Gastrointestinal (GI) toxicity mediated by dual cyclooxygenase (COX)-1 and COX-2 inhibition of nonsteroidal anti-inflammatory drugs (NSAIDs) can cause serious alterations of mucosal integrity or, ...more commonly, intolerable GI symptoms that may necessitate discontinuation of therapy. Unlike NSAIDs, rofecoxib targets only the COX-2 isoform.
To assess the tolerability of rofecoxib compared with naproxen for treatment of osteoarthritis.
Randomized, controlled trial.
600 office and clinical research sites.
5557 patients (mean age, 63 years) with a baseline diagnosis of osteoarthritis of the knee, hip, hand, or spine.
Rofecoxib, 25 mg/d, or naproxen, 500 mg twice daily. Use of routine medications, including aspirin, was permitted.
Discontinuation due to GI adverse events (primary end point) and use of concomitant medication to treat GI symptoms (secondary end point). Efficacy was determined by patient-reported global assessment of disease status and the Australian/Canadian Osteoarthritis Hand Index, as well as discontinuations due to lack of efficacy. Patients were evaluated at baseline and at weeks 6 and 12.
Rates of cumulative discontinuation due to GI adverse events were statistically significantly lower in the rofecoxib group than in the naproxen group (5.9% vs. 8.1%; relative risk, 0.74 95% CI, 0.60 to 0.92; P = 0.005), as were rates of cumulative use of medication to treat GI symptoms (9.1% vs. 11.2%; relative risk, 0.79 CI, 0.66 to 0.96; P = 0.014). Subgroup analysis of patients who used low-dose aspirin (13%) and those who previously discontinued using arthritis medication because of GI symptoms (15%) demonstrated a relative risk similar to the overall sample for discontinuation due to GI adverse events (relative risk, 0.56 CI, 0.31 to 1.01 and 0.53 CI, 0.34 to 0.84, respectively). No statistically significant difference was observed between treatments for efficacy in treating osteoarthritis or for occurrence of other adverse events.
In patients with osteoarthritis treated for 12 weeks, rofecoxib, 25 mg/d, was as effective as naproxen, 500 mg twice daily, but had statistically significantly superior GI tolerability and led to less use of concomitant GI medications. Benefits of rofecoxib in subgroup analyses were consistent with findings in the overall sample.
The effect of poloidal asymmetry of impurities on impurity transport driven by electrostatic turbulence in tokamak plasmas is analyzed. It is found that in the presence of in-out asymmetric impurity ...populations the zero-flux impurity density gradient (the so-called peaking factor) is significantly reduced. A sign change in the impurity flux may occur if the asymmetry is sufficiently large. This may be a contributing reason for the observed outward convection of impurities in the presence of radio frequency heating. The effect of in-out asymmetry is most significant in regions with low temperature gradients. In the trapped electron mode dominated case also an up-down asymmetry can lead to a sign change in the peaking factor from positive to negative. The effect of ion parallel compressibility on the peaking factor is significant, and leads to positive peaking factors in regions with high temperature gradients, even in the presence of in-out asymmetry.
Isolated teeth, collected from strata assigned to the Brussel Sand Formation (Lutetian, Eocene) at the Imbrechts sand pit (Nederokkerzeel, Vlaams-Brabant, Belgium), form the basis for erecting a new ...species of scyliorhinid shark, Premontreia (Premontreia) lutetiensis. Affinities and heterodonty are discussed.
By presenting linear and nonlinear gyrokinetic studies, based on a balanced neutral beam injection deuterium discharge from the DIII-D tokamak, we demonstrate that impurities alter the scaling of the ...transport on the charge and mass of the main species, and even more importantly, they can dramatically change the energy transport even in relatively small quantities. A poloidally varying equilibrium electrostatic potential can lead to a strong reduction or sign change of the impurity peaking factor due to the combined effect of the in-out impurity density asymmetry and the EXB drift of impurities. We present an approximate expression for the impurity peaking factor and demonstrate that impurity peaking is not significantly affected by impurity self-collisions.
The recently discovered superdeformed band in one of the strontium isotopes has been identified as belonging to
83Sr from a study with the Gammasphere array and the Microball charged-particle ...detector system. From its decay pattern, a spin of
(81 ± 2)
2
h
̵
is deduced for the highest level of this band. Evidence for very fast transition rates and agreement of the characteristics of this band with the theoretical predictions establish the yrast superdeformed nature of this band in
83Sr.
Analog-to-digital converters (ADCs) stand for a significant part of the total power consumption in a massive multiple-input multiple-output (MIMO) base station. One-bit ADCs are one way to reduce ...power consumption. This paper presents an analysis of the spectral efficiency of single-carrier and orthogonal-frequency-division-multiplexing (OFDM) transmission in massive MIMO systems that use one-bit ADCs. A closed-form achievable rate, i.e., a lower bound on capacity, is derived for a wideband system with a large number of channel taps that employ low-complexity linear channel estimation and symbol detection. Quantization results in two types of error in the symbol detection. The circularly symmetric error becomes Gaussian in massive MIMO and vanishes as the number of antennas grows. The amplitude distortion, which severely degrades the performance of OFDM, is caused by variations between symbol durations in received interference energy. As the number of channel taps grows, the amplitude distortion vanishes and OFDM has the same performance as single-carrier transmission. A main conclusion of this paper is that wideband massive MIMO systems work well with one-bit ADCs.
Four superdeformed bands extending over five to twelve transitions have been identified in
81Sr from a study with the Gammasphere array and the Microball charged-particle array. One of the bands ...shows an upbend in the dynamic moment of inertia at a rotational frequency of 1.2 MeV and all bands exhibit a nearly constant moment of inertia below that frequency.
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