia , Inducción de Remisión
6.
Br J Psychiatry ; 183: 498-506, 2003 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-14645020

RESUMEN

BACKGROUND: Concern is widespread about potential sponsorship influence on research, especially in pharmacoeconomic studies. Quantitative analysis of possible bias in such studies is limited. AIMS: To determine whether there is an association between sponsorship and quantitative outcomes in pharmacoeconomic studies of antidepressants. METHOD: Using all identifiable articles with original comparative quantitative cost or cost-effectiveness outcomes for antidepressants, we performed contingency table analyses of study sponsorship and design v. study outcome. RESULTS: Studies sponsored by selective serotonin reuptake inhibitor (SSRI) manufacturers favoured SSRIs over tricyclic antidepressants more than non-industry-sponsored studies. Studies sponsored by manufacturers of newer antidepressants favoured these drugs more than did non-industry-sponsored studies. Among industry-sponsored studies, modelling studies favoured the sponsor's drug more than did administrative studies. Industry-sponsored modelling studies were more favourable to industry than were non-industry-sponsored ones. CONCLUSIONS: Pharmacoeconomic studies of antidepressants reveal clear associations of study sponsorship with quantitative outcome.


Asunto(s)
Antidepresivos/economía , Investigación Biomédica/normas , Industria Farmacéutica , Antidepresivos/uso terapéutico , Antidepresivos Tricíclicos/economía , Antidepresivos Tricíclicos/uso terapéutico , Conflicto de Intereses , Análisis Costo-Beneficio/métodos , Ética en Investigación , Organización de la Financiación/economía , Humanos , Proyectos de Investigación/normas , Inhibidores Selectivos de la Recaptación de Serotonina/economía , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéutico , Resultado del Tratamiento
7.
Depress Anxiety ; 17(1): 1-9, 2003.
Artículo en Inglés | MEDLINE | ID: mdl-12577272

RESUMEN

The limitations in design and analysis of currently available dose-response studies of SSRI treatment of major depression have led to the conclusion that dose response is flat. We applied concepts from our companion article to determine if currently available data is consistent with a "potential" and an "expressed" dose response. Using these concepts, we performed a meta-analysis on all identifiable published fixed-dose and dose-escalation studies that reported the effect of different SSRI oral doses on efficacy. "Potential" dose response in fixed-dose studies with categorical response outcomes equaled a significant meta-analyzed slope of 3.1%/100 SSRI mg equivalents (SMEs) (SE=1.2%) or 7.8% across the dose range. Similar analysis in dose-escalation studies that reported categorical response data yielded a non-significant meta-analyzed slope of 3.7%/100 SMEs (SE=2.3%) or 9.3% across the dose range. Analyses of the "expressed" dose response demonstrated in the studies indicated a slope statistically equal to zero. The current analysis suggests a "potential" dose response can be demonstrated for SSRIs in treating major depression. The analysis suggests an "expressed" dose response could exist in best clinical practice. Study designs better tailored to address the relevant clinical question would test these hypotheses more appropriately than previous studies.


Asunto(s)
Trastorno Depresivo Mayor/tratamiento farmacológico , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéutico , Relación Dosis-Respuesta a Droga , Humanos , Inhibidores Selectivos de la Recaptación de Serotonina/administración & dosificación
8.
Depress Anxiety ; 17(1): 10-8, 2003.
Artículo en Inglés | MEDLINE | ID: mdl-12577273

RESUMEN

It has been widely stated that the available research data has not demonstrated a SSRI dose response for major depression. We re-evaluated the methods used to analyze the SSRI data by clarifying two key alternative definitions of dose response and their implications for enhancing analysis of currently available data as well as future study design. We differentiated "potential" dose response, which focuses exclusively on response excluding tolerability effects and asks whether differences in dose can result in significant differences in response, from "expressed" dose response, which incorporates all tolerability effects currently associated with dose (including those caused by study protocol or treatment practice) and asks whether differences in dose do result in significant differences in response. To analyze potential dose response for all studies, one should use a "dose-tolerant" sample, i.e., an ITT sample from which dropouts due to adverse events have been removed. To analyze an expressed dose response, an ITT sample is the optimum sample if the study conforms to several design specifications. In the absence of conformance to these specifications, an ITT sample may be an approximation of the appropriate sample. Given design limitations of currently available studies, a dose-tolerant sample may provide a more informative approximation of an optimal sample to be used in evaluating the expressed dose response that could be expected in the best clinical practice. Future studies of dose-response relations could be enhanced by taking into account the principles noted above, and currently available data should be reanalyzed based on these principles. This re-analysis is performed in a companion article [Baker et al. 2003, Depress Anxiety 17:1-9].


Asunto(s)
Trastorno Depresivo Mayor/tratamiento farmacológico , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéutico , Relación Dosis-Respuesta a Droga , Tolerancia a Medicamentos , Humanos , Pacientes Desistentes del Tratamiento , Inhibidores Selectivos de la Recaptación de Serotonina/efectos adversos
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