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Oregon Legislature
Divide over drug costs spills into Legislature
Groups with ties to industry attack bill in Oregon House
Groups with ties to industry attack bill in Oregon House
Appeared in print: page A1
SALEM — An ambitious attempt to try to rein in prescription drug prices on about a third of Oregon health insurance plans has run into a buzz saw of opposition in the Capitol.
The concept of curbing fast-growing drug costs is very popular with voters nationally, polls show. Democratic and Republican state lawmakers say high prices are a problem.
But the experience of House Bill 2387 this session illustrates strong differences of opinion about how to cut prices.
It also shows how two well-funded lobby groups — the pharmaceutical industry and health insurance companies — have aggressively tried to shift the policy discussion to their advantage. The drug industry opposes the bill, but many insurers like it.
Two groups with ties to the pharmaceutical industry are running unusual full-page ads in several Oregon newspapers, including The Register-Guard, attacking the bill, which is stuck in committee.
HB 2387 would apply to health insurance plans provided by small businesses and some larger companies to their employees, as well as insurance the state of Oregon offers to state government workers and K-12 public school teachers, and to people who buy their own insurance. It wouldn't apply to people who are covered through Medicaid or Medicare, or are insured through big self-insured companies.
Rep. Rob Nosse, a Portland Democrat, wrote HB 2387 after months of meetings with representatives of both industries as well as patient advocacy and consumer protection groups. No state has ever passed a law like it. But supporters say states need to act now because the federal government for years has failed to control drug costs.
Originally, Nosse conceived a simple maximum amount, either $250 or $500, that patients on all state-regulated private insurance plans and some public employees would pay out of pocket for prescriptions every year.
But in a key concession to the health insurance industry, Nosse then added an unusual component to his bill: If a drug company charges a patient in Oregon more for a pharmaceutical than an average price for that drug in other developed countries, the drug company must pay — or "rebate" — the difference directly to the health insurer. The bill doesn't specify how the insurer must use that rebate money.
Essentially, the bill would try to peg what drug companies are paid for drugs in Oregon to what they are paid in other developed countries, many of which cap or otherwise control drug prices.
A new line of attack
Nosse said "the pretty robust rebate" component to insurance companies is what makes the bill work. Otherwise, he said, health insurers would just respond to a cap on how much consumers pay for prescriptions by upping the overall premiums for their plans.
"Then the bill would just end up being a shift in health care costs," Nosse said.
Crucially, the addition of the rebate section won support for the bill from many Oregon health insurers.
"Unlike a 'standalone' co-pay dollar cap, HB 2387 is a sustainable solution that requires shared accountability by (drug) manufacturers and insurers," Jacob Thompson of Providence Health Plans wrote to lawmakers in a hearty endorsement of the bill.
But for the pharmaceutical industry, Nosse's sweetener for insurers opened up a new line of attack on the bill — beyond the traditional arguments that price controls reduce patient access to medicine and revenue for the research and development of new drugs.
Pharma representatives soon began arguing that the "rebate" would give a "windfall" to health insurers.
More unexpectedly, several national groups that claim to advocate for the sick came out against the bill as well.
Caregivers voice opposition
One Washington, D.C.-based nonprofit group, Caregiver Voices United, is running a newspaper and radio ad campaign against the bill in Oregon. The group calls the bill a "big insurance bailout."
The group is a subsidiary of the Caregiver Action Network, whose top funder is the Pharmaceutical Research and Manufacturers of America. Other corporate partners include pharma firms Allergan, Genentech and GlaxoSmithKline, according to its website.
John Schall, the group's CEO, said he opposes HB 2387 because "it was never clear to us how the savings (from the rebate) would be passed on to the consumer."
Schall declined to say what share of his group's $1 million-a-year budget comes from pharmaceutical firms, but he added the drug industry "has no control at all over our editorial content, which comes from caregivers."
"Nonprofits always exist on donations from individuals and corporations," he said.
Another national group, The Partnership to Fight Chronic Disease, has submitted written testimony against the bill. That nonprofit group, which didn't respond to Register-Guard requests for comment, has yearly revenues of more than $3 million.
While it doesn't disclose individual donations, its funders include a half-dozen pharmaceutical companies. Its executive director, Ken Thorpe, has an annual salary of $480,000 a year, and he serves as a paid consultant for California-based Vivus Pharmaceuticals.
Other ads have been paid for by PILMA — the Pharmaceutical Industry Labor-Management Association — a coalition of labor unions and pharma interests. The unions that are part of the group build and maintain pharmaceutical research and development facilities.
OSPIRG rep weighs in
The attacks are frustrating for Jesse Ellis O'Brien of consumer advocacy group OSPIRG, which supports HB 2387.
"It's not unreasonable to say that they're coming from front groups" for the pharmaceutical industry, he said.
More than 80 percent of patient advocacy groups nationwide receive at least some funds from pharmaceutical or medical device firms, according to a recent study in The New England Journal of Medicine.
"People are not aware of it at all," Ellis O'Brien said about the ads that claim to represent patient interests, "or of the broader ties between some patient advocacy groups and pharma."
Ellis O'Brien said the fears about HB 2387 benefiting insurance companies through the rebate mechanism are being "dramatically overstated."
Insurers would take a financial hit from the mandated cap on prescription co-pays, he said. And any excess money they collect from drug company rebates would be apparent when insurers went before Oregon's insurance commission annually to get their premium rates reviewed and approved, he argued.
"We are confident that the state's regulators will take action to reduce premiums, if necessary, rather than allow insurers windfall profits," Ellis O'Brien said.
In search of middle ground
Still, he acknowledged the bill doesn't contain language explicitly mandating that insurers pass on the full value of the rebates to patients.
Insurance companies' support for HB 2387 "is an interesting aspect of the politics here," Ellis O'Brien said.
But the rebate provision is also raising eyebrows among more credible, Oregon-based patient advocacy groups. Many are noticeably taking a neutral stance on HB 2387 or pursuing other, typically more modest, bills.
Peter Parisot of the Cascade Aids Project said his group supports Nosse's "effort to find compromise" in going after drug prices that "are really out of whack."
But "my concern is: Where does the rebate money go? Does the bill achieve its objective?" he said.
Nosse said he still stands behind the rebate idea.
The "insurance industry made a concession by agreeing to the co-pay cap. That's how negotiations are supposed to work," he said. "But these pharma guys have offered nothing about how to actually control their costs."
Nosse said he is now weighing changes to HB 2387 because of strong Republican opposition and to generate support in the more moderate Oregon Senate. The policy still has momentum, however, in part because powerful House Speaker Tina Kotek, a Portland Democrat, has made tackling prescription costs a priority of hers this session.
GOP Rep. Knute Buehler of Bend said in a House Healthcare Committee hearing this week that "the excessive profits" in pharmaceuticals "need to be fixed."
However, "good intentions aren't enough," he added. "Price controls (on prescriptions) are like heroin. That first dose feels great. ... But the market will always find a way around those controls."
Email Saul at email@example.com .


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Scorcher is a special Troop that after attacking a building for a few seconds, the Scorcher will change targets even if its target is not destroyed yet. But it can return to Buildings that is has targeted before. Once being destroyed, the Scorcher explodes which deals damage to nearby buildings and Troops. Also, buildings damaged by Scorchers will continue burning for 5 seconds.
In my opinion, Scorcher can be as powerful as Warrior. The only difference is that each Scorcher costs 12 Gunboat Energy to deploy. That means you need to have a lot of Gunboat Energy so that you can use Scorchers rush with Smoke Screen and Flare.
Before you want to use Scorcher in the battle, you need to max it out. Only in that way can your Scorchers display their maximum power. You will be surprised that your Scorchers rush will tear your enemy's base quickly without loss.
If you have unlocked the Scorcher, it is worth a try. And you can watch the video below for better understanding:

subset: commoncrawl


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Are men more difficult to buy gifts for than women? Yeah sure they are, unless you lucky like me to have men that love wildlife, fishing, boating, hunting and being a grandpa. We always make handmade gifts for our dad's birthdays and fathers days gifts. This year we were running a tad bit late but wow were they worth the wait. Embroidery Library has some wonderful designs and I have access to them for all of our embroidery design needs. These towel sets will retail on my website for around $25.00 plus shipping. Different color options will be available in the towels as well as thread colors.
Tuesday, July 8, 2008
Wildlife Towels
Posted by Charlene Karger at 5:55 AM
Labels: animals, bath towels, deer, ducks, hand towels
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A Philosophical Perspective on the Utility of Quantitative Methods in Educational Research
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This chapter examines quantitative educational research methods with a view to identifying how the utility of this kind of research can be improved. The paradigmatic considerations of ontology, epistemology and methodology are viewed from a philosophical perspective. A combination of inductive and deductive logic is used to assay evidence, develop arguments and counter-arguments, and to substantiate claims made about quantitative and qualitative research. The substantive content of the chapter concerns information on philosophical inquiry, quantitative and qualitative research approaches in education, and the analytic techniques specific to quantitative educational research. The philosophical critique of quantitative methods contained in this chapter highlights limitations of the method in dealing with the temporal and socio-cultural nature of education. This focuses on a bias in the method where more attention is given to methodological issues than to those concerning ontology and epistemology. However, a detailed examination of specific aspects of the method as it is currently applied to investigate more 'subjective' (e.g. socio-cultural) educational problems suggests that the limitations and bias could be addressed without detracting from the inherent scientific rigour of the method. This is viewed as achievable in two ways. Firstly, by incorporating philosophical considerations in the conceptualisation of theoretical models and the specification of research hypotheses. Secondly, by exploiting fully multi-variate techniques, statistical modelling techniques, and other recent developments in the construction of attitude scales and analysis of rating scale data.
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11 Feb 2018 15:20
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Rep. Richard Geist (R-Dist. 79), Rep. John
Perzel (R-House Speaker), AOPA President
Phil Boyer, Rep. Gene McGill (R-Dist.
151), Rep. Keith McCall (D-Dist. 122)
Remember that poor pipeline patrol pilot who unwittingly flew over the presidential motorcade in Philadelphia earlier this year? The Pennsylvania legislature certainly does. AOPA President Phil Boyer was the honored guest of state Rep. Gene McGill (R-Dist. 151) as the state House of Representatives on Monday passed by a near-unanimous vote a resolution sponsored by McGill that calls on federal security officials to reduce the size of presidential-movement temporary flight restrictions (TFRs).
The four-page resolution also calls for authorities to "reconsider the need to issue such restrictions based on nonspecific threats and ways to improve the timely dissemination of flight restriction information to pilots."
Presenting the measure on the floor of the House, McGill, an AOPA member, said, "If it wasn't for the help and assistance of AOPA to carry this message to Washington, D.C., this resolution would not be possible."
In step-by-step detail, the resolution outlines the importance of general aviation in Pennsylvania and nationwide, the lopsided nature of the TFRs—affecting only GA, not scheduled air carriers, the economic impact of the TFRs and the confusion they can cause.
"Pennsylvania lawmakers are serious about getting this message across to the federal government," said Boyer. "The resolution is being sent to President Bush, Homeland Security Secretary Tom Ridge, FAA Administrator Marion Blakey, the director of the U.S. Secret Service, and each member of Pennsylvania's congressional delegation.
"All pilots recognize the need to protect the President, but at some point someone in a position of authority needs to step back and ask if the excessively large airspace restrictions are worth the cost to a vital portion of America's transportation industry."


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Thomas Drozda was sworn in as Federal Minister by President Heinz Fischer on 18th May 2016. He took office as Federal Minister for Arts and Culture, Constitution and Media on 25 May 2016.
Born in 1965, Mr. Drozda earned a degree in business administration and economics from the University of Linz. After completing his studies, he worked as a general manager at "Trotzdem", the publishing house of the Austrian Socialist Youth organisation in Vienna; shortly thereafter, he worked in the Economic Studies Division at the Austrian central bank (Österreichische Nationalbank).
In 1993, Mr. Drozda became an economic policy advisor in Federal Chancellor Franz Vranitzky's cabinet, where he was responsible for budgetary, fiscal, social, youth and family affairs; from 1996 onward, Mr. Drozda's remit was expanded to include the field of arts and culture. From 1997 to 1998, he continued his career as an economic and cultural policy advisor to Federal Chancellor Viktor Klima.
Mr. Drozda went on to serve as the business manager at Vienna's Burgtheater from 1998 to 2008, and from 2007 to 2014 he was also a member of the Board of the Austrian Broadcasting Corporation (ORF) Foundation. In 2008, he became the Chief Executive Officer at Vereinigte Bühnen Wien, which operates three prominent theatre venues in Vienna.
Neil Harbisson is a Catalan-raised, British-born contemporary artist and cyborg activist best known for having an antenna implanted in his skull and for being officially recognized as a cyborg by a government. The antenna allows him to perceive visible and invisible colours such as infrareds and ultraviolets via sound waves. The antenna's internet connection allows him to receive colors from space as well as images, videos, music or phone calls directly into his head via external devices such as mobile phones or satellites. Harbisson identifies himself as a cyborg, he feels both his mind and body are united to cybernetics. He doesn't feel he is using or wearing technology, instead he feels he is technology. His artworks investigate the relationship between colour and sound, experiment the boundaries of human perception and explore the use of artistic expression via sensory extensions. In 2010 he co-founded the Cyborg Foundation with Moon Ribas, an international organization that aims to help humans become cyborgs, defend cyborg rights and promote cyborgism as a social and artistic movement.
An architect and engineer by training, Professor Carlo Ratti teaches at MIT, where he directs the Senseable City Lab. He is also a founding partner of the international design and innovation office Carlo Ratti Associati. He graduated from the Politecnico di Torino and the École Nationale des Ponts et Chaussées in Paris, and later earned his MPhil and PhD at the University of Cambridge, UK.
Carlo holds several patents and has co-authored over 250 publications, including "The City of Tomorrow" (Yale University Press, June 2016, with Matthew Claudel). As well as being a regular contributor to Project Syndicate, he has written for international media including New York Times, Washington Post, Financial Times, Scientific American, BBC, Il Sole 24 Ore, La Stampa, Corriere della Sera, Domus. His work has been exhibited worldwide at venues such as the Venice Biennale, the Design Museum Barcelona, the Science Museum in London, MAXXI in Rome, and MoMA in New York City.
Carlo has been featured in Esquire Magazine's 'Best & Brightest' list and in Thames & Hudson's selection of '60 innovators' shaping our creative future. Blueprint Magazine included him as one of the '25 People Who Will Change the World of Design', Forbes listed him as one of the 'Names You Need To Know' and Fast Company named him as one of the '50 Most Influential Designers in America'. He was also featured in Wired Magazine's 'Smart List: 50 people who will change the world'. Two of his projects – the Digital Water Pavilion and the Copenhagen Wheel – have been included by TIME Magazine in the list of the 'Best Inventions of the Year'.
Carlo has been a presenter at TED (in 2011 and 2015), program director at the Strelka Institute for Media, Architecture and Design in Moscow, curator of the BMW Guggenheim Pavilion in Berlin, and was named Inaugural Innovator in Residence by the Queensland Government. He was the curator of the Future Food District pavilion for the 2015 World Expo in Milan. He is currently serving as co-chair of the World Economic Forum Global Future Council on Cities and Urbanization, and as special adviser on Urban Innovation to the President and Commissioners of the European Commission.
For further information visit www.carloratti.com and senseable.mit.edu.
Since January 1st 2017 Rudiger Wanck is founder & MD of SNDC8.
SNDC8 operate and deploy technology and monetization platform to help publishers compete successfully in the real time area.
On May 1st 2015 Rudiger Wanck was named CEO Worldwide of GroupM Connect. Connect is GroupM's worldwide digital agency platform and consolidated services organization. Being part of an increasingly real-time world, the focus of Connect is to apply our groups leverage and scale to data, operations and technology across search, social, mobile, programmatic and all other real-time and biddable media. By bringing these services together Connect is able to deliver real time media investment management across all of these classes of digital media providing an unrivalled competitive advantage for our group.
Rudiger Wanck is part of GroupM's Worldwide Executive Committee since 2013. Prior to his appointment as CEO Worldwide for Connect he was the Global COO for GroupM Interaction. As Global COO he focused on GroupM's digital operations, digital technology and digital trading development in North America, Latin America, EMEA and APAC. Before taking on a global role he was the Chairman of GroupM for the Benelux and the Chief Digital Officer for GroupM in EMEA.
Stephan A Jansen (* June 12th 1971) is Professor for Management, Innovation & Finance and Head of the "Center for Philanthropy & Civil Society | PhiCS" at Karlshochschule, Karlsruhe, Germany.
Member of several advisory boards and scientific consulting for corporates, foundations, educational institutions as well as ministries (e.g. "Innovationsdialog" of the chancelor, personal advising board of Minister Peer Steinbrück a.D., or "Forschungsunion" of the Ministry of Education and Research).
He was Visiting Scholar at Harvard Business School 2000 and 2001 and since 1999 regularly Visiting Scholar at Stanford University.
In May 2003 Jansen was appointed the founding president and managing director of Zeppelin Universität, a state-recognized privately held and endowed university in Friedrichshafen at Lake Constance. In the same year he was appointed professor at the "Chair for Strategic Organization and Financing | SOFI" by the federal ministry of science. At the time of this appointment, he was 31 years old and thus Germany`s youngest university president.
He is author of more than 200 publications (including 25 books and edited anthologies), especially in the areas of organization, network, leadership and management theory, mergers & acquisitions, philanthropy as well as analyses of educational systems.
He is regular columnist in German (e.g. bimonthly in "Brand eins") and co-editor of the "Zeitschrift für Management (ZfM)".
He is appointed for the global election as one of the "Thinkers50" 2017.
His research interests: analysis of networks from the perspective of communication and organizational theory, social enterprises, civil society & philanthropy, mergers & acquisistions, as well as educational systems.
Prof. Dr. Gernot Müller-Putz is head of the Institute of Neural Engineering and its associated Laboratory of Brain-Computer Interfaces. He received his MSc in electrical and biomedical engineering in 2000, his PhD in electrical engineering in 2004 and his habilitation and "venia docendi" in medical informatics from Graz University of Technoloy in 2008. Since 2014 he is full professor for semantic data analysis. He has gained extensive experience in the field of biosignal analysis, brain-computer interface research, EEG-based neuroprosthesis control, communication with BCI in patients with disorders of consciousness, hybrid BCI systems, the human somatosensory system, and BCIs in assistive technology over the past 16 years. He has also managed several national projects (State of Styria) and international projects (Wings for Life, EU Projects) and is currently coordinator of the EU Horizon 2020 project MoreGrasp. Furthermore, he organized and hosted six international Brain-Computer Interface Conferences over the last 13 years in Graz, currently preparing the 7th Conference in Sept. 2017. He is also steering board member of the International BCI Meeting, which takes place in the US every three years (next time in 2016). He is Review Editor of Frontiers in Neuroscience, special section Neuroprosthetics, Associate Editor of IEEE Transactions in Biomedical Engineering and Associate Editor of the Brain-Computer Interface Journal. In 2014/15 he was Guest editor in chief of a special issue of the Proceedings if the IEEE "The Plurality of Human Brain-Computer Interfacing". He has authored more than 130 peer reviewed publications and more than 100 contributions to conferences which were cited more than 8100 times (h-index 43). Recently he was awarded with an ERC Consolidator Grant "Feel your Reach" from the European Research Council.
Horst Eidenberger received the doctoral degree in computer science from the University of Vienna in 2000 and Habilitation (tenure) from the Technical University of Vienna in 2005. Currently, he is an associate professor of computer science and engineering at the Technical University of Vienna, Austria where he works in the area of computational perception on novel signal processing techniques for multimedia sensor data and on machine learning solutions for media categorization. Further research interests include virtual reality where he implemented the Vienna Jumpcube project, widely recognized for its extended use of haptic and olfactory stimuli (see http://jumpcu.be/ for more). Since 2006, he has been a certified expert witness for software development, forensic biometrics and applied statistics at all Austrian courts (member of EuroExpert). He has published seven textbooks on various artificial intelligence and media programming topics as well as more than one-hundred peer-reviewed papers in international journals and conference proceedings. His teaching focuses on the problem of modeling human-like similarity perception in computers (e.g. in computer vision, audio event recognition, strategic gaming, etc.). Please refer to http://www.ims.tuwien.ac.at/hme/ for more information.
Nir Eyal writes, consults, and teaches about the intersection of psychology, technology, and business. The M.I.T. Technology Review dubbed Nir, "The Prophet of Habit-Forming Technology."
Nir founded two tech companies since 2003 and has taught at the Stanford Graduate School of Business and the Hasso Plattner Institute of Design at Stanford. He is the author of the bestselling book, Hooked: How to Build Habit-Forming Products.
In addition to blogging at NirAndFar.com, Nir's writing has been featured in The Harvard Business Review, TechCrunch, and Psychology Today.
Nir is also an active investor in habit-forming technologies. Some of his past investments include: Eventbrite, Product Hunt, Pantry, Refresh.io (acquired by LinkedIn), Happy Bits, Presence Learning, 7 Cups, Pana, and Symphony Commerce.
Nir attended The Stanford Graduate School of Business and Emory University.


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Weyerhaeuser Co. on Friday said its first-quarter earnings rose on benefits from special items and strong sales from its timberlands business, despite severe winter weather.
Earnings topped analysts' expectations, while revenue fell short.
The forest-products company posted first-quarter earnings of $183 million, or 31 cents a share, up from $144 million, or 26 cents a share, a year earlier. Excluding net gains of $30 million from special items, such as an asset sale and an amendment to the company's retirement plan, earnings were 26 cents a share for the quarter.
Net sales rose 1.7% to $1.98 billion.
Analysts surveyed by Thomson Reuters had projected a profit of 24 cents a share and revenue of $2.08 billion.
Weyerhaeuser's increased focus on its core wood-products division has generally paid off recently, as the company has enjoyed strong results with the housing market on the mend. However, revenue in the segment followed the prior period's decline with another drop during the first quarter, falling 9% to $898 million.
The company's timberlands business was a bright spot, though, posting a 29% jump in net sales to $377 million, driven by higher selling prices for Western logs in domestic and international markets.
"Our Timberlands business is realizing increasing benefits from the Longview Timber acquisition and reported its highest quarterly earnings excluding land sales since 2006," Doyle Simons, president and chief executive, said in a statement.
The cellulose-fibers division posted a 2.7% drop in sales to $461 million, as higher energy and maintenance costs weighed on results.
Write to Michael Calia at firstname.lastname@example.com
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text:
Vatican Secretary of State Cardinal Pietro Parolin has echoed Pope Francis in calling for a "change of attitude" towards migrants and refugees. Source: Zenit.
In an address to Plenary Assembly of the International Catholic Commission for Migration (ICMC), which began in Rome yesterday, Cardinal Parolin stressed that it is a "crucial moment" for the commission to provide "effective answers to new questions and to consider the most appropriate contemporary way for it to carry out its commitment in situations of migration."
He quoted from Pope Francis's 2014 World Day of Migrants and Refugees message, saying "a change of attitude towards migrants and refugees is needed on the part of everyone, moving away from attitudes of defensiveness and fear, indifference and marginalisation – all typical of a throwaway culture – towards attitudes based on a culture of encounter, the only culture capable of building a better, more just and fraternal world."
Cardinal Parolin recalled that the ICMC was created by Pope Pius XII in the wake of World War II to help deal with the massive displacement of refugees. He spoke favourably of the group's efforts, noting that it now works closely with the Migrants and Refugees Section of the Dicastery for Promoting Integral Human Development.
Again citing the words of Francis, Cardinal Parolin reminded the group that migrants "are not numbers: they are people, women, men, children, who have a face, who often suffer and are discarded".
He went on to stress the importance of helping migrant families, both those who have moved and those who remain in the country of origin. And he pointed out that in today's world, migration has become more than emergency, it "has become a characteristic element of our societies."
"One of the purposes for which the ICMC was created is to support migrant families, who often emigrate in search of safety and a dignified life, especially for their children.," Cardinal Parolin continued. "Many of these, however, reach their point of arrival having experienced violence and abuse on the journey, only to then face new experiences of misery and previously unthinkable difficulties.
Cardinal Parolin: Change of attitude toward migrants needed (Zenit)


text:
I understand the date for the reopening of the Southside Surgery (currently Bernard Terrace) is now Tuesday 2nd May. It will be opening on that date at the Conan Doyle Medical Centre at Cameron Toll.
Here is a map showing the location of the Conan Doyle Medical Centre.
You might be interested in the recruitment ad here.


text:
What is Quintaphobia?
Quintaphobia, or Pentaphobia, is the extreme and irrational fear of the number five. Five is not usually a number to be scared of, but few people are scared of it for unknown reasons. This phobia is not as commonly suffered as other number phobias, such as Tetraphobia (fear of 4), Triskaidekaphobia (fear of 13), and Eikositriophobia (fear of 23).
The name originates from the Latin word 'quinta' meaning 'five' and the word 'phobia' comes from the Greek word 'phóbos' meaning 'fear.'
If you want to be inspired to change your life, click here. You won't regret it.
Symptoms of Quintaphobia
Extreme Anxiety, Dread
- Shortness of Breath
- Rapid Breathing
- Heart Palpitations
- Excessive Sweating
- Nausea
- Dry Mouth
- Confusion / Inability to Articulate Clearly
- Lack of Focus
- Irritability
- Shaking
- Feelings of Powerlessness
- Obsession with the Subject of the Phobia
- Fear or Feelings of Losing Control
- Avoidance Behavior
- Headaches
Learn more about phobia symptoms ›
Causes of Quintaphobia
Quintaphobia is a specific (or "isolated") phobia, centered on non-social key factors. Isolated phobias tend to have some previous trauma (often in childhood and often physically injurious) as a root cause; a fear of bees may stem from an injury in childhood, for instance.
Upbringing can also play a role, such as parental warnings about a direct threat (such as "snakes can bite and kill you") which is especially notable in cases where a threat is more imminent. (An allergy to bees or peanut butter, for instance, would naturally reinforce a real medical concern.)
It is thought that genetics and hereditary factors may play a role in specific phobias, especially those related to a danger of injury. (A primal "fight or flight" reflex may be more easily triggered in those with a genetic predisposition, for instance.)
By contrast, social phobias (like a fear of body odor or touch) are less well-understood, are driven by social anxiety, and are broadly labeled as "social anxiety disorder".
In all kinds of phobias, external experiences and / or reports can further reinforce or develop the fear, such as seeing a family member or friend who is affected. In extreme cases, indirect exposures can be as remote as overhearing a reference in conversation, seeing something in the news, on TV, or in the movies.
Quintaphobia, like most phobias, stems from a subconscious overprotection mechanism, and as with many phobias can also be rooted in an unresolved emotional conflict.
Quintaphobia could be triggered due to anxiety of its unique multiples of five, with the last digits being either five or zero.
Learn more about the causes of phobias ›
Treatments for Quintaphobia
Cognitive Behavior Therapy (CBT)
- Habit Strategies To Relax
- Cognitive Therapy (CT)
- In Vivo Exposure
- Response Prevention
- Hypnotherapy
- Group Therapy
- Psychotherapy
- Energy Psychology
- Medication
- Meditation


text:
- Research article
- Open Access
- Open Peer Review
Rotigotine transdermal system as add-on to oral dopamine agonist in advanced Parkinson's disease: an open-label study
© Kim et al.; licensee BioMed Central. 2015
- Received: 29 May 2014
- Accepted: 29 January 2015
- Published: 28 February 2015
Achieving optimal symptom control with minimal side effects is a major goal in clinical practice. Dual-agent dopamine receptor agonist (DA) therapy in Parkinson's disease (PD) may represent a promising approach to treatment, as the combination of different pharmacokinetic/pharmacological profiles may result in a lesser need for high dosages and, accordingly, may be well tolerated. The objective of the current study was to investigate safety and efficacy of rotigotine transdermal system as add-on to oral DA in patients with advanced PD inadequately controlled with levodopa and low-dose oral DA.
PD0015 was an open-label, multinational study in patients with advanced-PD and sleep disturbance or early-morning motor impairment. Patients were titrated to optimal dose rotigotine (≤8 mg/24 h) over 1–4 weeks and maintained for 4–7 weeks (8-week treatment). Dosage of levodopa and oral DA (pramipexole ≤1.5 mg/day, ropinirole ≤6.0 mg/day) was stable. Primary variable was Clinical Global Impressions (CGI) item 4: side effects, assessing safety. Other variables included adverse events (AEs), Patient Global Impressions of Change (PGIC), Unified Parkinson's Disease Rating Scale (UPDRS) II and III, Parkinson's Disease Sleep Scale (PDSS-2), Pittsburgh Sleep Quality Index (PSQI), and "off" time.
Of 90 patients who received rotigotine, 79 (88%) completed the study; 5 (6%) withdrew due to AEs. Most (83/89; 93%) had a CGI-4 score <3 indicating that rotigotine add-on therapy did not interfere with functioning; 6 (7%) experienced drug-related AEs that interfered with functioning (score ≥3). AEs occurring in ≥5% were application site pruritus (13%), dizziness (10%), orthostatic hypotension (10%), nausea (8%), dyskinesia (8%), and nasopharyngitis (6%). Numerical improvements in motor function (UPDRS III), activities of daily living (UPDRS II), sleep disturbances (PDSS-2, PSQI), and reduction in "off" time were observed. The majority (71/88; 81%) improved on PGIC.
Addition of rotigotine transdermal system to low-dose oral DA in patients with advanced-PD was feasible and may be associated with clinical benefit.
Trial registration
ClinicalTrials.gov identifier NCT01723904. Trial registration date: November 6, 2012.
- Advanced Parkinson's disease
- Dual therapy
- Rotigotine transdermal system
- Oral dopamine receptor agonist
- Safety
Treatment with chronic levodopa for the symptoms of advanced Parkinson's disease (PD) is often associated with the development of motor fluctuations and dyskinesia, which gradually worsen as the disease progresses [1,2]. These limitations of levodopa therapy have been managed by the use of concomitant treatment with non-ergot derived dopamine receptor agonists (DAs). The DAs have some advantages over levodopa, including longer half-lives [3], which may reduce or delay the onset of motor complications. Achieving optimal symptom control with minimal side effects is a major goal in clinical practice. Dual-agent DA therapy in PD may represent a promising approach to treatment, as the combination of different pharmacokinetic/pharmacological profiles may result in a lesser need for high dosages and, accordingly, may be well tolerated [4-6].
Rotigotine is a non-ergot derived DA with activity across D1 through D5 receptors as well as select adrenergic and serotonergic sites [7]. Continuous transdermal delivery of rotigotine maintains stable plasma levels over 24 hours with a single daily application [8], thus avoiding plasma level peaks and troughs associated with more pulsatile oral drug delivery. Symptoms of some PD patients may not be adequately controlled over the entire 24-h range with existing oral DA treatment. Since rotigotine transdermal system maintains stable plasma concentration over 24 h, add-on rotigotine may supplement the effects of oral DAs. Activation of the D1 receptor is unique to rotigotine among the non–ergot-derived DAs; pramipexole and ropinirole have been shown to act at the D2 and D3 receptors, but exhibit little or no affinity at the D1 receptor [9,10]. A synergistic interaction may exist between D1 and D2 receptors; a D1 receptor agonist has been shown to act synergistically with a D2 receptor agonist to prolong the motor stimulation induced by each agonist alone in the MPTP-lesioned monkey model of PD [11]. Thus, as a result of their different pharmacokinetic/pharmacological properties, there may be benefits of dual treatment with transdermally delivered rotigotine and oral ropinirole or pramipexole. Significant treatment effects of rotigotine transdermal system have been observed in double-blind, placebo-controlled studies as add-on therapy to levodopa in advanced-stage PD [12,13] (improvements in motor fluctuations; i.e., "on" and "off" time), and also in patients with PD and unsatisfactory control of early-morning motor function (improvements in early-morning motor function and sleep disturbance [a non-motor symptom of PD]) [14]. In addition, improvements in motor function and motor fluctuations have been demonstrated with 3-times-daily oral immediate-release (IR) ropinirole or pramipexole, or their once-daily oral extended-release (ER) formulations in combination with levodopa in patients with advanced PD [15,16].
The objective of this study was to investigate the safety and efficacy of rotigotine transdermal system as add-on to therapy with low-dose pramipexole or ropinirole, in patients with advanced PD. Enrolled patients were insufficiently controlled with levodopa and low-dose oral DA, identified as experiencing motor complications and sleep disturbance or early-morning motor impairment.
Patients enrolled in the PD0015 study included men and women, aged 30–80 years, with idiopathic PD of longer than 3 years' duration, and Hoehn and Yahr stage II-IV. PD was defined by the presence of bradykinesia and at least one of the following: resting tremor, rigidity, or impairment of postural reflexes. In addition, all patients included had to be taking levodopa (immediate or controlled release, and at a stable dose) in combination with benserazide or carbidopa, and a stable low dose of IR or ER pramipexole (≤1.5 mg/day) or ropinirole (≤6.0 mg/day) for at least 28 days before baseline. Patients had to experience motor fluctuations ("wearing off", "on-off" phenomena, delayed "on" or "non-on") or dyskinesia, sleep disturbance or early-morning motor impairment, as determined by the investigator, and nocturia for at least 3 nights within 7 days before baseline. At the screening visit, patients were instructed to differentiate between "off" and "on" states and symptoms of "troublesome dyskinesia" for diary recordings. Patients completed 7 days of diary recordings before beginning study treatment; four of the diaries had to be determined "valid" by the investigator for the patient to be eligible. Permitted PD medications included anticholinergics, monoamine oxidase B (MAO-B) inhibitors, N-methyl-D-aspartate (NMDA) antagonists (e.g., amantadine), and entacapone; permitted CNS active drugs included sedatives, antidepressants, anxiolytics, hypnotics. All permitted drugs were required to be at stable doses for at least 28 days prior to baseline, and were to remain stable for the duration of the study.
Patients with clinically significant hepatic or renal impairment were excluded. Prohibited medications included DAs other than pramipexole or ropinirole, MAO-A inhibitors, dopamine-releasing substances, dopamine-modulating substances, tolcapone, budipine, dopamine receptor antagonists (antiemetics [other than domperidone, e.g., metoclopramide], and neuroleptics). The study was conducted in accordance with Good Clinical Practice and the Declaration of Helsinki. The study protocol and amendments were approved by the Institutional Review Board of all 21 centers (Additional file 1: Table S1). All patients provided written, informed consent before study participation.
Study design and procedures
PD0015 (ClinicalTrials.gov:NCT01723904) was a Phase IIIb, open-label, single-arm study in patients with advanced PD (between October 2012 and April 2013). Twenty one centers enrolled patients, who applied at least one rotigotine patch, in South Korea, Malaysia, Taiwan, Australia, and Singapore.
Baseline data were recorded following a screening period of up to 4 weeks. Rotigotine was administered as once-daily patches of three different sizes; patches provided nominal doses of rotigotine 2 mg/24 h (10 cm2), 4 mg/24 h (20 cm2), or 6 mg/24 h (30 cm2). The study consisted of a 1-4-week titration and 4-7-week maintenance period (total of 8-week treatment); patients were titrated in weekly increments of 2 mg/24 h rotigotine to their optimal (or maximal allowed) dose (up to 8 mg/24 h) (Additional file 2: Figure S1). The optimal dose was defined as the dose at which both the investigator and patient felt that sleep disturbance or early-morning motor impairment was controlled. As this was the first study of rotigotine used concomitantly with a DA, the permitted upper doses were considered based on safety and the potential for overdose from concurrent use of DAs, in reference to the equivalent dosing regimens (Additional file 3: Table S2) [4,12,17]. The upper limit was determined as 1.5 mg/day for pramipexole (approved dose 4.5 mg/day), 6 mg/day for ropinirole (approved dose 24 mg/day), and 8 mg/24 h for rotigotine (EU-approved dose 16 mg/24 h). Using these upper dose limits, the combined total DA dose would not exceed the maximum approved dose of any of the DAs (see the equivalent dosing regimens in Additional file 3: Table S2). During titration, if AEs occurred that might be the result of excessive dopaminergic stimulation, rotigotine could be back-titrated once to the previous dose (and the patient was requested to visit the study site within 1 week for a safety assessment), the patient began the maintenance phase immediately at the back-titrated dose. Dose adjustments were not permitted during maintenance. Clinic visits occurred at screening, baseline, and weeks 1, 2, 3, 4, 5, and 8 of titration/maintenance. Patients who withdrew prematurely were asked to return for a withdrawal visit.
Outcome measures
The primary variable was safety, as assessed using the Clinical Global Impressions (CGI) item 4 score (side effects) at the end of maintenance: 1 = "None", 2 = "Not significantly interfering with patient's functioning", 3 = "Significantly interfering with the patient's functioning", and 4 = "Side effects outweigh therapeutic efficacy". Other safety evaluations included extent of rotigotine exposure, and treatment-emergent adverse events (AEs, regardless of a causal relationship). In addition, AEs of special interest (those typical of dopaminergic stimulation, use of a transdermal patch, or complications related to PD) were pre-identified and assessed. The AEs of special interest were pre-identified as application site reactions, nausea and vomiting, somnolence, psychosis, sleep attacks/sudden onset of sleep, obsessive-compulsive disorder/impulse-control disorder, postural deformities, freezing gait, and perception disturbances that required atypical antipsychotic treatment. In addition, the modified Minnesota Impulsive Disorder Interview was used to prompt the investigators and patients to monitor the emergence of impulse control disorders. Finally, physical and neurological examinations, changes in laboratory tests, vital signs, 12-lead electrocardiography (ECG), and the Columbia-Suicide Severity Rating Scale (C-SSRS) were also assessed.
Efficacy variables included outcomes assessing motor symptoms, motor fluctuations, non-motor symptoms (sleep disturbance), and quality of life. Change from baseline to end of maintenance was assessed for Unified Parkinson's Disease Rating Scale (UPDRS) Parts II (activities of daily living [ADL]; mean for the "on" and "off" state), and III (motor examination; in the "on" state); absolute time spent "off" and absolute time spent "on" without troublesome dyskinesia (assessed from patient diaries); Parkinson's Disease Sleep Scale version 2 (PDSS-2); global score of the Pittsburgh Sleep Quality Index (PSQI); Patient Global Impression of Change (PGIC; change from baseline in activity limitations, symptoms, emotions, and overall quality of life; PGIC score 1 = "Very much improved", 2 = "Much improved", 3 = "Minimally improved", 4 = "No change", 5 = "Minimally worse", 6 = "Much worse", 7 = "Very much worse"), and the 8-item short-form Parkinson's Disease Questionnaire (PDQ-8; assessing PD-related quality of life). Other variables included number of awakenings during the night and number of nocturias, assessed from patient diaries.
Statistical analyses
The primary variable (CGI item 4 score) was analyzed by the safety set (all enrolled patients who had at least one rotigotine patch applied during the treatment period), using last observation carried forward (LOCF). With the exception of time spent "off", efficacy variables were analyzed using the full analysis set (FAS; all patients who applied at least one rotigotine patch, and had a baseline and at least one post-baseline UPDRS III assessment), with LOCF. Time spent "off" was analyzed using a subgroup of the FAS comprising patients who recorded time spent "off" at baseline in the patient diary. Efficacy variables were summarized with univariate statistics (mean ± SD), and 95% confidence intervals (CI) were calculated for changes from baseline (i.e., before and after rotigotine add-on).
Patient disposition and baseline characteristics
Patient demographics and baseline characteristics, safety set
n = 90
Age, mean ± SD, years
61.3 ± 9.3
Female, n (%)
43 (48)
Duration of PD, mean ± SD, years
7.4 ± 3.9
Race, n (%)
84 (93)
6 (7)
Hoehn and Yahr Stage during "on", n (%)
1 (1)
65 (72)
23 (26)
1 (1)
Hoehn and Yahr Stage during "off", n (%)†
35 (39)
46 (51)
7 (8)
Levodopa dosage, mean ± SD, mg/day
547.2 ± 287.7
Oral dopamine receptor agonists dosage, mean ± SD, mg/day
0.9 ± 0.5 (n = 51; 57%)
3.4 ± 2.0 (n = 39; 43%)
Oral dopamine receptor agonist formulation, n (%)
54 (60)
36 (40)
Safety and tolerability
Rotigotine exposure
The mean (±SD) duration of rotigotine exposure was 58.7 ± 14.9 days. A total of 84 patients (93%) entered maintenance. The maintenance dose was 2 mg/24 h in 14 patients, 4 mg/24 h in 19 patients, 6 mg/24 h in 16 patients, and 8 mg/24 h in 35 patients (mean ± SD dose: 5.71 ± 2.28 mg/24 h). Of the 11 patients who discontinued the study, six patients discontinued during the first 2 weeks of titration (at 2 mg/24 h), and the remaining five patients discontinued after between 43 and 56 days (i.e., approx. 6–8 weeks) of rotigotine treatment.
The dose of concomitant oral DA at baseline (as rotigotine converted dose) was 2 mg/24 h in 30 patients, 4 mg/24 h in 29 patients, and 6 mg/24 h in 31 patients (mean ± SD dose: 4.02 ± 1.66 mg/24 h). There was no obvious relationship between the dose of oral DA and dose of rotigotine (Additional file 4: Figure S2).
Primary outcome: safety assessed by CGI item 4
Primary outcome: CGI item 4 † - Side effects interfering with patient's functioning (score ≥3); FAS, LOCF
Treatment-related AE ‡ (CGI item 4 score)
Intensity of AE
Rotigotine dose (study phase) at AE onset
Action taken with rotigotine
Oral DA (actual dose [converted rotigotine dose])
Total DA dose*
Levodopa dose mg/day
Severity of disease: Hoehn & Yahr Stage during "on"; duration of PD
Patient 1: Hallucination (score 3)
8 mg/24 h (maintenance)
No change
Pramipexole ER (0.75 mg/day [3 mg/24 h])
11 mg/24 h
2; 3 years
Patient 2: Dyskinesia (score 4)
4 mg/24 h (maintenance)
Ropinirole IR (2 mg/day [2 mg/24 h])
6 mg/24 h
3; 21 years
Patient 3: Nausea (score 3)
2 mg/24 h (maintenance)
Pramipexole IR (0.375 mg/day [1.5 mg/24 h])
3.5 mg/24 h
3; 10 years
Patient 4: Nausea, dizziness, insomnia, hyperhidrosis (score 4)
2 mg/24 h (titration)
Pramipexole IR (1 mg/day [4 mg/24 h])
6 mg/24 h
3; 6 years
Patient 5: Rash, dizziness postural (score 3)
Moderate, mild
8 mg/24 h (maintenance)
No change
Pramipexole IR (0.25 mg/day [1 mg])
9 mg/24 h
1; 9 years
Patient 6: Worsening of PD (score 4)
2 mg/24 h (titration)
Pramipexole ER (0.75 mg/day [3 mg/24 h])
5 mg/24 h
3; 11 years
Adverse events
Fifty eight patients (64%) experienced a total of 147 AEs. AEs occurring with an overall incidence of 5% or higher were application site pruritus reported by 12 patients (13%), dizziness (9; 10%), orthostatic hypotension (9; 10%), nausea (7; 8%), dyskinesia (7; 8%), and nasopharyngitis (5; 6%). The incidence of AEs by 1) rotigotine dose, and 2) oral DA dose is presented in Additional file 5: Table S3, and 3) by total DA dose is presented in Additional file 6: Table S4.
Forty four patients (49%) experienced at least one AE during titration, and 25 patients (30%) experienced at least one AE during maintenance. The majority of AEs were mild or moderate in intensity; six patients (7%) experienced at least one severe AE. Six serious AEs were reported in five patients (6%): hallucination, subdural hemorrhage, nasopharyngeal cancer, delirium, confusional state, and urinary retention. Except for the hallucination, all the events were considered unrelated to rotigotine. No deaths were reported.
Five patients were prematurely withdrawn from the study due to AEs (primary reason for withdrawal): dyskinesia (one patient), orthostatic hypotension (one patient), worsening of Parkinson's disease (one patient), subdural hemorrhage (one patient), dizziness, hyperhidrosis, insomnia, and nausea (one patient). One patient, whose primary reason for withdrawal was due to noncompliance, also discontinued the study due to an AE (nausea). Down-titration of rotigotine was performed in 15 patients due to AEs.
Of the AEs of special interest, 22 (24%) patients experienced application site reactions, eight (9%) nausea and vomiting (seven nausea [preferred term; PT], one vomiting [PT]), four (4%) somnolence (three insomnia [PT], one somnolence [PT]), four (4%) psychosis (two hallucination [PT], one confusional state [PT], one delirium [PT]), and one (1%) patient experienced obsessive-compulsive disorder/impulse-control disorder.
There were no clinically relevant changes in laboratory parameters, vital signs, ECGs, physical and neurological examinations, or the C-SSRS.
The majority of patients reported an improvement on the PGIC (71/88; 81%), with 29/88 (33%) reporting "much improved" or "very much improved", and only 3% (3/88) reporting a deterioration of "much worse" or "very much worse". Mean (±SD) PDQ-8 total score at baseline was 29.4 ± 17.0, and change from baseline to the end of titration/maintenance was −6.6 ± 14.2 (95% CI: −9.7, −3.6). The upper limit of 95% CI was below 0, suggesting an improvement in items assessing PD-related quality of life.
This open-label study was the first study of rotigotine transdermal system used as an adjunct to treatment with an oral DA. The majority of patients in this study were Hoehn and Yahr stage II-III, and all were inadequately controlled with a treatment regimen of levodopa and low-dose oral pramipexole or ropinirole, presenting with early-morning motor impairment or nocturnal sleep disturbance. The study identified no major safety concerns when rotigotine was added to this treatment regimen. The addition of rotigotine was also associated with numerical improvements in efficacy outcomes, including motor function and sleep disturbances.
The addition of rotigotine was generally well tolerated, with the majority of patients (93%) not experiencing drug-related AEs that interfered with functioning, as assessed by the primary outcome (CGI item 4). In the patients experiencing drug-related AEs that interfered with functioning (CGI item 4 ≥ 3), there was no obvious relationship with the total DA dose (i.e., sum of rotigotine and oral DA dose) or levodopa dose. Of note, the majority of patients experienced an improvement on the PGIC (81%), demonstrating that most patients considered rotigotine add-on therapy as beneficial.
The AE profile was similar to previous studies of rotigotine in patients with advanced PD, with typical dopaminergic side-effects and application site reactions observed, and AEs were comparable with those seen with ropinirole or pramipexole [12-14,18]. They were generally mild or moderate in intensity and led to discontinuation in 6% patients. There was no apparent relationship between the incidence of the most common AEs and the dose of rotigotine, dose of oral DA, or total DA dose. However, as the number of patients receiving the different doses was relatively low, it is not possible to reach conclusions on any potential AE dose-response relationship. Hallucination was reported as an AE in two patients, and the incidence of other dopaminergic AEs including somnolence and impulsive behavior were low (one patient each), and there were no reports of sleep attacks. Therefore, taken together with the CGI item 4 results, the combination of low-dose rotigotine with a low-dose oral DA is likely feasible from a safety perspective.
Numerical improvements in patients' motor function (UPDRS III) and ability to carry out ADL (UPDRS II) were observed following rotigotine add-on therapy. A reduction in "off" time was observed, with a corresponding prolongation of time spent "on" without troublesome dyskinesia (patient diary). This suggests that the improvement in "on" time was not at the expense of increased dyskinesia. The current study was not designed to investigate the effect of the oral DA formulation (i.e., IR vs ER) on the efficacy outcomes; however, the formulation of the oral DA did not appear to have an obvious effect on the improvement in "off" time. Improvements in the non-motor symptom of sleep disturbance (PDSS-2, PSQI, and patient diaries), and PD-related quality of life (PDQ-8) were also observed.
In some patients with PD, symptoms may not be adequately controlled with existing oral DA treatment, and the dose cannot be sufficiently increased due to adverse drug reactions. In addition, in some cases, night-time symptoms may be observed although the current dose of DA improves day-time symptoms. In the present study, the patients were taking seemingly low doses of pramipexole/ropinirole, yet they were receiving stable doses which were maximal for the individual (i.e., "best" pharmacological therapy). The patients were inadequately controlled on these doses, and the addition of rotigotine aimed to further control their symptoms. We observed that concurrent activation of D2 and D3 receptors following dual DA therapy was feasible, at least in the dose ranges used. However, the mechanism/s by which rotigotine added to pramipexole or ropinirole induced potential benefits on efficacy outcomes (e.g., motor control, fluctuations, sleep disturbance) can only be speculated. They may result from the increase in DA total dose (i.e., leading to more robust activation of D2/D3 receptors), the different DA receptor profiles (i.e., stimulation of D1 receptor, which is unique to rotigotine, combined with D2/D3 activation) and/or the different pharmacokinetics.
There are some potential limitations to consider. First, as there was no comparator arm or control group, and no statistical significance testing was performed, this limits the conclusions that can be drawn. Second, the ability to generalize the results of this study is restricted by the entry criteria of the study, and so limited to patients with advanced PD inadequately controlled on levodopa and a low-dose oral DA. Third, longer term safety cannot be concluded from this 8-week study. Finally, to prevent potential overstimulation of D2/D3 receptor after concomitant use of rotigotine-pramipexole and rotigotine-ropinirole, less than half of the respective approved maximum doses were used in this study. Therefore, we cannot conclude whether higher doses may provide further benefits or be associated with safety concerns.
In summary, this study demonstrates that addition of rotigotine transdermal system to a low-dose oral DA was feasible and may be associated with clinical benefit in patients with advanced PD inadequately controlled on levodopa and a low-dose oral DA. Dual therapy with rotigotine transdermal system and a low-dose oral DA in PD may represent a promising approach to treatment. Equivalent dose should be taken into consideration when the DAs are used concomitantly, and the maximum dose of DAs should not exceed the upper limit of the approved dose of any of the DAs. Double-blind controlled studies are required to determine the significance and clinical relevance of these findings.
This study was supported by UCB Pharma, Monheim am Rhein, Germany, and Otsuka Pharmaceutical Company, Ltd. Tokyo, Japan. The sponsors were involved in the design of the study, the analysis and interpretation of data, and in the decision to submit the paper for publication. The authors acknowledge the Asia Pacific Rotigotine Add-on Study Group for their contributions to data acquisition; Korea: Young-Ho Sohn (Severance Hospital), Myung Sik Lee (Gangnam Severance Hospital), Sun Ju Chung (Asan Medical Center), Sang Jin Kim (Inje University Busan Paik Hospital), Jin Whan Cho (Samsung Medical Center), Hee Tae Kim (Hanyang University Hospital), Kun Woo Park (Korea University Anam Hospital), Ho-Won Lee (Kyungpook National University Medical Center), Beom Seok Jeon (Seoul National University Hospital), Jong Min Kim (Seoul National University Bundang Hospital), Jae Woo Kim (Dong-A University Medical Center); Malaysia: Looi Irene (Hospital Seberang Jaya), Zariah Bt Abd Aziz (Hospital Sultanah Nur Zahirah), Siew Hung Sim (Hospital Umum Sarawak); Taiwan: Chon-Haw Tsai (China Medical University Hospital), Tian-Jun Zheng (ChiMei Medical Center-Yongkang), Ruey-Meei Wu (National Taiwan University Hospital); Australia: Raymond Schwartz (Southern Neurology St George Private Hospital), Roy Beran (Strategic Health Evaluators), Andrew Evans (Flemington Neurology), Michael Hayes (Concord Hospital); Singapore: Louis Tan (National Neuroscience Institute), Eng King Tan (Singapore General Hospital).
The authors also acknowledge Emily Thompson, PhD, Evidence Scientific Solutions, London, UK, for writing and editorial assistance towards the development of the manuscript, which was funded by UCB Pharma, Brussels, Belgium, and Azita Tofighy, Publications Manager, UCB Pharma, Brussels, Belgium, for publication coordination.
Authors' Affiliations
- Ahlskog JE, Muenter MD. Frequency of levodopa-related dyskinesias and motor fluctuations as estimated from the cumulative literature. Mov Disord. 2001;16:448–58.View ArticlePubMedGoogle Scholar
- Jankovic J. Motor fluctuations and dyskinesias in Parkinson's disease: clinical manifestations. Mov Disord. 2005;20 Suppl 11:S11–6.View ArticlePubMedGoogle Scholar
- Kvernmo T, Härtter S, Burger E. A review of the receptor-binding and pharmacokinetic properties of dopamine agonists. Clin Ther. 2006;28:1065–78.View ArticlePubMedGoogle Scholar
- Reichmann H, Herting B, Mïller A, Sommer U. Switching and combining dopamine agonists. J Neural Transm. 2003;110:1393–400.View ArticlePubMedGoogle Scholar
- Junghanns S, Glöckler T, Reichmann H. Switching and combining of dopamine agonists. J Neurol. 2004;251 Suppl 6:VI/19–23.Google Scholar
- Stocchi F, Vacca L, Berardelli A, Onofrj M, Manfredi M, Ruggieri S. Dual dopamine agonist treatment in Parkinson's disease. J Neurol. 2003;250:822–6.View ArticlePubMedGoogle Scholar
- Scheller D, Ullmer C, Berkels R, Gwarek M, Lübbert H. The in vitro receptor profile of rotigotine: a new agent for the treatment of Parkinson's disease. Naunyn Schmiedebergs Arch Pharmacol. 2009;379:73–86.View ArticlePubMedGoogle Scholar
- Elshoff JP, Braun M, Andreas JO, Middle M, Cawello W. Steady-state plasma concentration profile of transdermal rotigotine: an integrated analysis of three, open-label, randomized, phase I multiple dose studies. Clin Ther. 2012;34:966–78.View ArticlePubMedGoogle Scholar
- Millan MJ. From the cell to the clinic: a comparative review of the partial D(2)/D(3)receptor agonist and alpha2-adrenoceptor antagonist, piribedil, in the treatment of Parkinson's disease. Pharmacol Ther. 2010;128:229–73.View ArticlePubMedGoogle Scholar
- Radad K, Gille G, Rausch WD. Short review on dopamine agonists: insight into clinical and research studies relevant to Parkinson's disease. Pharmacol Rep. 2005;57:701–12.PubMedGoogle Scholar
- Vermeulen RJ, Drukarch B, Sahadat MC, Goosen C, Wolters EC, Stoof JC. The dopamine D1 agonist SKF 81297 and the dopamine D2 agonist LY 171555 act synergistically to stimulate motor behavior of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-lesioned parkinsonian rhesus monkeys. Mov Disord. 1994;9:664–72.View ArticlePubMedGoogle Scholar
- Poewe WH, Rascol O, Quinn N, Tolosa E, Oertel WH, Martignoni E, et al. Efficacy of pramipexole and transdermal rotigotine in advanced Parkinson's disease: a double-blind, double-dummy, randomised controlled trial. Lancet Neurol. 2007;6:513–20.View ArticlePubMedGoogle Scholar
- LeWitt PA, Lyons KE, Pahwa R. Advanced Parkinson disease treated with rotigotine transdermal system: PREFER Study. Neurology. 2007;68:1262–7.View ArticlePubMedGoogle Scholar
- Trenkwalder C, Kies B, Rudzinska M, Fine J, Nikl J, Honczarenko K, et al. Rotigotine effects on early morning motor function and sleep in Parkinson's disease: a double-blind, randomized, placebo-controlled study (RECOVER). Mov Disord. 2011;26:90–9.View ArticlePubMedGoogle Scholar
- Schapira AH, Barone P, Hauser RA, Mizuno Y, Rascol O, Busse M, et al. Extended-release pramipexole in advanced Parkinson disease: a randomized controlled trial. Neurology. 2011;77:767–74.View ArticlePubMedGoogle Scholar
- Stocchi F, Giorgi L, Hunter B, Schapira AH. PREPARED: comparison of prolonged and immediate release ropinirole in advanced Parkinson's disease. Mov Disord. 2011;26:1259–65.View ArticlePubMedGoogle Scholar
- Giladi N, Boroojerdi B, Korczyn AD, Burn DJ, Clarke CE, Schapira AH. Rotigotine transdermal patch in early Parkinson's disease: a randomized, double-blind, controlled study versus placebo and ropinirole. Mov Disord. 2007;22:2398–404.View ArticlePubMedGoogle Scholar
- Etminan M, Gill S, Samii A. Comparison of the risk of adverse events with pramipexole and ropinirole in patients with Parkinson's disease: a meta-analysis. Drug Saf. 2003;26:439–44.View ArticlePubMedGoogle Scholar
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Stem Cell Science Physicians only use stem cells from Reputable Approved and Certified Laboratories
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Stem cells for bone marrow transplantations have been in use in the US since the 1960's.
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According to various reports, news and articles Nancy Reagan was a very strong Advocate for Stem Cells and Alzheimer's Disease; Kobe Bryant; Tiger Woods, Michael J. Fox, Christopher Reeve; Muhammad Ali, Janet Jackson, Kelly Osborn, Imelda Marcos and more big names and regular people, have travelled to countries where they offered the stem cell therapy.
S.R. LA: Alzheimer's: Husband is an MD. His wife of 60 years was in vegetative state, unable to feed herself, incontinent and did not recognize him anymore. MD researched endlessly for ways to "bring her back". SCS referred them to our MD. After the first therapy, this is his story: "We arrived home, she slept for several hours. When she awoke, she said, she was so hungry. She went straight to the kitchen and prepared a meal, she sat down and ate." The MD was shocked. After 4 weeks, he took her for another therapy. Over 6 months have passed, SCS called to follow up, the MD secretary said, "Oh, she is doing so great. Thank you for checking."
S.L.: Osteoarthritis. Severe condition, the wounds were not healing and continued to erupt throughout his body. When he started the therapy, no new eruptions. The wounds were drying and healing. Pain throughout his body was reduced tremendously.
B.L. MD: Fibromylagia: Client was unable to go to their basement for years, could not go up and down the stairs. A few months after the therapy, she was going up and down to get her gardening tools. She said, "I didn't even know that I have been able to do this, I was not paying attention to my development. I was just surprised one day when I realized that I have been doing that for quite sometime after the stem cell therapy, not even aware of it. I was not able to do that for so many years since I've been sick. Now I am even able to do gardening."
B.P: RA: I can tell you that my feet feel better than before, I'd say about 50% better. And this is odd, I get "land sick" after being on a boat for any given time. I get very dizzy and nauseous for hours after being on the boat. We went sailing the day after the therapy and I did not get sick after being on the boat for five hours. Very strange, I thought. But great!
E.B. PI: RA and etc: 75 yrs old with frozen and joint pains, unable to move in the mornings, diabetes, hbp, dermatological problems, thyroid problems, not able to walk over 10 paces without help, weak, tired easily, lack of energy and stressed, depressed and frustrated. Mere 3 hours after therapy, was able to walk 10 blocks without help and tireless, energetic, happy, excited, no more pain. Following days after, were more positive improvements, body felt like 25 years younger. Continued to improve and was able to continue her uniform sewing business again which was disrupted from her condition.
D.B. PI: RA and etc: 62 yrs old. "By the time i took my therapy, i was suffering pain on my right collarbone down to my left chest. When I coughed, I had more pain, I felt as if my chest was being torn apart, at that time, I also have cough and cold. I didn't take any medication hoping that it would go away, weeks past and the pain would not go away. I do not believe in the stem cells, i was "forced" by my family into taking it. I doubted that it would do me any good. OMG, all my pains were gone, my cold and cough disappeared in spite of the bad weather. I could not believe it. I was ready to go jogging, lots of energy, felt so happy and no depression, felt very strong. I felt rejuvenated and energized. Thanks to the stem cell technology and my family who pushed me into taking it. I would not have known the best feelings until I felt better and pain-free.
M.G. PI: Stroke: 80 yrs old stroke patient, unable to move on her own. Screams in pain when being lifted from bed to the wheelchair, required 24/7 nurse. Attention goes on and off from present to past. A few days after the therapy, didn't not scream with pain when lifted off the bed or sitting down, her attention and mind is on real-time and more aware of the present. Appetite was better, communication is better too and less depressed mood.
L.G. PI: 85 yrs old, feeling weak, tired, RA and lack of energy. After therapy, he said, he felt stronger, better and happier.
T.C. LA: Severe Skin Condition: She was not able to work for 2 months from severe skin allergies, specially her palms, plus hbp and stress. She had a doctor, dermatologist, allergy specialist and so many medications. Skin problem was not getting better, going on for 10 years and getting worse. A week after the therapy, her skin dried up, her hbp became normal, she stopped her medications. She was back to work 3 weeks after the therapy.
B.B. NY: Back Problems: I suffered from a degenerative disk issue for over a year now. I recently did and infusion of 1.5 cc's into my blood. I then had my doctor administer .5 cc's directly into the area of my degenerative disk. Not even 72 hours later, I was able to sleep on my stomach for the first time in over a year. I have no issues getting out of bed and I am moving completely pain-free.
A.L. LA: RA: 68 years old had several infusions of vitamins C's and other chemicals. She got very sick from the reactions and had serious side effects. She was in a hospital for a few days. After recovery, she had stem cells injection. She was very happy with the result, she had more energy and the pain and inflammation from RA disappeared. Mind is much clearer and very happy with the result. Scheduling another therapy for body rejuvenation.
P.R. UTAH: RA and Injuries: 82 years old with a lot of pain all over his body, from rheumatoid arthritis and previous injuries. He had stem cell therapy and within a few days, relieved of his pain. He drove back to Utah and referred stem cells therapy to his friends. He is very happy with the result and he said he is now pain-free.
S.T. LA: PAIN and Psoriasis: He was taking a lot of pain medications from previous injuries. He had to take more pain medications and the doctors kept substituting because they stopped working, he would take more drugs. He also have a bad skin condition of psoriasis for a very long time. He had the stem cell therapy and the skin condition disappeared after a few days and pain subsided. He no longer take pain medications, sleeping much better and more energy and concentration. Very happy of the result of the therapy.
B.B.: Back Pain: I've been on pain pills for a very long time, at least 6 large dosage every single day and various other medications to go along with it for very severe back pain. Two weeks after the therapy, I was down to 1 pain pill a day.
F.L. LA: 72 years old MS patient for over 25 years, wheelchair-bound, doctor advised him that there's no cure, just wait to die. He has trouble getting in and out of the bed, both legs are frozen, can only sleep on his left side. He had a urinary surgery then got 2cc of stem cells. He never felt any pain from the surgery. After 10 days, he had more energy, his memory and mind are so active and clear, he feels excited and happy, most of all, he can get in and out of his bed without much effort, he can now sleep on either left or right side and is able to roll back and forth in bed, which he was not able to do for as long as he can remember. He is very happy and amazed of this development. He is scheduled for another 2cc therapy after 3 weeks and looking forward to that excitedly.
R.L. LA: I'm 60 and a heavy smoker with genetic HBP. I had a heart attack and brought me to the emergency and immediate surgery to unclog my arteries. I was very concerned with my recovery and the after effect of the stroke. After I was released from the hospital, I took 2cc of Stem Cells Therapy. After 24 hours I was back to "normal" with more energy and no effect or no pain from my stroke or surgeries. I attended a dinner party the next evening and continued to do my regular gardening and painting my fence at my house. It was a miracle for me, it seemed like I never had a stroke or surgery and I have more energy. I am so happy that I took the therapy right away. I have no side effects from my stroke and no pain.
O. B: I had rheumatoid arthritis and inflammation on all of my finger joints. They can be very painful and I take pain relievers for them. I have not been able to wear my rings for 3 1/3 years. I took the stem cell therapy, 4cc. The very next day, the inflammations were gone and I was able to wear my rings again and I have no more pain. I am so very happy that I did it. Pain relievers only gave me a few hours of relief, then I had to take again and again. After my therapy 6 months ago, I haven't taken pain relievers or inflammations. In addition, I am more energetic, have more focus and concentration.
S.M.: Suffered from asthma, COPD, high blood pressure, type 2 diabetes, gout, rheumatoid arthritis, stress, overweight, failing eyesight. Infused 3cc stem cells, within 24 hours, gout and arthritis inflammation were gone, can walk without limping, lots of energy, felt like "superman" he said, eyesight much clearer, great concentration, very happy with the result of the infusion. After one week, he felt so great, he wants his entire family to take the stem cell therapy. He wanted another 3cc next month and another 3cc after.
S.M.: Two months after my infusion, my A1 test from 10.1 to 6.1. My blood pressure used to be constantly 220/180. Now it's at 180/120. This is without taking any of the diabetic and high blood pressure medications which had so many side effects. My gout and arthritis were completely gone. I am walking normally now.
A.L.: I took 2 cc Stem Cell injection for my arthritic pain and inflammation throughout my body. After 2 weeks, all the pain and inflammation are gone. I am feeling much better.
C.S.: 59 years old, has rheumatoid arthritis, muscle stiffness throughout her body, in pain all the time, she has legs tremors and unable to work in her condition. Took 2cc of stem cells. Within 48 hours, all stiffness throughout her body relaxed, no pain, very excited to go back to work, more energetic, mind is clearer, can focus easily. Loves the result of the therapy and will recommend to her friends.
B.L.: Needs energy, very active person with a lot of social events. Took 4cc stem cell infusion. "I had rosy cheeks right after infusion and i felt the strength, my mind is so active and can feel the great improvement in my body. I am so very happy and I really believe in it, i will tell all the people I know about it. I feel great and I want to get another 4cc when I come back from my long trip."N.O. : Suffered from face rosacea for 50 years, dry, scaly skin, red and very itchy. Also have pain killers and other drugs addiction, memory loss, depression, alcohol and smoke addiction, lack of energy and rheumatoid arthritis. He took 4cc of stem cell therapy. Rosacea cleared his face within 48 hours, loss the urge for drugs, alcohol and tobacco addiction after 3 days, slept well, depression went away, happy and working out at the gym, feels healthy and can think clearly. M.P. : 89 years old, suffered rheumatoid arthritis, cannot walk without a cane. Feeling very tired and weak. Took 2cc of stem cell therapy. The very next day, she started walking without her cane. She said she is much stronger and she is very happy. B.L. : 65 years old, suffered from stroke 10 years ago, limps and cannot get his pants on without leaning on the wall or with someone's help, weak, rheumatoid arthritis, catching his breath when he talks, memory loss, forgetful, depressed, high blood pressure. Took 2cc of stem cell therapy, he felt very good the next day, very happy and feels much stronger, can speak in long sentences without catching his breath, very calm and can now stand on his own to put his pants on without any help or leaning on the wall. His mind is sharper and thinks clearly.M.L.: 29 years old and feeling weak and drinking. Took 2cc of stem cell therapy. He felt rejuvenated, feels much stronger, more focused, and more energy and happy. Less urge to drink. B.L.: 36 years old, losing weight, drinking alcohol, feels depressed and no appetite to eat. Took 2cc of stem cell therapy. After one week, he felt much stronger, energetic, can focus, very happy and less urge to drink alcohol.A.M.: 56 years old with rheumatoid arthritis, frozen knees at times, memory loss, and lack of energy, with high blood pressure, coughing for several weeks. Took 2cc of stem cell therapy, the coughing stopped and throat itching gone in 15 minutes, feeling much stronger, more energy, mind clearer and more focused. Very happy.
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Today is one of those days that I feel - what's the un-holy alternative for 'blessed'? privileged? - privileged to get to do what I do through this site, even if I've never seen a penny profit from any of it. Payoff for me comes in the form of meeting/e-meeting really cool bands/artists who send me really amazing music ahead of the release date. And sometimes they even spill the beans on big news that the public isn't privy to yet.
Such is the case with the upcoming Gameday Regulars and Guerrilla Monsoon and their split 7". Although Guerrilla Monsoon seem to have their 2 of the 4 tracks online right now, I don't think Gameday Regulars do and so it's kinda cool to be able to indulge myself in those so far ahead of time.
I've been a big fan of GR for a while now but this is my first time hearing their split-bro's Guerrilla Monsoon, and I greatly appreciate this split-troduction. It was one of the members of this new found favourite band who introduced the 7" to me via email, and he's about as cool as his band is great, which makes this discovery the equivalent to a stripper's salary - and from what I hear that's a pretty thick (heh) income!
As I listen to the 4 killer tracks over and over I hear the 'cha-ching' sound ring through my head, like imaginary money is being stuffed down my ear-bra with each song.
Here, see for yourself with the GM preview of the split and stay tuned for some really cool news from the band!
I'm Sarah. I do what I want.


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MGCOOL Explorer Pro claims to be the hottest sub-$70 action camera
by Apr 21, 2017 5:15 pm6
After the spontaneous success of MGCOOL Explorer 1S and the budget-friendly MGCOOL Explorer ES, the Chinese-based action camera company has launched MGCOOL Explorer Pro with enhanced specs. The camera is available in Black and Silver color variants at $69.99.
The killer feature of MGCOOL Explorer Pro is the integration of 6G Sharkeye wide-angle HD lens which reduces distortion in images and videos. The company claims that its yields can be even better than that of GoPro Hero 4. When it comes to light transmission and color revivification, the Sharkeye technology stays ahead of other competitors.
The camera also includes Sony IMX179 Sensor with the capability to shoot images of up to 16MB starting from 2MB. Moreover, the sensor provides support for Back Side Illumination (BSI), which helps in capturing excellent images even in low-light conditions. Furthermore, the overall power consumption is be reduced to a large extent.
As other MGCOOL cameras, Explorer Pro is equipped with Allwinner V3 processor with support for H.264 video capturing. It is capable of recording 4K videos @30fps as well as 2.7K @30fps and 1080p videos @60fps.
Add to that the 170-degree ultra-wide lens and support for time-lapse and slo-motion shooting mode and you get the picture. Lastly, Explorer Pro has all the standard features of the rest of the Series, such as waterproofing, microSD expansion up to 64GB and large 1050mAh battery that enables you to shoot 100 minutes of non-stop 4K video. WiFi is also present as well as Android and iOS apps.
You can order it directly from their official site. Also, it will be available on several online retailers in a few days. Learn more about the camera here and check their Facebook page here.


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Gardeners have a new place to sit and relax at the Windham Community Garden, courtesy of Windham Girl Scout Troop 1040. The project is part of the girls' work towards their Bronze Award, which requires a community service component.
Priscilla Payne, secretary of the Windham Community Garden board of directors, said that the bench will be a nice addition to the garden. "People come here to work, and it is hot, and they get tired. It will be a great place to sit and relax," she said. Although there are a few chairs at the garden, there are no other benches. The new bench was placed near the center of the garden next to a couple of rock formations. "The rocks are like cairns where people can reflect and meditate, so we thought that would be the most appropriate place for it," Payne said.
The project introduced the girls to new skills, including the decision making process, using a drill and painting. Leader Jennifer Prescott said they began with a long list of ideas and places they could help before narrowing the decision down to the bench.
"They had all kinds of great ideas," she said, adding that the troop has already done a lot of service to places like the food pantry, and wanted to try something different. Another leader, Penny Peterson, added that they wanted to build something that people in the community could use.
Leader Gaye Gallant-Prescott said the plan for building the bench was found online, and Home Depot cut the wood pieces to the appropriate sizes. The troop then worked to put the pieces together like a puzzle, she said.
Troop member Ava Collins said that the project was both easy and challenging at times. Painting was the easy part, she said. She had never built anything before, however, so screwing the bench together was challenging.
The girls in Troop 1040 are: Annabelle Demar, Hannah Peterson, Madison Myers, Julia Demar, Ava Collins, Alana Grant and Maggie Dalton. All except Dalton were present at the presentation of the bench to the garden on Thursday, September 8, 2016.


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